Cognitive vulnerabilities and depression versus other psychopathology symptoms and diagnoses in early adolescence.

PubMed

Alloy, Lauren B; Black, Shimrit K; Young, Mathew E; Goldstein, Kim E; Shapero, Benjamin G; Stange, Jonathan P; Boccia, Angelo S; Matt, Lindsey M; Boland, Elaine M; Moore, Lauren C; Abramson, Lyn Y

2012-01-01

We examined the concurrent associations between multiple cognitive vulnerabilities to depression featured in hopelessness theory, Beck's theory, and response styles theory and depressive symptoms and diagnoses in a sample of early adolescents. We also examined the specificity of these cognitive vulnerabilities to depression versus anxiety and externalizing psychopathology, controlling for co-occurring symptoms and diagnoses. Male and female, Caucasian and African American, 12- to 13-year-old adolescents were assessed in a cross-sectional design. Cognitive vulnerabilities of hopelessness, inferential style, rumination, and self-referent information processing were assessed with self-reports and behavioral tasks. Symptoms and diagnoses of depressive, anxiety, and externalizing disorders were assessed with self-report questionnaires and diagnostic interviews. Hopelessness exhibited the greatest specificity to depressive symptoms and diagnoses, whereas negative inferential styles, rumination, and negative self-referent information processing were associated with both depressive and anxiety symptoms and diagnoses and, in some cases, with externalizing disorders. Consistent with cognitive theories of depression, hopelessness, negative inferential styles, rumination, and negative self-referent information processing were associated with depressive symptoms and diagnoses. However, with the exception of hopelessness, most of the remaining cognitive vulnerabilities were not specific to depression. With further maturation of our sample, these cognitive vulnerabilities may become more specific to depression as cognitive styles further develop and consolidate, the rates of depression increase, and individuals' presentations of psychopathology become more differentiated.

Sedentary time and markers of inflammation in people with newly diagnosed type 2 diabetes

PubMed Central

Falconer, C.L.; Cooper, A.R.; Walhin, J.P.; Thompson, D.; Page, A.S.; Peters, T.J.; Montgomery, A.A.; Sharp, D.J.; Dayan, C.M.; Andrews, R.C.

2014-01-01

Background and aims We investigated whether objectively measured sedentary time was associated with markers of inflammation in adults with newly diagnosed type 2 diabetes. Methods and results We studied 285 adults (184 men, 101 women, mean age 59.0 ± 9.7) who had been recruited to the Early ACTivity in Diabetes (Early ACTID) randomised controlled trial. C-reactive protein (CRP), adiponectin, soluble intracellular adhesion molecule-1 (sICAM-1), interleukin-6 (IL-6), and accelerometer-determined sedentary time and moderate-vigorous physical activity (MVPA) were measured at baseline and after six-months. Linear regression analysis was used to investigate the independent cross-sectional and longitudinal associations of sedentary time with markers of inflammation. At baseline, associations between sedentary time and IL-6 were observed in men and women, an association that was attenuated following adjustment for waist circumference. After 6 months of follow-up, sedentary time was reduced by 0.4 ± 1.2 h per day in women, with the change in sedentary time predicting CRP at follow-up. Every hour decrease in sedentary time between baseline and six-months was associated with 24% (1, 48) lower CRP. No changes in sedentary time between baseline and 6 months were seen in men. Conclusions Higher sedentary time is associated with IL-6 in men and women with type 2 diabetes, and reducing sedentary time is associated with improved levels of CRP in women. Interventions to reduce sedentary time may help to reduce inflammation in women with type 2 diabetes. PMID:24925122

Adult T-cell leukemia-lymphoma in a pregnant woman diagnosed as a human T-cell lymphotropic virus type 1 carrier.

PubMed

Fuchi, Naoki; Miura, Kiyonori; Imaizumi, Yoshitaka; Hasegawa, Hiroo; Yanagihara, Katsunori; Miyazaki, Yasushi; Masuzaki, Hideaki

2016-03-01

Human T-cell leukemia virus type 1 (HTLV-1) is the causative agent of adult T-cell leukemia-lymphoma (ATL), which is difficult to cure. In Japan, a nationwide HTLV-1 screening test in pregnant women has been recommended since 2011. A 30-year-old woman was diagnosed as being an HTLV-1 carrier in her previous pregnancy. During the current pregnancy, she had persistent fever and cough. Although she had treatment with antibiotics, peripheral white blood cell count remained high, with an abnormal lymphocyte count. Given that she was an HTLV-1 carrier, she was diagnosed with unfavorable chronic ATL (aggressive ATL) at 12 weeks gestation. After pregnancy termination, her ATL status became favorable chronic ATL (indolent ATL). Therefore, watchful waiting was performed until disease progression. This is the first case report of chronic ATL in early pregnancy, in a woman already diagnosed as an HTLV-1 carrier on screening test. © 2015 Japan Society of Obstetrics and Gynecology.

Usher syndrome type 1: early detection of electroretinographic changes.

PubMed

Flores-Guevara, Roberto; Renault, Francis; Loundon, Natalie; Marlin, Sandrine; Pelosse, Béatrice; Momtchilova, Martha; Auzoux-Chevé, Monique; Vermersch, Anne Isabelle; Richard, Pascal

2009-11-01

Usher syndrome type 1 needs to be diagnosed at early age in order to timely manage speech therapy, cochlear implantation, and genetic counseling. Few data are available regarding electroretinographic testing before the age of six years. To describe electroretinographic changes in young children with Usher syndrome type 1. Retrospective study of fourteen patients. Age at first neurophysiologic testing was between 17 months and 5 years 4 months. Electroretinogram was performed using flash stimulation in mesopic conditions in the conscious child. Analysis was focused on the amplitudes and latencies of a- and b-waves. Whatever the age, an abnormal fundus was always confirmed with an absent electroretinogram. The youngest patient with absent electroretinogram was 17 month-old. When recorded on and after the 29th month of age, electroretinogram was absent in all cases, including 6 patients with normal fundus. In three patients a low-amplitude electroretinogram was present at first recording within the 26th and 27th months. Electroretinogram showed retinopathy in young children with Usher syndrome type 1, even in the absence of fundoscopic signs of retinal degeneration.

Diagnoses of Early and Late Readmissions after Hospitalization for Pneumonia. A Systematic Review

PubMed Central

Sjoding, Michael W.; Iwashyna, Theodore J.

2014-01-01

Rationale: Pneumonia is a frequent cause of hospitalization, yet drivers of post-pneumonia morbidity remain poorly characterized. Causes of hospital readmissions may elucidate important sources of morbidity and are of particular interest given the U.S. Hospital Readmission Reductions Program. Objectives: To review the primary diagnoses of early (≤30 d) and late (≥31 d) readmissions after pneumonia hospitalization. Methods: Systematic review of MEDLINE, Embase, and CINAHL databases. We identified original research studies of adults aged 18 years or older, hospitalized for pneumonia, and for whom cause-specific readmission rates were reported. Two authors abstracted study results and assessed study quality. Measurements and Main Results: Of the 1,243 citations identified, 12 met eligibility criteria. Included studies were conducted in the United States, Spain, Canada, Croatia, and Sweden. All-cause 30-day readmission rates ranged from 16.8 to 20.1% across administrative studies; the weighted average for the studies using chart review was 11.6% (15.6% in United States–based studies). Pneumonia, heart failure/cardiovascular causes, and chronic obstructive pulmonary disease/pulmonary causes are the most common reasons for early readmission after pneumonia hospitalization. Although it was the single most common cause for readmission, pneumonia accounted for only 17.9 to 29.4% of all 30-day readmissions in administrative studies and a weighted average of 23.0% in chart review studies. After accounting for study population, there was no clear difference in findings between claims-based versus chart-review studies. Few studies assessed readmissions beyond 30 days, although the limited available data suggest similar primary diagnoses for early and late readmissions. No studies assessed whether reasons for readmission were similar to patients’ reasons for healthcare use before hospitalization. Conclusions: Pneumonia, heart failure/cardiovascular disease, and chronic

Emotional suppression and depressive symptoms in women newly diagnosed with early breast cancer.

PubMed

Li, Lingyan; Yang, Yanjie; He, Jincai; Yi, Jinyao; Wang, Yuping; Zhang, Jinqiang; Zhu, Xiongzhao

2015-10-24

Patients with breast cancer usually present varying levels of depressive symptoms. Emotional suppression, as a coping style, refers to an individual's ability to consciously control expression of negative emotions. Thus, emotional suppression is an important psychological factor related to depressive symptoms in patients with breast cancer. It has long been considered that compared to European and American women, Chinese women are more likely to ascribe to norms of negative emotion control for smooth social interaction. However, there is paucity of research focusing on emotional suppression among Chinese women with breast cancer. Thus the aims of the current study were (1) to investigate the incidence of depressive symptoms in women newly diagnosed with early breast cancer in Mainland China, and (2) to examine the relationships between emotional suppression and depressive symptoms in these patients. The Center for Epidemiological Studies Depression Scale (CES-D), the Beck Anxiety Inventory (BAI) and the Chinese version of the Courtauld Emotional Control Scale (CECS) were used to assess the level of depressive symptoms, anxiety symptoms and emotional suppression respectively in 247 women with early breast cancer and 362 healthy women. Analyses of variance were conducted to investigate group differences on depressive symptoms and emotional suppression. Bivariate correlations and Hierarchical regression analyses were performed to examine the effect of emotional suppression on depressive symptoms in participants after controlling the impact of group membership and anxiety level. (1) The incidence rates of clinical and severe depressive symptoms in patients were 36.4 and 36.0 % respectively. (2) Patients scored significantly higher than healthy women on CECS. (3) The scores on CECS were significantly associated with the total CES-D scores in all participants; Anger suppression significantly predicted the total CES-D scores. The majority of women newly diagnosed with

Feasibility, Acceptability, and Predictive Validity of a Psychosocial Screening Program for Children and Youth Newly Diagnosed With Type 1 Diabetes

PubMed Central

Schwartz, David D.; Cline, Virginia Depp; Axelrad, Marni E.; Anderson, Barbara J.

2011-01-01

OBJECTIVE Psychosocial screening has been recommended for pediatric patients with newly diagnosed type 1 diabetes and their families. Our objective was to assess a psychosocial screening protocol in its feasibility, acceptability to families, and ability to predict early emerging complications, nonadherent family behavior, and use of preventive psychology services. RESEARCH DESIGN AND METHODS A total of 125 patients and their caregivers were asked to participate in a standardized screening interview after admission at a large urban children’s hospital with a new diagnosis of type 1 diabetes. Medical records were reviewed for subsequent diabetes-related emergency department (ED) admissions, missed diabetes clinic appointments, and psychology follow-up within 9 months of diagnosis. RESULTS Of 125 families, 121 (96.8%) agreed to participate in the screening, and a subsample of 30 surveyed caregivers indicated high levels of satisfaction. Risk factors at diagnosis predicted subsequent ED admissions with a sensitivity of 100% and a specificity of 98.6%. Children from single-parent households with a history of behavior problems were nearly six times more likely to be seen in the ED after diagnosis. Missed appointments were likeliest among African Americans, 65% of whom missed at least one diabetes-related appointment. Psychology services for preventive intervention were underutilized, despite the high acceptability of the psychosocial screening. CONCLUSIONS Psychosocial screening of newly diagnosed patients with type 1 diabetes is feasible, acceptable to families, and able to identify families at risk for early emerging complications and nonadherence. Challenges remain with regards to reimbursement and fostering follow-up for preventive care. PMID:21216856

An infant with glutaric aciduria type IIc diagnosed with a novel mutation.

PubMed

Işıkay, Sedat; Yaman, Ayhan; Ceylaner, Serdar

2017-01-01

Işıkay S, Yaman A, Ceylaner S. An infant with glutaric aciduria type IIc diagnosed with a novel mutation. Turk J Pediatr 2017; 59: 315-317. Glutaric aciduria type II is a rare inborn error of metabolism. The clinical picture is highly variable with symptoms ranging from acute metabolic decompensations to chronic, mainly muscular problems or even asymptomatic cases. Herein we described a 7-month-old female patient presented with respiratory failure and diagnosed with glutaric aciduria type II via whole exome sequencing that exhibited one known and a novel mutation. Her blood and urine analyses were all normal. After the diagnosis, dramatic and sustained improvement on a low-fat, low-protein, and high-carbohydrate diet supplemented with oral riboflavin and carnitine was determined. In especially hypotonic patients with unknown etiologies, though the blood and urine analyses are normal, glutaric aciduria type II should also be kept in mind and genetic tests may be required for the diagnosis.

Cognitive Vulnerabilities and Depression versus Other Psychopathology Symptoms and Diagnoses in Early Adolescence

PubMed Central

Alloy, Lauren B.; Black, Shimrit K.; Young, Mathew E.; Goldstein, Kim E.; Shapero, Benjamin G.; Stange, Jonathan P.; Boccia, Angelo S.; Matt, Lindsey M.; Boland, Elaine M.; Moore, Lauren C.; Abramson, Lyn Y.

2012-01-01

Objective We examined the concurrent associations between multiple cognitive vulnerabilities to depression featured in Hopelessness Theory, Beck’s Theory, and Response Styles Theory and depressive symptoms and diagnoses in a sample of early adolescents. We also examined the specificity of these cognitive vulnerabilities to depression versus anxiety and externalizing psychopathology, controlling for co-occurring symptoms and diagnoses. Method Male and female, Caucasian and African-American, 12–13 year old adolescents were assessed in a cross-sectional design. Cognitive vulnerabilities of hopelessness, inferential style, rumination, and self-referent information processing were assessed with self-reports and behavioral tasks. Symptoms and diagnoses of depressive, anxiety, and externalizing disorders were assessed with self-report questionnaires and diagnostic interviews. Results Hopelessness exhibited the greatest specificity to depressive symptoms and diagnoses, whereas negative inferential styles, rumination, and negative self-referent information processing were associated with both depressive and anxiety symptoms and diagnoses and, in some cases, with externalizing disorders. Conclusions Consistent with cognitive theories of depression, hopelessness, negative inferential styles, rumination, and negative self-referent information processing were associated with depressive symptoms and diagnoses. However, with the exception of hopelessness, most of the remaining cognitive vulnerabilities were not specific to depression. With further maturation of our sample, these cognitive vulnerabilities may become more specific to depression as cognitive styles further develop and consolidate, the rates of depression increase, and individuals’ presentations of psychopathology become more differentiated. PMID:22853629

Differential Patterns of Impaired Cardiorespiratory Fitness and Cardiac Autonomic Dysfunction in Recently Diagnosed Type 1 and Type 2 Diabetes.

PubMed

Röhling, Martin; Strom, Alexander; Bönhof, Gidon; Püttgen, Sonja; Bódis, Kálmán; Müssig, Karsten; Szendrödi, Julia; Markgraf, Daniel; Lehr, Stefan; Roden, Michael; Ziegler, Dan

2017-02-01

Both impaired cardiorespiratory fitness (CRF) and heart rate variability (HRV) are predictors of mortality, but their relative roles in recent-onset diabetes are unknown. We determined to which extent CRF and HRV are reduced and interrelated in recent-onset diabetes. Participants from the German Diabetes Study with type 1 (n = 163) or type 2 (n = 188) diabetes with known diabetes duration <1 year and two age-matched glucose-tolerant control groups (n = 40 each) underwent spiroergometry and HRV assessment during a hyperinsulinemic-euglycemic clamp. Compared with control subjects, patients with type 2 diabetes showed reduced VO 2max (median [1st-3rd quartiles] 19.3 [16.5-22.9] vs. 25.6 [20.7-29.9] mL/kg body weight/min; P < 0.05), diminished VCO 2max (23.0 [19.1-26.8] vs. 30.9 [24.5-34.4] mL/kg body weight/min; P < 0.05), blunted heart rate recovery after 2 min (-29.0 [-35.0 to -23.0] vs. -36.0 [-42.8 to -28.0] beats/min; P < 0.05), and reduced HRV in four of nine indices, whereas patients with type 1 diabetes had unaltered CRF but reduced HRV in three of nine indices (P < 0.05), indicating diminished vagal and sympathetic HRV modulation. HRV measures correlated with VO 2max in patients with type 1 diabetes (r >0.34; P < 0.05) but not in those with type 2 diabetes. CRF is reduced in recently diagnosed type 2 diabetes but preserved in type 1 diabetes, whereas cardiac autonomic function is reduced in both diabetes types but is strongly associated with CRF only in type 1 diabetes. These results support the therapeutic concept of promoting physical fitness in the early course of diabetes. © 2017 by the American Diabetes Association.

Inverse association of plasma vanadium levels with newly diagnosed type 2 diabetes in a Chinese population.

PubMed

Wang, Xia; Sun, Taoping; Liu, Jun; Shan, Zhilei; Jin, Yilin; Chen, Sijing; Bao, Wei; Hu, Frank B; Liu, Liegang

2014-08-15

Vanadium compounds have been proposed to have beneficial effects on the pathogenesis and complications of type 2 diabetes. Our objective was to evaluate the association between plasma vanadium levels and type 2 diabetes. We performed a case-control study involving 1,598 Chinese subjects with or without newly diagnosed type 2 diabetes (December 2004-December 2007). Cases and controls were frequency-matched by age and sex. Plasma vanadium concentrations were measured and compared between groups. Analyses showed that plasma vanadium concentrations were significantly lower in cases with newly diagnosed type 2 diabetes than in controls (P = 0.001). Mean plasma vanadium levels in participants with and without diabetes were 1.0 μg/L and 1.2 μg/L, respectively. Participants in the highest quartile of plasma vanadium concentration had a notably lower risk of newly diagnosed type 2 diabetes (odds ratio = 0.26, 95% confidence interval: 0.19, 0.35; P < 0.001), compared with persons in the lowest quartile. The trend remained significant after adjustment for known risk factors and in further stratification analyses. Our results suggested that plasma vanadium concentrations were inversely associated with newly diagnosed type 2 diabetes in this Chinese population. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Obstetrical outcomes in patients with early onset gestational diabetes.

PubMed

Gupta, Simi; Dolin, Cara; Jadhav, Ashwin; Chervenak, Judith; Timor-Tritsch, Ilan; Monteagudo, Ana

2016-01-01

The objective of this study was to characterize patients with early onset gestational diabetes and compare outcomes to patients diagnosed with standard gestational diabetes and pregestational diabetes. This is a retrospective cohort study of patients diagnosed with gestational or pregestational diabetes. All patients received a glucose challenge test at their first prenatal visit to diagnose early onset gestational diabetes and were recommended to have postpartum glucose tolerance tests to detect undiagnosed type 2 diabetes. Outcomes were compared between patients with early onset gestational diabetes and both standard gestational diabetes and pregestational diabetes with p < 0.05 was used for significance. Four hundred and twenty-four patients met the inclusion criteria. Nine percent of the patients with early onset gestational diabetes were found to have undiagnosed type 2 diabetes based on postpartum testing and 91% to have resolution in the postpartum period. No patient with early onset gestational diabetes and resolution in the postpartum period had abnormal screening for renal or ophthalmologic disease, but 5% had abnormal fetal echocardiograms. These patients were more likely to require pharmacotherapy for glycemic control than patients with standard gestational diabetes and less likely than patients with pregestational diabetes (55% versus 39% versus 81%). Most patients diagnosed with early onset gestational diabetes do not have undiagnosed type 2 diabetes but do have unique characteristics and obstetrical outcomes.

Early phenotypical diagnoses in Trembler-J mice model.

PubMed

Rosso, Gonzalo; Cal, Karina; Canclini, Lucía; Damián, Juan Pablo; Ruiz, Paul; Rodríguez, Héctor; Sotelo, José Roberto; Vazquez, Cristina; Kun, Alejandra

2010-06-30

Pmp-22 mutant mice (Trembler-J: B6.D2-Pmp22/J), are used as a model to study Charcot-Marie-Tooth type 1A (CMT1A). The identification of individual genotypes is a routine in the management of the Tr(J) colony. The earliest phenotypic manifestation of the pmp-22 mutation is just about 20th postnatal days, when pups begin to tremble. In this study, a rapid and simple diagnostic method was developed by modifying the Tail Suspension Test (MTST) to determine the difference between the Tr(J) and the wild-type mice phenotype. The animal behavioral phenotypes generated during the test were consistent with the specific genotype of each animal. The MTST allowed us to infer the heterozygous genotype in early postnatal stages, at 11 days after birth. The motor impairment of Tr(J) mice was also analyzed by a Fixed Bar Test (FBT), which revealed the disease evolution according to age. The main advantages of MTST are its objectivity, simplicity, and from the viewpoint of animal welfare, it is a non-invasive technique that combined with his rapidity show its very well applicability for use from an early age in these mice. Copyright 2010 Elsevier B.V. All rights reserved.

PERFORMANCE OF TWO DIFFERENT CLINICAL SCORING SYSTEMS IN DIAGNOSING DISTAL SENSORY POLYNEUROPATHY IN PATIENTS WITH TYPE-2 DIABETES.

PubMed

Khan, Fehmeda Farrukh; Numan, Ahsan; Khawaja, Khadija Irfan; Atif, Ali; Fatima, Aziz; Masud, Faisal

2015-01-01

Early diagnosis of distal peripheral neuropathy (DSPN) the commonest diabetes complications, helps prevent significant morbidity. Clinical parameters are useful for detection, but subjectivity and lack of operator proficiency often results in inaccuracies. Comparative diagnostic accuracy of Diabetic Neuropathy Symptom (DNS) score and Diabetic Neuropathy Examination (DNE) score in detecting DSPN confirmed by nerve conduction studies (NCS) has not been evaluated. This study compares the performance of these scores in predicting the presence of electro physiologically proven DSPN. The objective of this, study was to compare the diagnostic accuracy of DNS and DNE scores in detecting NCS proven DSPN in type-2 diabetics, and to determine the frequency of sub-clinical DSPN among type-2 diabetics. In this cross-sectional study the DNS score and DNE score were determined in 110 diagnosed type-2 diabetic patients. NCS were carried out and amplitudes, velocities and latencies of sensory and motor nerves in lower limb were recorded. Comparison between the two clinical diagnostic modalities and NCS using Pearson's chi square test showed a significant association between NCS and DNE scores (p-value =.003, specificity 93%). The DNS score performed poorly in comparison (p-value = .068, specificity 77%). When the two scores were taken in combination the specificity in diagnosing DSPN was greater (p-value = .018, specificity 96%) than either alone. 33% of patients had subclinical neuropathy. DNE score alone and in combination with DNS score is reliable in predicting DSPN and is more specific than DNS score in evaluating DSPN. Both tests lack sensitivity. Patients without any evidence of clinical neuropathy manifest abnormalities on NCS.

A Practice-Based Evaluation of Barnardo's Forward Steps Early Intervention Programme for Children Diagnosed with Autism

ERIC Educational Resources Information Center

Braiden, Hannah Jane; McDaniel, Benny; McCrudden, Eunan; Janes, Michele; Crozier, Barbara

2012-01-01

This study used a pre-experimental and post-experimental design to evaluate a TEACCH-based Early Intervention Programme. Thirty-one parents of 18 preschool children recently diagnosed with an Autistic Spectrum Disorder attended the eight-week programme delivered by trained facilitators. Parents completed pre-intervention and post-intervention…

[Clinical profile of patients diagnosed with type 2 Diabetes Mellitus].

PubMed

Represas Carrera, Francisco Jesús; Carrera García, Álvaro; Clavería Fontán, Ana

2018-03-09

Type 2 Diabetes Mellitus is a chronic disease that represent an important problem of public health. The objective of this study was to describe the sociodemographic, anthropometric, metabolic control, comorbidity and cardiovascular risk characteristics of patients diagnosed with Diabetes Mellitus type 2 in the health area of Vigo. Retrospective observational descriptive study. Between March and September 2016, it did telephone interview and an audit of electronic medical records to 195 patients ≥ 18 years old from the health area of Vigo diagnosed with type 2 Diabetes Mellitus. It selected by random sampling with replacement. It evaluated the cardiovascular risk using the method "United Kingdom Prospective Diabetes Study", the metabolic control with the recommendations of the "American Diabetes Association" 2016, and the comorbidity using the Charlson index. It performed a descriptive and bivariate analysis with R statistical package. The glycemic control was adequate (HbA1c less than 7.0%) in the 61.03% of the patients. The 58.46% had a blood pressure under 140/90mmHg, 52.82% had a total cholesterol under 185mg/dl and 66.15% had a triglyceride level under 150mg/dl. The 49.74% presented a high comorbidity (Charlson larger or the same as 3 points). The risk of suffering and/or dying of heart disease was 37.81%, and 23.50% of suffering and/or dying of a stroke in the next 10 years. Most diabetic patients of the health area of Vigo have a good control of their disease but they present a high index of comorbidity and high cardiovascular risk.

Objective measurements of activity patterns in people with newly diagnosed Type 2 diabetes demonstrate a sedentary lifestyle.

PubMed

Cichosz, S L; Fleischer, J; Hoeyem, P; Laugesen, E; Poulsen, P L; Christiansen, J S; Ejskjær, N; Hansen, T K

2013-09-01

To evaluate physical activity in people with newly diagnosed Type 2 diabetes using objective measures. We analysed data from a study aimed at assessing carotid femoral pulse wave velocity in which a piezoelectric accelerometer was worn by 100 people with newly diagnosed Type 2 diabetes and by 100 age- and sex-matched control subjects. Differences in physical activity patterns were investigated. Compared with the control group, the people with Type 2 diabetes spent significantly more time engaged in sedentary or lower level activities during the day, with a mean (sd) time of 926 (44) vs 898 (70) min, P < 0.001). This difference remained significant after correction for differences in BMI between the two groups. Using objective measurements, our findings demonstrate that people with newly diagnosed Type 2 diabetes have a more sedentary lifestyle compared with well-matched controls. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

Frequency of Ketoacidosis in Newly Diagnosed Type 1 Diabetic Children

PubMed Central

Razavi, Zahra

2010-01-01

Objectives Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (TIDM). Many patients with newly diagnosed type 1 diabetes present with DKA. The aim of this study is to determine the frequency and the clinical presentation of diabetic ketoacidosis at the diagnosis of type 1 diabetes mellitus in youths in hamadan, Western Province of Iran. Methods The Clinical and laboratory data of a total of 200 patients under 19 years of age with newly diagnosed type 1 diabetes mellitus between 1995-2005 were retrospectively reviewed. Statistical analysis was performed using SPSS 11. Results 48 (24%)of the children were presented in a state of ketoacidosis. Sever form of DKA (pH≤7.2) was observed in 54.5% of patients. The mean age at diagnosis was 7.3±5.15 years in DKA group and 8.59±3.07 in non-DKA group (p=0.22). 60.4% of patient with DKA were female whereas in the non-DKA group, 53.3% of patients were female, the difference was not significant (p=0.38). The duration of symptoms before diagnosis was 14.84±8.19 days in patients with DKA and 22.39±2.27 in the non-DKA group, (p=0.11). No significant difference was found between the age, sex and duration of the symptoms and occurance of DKA. Polydipsia (85.4) polyuria (83.3%), weakness (68.8%) and abdominal pain (52.1%) were the most frequently notified symptoms among the patients. In two cases, diagnosis of DKA was preceded by as appendicitis and the patient underwent appendectomy. Conclusion Frequency of DKA at onset of type 1 diabetes mellitus was significant in the studied region. However, it was lower than other regions in Asia. Polydipsia, polyuria, fatigue and abdominal pain were the most common symptoms on presentation. PMID:22125712

An investigation of the associations among sleep duration and quality, body mass index and insulin resistance in newly diagnosed type 2 diabetes mellitus patients.

PubMed

Arora, Teresa; Chen, Mimi Z; Omar, Omar M; Cooper, Ashley R; Andrews, Rob C; Taheri, Shahrad

2016-02-01

To examine direct and indirect associations of sleep duration and quality with insulin resistance, considering body mass index (BMI) as a potential mediator in newly diagnosed type 2 diabetes mellitus patients. Cross-sectional data from patients enrolled in the Early Activity in Diabetes study. We studied 522 newly diagnosed type 2 diabetes mellitus patients, 65.9% male, mean age 63.5 ± 10.1 years. Of the total sample 53% had a BMI of ⩾30 kg/m(2). Participants completed a 7-day sleep diary and sleep questionnaire. Average sleep duration (minutes), average nap duration (minutes) and average number of night awakenings were derived. Objective measures of height and body weight were obtained for the BMI calculation (kg/m(2)). Insulin resistance was obtained using the homeostatic model assessment - insulin resistance (HOMA2-IR) standardized technique. Average number of night awakenings was positively correlated with BMI (r= 0.22, p < 0.001) and negatively associated with logged HOMA2-IR (r= -0.16, p = 0.04). Path analysis demonstrated night awakenings were directly associated with BMI and indirectly associated with insulin resistance, whilst considering BMI as a potential mediator (p < 0.05). Sleep duration was not associated with BMI or insulin resistance (p > 0.05). Sleep quality, not sleep duration, plays an important role in insulin resistance in newly diagnosed type 2 diabetes mellitus patients. BMI may mediate the relationship between indicators of sleep quality and insulin resistance. There is a need to examine the impact of improving sleep quality on obesity and insulin resistance in patients with type 2 diabetes mellitus.

The effects of short-term continuous subcutaneous insulin infusion treatment on fasting glucagon-like peptide-1 concentrations in newly diagnosed type 2 diabetes.

PubMed

Huang, Xiaofei; Li, Sha; Yang, Mei; Fu, Xuquan; Li, Huaqi; Yan, Tong; Liu, Yidong; Chen, Lihong; Lan, Lingsheng; Li, Libo; Zhong, Xiaowei

2018-04-01

Early short-term intensive insulin therapy in newly diagnosed type 2 diabetes patients shows benefit in glycemic control and β-cell function. Glucagon-like peptide-1 (GLP-1) plays an important role in glucose metabolism and development of type 2 diabetes. We did a study to observe the changes of GLP-1 and β-cell function after short-term continuous subcutaneous insulin infusion (CSII) treatment. A total of 66 subjects were enrolled, including 30 normal glucose tolerance controls (NGT) and 36 patients with newly diagnosed type 2 diabetes between October 2015 and July 2016. Fasting plasma glucose (FPG), insulin, and GLP-1 were measured in each subject. The patients underwent CSII treatment for 2 weeks, and then FBG, insulin, and GLP-1 were measured. HOMA-IR and HOMA-B were then calculated. All patients achieved target glycemic control in two weeks. HOMA-IR and HOMA-B improved significantly after intensive interventions (p < 0.05). The GLP-1 concentration increased significantly in patients after treatment (p < 0.05). When grouped according to bodyweight and age in all patients, the HOMA-IR changed significantly in overweight and old age subgroups, the HOMA-B increased significantly in normal weight, overweight and middle age subgroups, and the GLP-1 concentration also increased significantly in overweight and middle age subgroups respectively (p < 0.05). Short-term CSII treatment can obtain glycemic control target and recover β-cell function and GLP-1 secretion in newly diagnosed type 2 diabetes patients. The overweight and middle-aged patients may get more benefit from this treatment. Copyright © 2018 Elsevier B.V. All rights reserved.

Time perspective and weight management behaviors in newly diagnosed Type 2 diabetes: a mediational analysis.

PubMed

Hall, Peter A; Fong, Geoffrey T; Cheng, Alice Y

2012-12-01

The primary objective of the current study was to examine the extent to which domain-specific time perspective predicts weight management behaviors (dietary behavior and physical activity) among those newly diagnosed with Type 2 diabetes. A secondary objective was to test potential mediators of the hypothesized effect (behavioral intention, self-efficacy and control beliefs). A total of 204 adults newly diagnosed (≤6 months) with Type 2 diabetes participated in the study, which included a baseline assessment of domain-general and domain-specific time perspective, as well as strength of intention to perform two weight-management behaviors (dietary choice and physical activity); both weight-management behaviors were assessed again at 6 month follow-up. Hierarchical multiple regression analyses revealed a prospective association between domain-specific time perspective and uptake of weight management behaviors. Individuals with newly diagnosed T2DM possessing a future-oriented time perspective reported making less frequent fatty food choices and greater increases in physical activity over the 6-month follow-up interval. These effects were selectively mediated by intention strength, and not competing social cognitive variables. For both behaviors, the total effects and meditational models were robust to adjustments for demographics, body composition and disease variables. A future-oriented time perspective is prospectively associated with superior uptake of weight management behaviors among those with newly diagnosed Type 2 diabetes. The facilitating effect of future-oriented thinking appears to occur via enhanced strength of intentions to perform weight management behaviors.

Prevalence of diagnosed depression in South Asian and white European people with type 1 and type 2 diabetes mellitus in a UK secondary care population.

PubMed

Ali, S; Davies, M J; Taub, N A; Stone, M A; Khunti, K

2009-05-01

To examine the prevalence and correlates of diagnosed depression among South Asians and white Europeans with type 1 and type 2 diabetes mellitus, attending a specialist diabetes clinic in the UK. A cross-sectional study was conducted using the hospital clinic's computerised database. Medical and demographic data were extracted for 6230 people with diabetes attending the clinic between 2003 and 2005. Multiple logistic regression was used to model ethnic differences in the probability of diagnosed depression after controlling for demographic and diabetes related factors. Analyses were conducted separately for type 1 and type 2 diabetes. The unadjusted prevalence of depression in people with type 1 and type 2 diabetes was 8.0% and 9.3%, respectively. Risk factors for depression in type 1 diabetes included female gender, diabetes related complications, and comorbidities. In people with type 2 diabetes the risk factors for depression included younger age, diabetes related complications, comorbidities, insulin use and deprivation. In addition, white Europeans were significantly more likely to be diagnosed with depression compared to South Asians (odds ratio (OR) 1.59, 95% confidence interval (CI) 1.21 to 2.08; p<0.001). Further interaction analyses revealed no evidence that the association between ethnicity and depression differed according to any of the other factors examined in this study. The findings add to the limited body of knowledge regarding ethnic differences in depression and diabetes. Among those with type 2 diabetes, white Europeans had nearly 60% higher adjusted odds of diagnosed depression compared to South Asians. Disparities may be due to differences in presentation or identification of depression between these two ethnic groups.

Five common tumor biomarkers and CEA for diagnosing early gastric cancer: A protocol for a network meta-analysis of diagnostic test accuracy.

PubMed

Shen, Minghui; Wang, Hui; Wei, Kongyuan; Zhang, Jianling; You, Chongge

2018-05-01

Although surgical resection is the recommended treatment for the patients with gastric cancer, lots of patients show advanced or metastatic gastric cancer at the time of diagnosis. Detection of gastric cancer at early stages is a huge challenge because of lack of appropriate detection tests. Unfortunately, existing clinical guidelines focusing on early diagnosis of gastric cancer do not provide consistent and prudent evidence. Serum carcinoembryonic antigen was considered as a complementary test, although it is not good enough to diagnose early gastric cancer. There are no other tumor markers recommended for diagnosing early gastric cancer. This study aims to evaluate and compare the diagnostic accuracy of 5 common tumor biomarkers (CA19-9, CA125, PG, IncRNA, and DNA methylation) and CEA and their combinations for diagnosing gastric cancer through network meta-analysis method, and to rank these tests using a superiority index. PubMed, EMBASE.com, and the Cochrane Central Register of Controlled Trials (CENTRAL) will be searched from their inception to March 2018. We will include diagnostic tests which assessed the accuracy of the above-mentioned tumor biomarkers and CEA for diagnosing gastric cancer. The risk of bias for each study will be independently assessed as low, moderate, or high using criteria adapted from Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Network meta-analysis will be performed using STATA 12.0 and R 3.4.1 software. The competing diagnostic tests will be ranked by a superiority index. This study is ongoing and will be submitted to a peer-reviewed journal for publication. This study will provide systematically suggestions to select different tumor biomarkers for detecting the early gastric cancer.

Prospective Study of Posttraumatic Stress Disorder in Parents of Children with Newly Diagnosed Type 1 Diabetes.

ERIC Educational Resources Information Center

Landolt, Markus A.; Vollrath, Margarete; Laimbacher, Joseph; Gnehm, Hanspeter E.; Sennhauser, Felix H.

2005-01-01

Objective: To determine the prevalence, course, and predictors of posttraumatic stress disorder (PTSD) in mothers and fathers of children with newly diagnosed type 1 diabetes. Method: Forty-nine mothers and 48 fathers of 52 children (response rate 65%) with newly diagnosed diabetes (age 6.5-15 years) were assessed at 6 weeks, 6 months, and 12…

Dysmorphic choroid plexuses and hydrocephalus associated with increased nuchal translucency: early ultrasound markers of de novo thanatophoric dysplasia type II with cloverleaf skull (Kleeblattschaedel).

PubMed

Tonni, Gabriele; Palmisano, Marcella; Ginocchi, Vladimiro; Ventura, Alessandro; Baldi, Maurizia; Baffico, Ave Maria

2014-11-01

Prenatal diagnosis of thanatophoric dysplasia (TD) type II presenting in the first trimester with increased nuchal translucency (NT) and cloverleaf skull (Kleeblattschaedel) have been scantly reported in the medical record. Abnormal choroid plexus has been seen in association with fetal anomalies. Here we described a case of increased NT associated with indented choroid plexuses, early onset hydrocephalus and cloverleaf skull in a fetus subsequently diagnosed at early second trimester to carry a de novo mutation encoding for TD type II. The findings of dysmorphic choroid plexus, early onset hydrocephalus and cloverleaf skull at first trimester scan may be early, useful ultrasound markers of TD type II. Molecular analysis to control for possible overlapping syndromes were performed and resulted negative. Postmortem X-ray and 3D-CT scan confirmed the cloverleaf skull, narrow thorax, straight femur with rhizomelic shortening of the limbs and the presence of a communicating hydrocephalus. © 2014 Japanese Teratology Society.

Survival Outcomes and Effect of Early vs. Deferred cART Among HIV-Infected Patients Diagnosed at the Time of an AIDS-Defining Event: A Cohort Analysis

PubMed Central

Mussini, Cristina; Johnson, Margaret; d'Arminio Monforte, Antonella; Antinori, Andrea; Gill, M. John; Sighinolfi, Laura; Uberti-Foppa, Caterina; Borghi, Vanni; Sabin, Caroline

2011-01-01

Objectives We analyzed clinical progression among persons diagnosed with HIV at the time of an AIDS-defining event, and assessed the impact on outcome of timing of combined antiretroviral treatment (cART). Methods Retrospective, European and Canadian multicohort study.. Patients were diagnosed with HIV from 1997–2004 and had clinical AIDS from 30 days before to 14 days after diagnosis. Clinical progression (new AIDS event, death) was described using Kaplan-Meier analysis stratifying by type of AIDS event. Factors associated with progression were identified with multivariable Cox regression. Progression rates were compared between those starting early (<30 days after AIDS event) or deferred (30–270 days after AIDS event) cART. Results The median (interquartile range) CD4 count and viral load (VL) at diagnosis of the 584 patients were 42 (16, 119) cells/µL and 5.2 (4.5, 5.7) log10 copies/mL. Clinical progression was observed in 165 (28.3%) patients. Older age, a higher VL at diagnosis, and a diagnosis of non-Hodgkin lymphoma (NHL) (vs. other AIDS events) were independently associated with disease progression. Of 366 patients with an opportunistic infection, 178 (48.6%) received early cART. There was no significant difference in clinical progression between those initiating cART early and those deferring treatment (adjusted hazard ratio 1.32 [95% confidence interval 0.87, 2.00], p = 0.20). Conclusions Older patients and patients with high VL or NHL at diagnosis had a worse outcome. Our data suggest that earlier initiation of cART may be beneficial among HIV-infected patients diagnosed with clinical AIDS in our setting. PMID:22043301

Early cancer diagnoses through BRCA1/2 screening of unselected adult biobank participants

PubMed Central

Buchanan, Adam H; Manickam, Kandamurugu; Meyer, Michelle N; Wagner, Jennifer K; Hallquist, Miranda L G; Williams, Janet L; Rahm, Alanna Kulchak; Williams, Marc S; Chen, Zong-Ming E; Shah, Chaitali K; Garg, Tullika K; Lazzeri, Amanda L; Schwartz, Marci L B; Lindbuchler, D'Andra M; Fan, Audrey L; Leeming, Rosemary; Servano, Pedro O; Smith, Ashlee L; Vogel, Victor G; Abul-Husn, Noura S; Dewey, Frederick E; Lebo, Matthew S; Mason-Suares, Heather M; Ritchie, Marylyn D; Davis, F Daniel; Carey, David J; Feinberg, David T; Faucett, W Andrew; Ledbetter, David H; Murray, Michael F

2018-01-01

Purpose The clinical utility of screening unselected individuals for pathogenic BRCA1/2 variants has not been established. Data on cancer risk management behaviors and diagnoses of BRCA1/2-associated cancers can help inform assessments of clinical utility. Methods Whole-exome sequences of participants in the MyCode Community Health Initiative were reviewed for pathogenic/likely pathogenic BRCA1/2 variants. Clinically confirmed variants were disclosed to patient–participants and their clinicians. We queried patient–participants’ electronic health records for BRCA1/2-associated cancer diagnoses and risk management that occurred within 12 months after results disclosure, and calculated the percentage of patient–participants of eligible age who had begun risk management. Results Thirty-seven MyCode patient–participants were unaware of their pathogenic/likely pathogenic BRCA1/2 variant, had not had a BRCA1/2-associated cancer, and had 12 months of follow-up. Of the 33 who were of an age to begin BRCA1/2-associated risk management, 26 (79%) had performed at least one such procedure. Three were diagnosed with an early-stage, BRCA1/2-associated cancer—including a stage 1C fallopian tube cancer—via these procedures. Conclusion Screening for pathogenic BRCA1/2 variants among unselected individuals can lead to occult cancer detection shortly after disclosure. Comprehensive outcomes data generated within our learning healthcare system will aid in determining whether population-wide BRCA1/2 genomic screening programs offer clinical utility. PMID:29261187

Development of an e-learning system for teaching endoscopists how to diagnose early gastric cancer: basic principles for improving early detection.

PubMed

Yao, Kenshi; Uedo, Noriya; Muto, Manabu; Ishikawa, Hideki

2017-03-01

We developed an internet e-learning system in order to improve the ability of endoscopists to diagnose gastric cancer at an early stage. The efficacy of this system at expanding knowledge and providing invaluable experience regarding the endoscopic detection of early gastric cancer was demonstrated through an international multicenter randomized controlled trial. However, the contents of the system have not yet been fully described in the literature. Accordingly, we herein introduce the contents and their principles, which comprise three main subjects: technique, knowledge, and experience. Since all the e-learning contents and principles are based on conventional white-light endoscopy alone, which is commonly available throughout the world, they should provide a good reference point for any endoscopist who wishes to devise learning materials and guidelines for improving their own clinical practice.

CHD associated with syndromic diagnoses: peri-operative risk factors and early outcomes

PubMed Central

Landis, Benjamin J.; Cooper, David S.; Hinton, Robert B.

2016-01-01

CHD is frequently associated with a genetic syndrome. These syndromes often present specific cardiovascular and non-cardiovascular co-morbidities that confer significant peri-operative risks affecting multiple organ systems. Although surgical outcomes have improved over time, these co-morbidities continue to contribute substantially to poor peri-operative mortality and morbidity outcomes. Peri-operative morbidity may have long-standing ramifications on neurodevelopment and overall health. Recognising the cardiovascular and non-cardiovascular risks associated with specific syndromic diagnoses will facilitate expectant management, early detection of clinical problems, and improved outcomes – for example, the development of syndrome-based protocols for peri-operative evaluation and prophylactic actions may improve outcomes for the more frequently encountered syndromes such as 22q11 deletion syndrome. PMID:26345374

Neurodevelopmental profiles of children with glutaric aciduria type I diagnosed by newborn screening: a follow-up case series.

PubMed

Brown, Amy; Crowe, Louise; Beauchamp, Miriam H; Anderson, Vicki; Boneh, Avihu

2015-01-01

Glutaric aciduria type I (GA-I) is an inherited metabolic disorder that may lead to severe motor disorder and cognitive impairment. GA-I is now included in the newborn screening programme in many countries as early detection allows for prompt treatment and effectively reduces the risk of poor developmental outcome. Information regarding the long-term neurodevelopmental outcome of children with GA-I treated early is sparse.We recruited children with a confirmed diagnosis of GA-I diagnosed via newborn screening, treated in our centre and >3 years of age (n = 6). Children were assessed at two time points using a comprehensive neuropsychological test battery. Four of these had been the subject of a previous report. All participants were male, 3-6 years at the initial assessment and 6-12 years of age at the follow-up assessment.Fine motor skills were below average in all patients. Speech, which was affected in all four patients reported previously, improved following speech therapy. IQ scores remained generally stable within the normal range. Executive functioning was average to high average in four patients. Behaviour, as assessed through parental questionnaires, was problematic in two patients. Compounding factors included child neglect, family history of autism and multiple admissions to hospital (n = 1 in each).GA-I affects fine motor skills and speech, regardless of early treatment, but not IQ scores. Patients with GA-I should be referred for assessment and appropriate early intervention. Further research is needed to correlate specific neuropsychological deficits with neuroimaging.

Plasma Free Amino Acid Profiling of Five Types of Cancer Patients and Its Application for Early Detection

PubMed Central

Miyagi, Yohei; Higashiyama, Masahiko; Gochi, Akira; Akaike, Makoto; Ishikawa, Takashi; Miura, Takeshi; Saruki, Nobuhiro; Bando, Etsuro; Kimura, Hideki; Imamura, Fumio; Moriyama, Masatoshi; Ikeda, Ichiro; Chiba, Akihiko; Oshita, Fumihiro; Imaizumi, Akira; Yamamoto, Hiroshi; Miyano, Hiroshi; Horimoto, Katsuhisa; Tochikubo, Osamu; Mitsushima, Toru; Yamakado, Minoru; Okamoto, Naoyuki

2011-01-01

Background Recently, rapid advances have been made in metabolomics-based, easy-to-use early cancer detection methods using blood samples. Among metabolites, profiling of plasma free amino acids (PFAAs) is a promising approach because PFAAs link all organ systems and have important roles in metabolism. Furthermore, PFAA profiles are known to be influenced by specific diseases, including cancers. Therefore, the purpose of the present study was to determine the characteristics of the PFAA profiles in cancer patients and the possibility of using this information for early detection. Methods and Findings Plasma samples were collected from approximately 200 patients from multiple institutes, each diagnosed with one of the following five types of cancer: lung, gastric, colorectal, breast, or prostate cancer. Patients were compared to gender- and age- matched controls also used in this study. The PFAA levels were measured using high-performance liquid chromatography (HPLC)–electrospray ionization (ESI)–mass spectrometry (MS). Univariate analysis revealed significant differences in the PFAA profiles between the controls and the patients with any of the five types of cancer listed above, even those with asymptomatic early-stage disease. Furthermore, multivariate analysis clearly discriminated the cancer patients from the controls in terms of the area under the receiver-operator characteristics curve (AUC of ROC >0.75 for each cancer), regardless of cancer stage. Because this study was designed as case-control study, further investigations, including model construction and validation using cohorts with larger sample sizes, are necessary to determine the usefulness of PFAA profiling. Conclusions These findings suggest that PFAA profiling has great potential for improving cancer screening and diagnosis and understanding disease pathogenesis. PFAA profiles can also be used to determine various disease diagnoses from a single blood sample, which involves a relatively simple

Early Puberty Linked to Higher Type 2 Diabetes Risk

MedlinePlus

... Risk? Home Prevention Diagnosing Diabetes and Learning About Prediabetes Type 2 Diabetes Risk Test Lower Your Risk ... Nearly half of American adults have diabetes or prediabetes; more than 30 million adults and children have ...

The Origin of Dwarf Early-Type Galaxies

NASA Astrophysics Data System (ADS)

Toloba, Elisa

2012-10-01

Abridge. We have conducted a spectrophotometric study of dwarf early-type galaxies (dEs) in the Virgo cluster and in regions of lower density. We have found that these galaxies show many properties in common with late-type galaxies but not with more massive early-types (E/S0). The properties of the dEs in Virgo show gradients within the cluster. dEs in the outer parts of the Virgo cluster are kinematically supported by rotation, while those in the center are supported by the random motions of their stars (i.e. pressure supported). The rotationally supported dEs have disky isophotes and faint underlying spiral/irregular substructures, they also show younger ages than those pressure supported, which have boxy isophotes and are smooth and regular, without any substructure. We compare the position of these dEs with massive early-type galaxies in the Faber-Jackson and Fundamental Plane relations, and we find that, although there is no difference between the position of rotationally and pressure supported dEs, both deviate from the relations of massive early-type galaxies in the direction of dwarf spheroidal systems (dSphs). We have used their offset with respect to the Fundamental Plane of E/S0 galaxies to estimate their dark matter fraction. All the properties studied in this work agree with a ram pressure stripping scenario, where late-type galaxies infall into the cluster, their interaction with the intergalactic medium blows away their gas and, as a result, they are quenched in a small amount of time. However, those dEs in the center of the cluster seem to have been fully transformed leaving no trace of their possible spiral origin, thus, if that is the case, they must have experienced a more violent mechanism in combination with ram pressure stripping.

Healthy Behaviour Change and Cardiovascular Outcomes in Newly Diagnosed Type 2 Diabetes Patients - ADDITION-Cambridge Cohort Study

PubMed Central

Long, Gráinne H; Cooper, Andrew J M; Wareham, Nicholas J; Griffin, Simon J; Simmons, Rebecca K

2014-01-01

OBJECTIVE To examine whether improvements in health behaviours are associated with reduced risk of cardiovascular disease (CVD) in individuals with newly-diagnosed type 2 diabetes. RESEARCH DESIGN AND METHODS Population-based prospective cohort study of 867 newly diagnosed diabetes patients aged between 40 and 69 years from the treatment phase of the ADDITION-Cambridge study. As the results for all analyses were similar by trial arm, data were pooled and results presented for the whole cohort. Participants were identified via population-based stepwise screening between 2002 and 2006 and underwent assessment of physical activity (EPAQ questionnaire), diet (plasma vitamin C and self-report), and alcohol consumption (self-report) at baseline and one year. A composite primary CVD outcome was examined, comprised of cardiovascular mortality, non-fatal myocardial infarction, nonfatal stroke and revascularisation. RESULTS After a mean (SD) follow-up of 5.1 (1.1) years, 6% of the cohort experienced a CVD event (12.2/1000-person years; 95% CI 9.3 to 15.9). CVD risk was inversely related to the number of positive health behaviours changed in the year following diabetes diagnosis. The relative risk (95% CI) for primary CVD event in individuals who did not change any health behavior compared to those who adopted three/four healthy behaviors was 4.17 (1.02 to 17.09), adjusting for age, sex, study group, social class occupation and prescription of cardio-protective medication (ptrend = 0.005). CONCLUSIONS Cardiovascular disease risk was inversely associated with the number of healthy behaviour changes adopted in the year following diagnosis of diabetes. Interventions that promote early achievement of these goals in newly diagnosed patients could help reduce the burden of diabetes-related morbidity and mortality. PMID:24658389

Prevalence of Chronic Diabetic Complications in Newly Diagnosed versus Known Type 2 Diabetic Subjects in a Sample of Alexandria Population, Egypt.

PubMed

Khalil, Samir Assaad; Megallaa, Magdy Helmy; Rohoma, Kamel Hemida; Guindy, Myriam AbouSeif; Zaki, Adel; Hassanein, Mohamed; Malaty, Amin Helmy; Ismael, Hanaa Mohamed; Kharboush, Ibrahim Fahmy; El Kafash, Dalal Nasr-Eldein; Sallam, Hassan Nooman; Desouky, Iman Abdelkareem

2018-01-24

In Egypt, data on the prevalence of chronic diabetic complications, which are essential for the adjustment of policies and practices related to diabetes care, are scarce. Therefore, the aim of this study was to determine the frequency of chronic complications of diabetes; namely neuropathy, diabetic kidney disease (DKD), retinopathy and peripheral arterial disease (PAD) in newly-diagnosed versus known type 2 diabetic patients. This is a cross-sectional study that is based on a previous household survey conducted on a representative sample of the population of Alexandria, Egypt. This study included 506 consecutive subjects with type 2 diabetes; 323 patients with previously known T2DM and 183 patients with newly diagnosed T2DM (discovered during the survey). For each participant, a focused history was taken. Comprehensive clinical examination was done including fundus examination, foot examination and assessment of ankle brachial index. Laboratory tests included HbAlc, lipids profile, serum creatinine and urinary albumin creatinine ratio (UACR). Peripheral neuropathy was detected in 20% of the studied patients; 29.4% of known patients and 3.3% of newly diagnosed patients (p<0.001). Diabetic kidney disease was detected in 33.2% of the studied patients; 46.1% of known patients and 10.4% of newly diagnosed patients (p<0.001). Diabetic retinopathy was detected in 34.6% of the studied patients; 48.3% of known patients and 10.4% of newly diagnosed patients (p<0.001). Peripheral arterial disease was detected in 32.6% of the studied patients; 45.5% of known patients and 9.8% of newly diagnosed patients (p<0.001). In patients with known diabetes, the presence of any of the studied complications (neuropathy, diabetic kidney disease, retinopathy or PAD) was significantly associated with the presence of all other complications (p< 0.001). In patients with newly-diagnosed diabetes, the presence of diabetic kidney disease was significantly associated with the presence of

Complication of hybrid treatment in type B aortic dissection diagnosed by echocardiography.

PubMed

Weber, Thaís Rossoni; Hotta, Viviane Tiemi; Rochitte, Carlos Eduardo; Staszko, Kamila Fernanda; Dias, Ricardo Ribeiro; Mady, Charles

2017-05-01

This case illustrates an unusual and fatal complication after endovascular treatment of type B aortic dissection and highlights the role of echocardiography in the early diagnosis of complications. In this case, a patient with previous diagnosis of chronic type B aortic dissection and moderate aortic regurgitation underwent endovascular repair of the proximal descending aorta and conservative surgical correction of the aortic valve. On early postoperative, a transesophageal echocardiogram and aortic angiotomography demonstrated proximal endoleak by contrast extravasation around the proximal graft attachment site, causing compression of the stent in its middle portion, resulting in narrowing with reduced cross-sectional area. © 2017, Wiley Periodicals, Inc.

An Usher syndrome type 1 patient diagnosed before the appearance of visual symptoms by MYO7A mutation analysis.

PubMed

Yoshimura, Hidekane; Iwasaki, Satoshi; Kanda, Yukihiko; Nakanishi, Hiroshi; Murata, Toshinori; Iwasa, Yoh-ichiro; Nishio, Shin-ya; Takumi, Yutaka; Usami, Shin-ichi

2013-02-01

Usher syndrome type 1 (USH1) appears to have only profound non-syndromic hearing loss in childhood and retinitis pigmentosa develops in later years. This study examined the frequency of USH1 before the appearance of visual symptoms in Japanese deaf children by MYO7A mutation analysis. We report the case of 6-year-old male with profound hearing loss, who did not have visual symptoms. The frequency of MYO7A mutations in profound hearing loss children is also discussed. We sequenced all exons of the MYO7A gene in 80 Japanese children with severe to profound non-syndromic HL not due to mutations of the GJB2 gene (ages 0-14 years). A total of nine DNA variants were found and six of them were presumed to be non-pathogenic variants. In addition, three variants of them were found in two patients (2.5%) with deafness and were classified as possible pathogenic variants. Among them, at least one nonsense mutation and one missense mutation from the patient were confirmed to be responsible for deafness. After MYO7A mutation analysis, the patient was diagnosed with RP, and therefore, also diagnosed with USH1. This is the first case report to show the advantage of MYO7A mutation analysis to diagnose USH1 before the appearance of visual symptoms. We believed that MYO7A mutation analysis is valid for the early diagnosis of USH1. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Proposed recommendations for diagnosing and managing individuals with glutaric aciduria type I: second revision.

PubMed

Boy, Nikolas; Mühlhausen, Chris; Maier, Esther M; Heringer, Jana; Assmann, Birgit; Burgard, Peter; Dixon, Marjorie; Fleissner, Sandra; Greenberg, Cheryl R; Harting, Inga; Hoffmann, Georg F; Karall, Daniela; Koeller, David M; Krawinkel, Michael B; Okun, Jürgen G; Opladen, Thomas; Posset, Roland; Sahm, Katja; Zschocke, Johannes; Kölker, Stefan

2017-01-01

Glutaric aciduria type I (GA-I; synonym, glutaric acidemia type I) is a rare inherited metabolic disease caused by deficiency of glutaryl-CoA dehydrogenase located in the catabolic pathways of L-lysine, L-hydroxylysine, and L-tryptophan. The enzymatic defect results in elevated concentrations of glutaric acid, 3-hydroxyglutaric acid, glutaconic acid, and glutaryl carnitine in body tissues, which can be reliably detected by gas chromatography/mass spectrometry (organic acids) and tandem mass spectrometry (acylcarnitines). Most untreated individuals with GA-I experience acute encephalopathic crises during the first 6 years of life that are triggered by infectious diseases, febrile reaction to vaccinations, and surgery. These crises result in striatal injury and consequent dystonic movement disorder; thus, significant mortality and morbidity results. In some patients, neurologic disease may also develop without clinically apparent crises at any age. Neonatal screening for GA-I us being used in a growing number of countries worldwide and is cost effective. Metabolic treatment, consisting of low lysine diet, carnitine supplementation, and intensified emergency treatment during catabolism, is effective treatment and improves neurologic outcome in those individuals diagnosed early; treatment after symptom onset, however, is less effective. Dietary treatment is relaxed after age 6 years and should be supervised by specialized metabolic centers. The major aim of this second revision of proposed recommendations is to re-evaluate the previous recommendations (Kölker et al. J Inherit Metab Dis 30:5-22, 2007b; J Inherit Metab Dis 34:677-694, 2011) and add new research findings, relevant clinical aspects, and the perspective of affected individuals.

The origin of dwarf early-type galaxies

NASA Astrophysics Data System (ADS)

Toloba, E.

2013-05-01

We have conducted a spectrophotometric study of dwarf early-type galaxies (dEs) in the Virgo cluster and in regions of lower density. We have found that these galaxies show many properties in common with late-type galaxies but not with more massive early-types (E/S0). The properties of the dEs in Virgo show gradients within the cluster. dEs in the outer parts of the Virgo cluster are kinematically supported by rotation, while those in the center are supported by the random motions of their stars (i.e. pressure supported). The rotationally supported dEs have disky isophotes and faint underlying spiral/irregular substructures, they also show younger ages than those pressure supported, which have boxy isophotes and are smooth and regular, without any substructure. We compare the position of these dEs with massive early-type galaxies in the Faber-Jackson and Fundamental Plane relations, and we find that, although there is no difference between the position of rotationally and pressure supported dEs, both deviate from the relations of massive early-type galaxies in the direction of dwarf spheroidal systems (dSphs). We have used their offset with respect to the Fundamental Plane of E/S0 galaxies to estimate their dark matter fraction. All the properties studied in this work agree with a ram pressure stripping scenario, where late-type galaxies infall into the cluster, their interaction with the intergalactic medium blows away their gas and, as a result, they are quenched in a small amount of time. However, those dEs in the center of the cluster seem to have been fully transformed leaving no trace of their possible spiral origin, thus, if that is the case, they must have experienced a more violent mechanism in combination with ram pressure stripping, the open problem is that even galaxy harassment does not fully explain the observed properties for the pressure supported dEs in the center of the Virgo cluster.

A Follow-up Study of Early Onset Psychosis: Comparison between Outcome Diagnoses of Schizophrenia, Mood Disorders, and Personality Disorders.

ERIC Educational Resources Information Center

McClellan, Jon M.; And Others

1993-01-01

This study of 95 youths previously diagnosed with psychotic disorders found that at follow-up, 24 had a diagnosis of schizophrenia, 9 with psychotic mood disorders, 5 with personality disorders, and 1 with schizo-affective disorder. The study confirmed findings regarding early onset schizophrenia and psychotic mood disorders and emphasized the…

Incretin secretion in obese Korean children and adolescents with newly diagnosed type 2 diabetes.

PubMed

Park, So Hyun; Jung, Min Ho; Cho, Won Kyoung; Park, Mi Sun; Suh, Byung Kyu

2016-01-01

The role of incretins in type 2 diabetes is controversial. This study investigated the association between incretin levels in obese Korean children and adolescents newly diagnosed with type 2 diabetes. We performed a 2-hr oral glucose tolerance test (OGTT) in obese children and adolescents with type 2 diabetes and with normal glucose tolerance. Twelve obese children and adolescents with newly diagnosed type 2 diabetes (DM group) and 12 obese age-matched subjects without type 2 diabetes (NDM group) were included. An OGTT was conducted and insulin, C-peptide, glucagon, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) were measured during the OGTT. The mean age of the patients was 13·8 ± 2·0 years, and the mean body mass index (BMI) Z-score was 2·1 ± 0·5. The groups were comparable in age, sex, BMI Z-score and waist:hip ratio. The DM group had significantly lower homeostasis model assessment of β and insulinogenic index values (P < 0·001). The homeostasis model assessment of insulin resistance index was not different between the two groups. Insulin and C-peptide secretions were significantly lower in the DM group than in the NDM group (P < 0·001). Total GLP-1 secretion was significantly higher in the DM group while intact GLP-1 and GIP secretion values were not significantly different between the two groups. Impaired insulin secretion might be important in the pathogenesis of type 2 diabetes in obese Korean children and adolescents, however, which may not be attributed to incretin secretion. © 2015 John Wiley & Sons Ltd.

Getting to goal in newly diagnosed type 2 diabetes using combination drug "subtraction therapy".

PubMed

Jennings, Anthony S; Lovett, Alexandra J; George, Tina M; Jennings, Jonathan S

2015-09-01

The treatment of newly diagnosed type 2 diabetes mellitus is diverse, with no clear consensus regarding the initial drug regimen or dosing to achieve optimal glycemic control. We treated 44 consecutive patients with newly diagnosed type 2 diabetes with maximally tolerated doses of pioglitazone 45 mg/day, metformin 1000-2000 mg/day, and repaglinide 1-4 mg before meals. The doses and drugs were subsequently decreased ("subtraction therapy") to achieve optimal glycemic control and minimize side effects. Three primary outcomes were measured: the short term HbA1c response, the long term HbA1c response, and the incidence of hypoglycemia. All 44 patients responded with a rapid, progressive decline in their HbA1c levels from 11.43±2.3% to 6.17±0.72% (101±25.1 mmol/mol to 44±7.9 mmol/mol) by three months, and remained stable thereafter. An HbA1c ≤7.0% (≤53 mmol/mol) was reached within 1-4 months in 42 of 44 patients, and in every patient by 12 months. Each patient's lowest HbA1c level, 5.65±0.6% (38±6.6 mmol/mol), was reached over 6.3±2.9 months. Patients with initial HbA1c levels >10% (>86 mmol/mol) (n=33) responded similarly as those with HbA1c levels <10% (<86 mmol/mol) (n=11). Combination drug therapy maintained HbA1c levels between 5.0 and 7.0% (31 and 53 mmol/mol) for up to 14.83 years. Only one clinically significant hypoglycemic event occurred during 261.08 person-years of follow-up. In our experience, combination drug "subtraction therapy" was safe and effective for treating all newly diagnosed type 2 diabetic patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Predictors of early discontinuation of basal insulin therapy in type 2 diabetes in primary care.

PubMed

Kostev, K; Dippel, F W; Rathmann, W

2016-04-01

To identify patient-related characteristics and other impact factors predicting early discontinuation of basal insulin therapy in type 2 diabetes in primary care. A total of 4837 patients who started basal insulin therapy (glargine: n=3175; NPH: n=1662) in 1072 general and internal medicine practices throughout Germany were retrospectively analyzed (Disease Analyser Database: 01/2008-03/2014). Early discontinuation was defined as switching back to oral antidiabetic drugs (OAD) therapy within 90 days after first basal insulin prescription (index date, ID). Patient records were assessed 365 days prior and post ID. Logistic regression models were used to adjust for age, sex, diabetes duration, diabetologist care, disease management program participation, HbA1c, and comorbidity. Within 3 months after ID, 202 (6.8%) of glargine patients switched back to OAD (NPH: 130 (8.5%); p<0.05). In multivariable logistic regression, predictors of early basal insulin discontinuation were ≥1 documented hypoglycemia before ID (adjusted Odds ratio; 95% CI: 2.20; 1.27-3.82), diagnosed depression (1.31; 1.01-1.70) and referrals to specialists within 90 days after ID (2.06; 1.61-2.63). Diabetologist care (0.57; 0.36-0.89) and glargine treatment (vs. NPH: 0.78; 0.61-0.98) were related to a lower odds of having early insulin discontinuation. Less than 10% of type 2 diabetes patients switched back to oral antidiabetic drugs within 90 days after start of basal insulin therapy. In particular, patients with baseline depression and frequent or severe hypoglycemia have a higher likelihood for early discontinuation of basal insulin, whereas use of insulin glargine and diabetologist care are related to an increased chance of continuous insulin treatment. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Diagnosing Dementia—Positive Signs

MedlinePlus

... test offers promise in the early detection of Alzheimer's. By Mary Best What if there were an easy, affordable blood test that could accurately diagnose Alzheimer's disease (AD)—even before symptoms began to show? ...

"I've made this my lifestyle now": a prospective qualitative study of motivation for lifestyle change among people with newly diagnosed type two diabetes mellitus.

PubMed

Sebire, Simon J; Toumpakari, Zoi; Turner, Katrina M; Cooper, Ashley R; Page, Angie S; Malpass, Alice; Andrews, Robert C

2018-01-31

Diagnosis with Type 2 Diabetes is an opportunity for individuals to change their physical activity and dietary behaviours. Diabetes treatment guidelines recommend theory-based, patient-centred care and advocate the provision of support for patient motivation but the motivational experiences of people newly diagnosed with diabetes have not been well studied. Framed in self-determination theory, this study aimed to qualitatively explore how this patient group articulate and experience different types of motivation when attempting lifestyle change. A secondary analysis of semi-structured interview data collected with 30 (n female = 18, n male = 12) adults who had been newly diagnosed with type two diabetes and were participants in the Early ACTID trial was undertaken. Deductive directed content analysis was performed using NVivo V10 and researcher triangulation to identify and describe patient experiences and narratives that reflected the motivation types outlined in self-determination theory and if/how these changed over time. The findings revealed the diversity in motivation quality both between and within individuals over time and that patients with newly-diagnosed diabetes have multifaceted often competing motivations for lifestyle behaviour change. Applying self-determination theory, we identified that many participants reported relatively dominant controlled motivation to comply with lifestyle recommendations, avoid their non-compliance being "found out" or supress guilt following lapses in behaviour change attempts. Such narratives were accompanied by experiences of frustrating slow behaviour change progress. More autonomous motivation was expressed as something often achieved over time and reflected goals to improve health, quality of life or family time. Motivational internalisation was evident and some participants had integrated their behaviour change to a new way of life which they found resilient to common barriers. Motivation for lifestyle change

Isolated Early-type Galaxies in the 2dFGRS

NASA Astrophysics Data System (ADS)

Fuse, Christopher R.; Lamir, C.

2014-01-01

Isolated galaxies are systems that have experienced limited external perturbations, thus the properties of these galaxies are largely due to internal processes. The features of isolated early-type galaxies (IEGs) provide a baseline from which to compare early-type systems residing in higher-density environments. We use the Two-Degree Field Galaxy Redshift Survey (2dFGRS) and the NASA Extragalactic Database (NED) to identify IEGs in the nearby universe. Search criteria in the 2dFGRS were chosen to insure that the IEGs have remained separated from neighboring galaxies for the majority of their lifetimes. Isolated galaxies are chosen utilizing a minimum projected physical separation of 1 Mpc from any neighboring non-dwarf galaxy brighter than Mb = -16.5 mags. A minimum redshift separation of 350 km/s between a candidate galaxy and a neighboring was imposed to further insure the candidate’s isolation. Early results of the search for isolated early-type galaxies in the southern sky are presented.

Study Protocol: Early Stereotactic Gamma Knife Radiosurgery to Residual Tumor After Surgery of Newly Diagnosed Glioblastoma (Gamma-GBM).

PubMed

Brehmer, Stefanie; Grimm, Mario Alexander; Förster, Alex; Seiz-Rosenhagen, Marcel; Welzel, Grit; Stieler, Florian; Wenz, Frederik; Groden, Christoph; Mai, Sabine; Hänggi, Daniel; Giordano, Frank Anton

2018-04-24

Glioblastoma (GBM) is the most common malignant brain tumor in adult patients. Tumor recurrence commonly occurs around the resection cavity, especially after subtotal resection (STR). Consequently, the extent of resection correlates with overall survival (OS), suggesting that depletion of postoperative tumor remnants will improve outcome. To assess safety and efficacy of adding stereotactic radiosurgery (SRS) to the standard treatment of GBM in patients with postoperative residual tumor. Gamma-GBM is a single center, open-label, prospective, single arm, phase II study that includes patients with newly diagnosed GBM (intraoperative via frozen sections) who underwent STR (residual tumor will be identified by native and contrast enhanced T1-weighted magnetic resonance imaging scans). All patients will receive SRS with 15 Gy (prescribed to the 50% isodose enclosing all areas of residual tumor) early (within 24-72 h) after surgery. Thereafter, all patients undergo standard-of-care therapy for GBM (radiochemotherapy with 60 Gy external beam radiotherapy [EBRT] plus concomitant temozolomide and 6 cycles of adjuvant temozolomide chemotherapy). The primary outcome is median progression-free survival, secondary outcomes are median OS, occurrence of radiation induced acute (<3 wk), early delayed (<3 mo), and late (>3 mo post-SRS) neurotoxicity and incidence of symptomatic radionecrosis. We expect to detect efficacy and safety signals by the immediate application of SRS to standard-of-care therapy in newly diagnosed GBM. Early postoperative SRS to areas of residual tumor could bridge the therapeutic gap between surgery and adjuvant therapies.

Predicting early cognitive decline in newly-diagnosed Parkinson's patients: A practical model.

PubMed

Hogue, Olivia; Fernandez, Hubert H; Floden, Darlene P

2018-06-19

To create a multivariable model to predict early cognitive decline among de novo patients with Parkinson's disease, using brief, inexpensive assessments that are easily incorporated into clinical flow. Data for 351 drug-naïve patients diagnosed with idiopathic Parkinson's disease were obtained from the Parkinson's Progression Markers Initiative. Baseline demographic, disease history, motor, and non-motor features were considered as candidate predictors. Best subsets selection was used to determine the multivariable baseline symptom profile that most accurately predicted individual cognitive decline within three years. Eleven per cent of the sample experienced cognitive decline. The final logistic regression model predicting decline included five baseline variables: verbal memory retention, right-sided bradykinesia, years of education, subjective report of cognitive impairment, and REM behavior disorder. Model discrimination was good (optimism-adjusted concordance index = .749). The associated nomogram provides a tool to determine individual patient risk of meaningful cognitive change in the early stages of the disease. Through the consideration of easily-implemented or routinely-gathered assessments, we have identified a multidimensional baseline profile and created a convenient, inexpensive tool to predict cognitive decline in the earliest stages of Parkinson's disease. The use of this tool would generate prediction at the individual level, allowing clinicians to tailor medical management for each patient and identify at-risk patients for clinical trials aimed at disease modifying therapies. Copyright © 2018. Published by Elsevier Ltd.

Pubertal development in children diagnosed with diabetes mellitus type 1 before puberty.

PubMed

Pereira, K C X; Pugliese, B S; Guimarães, M M; Gama, M P

2015-02-01

To investigate an association between pubertal development and timing of menarche with glycemic control, disease duration, and body mass index (BMI) in patients diagnosed with diabetes mellitus type 1 (DM1) before puberty. Retrospective study. The study was performed at the diabetes outpatient clinic of Instituto de Puericultura e Pediatria Martagão Gesteira--IPPMG of the Federal University of Rio de Janeiro--UFRJ. A total of 131 children, 61 girls and 70 boys, diagnosed with DM1 before puberty participated in the study. The study investigated how age at puberty onset relates to mean glycated hemoglobin (HbA1c) before puberty, BMI percentile, and disease duration; how puberty duration relates to mean HbA1c before and during puberty and to disease duration; and how timing of menarche relates to mean HbA1c before puberty, BMI percentile, and disease duration. Age at puberty onset was positively correlated with mean HbA1c before puberty (r = 0.204, R(2) = 0.042; P = .019) and disease duration (r = 0.451, R(2) = 0.203; P < .0001), and negatively correlated with BMI percentile (r = -0.289, R(2) = 0.084; P = .001). Timing of menarche was negatively correlated with BMI percentile (r = -0.556, R(2) = 0.310; P < .001). Children with longer disease duration began puberty later than those diagnosed more recently. Girls in higher BMI percentiles reached menarche sooner.

Glutaric aciduria type I: outcome of patients with early- versus late-diagnosis.

PubMed

Couce, Ma Luz; López-Suárez, Olalla; Bóveda, Ma Dolores; Castiñeiras, Daisy E; Cocho, José A; García-Villoria, Judith; Castro-Gago, Manuel; Fraga, José Ma; Ribes, Antonia

2013-07-01

Patients with Glutaric aciduria type 1 (GA-1) can be identified by newborn screening using tandem mass spectrometry. The clinical evolution of screened patients seems to be more favourable compared with those diagnosed later, although long-term evolution is still doubtful. We have evaluated the outcome in nine GA-1 patients diagnosed in our region during 12 years. Six were detected by newborn screening and 3 clinically. The birth prevalence was 1:35,027. High blood C5DC concentration, in 8/9 patients, was found, whereas all patients exhibited high concentration of this metabolite in urine. Therefore, urine C5DC was a good marker for the detection of this disease. Eight different mutations in the GCDH gene were identified, four of them were novel (p.R88H, p.Y398C, p.R372K, p.D220N); being p.R227P the mostcommon. Macrocephaly with enlarged frontotemporal subarachnoid space was present in 4/6 patients diagnosed by newborn screening, all these patients required high energy intake, and in two cases, enteral feeding during the first year of life was needed. One child had an intercurrent episode of feeding refuse with hypoglycemia at two years of age. The mean follow-up time of screened patients was 56 months, and patients still remain asymptomatic. However, after a mean follow-up of 97 months treatment efficacy was poor in unscreened patients, two of them showing a severe spastic tetraparesis. Plasma levels of lysine, tryptophan and carnitine, were the most useful biomarkers for the follow-up. Our data support that, early diagnosis and treatment strategies are essential measures for the good clinical evolution of GA-1 patients. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Early-Onset LMNA-Associated Muscular Dystrophy with Later Involvement of Contracture.

PubMed

Lee, Younggun; Lee, Jung Hwan; Park, Hyung Jun; Choi, Young Chul

2017-10-01

The early diagnosis of LMNA-associated muscular dystrophy is important for preventing sudden arrest related to cardiac conduction block. However, diagnosing early-onset Emery-Dreifuss muscular dystrophy (EDMD) with later involvement of contracture and limb-girdle muscular dystrophy type 1B is often delayed due to heterogeneous clinical presentations. We aimed to determine the clinical features that contribute to a delayed diagnosis. We reviewed four patients who were recently diagnosed with LMNA-associated muscular dystrophy by targeted exome sequencing and who were initially diagnosed with nonspecific or other types of muscular dystrophy. Certain clinical features such as delayed contracture involvement and calf hypertrophy were found to contribute to a delayed diagnosis. Muscle biopsies were not informative for the diagnosis in these patients. Genetic testing of single or multiple genes is useful for confirming a diagnosis of LMNA-associated muscular dystrophy. Even EDMD patients could experience the later involvement of contracture, so clinicians should consider early genetic testing for patients with undiagnosed muscular dystrophy or laminopathy. Copyright © 2017 Korean Neurological Association

Bedside heart type fatty acid binding protein (H-FABP): Is an early predictive marker of cardiac syncope.

PubMed

Sonmez, Bedriye Muge; Ozturk, Derya; Yilmaz, Fevzi; Altinbilek, Ertugrul; Kavalci, Cemil; Durdu, Tamer; Hakbilir, Oktay; Turhan, Turan; Ongar, Murat

2015-11-01

To determine the value of bedside heart-type fatty acid binding protein in diagnosis of cardiac syncope in patients presenting with syncope or presyncope. The prospective study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, between September 1, 2010, and January 1, 2011, and comprised patients aged over 18 years who presented with syncope or presyncope. Patients presenting to emergency department within 4 hours of syncope or presyncope underwent a bedside heart-type fatty acid binding protein test measurement. SPSS 16 was used for statistical analysis. Of the 100 patients evaluated, 22(22%) were diagnosed with cardiac syncope. Of them, 13(59.1%) patients had a positive and 9(40.9%) had a negative heart-type fatty acid binding protein result. Consequently, the test result was 12.64 times more positive in patients with cardiac syncope compared to those without. Bedside heart-type fatty acid binding protein, particularly at early phase of myocardial injury, reduces diagnostic and therapeutic uncertainity of cardiac origin in syncope patients.

Endoscopic mucosal resection for early gastric cancer. A case report.

PubMed

Gheorghe, Cristian; Sporea, Ioan; Becheanu, Gabriel; Gheorghe, Liana

2002-03-01

European experience in endoscopic mucosal resection (EMR) for early gastric cancer is still relatively low, since early stomach cancer is diagnosed at a much lower rate in Europe than in Japan and generally operable patients are referred to surgery for radical resection. Endoscopic mucosal resection or mucosectomy was developed as a promising technology to diagnose and treat mucosal lesions in the esophagus, stomach and colon. In contrast to surgical resection, EMR allows "early cancers" to be removed with a minimal cost, morbidity and mortality. We present the case of a patient with hepatic cirrhosis incidentally diagnosed with an elevated-type IIa early gastric cancer. Echoendoscopy was performed in order to assess the depth of invasion into the gastric wall confirming the only mucosal involvement. We performed an EMR using "cup and suction" method. After the procedure, the patient experienced an acute upper gastrointestinal bleeding from the ulcer bed requiring argon plasma coagulation. The histopathological examination confirmed an early cancer, without involvement of muscularis mucosae. The patient has had an uneventful evolution being well at six months after the procedure

New insight into the physics of atmospheres of early type stars

NASA Technical Reports Server (NTRS)

Lamers, H. J. G. L. M.

1981-01-01

The phenomenon of mass loss and stellar winds from hot stars are discussed. The mass loss rate of early type stars increases by about a factor of 100 to 1000 during their evolution. This seems incompatible with the radiation driven wind models and may require another explanation for the mass loss from early type stars. The winds of early type stars are strongly variable and the stars may go through active phases. Eclipses in binary systems by the stellar winds can be used to probe the winds. A few future IUE studies are suggested.

Comparison of acarbose and metformin therapy in newly diagnosed type 2 diabetic patients with overweight and/or obesity.

PubMed

Sun, Weiping; Zeng, Chunping; Liao, Lizhen; Chen, Juan; Wang, Ying

2016-08-01

To compare the efficacy of acarbose and metformin in overweight and/or obese patients with newly diagnosed type 2 diabetes mellitus (T2DM). A total of 108 drug-naïve patients with newly diagnosed T2DM, whose hemoglobin A1c (HbA1c) was between 7% and 10% and body mass index was greater than 24 kg/m(2), were enrolled in the First People's Hospital and Municipal Central Hospital of Xiangtan City, Xiangtan, China, from 1 February 2010 to 1 August 2011. Patients were randomly assigned to acarbose (100 mg three times a day) and metformin (1.5 g/day) groups for a predictive follow-up period of 24 weeks. Plasma glucose, insulin, and glucagons at 0, 0.5, and 2 hours after a standardized meal, and HbA1c were measured at baseline and 24 weeks. Baseline characteristics of the acarbose and metformin groups were similar. Glucose control improved significantly in both groups at 24 weeks. The percentage of patients achieving HbA1C <6.5% was comparable for acarbose and metformin therapy at 24 weeks. Body weight reduction from baseline to 24 weeks was 3.3 kg in the acarbose group and 2.7 kg in the metformin group, whereas the change in HbA1c and body weight was similar in both groups. The early-phase insulin secretion index improved only in the acarbose group at 24 weeks. After 24 weeks of therapy, fasting glucagon and 0.5 hour postprandial glucagon levels decreased markedly in the acarbose group compared to the metformin group. Twenty-four weeks of therapy with acarbose and metformin induced similar reductions in HbA1c and body weight, but acarbose showed superior efficacy in improving islet α-cell function compared with metformin in overweight/obese patients with newly diagnosed T2DM. However, more large-sample, multicenter, randomized controlled trials are needed to evaluate the efficacy, safety, cost-effectiveness, and glycemic variability of the two drugs.

EARLY REGULATION IN CHILDREN WHO ARE LATER DIAGNOSED WITH AUTISM SPECTRUM DISORDER. A LONGITUDINAL STUDY WITHIN THE DANISH NATIONAL BIRTH COHORT.

PubMed

Lemcke, Sanne; Parner, Erik T; Bjerrum, Merete; Thomsen, Per H; Lauritsen, Marlene B

2018-03-01

Studies have shown that children later diagnosed with autism spectrum disorders (ASD) in their first years of life might show symptoms in main developmental areas and that these signs might be sensed by the parents. The present study investigated in a large birth cohort if children later diagnosed with ASD had deviations at 6 and 18 months in areas such as the ability to self-regulate emotions, feeding, and sleeping. The study was based on prospective information collected from 76,322 mothers who participated in the Danish National Birth Cohort. When the children reached an average age of 11 years, 973 children with ASD and a control group of 300 children with intellectual disability (IDnoASD) were identified via Danish health registries. Associations were found between short periods of breast-feeding and the children later diagnosed with ASD and IDnoASD as well as associations at 18 months to deviations in regulation of emotions and activity. The similarities in these associations emphasize how difficult it is to distinguish between diagnoses early in life. © 2018 Michigan Association for Infant Mental Health.

Serum uric acid concentration is associated with early changes of glomerular filtration rate in patients with diabetes type 1 without increased albumin excretion.

PubMed

Spaleniak, Sebastian; Korzeniewska-Dyl, Irmina; Moczulski, Dariusz

2014-10-01

The early loss of renal function in patients with type 1 diabetes may begin before proteinuria. Only 30% of patients with diabetes manifest overt proteinuria. According to the previous studies, increased urinary albumin excretion, which is considered a classic marker of progression of diabetic kidney disease, can regress to normal urine albumin excretion. The current studies conducted in patients with type 1 diabetes without increased urine albumin excretion showed that the uric acid concentration was an independent factor for the development of diabetic kidney disease. The aim of study was to assess the impact of uric acid concentration and to identify risk factors of the early glomerular filtration loss in patients with type 1 diabetes and normal urinary albumin excretion. 147 patients (61 women and 86 men) with type 1 diabetes without increased urine albumin excretion were analysed. GFR (gromerular filtration rate) was estimated based on the serum cystatin C concentration. Centile charts were used to determine the variation of uric acid concentration depending on GFR and gender. The mean value of the filtration rate for the study group was 117 ml/min/m2. The uric acid level above 90th percentile in relation to GFR was diagnosed in 8.2% of women and 0% of men, between 90th and 50th percentile in 44.3 % of women and 5.8% of men and below 50th percentile in 47.5% of women and 94.2% of men. Contrary to men in women higher serum acid concentration was strongly associated with higher glomerular filtration rate. Hyperfiltraion was diagnosed in 15 of women and 19 of men. The high normal uric acid concentration in women with type 1 diabetes might play a crucial role in development of hyperfiltration.

What happens during early outpatient palliative care consultations for persons with newly diagnosed advanced cancer? A qualitative analysis of provider documentation.

PubMed

Bagcivan, Gulcan; Dionne-Odom, J Nicholas; Frost, Jennifer; Plunkett, Margaret; Stephens, Lisa A; Bishop, Peggy; Taylor, Richard A; Li, Zhongze; Tucker, Rodney; Bakitas, Marie

2018-01-01

Early outpatient palliative care consultations are recommended by clinical oncology guidelines globally. Despite these recommendations, it is unclear which components should be included in these encounters. Describe the evaluation and treatment recommendations made in early outpatient palliative care consultations. Outpatient palliative care consultation chart notes were qualitatively coded and frequencies tabulated. Outpatient palliative care consultations were automatically triggered as part of an early versus delayed randomized controlled trial (November 2010 to April 2013) for patients newly diagnosed with advanced cancer living in the rural Northeastern US. In all, 142 patients (early = 70; delayed = 72) had outpatient palliative care consultations. The top areas addressed in these consultations were general evaluations-marital/partner status (81.7%), spirituality/emotional well-being (80.3%), and caregiver/family support (79.6%); symptoms-mood (81.7%), pain (73.9%), and cognitive/mental status (68.3%); general treatment recommendations-counseling (39.4%), maintaining current medications (34.5%), and initiating new medication (23.9%); and symptom-specific treatment recommendations-pain (22.5%), constipation (12.7%), depression (12.0%), advanced directive completion (43.0%), identifying a surrogate (21.8%), and discussing illness trajectory (21.1%). Compared to the early group, providers were more likely to evaluate general pain ( p = 0.035) and hospice awareness ( p = 0.005) and discuss/recommend hospice ( p = 0.002) in delayed group participants. Outpatient palliative care consultations for newly diagnosed advanced cancer patients can address patients' needs and provide recommendations on issues that might not otherwise be addressed early in the disease course. Future prospective studies should ascertain the value of early outpatient palliative care consultations that are automatically triggered based on diagnosis or documented symptom

Lung cancers diagnosed at annual CT screening: volume doubling times.

PubMed

Henschke, Claudia I; Yankelevitz, David F; Yip, Rowena; Reeves, Anthony P; Farooqi, Ali; Xu, Dongming; Smith, James P; Libby, Daniel M; Pasmantier, Mark W; Miettinen, Olli S

2012-05-01

To empirically address the distribution of the volume doubling time (VDT) of lung cancers diagnosed in repeat annual rounds of computed tomographic (CT) screening in the International Early Lung Cancer Action Program (I-ELCAP), first and foremost with respect to rates of tumor growth but also in terms of cell types. All CT screenings in I-ELCAP from 1993 to 2009 were performed according to HIPAA-compliant protocols approved by the institutional review boards of the collaborating institutions. All instances of first diagnosis of primary lung cancer after a negative screening result 7-18 months earlier were identified, with symptom-prompted diagnoses included. Lesion diameter was calculated by using the measured length and width of each cancer at the time when the nodule was first identified for further work-up and at the time of the most recent prior screening, 7-18 months earlier. The length and width were measured a second time for each cancer, and the geometric mean of the two calculated diameters was used to calculate the VDT. The χ(2) statistic was used to compare the VDT distributions. The median VDT for 111 cancers was 98 days (interquartile range, 108). For 56 (50%) cancers it was less than 100 days, and for three (3%) cancers it was more than 400 days. Adenocarcinoma was the most frequent cell type (50%), followed by squamous cell carcinoma (19%), small cell carcinoma (19%), and others (12%). Lung cancers manifesting as subsolid nodules had significantly longer VDTs than those manifesting as solid nodules (P < .0001). Lung cancers diagnosed in annual repeat rounds of CT screening, as manifest by the VDT and cell-type distributions, are similar to those diagnosed in the absence of screening.

Vital signs, QT prolongation, and newly diagnosed cardiovascular disease during severe hypoglycemia in type 1 and type 2 diabetic patients.

PubMed

Tsujimoto, Tetsuro; Yamamoto-Honda, Ritsuko; Kajio, Hiroshi; Kishimoto, Miyako; Noto, Hiroshi; Hachiya, Remi; Kimura, Akio; Kakei, Masafumi; Noda, Mitsuhiko

2014-01-01

OBJECTIVE To assess vital signs, QT intervals, and newly diagnosed cardiovascular disease during severe hypoglycemia in diabetic patients. RESEARCH DESIGN AND METHODS From January 2006 to March 2012, we conducted a retrospective cohort study to assess type 1 and type 2 diabetic patients with severe hypoglycemia at a national center in Japan. Severe hypoglycemia was defined as the presence of any hypoglycemic symptoms that could not be resolved by the patients themselves in prehospital settings. RESULTS A total of 59,602 cases that visited the emergency room by ambulance were screened, and 414 cases of severe hypoglycemia were analyzed. The median (interquartile range) blood glucose levels were not significantly different between the type 1 diabetes mellitus (T1DM) (n = 88) and type 2 diabetes mellitus (T2DM) (n = 326) groups (32 [24-42] vs. 31 [24-39] mg/dL, P = 0.59). During severe hypoglycemia, the incidences of severe hypertension (≥180/120 mmHg), hypokalemia (<3.5 mEq/L), and QT prolongation were 19.8 and 38.8% (P = 0.001), 42.4 and 36.3% (P = 0.30), and 50.0 and 59.9% (P = 0.29) in the T1DM and T2DM groups, respectively. Newly diagnosed cardiovascular disease during severe hypoglycemia and death were only observed in the T2DM group (1.5 and 1.8%, respectively). Blood glucose levels between the deceased and surviving patients in the T2DM group were significantly different (18 [14-33] vs. 31 [24-39] mg/dL, P = 0.02). CONCLUSIONS T1DM and T2DM patients with severe hypoglycemia experienced many critical problems that could lead to cardiovascular disease, fatal arrhythmia, and death.

Hα Monitoring of Early-Type Emission Line Stars

NASA Astrophysics Data System (ADS)

Souza, Steven P.; Boettcher, E.; Wilson, S.; Hosek, M.

2011-05-01

We have begun a narrowband imaging program to monitor Hα emission in early-type stars in young open clusters and associations. A minority of early-type stars, particularly Be stars, show Hα in emission due to extended atmospheres and non-equilibrium conditions. Emission features commonly vary irregularly over a range of timescales (Porter, J.M. & Rivinus, T., P.A.S.P. 115:1153-1170, 2003). Some of the brightest such stars, e.g. γ Cas, have been spectroscopically monitored for Hα variability to help constrain models of the unstable disk, but there is relatively little ongoing monitoring in samples including fainter stars (Peters, G., Be Star Newsletter 39:3, 2009). Our program uses matched 5nm-wide on-band (656nm) and off-band (645nm) filters, in conjunction with the Hopkins Observatory 0.6-m telescope and CCD camera. Aperture photometry is done on all early-type stars in each frame, and results expressed as on-band to off-band ratios. Though wavelength-dependent information is lost compared with spectroscopy, imaging allows us to observe much fainter (and therefore many more) objects. Observing young clusters, rather than individual target stars, allows us to record multiple known and candidate emission line stars per frame, and provides multiple "normal" reference stars of similar spectral type. Observations began in the summer of 2010. This project has the potential to produce significant amounts of raw data, so a semi-automated data reduction process has been developed, including astrometric and photometric tasks. Early results, including some preliminary light curves and recovery of known Be stars at least as faint as R=13.9, are presented. We gratefully acknowledge support for student research through an REU grant to the Keck Northeast Astronomy Consortium from the National Science Foundation, and from the Division III Research Funding Committee of Williams College.

Imaging the Hot Stellar Content of Early Type Galaxies

NASA Astrophysics Data System (ADS)

Bertola, Francesco

1991-07-01

WE PROPOSE TO IMAGE WITH THE FOC IN THE F/96 CONFIGURATION FIVE EARLY TYPE GALAXIES IN FOUR PASSBANDS CENTERED AT 1500 A, 2200 A, 2800 A AND 3400 A. WHEN COUPLED WITH PHOTOMETRY OBTAINED FROM THE GROUND OUR OBSERVATIONS WILL ALLOW US TO DERIVE COMPLETE SED OF THESE GALAXIES AS A FUNCTION OF THE DISTANCE FROM THE CENTER. THIS IS A KEY STEP TOWARDS THE UNDERSTANDING OF STELLAR POPULATIONS - IN PARTICULAR THE ONE RESPONSIBLE FOR THE UV EMISSION - IN EARLY TYPE GALAXIES AND WILL PROVIDE IMPORTANT INSIGHT IN THEIR FORMATION AND EVOLUTION. WE PLAN TO OBSERVE NGC 1399, NGC 2681, NGC 4552, NGC 5018 AND NGC 4627 WHICH SAMPLE A WIDE RANGE OF INTRINSIC PROPERTIES AS INDICATED BY PREVIOUS IUE OBSERVATIONS. FOR NGC 4627 THERE IS EVIDENCE OF ONGOING STAR FORMATION AND THE HST WILL BE ABLE TO SHOW THE CHARACTERISTIC CLUMPINESS. NGC 2681 HAD A STARBUST OF AGE GREATER THAN 1 GYR. NGC 4552 IS ONE OF THE MOST METAL RICH GALAXY KNOWN. NGC 1399 HAS THE SAME METALLICITY AND LUMINOSITY OF THE PREVIOUS GALAXY BUT IS A MUCH STRONGER X-RAY EMITTER. NGC 5018 IS A VERY GOOD CANDIDATE FOR ONGOING STAR FORMATION. WE BELIEVE IN THIS WAY WE CAN OBTAIN SED FOR THE TWO-DIMENSIONAL IMAGES OF EARLY TYPE GALAXIES FROM BROAD BAND IMAGING ALONE. THE CALIBRATION OF OUR FILTER SYSTEM WILL ALLOW US TO APPLY IT TO THE BIDIMENSIONAL ANALYSIS OF THE GENERAL SAMPLE OF EARLY TYPE GALAXIES.

A survey of the properties of early-type galaxies

NASA Technical Reports Server (NTRS)

Bregman, Joel N.; Roberts, M. S.; Hogg, D. E.

1990-01-01

A compilation of the properties of elliptical and early disk galaxies was completed. In addition to material from the literature, such as Infrared Astronomy Satellite (IRAS) fluxes, the compilation includes recent measurements of HI and CO, as well as a review of the x ray properties by Forman and Jones. The data are used to evaluate the gas content of early systems and to search for correlations with x ray emission. The interstellar medium in early-type galaxies is generally dominated by hot interstellar gas (T approx. 10 to the 7th power K; c.f. the review by Fabbiano 1989 and references therein). In addition, a significant fraction of these galaxies show infrared emission (Knapp, et al., 1989), optical emission lines, and visible dust. Sensitive studies in HI and CO of a number of these galaxies have been completed recently, resulting in several detections, particularly of the later types. Researchers wish to understand the connection among these different forms of the interstellar medium, and to examine the theoretical picture of the fate of the hot gas. To do so, they compiled observations of several forms of interstellar matter for a well-defined sample of early-type galaxies. Here they present a statistical analysis of this data base and discuss the implications of the results.

Early cognitive impairment along with decreased stress-induced BDNF in male and female patients with newly diagnosed multiple sclerosis.

PubMed

Prokopova, Barbora; Hlavacova, Natasa; Vlcek, Miroslav; Penesova, Adela; Grunnerova, Lucia; Garafova, Alexandra; Turcani, Peter; Kollar, Branislav; Jezova, Daniela

2017-01-15

The aim of this study was to evaluate neuroendocrine activation during stress in patients with recently diagnosed multiple sclerosis before starting the immunomodulatory therapy (EDSS score≤2.0). We verified the hypothesis that certain cognitive and affective dysfunction is present already at this early stage of the disease. The sample consisted of 38 subjects, which involved patients who were recently diagnosed multiple sclerosis and age- and sex-matched healthy volunteers. Stroop test served as mental stress model enabling measurement of cognitive performance. Present results showed increased state anxiety, depression scores and poorer performance in the Stroop test in the group of patients compared to healthy subjects. The cognitive dysfunction was particularly evident in male patients with simultaneously decreased concentrations of the brain-derived neurotrophic factor (BDNF) in plasma. The patients at this stage of the disease have not yet developed the hyperactivity of the hypothalamic-pituitary-adrenocortical axis. They showed normal levels of plasma copeptin and reduced aldosterone response to mental stress test in women only. Concentrations of plasma copeptin were higher in men compared to women. Very early stages of multiple sclerosis are accompanied by disturbances in psychological well-being, mild cognitive dysfunction and decreased plasma concentrations of BDNF, particularly in male patients. Copyright © 2016. Published by Elsevier B.V.

Sensorineural hearing loss--a common finding in early-onset type 2 diabetes mellitus.

PubMed

Lerman-Garber, Israel; Cuevas-Ramos, Daniel; Valdés, Samantha; Enríquez, Lorena; Lobato, Marlette; Osornio, Melannie; Escobedo, Ana Rosa; Pascual-Ramos, Virginia; Mehta, Roopa; Ramírez-Anguiano, Jacqueline; Gómez-Pérez, Francisco J

2012-01-01

To evaluate the prevalence and potential associations of hearing impairment in patients 30 to 50 years old with diabetes diagnosed before age 40 years-early-onset type 2 diabetes mellitus (T2DM). The study cohorts consisted of 46 consecutive patients with early-onset T2DM and 47 age-matched control subjects with rheumatoid arthritis. All study subjects completed clinical, serologic, and auditory assessments. The patients with T2DM had a mean age of 42 ± 6 years and a mean disease duration of 11 ± 6 years. Microalbuminuria was present in 26.1%, proliferative retinopathy in 26.1%, and symptomatic peripheral neuropathy in 23.9%. The prevalence of unilateral or bilateral hearing loss was significantly higher in the patients with T2DM than in the patients with rheumatoid arthritis (21.7% versus 6.4%, respectively; P = .01). Most cases of hearing loss were mild and involved high or acute tones. After multivariate analysis with adjustment for age, there was a significant association between hearing loss and hemoglobin A1c (odds ratio, 1.3; 95% confidence interval, 1.02 to 1.81; P = .035). In the patients with T2DM, the lengthening of the brainstem response was not significantly increased; however, the wave morphologic features were abnormal and the reproducibility was poor in both ears in 11 patients (24%). Patients with early-onset T2DM and poor glycemic control have an increased prevalence of subclinical hearing loss and impaired auditory brainstem responses. Hearing impairment may be an underrecognized complication of diabetes.

[Prenatal cerebrovascular accidents diagnosed in the early infant stage: a series of 10 patients].

PubMed

Pina-Jover, María; Martinez-Del Villar, María; Lillo-Laguna, Lucía; Jadraque-Rodriguez, Rocío; Martinez-Pastor, Pedro; Jover-Cerda, Jenaro; Gomez-Gosalvez, Francisco

2013-07-01

INTRODUCTION. A foetal or prenatal cerebrovascular accident (CVA) is defined as an ischaemic, thrombotic or arterial or venous haemorrhagic event that occurs between the 14th week of gestation and the onset of labour. PATIENTS AND METHODS. We report a retrospective study of a series of 10 patients suffering from a, presumably foetal, stroke that went unnoticed during the pregnancy and was diagnosed in the early infant stage. The symptoms and the age at which they were identified are highlighted. RESULTS. None of the 10 patients studied presented any relevant events in the mothers' medical history, but there were four threats of a preterm birth that were solved using the usual means and without the occurrence of any alterations that later affected the foetus. The studies that led to the diagnosis were carried out between the sixth and ninth months of life, and the reason for visiting was reported by the family as being a lower degree of mobility on one side of the body with respect to the other. Two patients presented thrombophilia. With a mean follow-up time of six years, all the patients have an associated infantile cerebral palsy, a third of them have epilepsy and 75% have learning difficulties or intellectual disability. CONCLUSIONS. When CVA are not detected in the prenatal period, it is important in primary care to look for and detect the warning signs of the psychomotor development of the infant at an early stage in order to begin a study of the case and to undertake rehabilitation as early as possible.

Demise of faint satellites around isolated early-type galaxies

NASA Astrophysics Data System (ADS)

Park, Changbom; Hwang, Ho Seong; Park, Hyunbae; Lee, Jong Chul

2018-02-01

The hierarchical galaxy formation scenario in the Cold Dark Matter cosmology with a non-vanishing cosmological constant Λ and geometrically flat space (ΛCDM) has been very successful in explaining the large-scale distribution of galaxies. However, there have been claims that ΛCDM over-predicts the number of satellite galaxies associated with massive galaxies compared with observations—the missing satellite galaxy problem1-3. Isolated groups of galaxies hosted by passively evolving massive early-type galaxies are ideal laboratories for identifying the missing physics in the current theory4-11. Here, we report—based on a deep spectroscopic survey—that isolated massive and passive early-type galaxies without any signs of recent wet mergers or accretion episodes have almost no satellite galaxies fainter than the r-band absolute magnitude of about Mr = -14. If only early-type satellites are used, the cutoff is at the somewhat brighter magnitude of about Mr = -15. Such a cutoff has not been found in other nearby satellite galaxy systems hosted by late-type galaxies or those with merger features. Various physical properties of satellites depend strongly on the host-centric distance. Our observations indicate that the satellite galaxy luminosity function is largely determined by the interaction of satellites with the environment provided by their host.

Early Grade Repetition and Inattention Associated with Neurofibromatosis Type 1

ERIC Educational Resources Information Center

Coude, Francois X.; Mignot, Claire; Lyonnet, Stanislas; Munnich, Arnold

2007-01-01

Objective: The authors analyze the occurrence of grade repetition and inattention in children diagnosed with neurofibromatosis type 1 (NF1). Method: The participant group consisted of 310 patients with NF1 and a control group of 242 individuals. The number of grade repetitions for each participant during his or her time in elementary, middle, and…

The molecular cloud content of early type galaxies

NASA Technical Reports Server (NTRS)

Wiklind, Tommy; Henkel, Christian

1990-01-01

A survey of the CO content of early type galaxies led to 24 new detections, mostly lenticular galaxies. The galaxies, which are situated in both the Northern and Southern Hemispheres, were selected as being far-IR luminous compared to their blue luminosity, and situated at distances less than about 50 Mpc (H sub o=100 km/s Mpc(-1). Results for some early galaxies (NGC 404, NGC 3593 and NGC 4369 are given.

Breast and cervical cancers diagnosed and stage at diagnosis among women served through the National Breast and Cervical Cancer Early Detection Program.

PubMed

Miller, Jacqueline W; Royalty, Janet; Henley, Jane; White, Arica; Richardson, Lisa C

2015-05-01

To assess cancers diagnosed and the stage of cancer at the time of diagnosis among low-income, under-insured, or uninsured women who received services through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Using the NBCCEDP database, we examined the number and percent of women diagnosed during 2009-2011 with in situ breast cancer, invasive breast cancer, and invasive cervical cancer by demographic and clinical characteristics, including age, race and ethnicity, test indication (screening or diagnostic), symptoms (for breast cancer), and screening history (for cervical cancer). We examined these characteristics by stage at diagnosis, a new variable included in the database obtained by linking with state-based central cancer registries. There were 11,569 women diagnosed with invasive breast cancer, 1,988 with in situ breast cancer, and 583 with invasive cervical cancer through the NBCCEDP. Women who reported breast symptoms or who had diagnostic mammography were more likely to be diagnosed with breast cancer, and at a later stage, than those who did not have symptoms or who had screening mammography. Women who had been rarely or never screened for cervical cancer were more likely to be diagnosed with cervical cancer, and at a later stage, than women who received regular screenings. Women served through the NBCCEDP who have not had prior screening or who have symptoms were more often diagnosed with late-stage disease.

Diagnosing Diabetes and Learning about Prediabetes

MedlinePlus

... Listen En Español Diagnosing Diabetes and Learning About Prediabetes There are several ways to diagnose diabetes. Each ... or equal to 200 mg/dl What is Prediabetes? Before people develop type 2 diabetes, they almost ...

Diabetic subjects diagnosed through the Diabetes Prevention Trial-Type 1 (DPT-1) are often asymptomatic with normal A1C at diabetes onset.

PubMed

Triolo, Taylor M; Chase, H Peter; Barker, Jennifer M

2009-05-01

Upon diagnosis of type 1 diabetes, patients are usually symptomatic, and many have ketoacidosis. Screening for islet autoantibodies (IAs) has been shown to decrease A1C level and rate of hospitalization at diabetes onset. Metabolic tests and the presence of symptoms were described at diabetes onset during the Diabetes Prevention Trial-Type 1 (DPT-1). The DPT-1 screened relatives of patients with type 1 diabetes for islet cell autoantiobodies (ICAs). Those with positive ICAs had intravenous and oral glucose tolerance tests (IVGTTs and OGTTs) and were randomized into one of two prevention trials. Throughout the DPT-1 parenteral and oral insulin study, 246 people were diagnosed with type 1 diabetes. Of the 246 subjects diagnosed with diabetes, 218 had data regarding the presence of symptoms, and 138 (63.3%) reported no symptoms suggestive of diabetes. Eight subjects (3.67%) presented with ketosis. Subjects presented with a mean +/- SD A1C of 6.41 +/- 1.15%. At diagnosis, 90 subjects (50.8%) had A1C in the normal range (<6.2%). OGTT data at the time of diagnosis indicate that 35.4% had a glucose result of <100 mg/dl at 0 min. The majority of subjects diagnosed with type 1 diabetes through the DPT-1 were asymptomatic at onset and had normal fasting glucose and A1C levels. This suggests that intermittent screening (IA followed by OGTT) may allow diagnosis of diabetes before severe metabolic decompensation. Screening with A1C will miss identifying many of the subjects with newly diagnosed type 1 diabetes in this cohort.

Early immunotherapy using autologous adult stem cells reversed the effect of anti-pancreatic islets in recently diagnosed type 1 diabetes mellitus: preliminary results.

PubMed

Mesples, Alejandro; Majeed, Nasir; Zhang, Yun; Hu, Xiang

2013-10-14

Bone marrow stem cell treatment has been proven a promising therapeutic strategy and showed significant results given the strong immune modulating properties. We have investigated the safety and efficacy of autologous bone marrow stem cell transplantation through liver puncture in two patients with recently diagnosed type 1 diabetes mellitus. The procedure was approved by the Institutional Ethics Committee. In 2011, in three young patients, type 1 diabetes mellitus diagnosis was confirmed, with the presence of positive antibodies and ketoacidosis. Two patients was treated with autologous bone marrow stem cell stimulated with filgrastim and transplantation, through liver puncture, as immune modulators. One patients was treated with conventional treatment and participate in this experiment as a control group. The families of the patients signed the informed consent. No specific statistical analysis was performed. The patients had less than 8 years old, diagnosis of type 1 diabetes for less than 60 days, body mass index less than 22 kg/m2, normal complete blood count, coagulation and renal function, no lesions in target organs, glycosylated hemoglobin (HbA1c) level less than 13.70%, c-peptide level less than 0.67 ng/ml, positive results of Islets Cells Antibody (ICA), Glutamic Acid Decarboxylase (GAD) and insulin antibody. In two patients treated, the follow up at 12 months showed negative value in ICA, GAD and anti insulin antibody levels, with an increased levels of c peptide and decreased levels of blood glucose and HbA1c. Treatment with autologous bone marrow stem cells is easy and effective as it reversed the production and effect of anti pancreatic islet antibody and significantly resulted in an increased c-peptide concentration.

Effects of Mediterranean diet on sexual function in people with newly diagnosed type 2 diabetes: The MÈDITA trial.

PubMed

Maiorino, Maria Ida; Bellastella, Giuseppe; Caputo, Mariangela; Castaldo, Filomena; Improta, Maria Rosaria; Giugliano, Dario; Esposito, Katherine

To assess the long-term effect of Mediterranean diet, as compared with low-fat diet, on sexual function in patients with newly diagnosed type 2 diabetes. In a randomized clinical trial, with a total follow-up of 8.1years, 215 men and women with newly diagnosed type 2 diabetes were assigned to Mediterranean diet (n=108) or a low-fat diet (n=107). The primary outcome measures were changes of erectile function (IIEF) in diabetic men and of female sexual function (FSFI) in diabetic women. There was no difference in baseline sexual function in men (n=54 vs 52) or women (n=54 vs 55) randomized to Mediterranean diet or low-fat diet, respectively (P=0.287, P=0.815). Over the entire follow-up, the changes of the primary outcomes were significantly lower in the Mediterranean diet group compared with the low-fat group: IIEF and FSFI showed a significantly lesser decrease (1.22 and 1.18, respectively, P=0.024 and 0.019) with the Mediterranean diet. Baseline C-reactive protein levels predicted erectile dysfunction in men but not female sexual dysfunction in women. Among persons with newly diagnosed type 2 diabetes, a Mediterranean diet reduced the deterioration of sexual function over time in both sexes. Copyright © 2016 Elsevier Inc. All rights reserved.

Genetic risk score of common genetic variants for impaired fasting glucose and newly diagnosed type 2 diabetes influences oxidative stress.

PubMed

Kim, Minjoo; Kim, Minkyung; Huang, Limin; Jee, Sun Ha; Lee, Jong Ho

2018-05-18

We tested the hypothesis that the cumulative effects of common genetic variants related to elevated fasting glucose are collectively associated with oxidative stress. Using 25 single nucleotide polymorphisms (SNPs), a weighted genetic risk score (wGRS) was constructed by summing nine risk alleles based on nominal significance and a consistent effect direction in 1,395 controls and 718 patients with impaired fasting glucose (IFG) or newly diagnosed type 2 diabetes. All the participants were divided into the following three groups: low-wGRS, middle-wGRS, and high-wGRS groups. Among the nine SNPs, five SNPs were significantly associated with IFG and type 2 diabetes in this Korean population. wGRS was significantly associated with increased IFG and newly diagnosed type 2 diabetes (p = 6.83 × 10 -14 , odds ratio = 1.839) after adjusting for confounding factors. Among the IFG and type 2 diabetes patients, the fasting serum glucose and HbA 1c levels were significantly higher in the high-wGRS group than in the other groups. The urinary 8-epi-PGF 2α and malondialdehyde concentrations were significantly higher in the high-wGRS group than in the other groups. Moreover, general population-level instrumental variable estimation (using wGRS as an instrument) strengthened the causal effect regarding the largely adverse influence of high levels of fasting serum glucose on markers of oxidative stress in the Korean population. Thus, the combination of common genetic variants with small effects on IFG and newly diagnosed type 2 diabetes are significantly associated with oxidative stress.

The clinical characteristics of patients with mitochondrial tRNA Leu(UUR)m.3243A > G mutation: Compared with type 1 diabetes and early onset type 2 diabetes.

PubMed

Zhu, Jie; Yang, Peng; Liu, Xiang; Yan, Li; Rampersad, Sharvan; Li, Feng; Li, Hong; Sheng, Chunjun; Cheng, Xiaoyun; Zhang, Manna; Qu, Shen

2017-08-01

This study presents nine patients with mitochondrial tRNA Leu (UUR) m.3243A>G mutation and compares the clinical characteristics and diabetes complications with type 1 diabetes (T1DM) or early onset type 2 diabetes (T2DM). The study covers 9 patients with MIDD, 33 patients with T1DM and 86 patients (age of onset ≤35years) with early onset T2DM, matched for sex, age at onset of diabetes, duration of diabetes. All patients with MIDD were confirmed as carrying the m.3243A>G mitochondrial DNA mutation. Serum HbA1c, beta-cell function, retinal and renal complications of diabetes, bone metabolic markers, lumbar spine and femoral neck BMD bone mineral density were compared to characterize the clinical features of all patients. Nine patients were from five unrelated families, and the mean (SD) onset age of those patients was 31.2±7.2year. Two patients required insulin at presentation, and six patients progressed to insulin requirement after a mean of 7.2years. β-Cell function in the MIDD group was intermediate between T1DM and early-onset T2DM. In MIDD, four patients were diagnosed as diabetic retinopathy (4/9) and five patients (5/9) had macroalbuminuria. The number of patients with diabetic retinopathy and macroalbuminuria in the MIDD group was comparable to T1DM or early-onset T2DM. The rate of osteoporosis (BMD T-score<-2.5 SD) in the patient with MIDD was higher than the T1DM or early-onset T2DM group. Our study indicates that of the nine subjects with MIDD, three patients (1-II-1, 1-II-3, 1-II-4) who came from the same family had a history of acute pancreatitis. Compared with T1DM or early-onset T2DM matched for sex, age, duration of diabetes, MIDD patients had the highest rate of osteoporosis. Copyright © 2017 Elsevier Inc. All rights reserved.

The TESIS Project: Revealing Massive Early-Type Galaxies at z > 1

NASA Astrophysics Data System (ADS)

Saracco, P.; Longhetti, M.; Severgnini, P.; Della Ceca, R.; Braito, V.; Bender, R.; Drory, N.; Feulner, G.; Hopp, U.; Mannucci, F.; Maraston, C.

How and when present-day massive early-type galaxies built up and what type of evolution has characterized their growth (star formation and/or merging) still remain open issues. The different competing scenarios of galaxy formation predict much different properties of early-type galaxies at z > 1. The "monolithic" collapse predicts that massive spheroids formed at high redshift (z > 2.5-3) and that their comoving density is constant at z < 2.5-3 since they evolve only in luminosity. On the contrary, in the hierarchical scenario massive spheroids are built up through subsequent mergers reaching their final masses at z < 1.5 [3,5]. As a consequence, massive systems are very rare at z > 1, their comoving density decreases from z = 0 to z ~ 1.5 and they should experience their last burst of star formation at z < 1.5, concurrent with the merging event(s) of their formation. These opposed predicted properties of early-types at z > 1 can be probed observationally once a well defined sample of massive early-types at z > 1 is available. We are constructing such a sample through a dedicated near-IR very low resolution (λ/Δλ≃50) spectroscopic survey (TNG EROs Spectroscopic Identification Survey, TESIS, [6]) of a complete sample of 30 bright (K < 18.5) Extremely Red Objects (EROs).

Comparison of Acarbose and Metformin on Albumin Excretion in Patients With Newly Diagnosed Type 2 Diabetes

PubMed Central

Pan, Qingrong; Xu, Yuan; Yang, Ning; Gao, Xia; Liu, Jia; Yang, Wenying; Wang, Guang

2016-01-01

Abstract Increased urinary albumin excretion in diabetes not only signals nephropathy but also serves as a risk marker for cardiovascular disease. The data of MARCH (Metformin and AcaRbose in Chinese as the initial Hypoglycaemic treatment) trial demonstrated that acarbose and metformin were similarly efficacious at lowering blood glucose and blood pressure, as well as improving insulin sensitivity in Chinese patients newly diagnosed with type 2 diabetes mellitus. The purpose of this study was to identify the effects of acarbose and metformin therapy on albumin excretion in MARCH study. Baseline urine albumin/creatinine ratio (ACR) of 762 newly diagnosed, drug-naïve patients with type 2 diabetes mellitus was measured. Included patients were randomized to receive either acarbose or metformin and followed for 48 weeks. In addition to change in ACR, the estimated glomerular filtration rates (eGFR) and frequency of metabolic syndrome (MetS) were also assessed. Elevated ACR levels (≥30 mg/g) were present at baseline in 21.9% of all participants. A significant decline in urine ACR was observed in both the acarbose and metformin groups at week 24 and 48 (all P < 0.001). The proportion of patients with elevated ACRs was also reduced in both treatment groups at week 24 and 48 compared with baseline values (all P < 0.05). The change in urine ACR at week 48 was significantly greater in patients prescribed acarbose than in those prescribed metformin (P = 0.01). Both acarbose and metformin significantly decreased the frequency of MetS at week 24 and 48 (both P < 0.05). Neither treatment affected eGFR. In sum, both acarbose and metformin decreased urine ACR levels and reduced the frequency of elevated ACR and MetS in Chinese patients with newly diagnosed type 2 diabetes mellitus without affecting eGFR. After 48 weeks’ intervention, acarbose therapy resulted in a greater reduction in urine ACR compared with metformin. PMID:27057866

Nuclear magnetic resonance lipoprotein abnormalities in newly-diagnosed type 2 diabetes and their association with preclinical carotid atherosclerosis.

PubMed

Amor, Antonio J; Catalan, Marta; Pérez, Antonio; Herreras, Zoe; Pinyol, Montserrat; Sala-Vila, Aleix; Cofán, Montserrat; Gilabert, Rosa; Ros, Emilio; Ortega, Emilio

2016-04-01

Atherogenic dyslipidemia is common in type 2 diabetes (T2DM) and predicts cardiovascular disease, but information on the association of its components with atherosclerosis is scarce. We aimed to assess differences in the lipoprotein profile in newly-diagnosed T2DM and matched control individuals and their associations with preclinical carotid atherosclerosis. In a case-control study, we evaluated lipoprotein profiles by nuclear magnetic resonance (NMR) spectroscopy and determined carotid intima-media thickness (IMT) and plaque presence (IMT ≥1.5 mm) by B-mode ultrasonography. We assessed 96 T2DM patients (median age 63 years, 44% women, 19% smokers, 54% hypertension, 38% dyslipidemia) and 90 non-diabetic controls matched for age, sex, and cardiovascular risk factors. In T2DM VLDL-particles (mainly large and enriched in cholesterol and triglycerides) were increased, and large HDL-particles (enriched in triglycerides and depleted in cholesterol) were reduced (p < 0.05; all comparisons). Regarding associations with preclinical atherosclerosis, VLDL triglyceride content (odds ratio [OR], 8.975; 95% confidence interval [CI], 2.330-34.576), total number of VLDL particles (OR, 2.713; CI, 1.601-4.598) and VLDL size (OR, 2.044; CI, 1.320-3.166), and the ratio cholesterol/triglycerides in HDL (OR, 0.638; CI, 0.477-0.852) were associated with plaque burden (≥3 plaques) independently of confounders, including conventional lipid levels. NMR-assessed advanced lipoprotein profile identifies lipid abnormalities associated with newly-diagnosed T2DM and preclinical atherosclerosis that are not captured by the traditional lipid profile. At this early stage of diabetes, NMR lipoproteins could be useful to identify candidates for a more comprehensive cardiovascular risk prevention strategy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Early prenatal diagnosis of a lumbo-costo-vertebral syndrome.

PubMed

Pristavu, Anda Ioana; Furnica, Cristina; Ifrim, Mona Mihaela; Popovici, Razvan Mihai

2018-04-01

Lumbo-costo-vertebral syndrome (LCVS) is a rare type of lumbar hernia with associated abnormalities of the vertebral bodies, ribs, and trunk muscles. Only a few cases have been reported in the literature, all of which were diagnosed after birth. We present a case of LCVS diagnosed early in the second trimester of pregnancy using two- and three-dimensional ultrasound. In our case, the associated anomalies were: multiple costovertebral anomalies, lumbar hernia, anal imperforation, left hand supernumerary digit, and clubfoot.

Mullen scales of early learning: the utility in assessing children diagnosed with autism spectrum disorders, cerebral palsy, and epilepsy.

PubMed

Burns, Thomas G; King, Tricia Z; Spencer, Katherine S

2013-01-01

A group of 47 patients diagnosed with neurodevelopmental disorders were compared to 47 age-, gender-, and racially matched typically developing children to examine the frequency of impairment across domains of the Mullen Scales of Early Learning (MSEL). The MSEL is a comprehensive measure of cognitive functioning designed to assess infants and preschool children between the ages of birth to 68 months. In the neurodevelopmental group, the sample was composed of children 2 to 4 years of age who were diagnosed with autism spectrum disorders (ASD; n = 19), cerebral palsy (CP; n = 14), and epilepsy (EPI; n = 14). A sample of 47 matched controls, taken from the normative sample of the MSEL, was used as a comparison group. Each one of the clinical groups comprising the neurodevelopmental sample demonstrated statistically significant delays across domains relative to the respective matched control group (p < .001). Children failed to demonstrate a "signature" profile for a diagnosis of ASD, CP, or EPI. The clinical sensitivity of the MSEL and the need for obtaining specific intervention services for children diagnosed with these conditions are presented. Finally, these results are discussed within the context of the clinical sensitivity of the MSEL in working with these clinical populations.

Myotonic Dystrophy Type 2 Found in Two of Sixty-Three Persons Diagnosed as Having Fibromyalgia

PubMed Central

Auvinen, Satu; Suominen, Tiina; Hannonen, Pekka; Bachinski, Linda L.; Krahe, Ralf; Udd, Bjarne

2008-01-01

Because of its high prevalence, fibromyalgia (FM) is a major general health issue. Myotonic dystrophy type 2 (DM2) is a recently described autosomal-dominant multisystem disorder. Besides variable proximal muscle weakness, myotonia, and precocious cataracts, muscle pain and stiffness are prominent presenting features of DM2. After noting that several of our mutation-positive DM2 patients had a previous diagnosis of FM, suggesting that DM2 may be misdiagnosed as FM, we invited 90 randomly selected patients diagnosed as having FM to undergo genetic testing for DM2. Of the 63 patients who agreed to participate, 2 (3.2%) tested positive for the DM2 mutation. Their cases are described herein. DM2 was not found in any of 200 asymptomatic controls. We therefore suggest that the presence of DM2 should be investigated in a large sample of subjects diagnosed as having FM, and clinicians should be aware of overlap in the clinical presentation of these 2 distinct disorders. PMID:18975316

Early-life exposure to substance abuse and risk of type 2 diabetes in adulthood.

PubMed

Vaiserman, A M

2015-08-01

Type 2 diabetes (T2D) is a chronic non-communicable disease that is driven by insulin resistance as a result of increasing obesity and decreasing activity levels that occur with increasing age. This disease generally develops after the age of 40, but it is now increasingly diagnosed in children and young adults. Increasing evidence, however, suggests that T2D can originate during early development. It has been repeatedly found that malnutrition during the gestational period can result in intrauterine growth restriction and low birth weight, which in combination with postnatal catch-up growth may subsequently lead to the development of T2D. There is ample evidence that T2D may also be programmed by maternal substance abuse (the harmful use of psychoactive substances such as illicit drugs or alcohol) during pregnancy and/or lactation. The research activity in this field is currently mainly focused on the childhood health problems following prenatal exposures to substance abuse. The delayed programming effects on adult-onset disorders, including metabolic syndrome and T2D, however, have been reported only rarely. This review provides animal and human evidence that early-life exposure to substance abuse, including alcohol, nicotine, and cocaine, may program not only childhood health outcomes but also life-long metabolic health status, including risk of T2D and related conditions.

Discovery of the Kinematic Alignment of Early-type Galaxies in the Virgo Cluster

NASA Astrophysics Data System (ADS)

Kim, Suk; Jeong, Hyunjin; Lee, Jaehyun; Lee, Youngdae; Joo, Seok-Joo; Kim, Hak-Sub; Rey, Soo-Chang

2018-06-01

Using the kinematic position angles (PAkin), an accurate indicator for the spin axis of a galaxy, obtained from the ATLAS3D integral-field-unit (IFU) spectroscopic data, we discovered that 57 Virgo early-type galaxies tend to prefer the specific PAkin values of 20° and 100°, suggesting that they are kinematically aligned with each other. These kinematic alignment angles are further associated with the directions of the two distinct axes of the Virgo cluster extending east–west and north–south, strongly suggesting that the two distinct axes are the filamentary structures within the cluster as a trace of infall patterns of galaxies. Given that the spin axis of a massive early-type galaxy does not change easily even in clusters from the hydrodynamic simulations, Virgo early-type galaxies are likely to fall into the cluster along the filamentary structures while maintaining their angular momentum. This implies that many early-type galaxies in clusters are formed in filaments via major mergers before subsequently falling into the cluster. Investigating the kinematic alignment in other clusters will allow us to understand the formation of galaxy clusters and early-type galaxies.

The stellar populations of nearby early-type galaxies

NASA Astrophysics Data System (ADS)

Concannon, Kristi Dendy

The recent completion of comprehensive photometric and spectroscopic galaxy surveys has revealed that early-type galaxies form a more heterogeneous family than previously thought. To better understand the star formation histories of early-type galaxies, we have obtained a set of high resolution, high signal-to-noise ratio spectra for a sample of 180 nearby early-type galaxies with the FAST spectrograph and the 1.5m telescope at F. L. Whipple Observatory. The spectra cover the wavelength range 3500 5500 Å which allows the comparison of various Balmer lines, most importantly the higher order lines in the blue, and have a S/N ratio higher than that of previous samples, which makes it easier to investigate the intrinsic spread in the observed parameters. The data set contains galaxies in both the local field and Virgo cluster environment and spans the velocity dispersion range 50 < log σ < 250km s -1. In conjunction with recent improvements in population synthesis modeling, our data set enables us to investigate the star formation history of E/S0 galaxies as a function of mass (σ), environment, and to some extent morphology. We are able to probe the effects of age and metallicity on fundamental observable relations such as the Mg-σ relation, and show that there is a significant spread in age in such diagrams, at all log σ, such that their “uniformity” can not be interpreted as a homogeneous history for early-type galaxies. Analyzing the age and [Fe/H] distribution as a function of the galaxy mass, we find that an age-σ relation exists among galaxies in both the local field and the Virgo cluster, such that the lower log σ galaxies have younger luminosity-weighted mean ages. The age spread of the low σ galaxies suggests that essentially all of the low-mass galaxies contain young to intermediate age populations, whereas the spread in age of the high log σ galaxies (log σ >˜ 2.0) is much larger, with galaxies spanning the age range of 4 19 Gyr. Thus, rather

Risk factors of early proximal gastric carcinoma in Chinese diagnosed using WHO criteria.

PubMed

Fang, Cheng; Huang, Qin; Lu, Lin; Shi, Jiong; Sun, Qi; Xu, Gui Fang; Gold, Jason; Mashimo, Hiroshi; Zou, Xiao Ping

2015-06-01

The incidence of proximal gastric carcinoma (PGC) is rising worldwide for unknown reasons. Herein we compare the risk factors of early PGC with distal gastric carcinoma (DGC) in patients treated at a single tertiary hospital in China. Risk factors of 379 consecutive surgically resected early gastric carcinoma (EGC) diagnosed according to the 2010 World Health Organization criteria were studied by reviewing their medical records and esophagogastroduodenoscopy/biopsy findings and interviewing patients and family members for the patients' history of environmental toxin exposure (ETE), dietary habits, family (FCH) and personal cancer history (PCH) and survival. Differences between PGC (n = 115), DGC (n = 264) and age-matched and gender-matched controls (n = 225) were compared. Proportion of early PGC in all EGC patients was increased significantly (P < 0.05). The independent risk factors for both PGC and DGC identified by multivariate analysis were intake of preserved food and little fruit, and gastric mucosal intestinal metaplasia and atrophy (all P < 0.05). Advanced age (odds ratio [OR] 9.83, P < 0.01), PCH (OR 5.09, P < 0.05), a high body mass index (>24 kg/m(2) ) (OR 2.79, P < 0.01) and ETE (OR 2.31, P < 0.05) were independent risk factors for PGC, but not male gender, tobacco or alcohol abuse, hiatus hernia, gastroesophageal reflux disease or columnar-lined esophagus. In contrast, FCH (OR 2.34, P < 0.01) and Helicobacter pylori infection (OR 2.81, P < 0.001) were independent risk factors for DGC. Independent risk factors for PGC in Chinese patients differ from those of DGC or esophageal adenocarcinoma, supporting the classification of PGC as a separate gastric carcinoma entity in the Chinese populations. © 2015 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Diagnosing Chronic Pancreatitis.

PubMed

Anaizi, Ahmad; Hart, Phil A; Conwell, Darwin L

2017-07-01

Diagnosing CP can range from routine in those with severe disease and obvious calcifications on CT imaging to elusive in those patients with early changes in CP. The workup of suspected CP should follow a progressively noninvasive to more invasive STEP-wise approach in a patient with a suspicious clinical presentation and risk factors that raise their pretest probability of disease. After a thorough history and physical examination, basic laboratories should be obtained such as lipase, amylase, metabolic panel, and indirect PFTs (fecal elastase-1, serum trypsin). Computed tomography remains the best initial imaging modality to obtain as it has good sensitivity for severe CP and may obviate the need for other diagnostic tests. When equivocal, an MRCP should be obtained for a more detailed evaluation of the both the pancreatic parenchyma and ducts. If the diagnosis remains in doubt, EUS should be performed with or without pancreas function testing. ERCP remains a last-line diagnostic test and seldom should be used outside of therapeutic purposes. Future advances should target optimizing current diagnostic tools to more accurately diagnose early CP, as it is in this population where the benefits of delaying progression of CP may have the most profound effect. Likely the best way at establishing a diagnosis in these patients is via pancreatic function testing in the setting of indeterminate EUS results. Biomarker studies of pancreas fluid may supplement diagnosis.

Parents as Discerning Consumers at Three Types of Early Childhood Centres.

ERIC Educational Resources Information Center

Farquhar, Sarah-Eve

Parents' views on the goals of early childhood programs and on characteristics of a high quality center were examined in a study that also investigated parents' understandings of quality in three different types of early childhood services. The study was part of a major project on the quality of early childhood centers, which was funded by the New…

Dwarf galaxy populations in present-day galaxy clusters - II. The history of early-type and late-type dwarfs

NASA Astrophysics Data System (ADS)

Lisker, Thorsten; Weinmann, Simone M.; Janz, Joachim; Meyer, Hagen T.

2013-06-01

How did the dwarf galaxy population of present-day galaxy clusters form and grow over time? We address this question by analysing the history of dark matter subhaloes in the Millennium II cosmological simulation. A semi-analytic model serves as the link to observations. We argue that a reasonable analogue to early morphological types or red-sequence dwarf galaxies are those subhaloes that experienced strong mass-loss, or alternatively those that have spent a long time in massive haloes. This approach reproduces well the observed morphology-distance relation of dwarf galaxies in the Virgo and Coma clusters, and thus provides insight into their history. Over their lifetime, present-day late types have experienced an amount of environmental influence similar to what the progenitors of dwarf ellipticals had already experienced at redshifts above 2. Therefore, dwarf ellipticals are more likely to be a result of early and continuous environmental influence in group- and cluster-size haloes, rather than a recent transformation product. The observed morphological sequences of late-type and early-type galaxies have developed in parallel, not consecutively. Consequently, the characteristics of today's late-type galaxies are not necessarily representative for the progenitors of today's dwarf ellipticals. Studies aiming to reproduce the present-day dwarf population thus need to start at early epochs, model the influence of various environments, and also take into account the evolution of the environments themselves.

[New mutation in a young woman diagnosed with Niemann-Pick disease type C].

PubMed

Lario, Ana; de Miguel, Carlos; Ojeda, Emilio; Gil, Santiago; Coll, María J; Alfonso, Pilar

2016-06-03

To describe a new molecular variant of Niemann-Pick disease type C (NPC) in a 27 year-old patient with splenomegaly and abolition of osteotendinous reflexes. NPC1 is the main gene with described mutation in NPC disease. Here we report a case with a new mutation, p.N916S, not described before in a patient diagnosed with NPC. p.N916S was described as a cause of NPC disease by predictive programmes Mutation Master, PolyPhen2 and SIFT. p.N916S is a new mutation detected as a cause of NPC disease in a patient without severe neurological symptoms. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Patients With Newly Diagnosed Hypertension Treated With the Renin Angiotensin Receptor Blocker Azilsartan Medoxomil vs Angiotensin-Converting Enzyme Inhibitors: The Prospective EARLY Registry.

PubMed

Schmieder, Roland E; Potthoff, Sebastian A; Bramlage, Peter; Baumgart, Peter; Mahfoud, Felix; Buhck, Hartmut; Ouarrak, Taoufik; Ehmen, Martina; Senges, Jochen; Gitt, Anselm K

2015-12-01

For patients with newly diagnosed hypertension, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are usually the first-line therapies. There is, however, no real-life data regarding the relative clinical effectiveness and tolerability of either drug class. The prospective registry, Treatment With Azilsartan Compared to ACE Inhibitors in Antihypertensive Therapy (EARLY), was conducted to evaluate the effectiveness of the ARB azilsartan medoxomil (AZL-M) vs ACE inhibitors in real-world patients. Of the 1153 patients with newly diagnosed hypertension who were included in the registry, 789 were prescribed AZL-M and 364 were prescribed an ACE inhibitor. After multivariate adjustment, AZL-M was found to provide superior blood pressure reduction and better target blood pressure (<140/90 mm Hg) achievement. The proportion of patients with adverse events was not statistically different between groups. The authors conclude that in newly diagnosed hypertensive patients, AZL-M provides superior blood pressure control with a similar safety profile compared with ACE inhibitors. © 2015 Wiley Periodicals, Inc.

The distribution of early- and late-type galaxies in the Coma cluster

NASA Technical Reports Server (NTRS)

Doi, M.; Fukugita, M.; Okamura, S.; Turner, E. L.

1995-01-01

The spatial distribution and the morohology-density relation of Coma cluster galaxies are studied using a new homogeneous photmetric sample of 450 galaxies down to B = 16.0 mag with quantitative morphology classification. The sample covers a wide area (10 deg X 10 deg), extending well beyond the Coma cluster. Morphological classifications into early- (E+SO) and late-(S) type galaxies are made by an automated algorithm using simple photometric parameters, with which the misclassification rate is expected to be approximately 10% with respect to early and late types given in the Third Reference Catalogue of Bright Galaxies. The flattened distribution of Coma cluster galaxies, as noted in previous studies, is most conspicuously seen if the early-type galaxies are selected. Early-type galaxies are distributed in a thick filament extended from the NE to the WSW direction that delineates a part of large-scale structure. Spiral galaxies show a distribution with a modest density gradient toward the cluster center; at least bright spiral galaxies are present close to the center of the Coma cluster. We also examine the morphology-density relation for the Coma cluster including its surrounding regions.

Cost-effectiveness of statins for primary prevention in patients newly diagnosed with type 2 diabetes in the Netherlands.

PubMed

de Vries, Folgerdiena M; Denig, Petra; Visser, Sipke T; Hak, Eelko; Postma, Maarten J

2014-03-01

Statins are lipid-lowering drugs that reduce the risk of cardiovascular events in patients with diabetes. The objective of this study was to determine whether statin treatment for primary prevention in newly diagnosed type 2 diabetes is cost-effective, taking nonadherence, baseline risk, and age into account. A cost-effectiveness analysis was performed by using a Markov model with a time horizon of 10 years. The baseline 10-year cardiovascular risk was estimated in a Dutch population of primary prevention patients with newly diagnosed diabetes from the Groningen Initiative to Analyse Type 2 Diabetes Treatment (GIANTT) database, using the United Kingdom Prospective Diabetes Study risk engine. Statin adherence was measured as pill days covered in the IADB.nl pharmacy research database. Cost-effectiveness was measured in costs per quality-adjusted life-year (QALY) from the health care payers' perspective. For an average patient aged 60 years, the base case, statin treatment was highly cost-effective at €2245 per QALY. Favorable cost-effectiveness was robust in sensitivity analysis. Differences in age and 10-year cardiovascular risk showed large differences in cost-effectiveness from almost €100,000 per QALY to almost being cost saving. Treating all patients younger than 45 years at diabetes diagnosis was not cost-effective (weighted cost-effectiveness of almost €60,000 per QALY). Despite the nonadherence levels observed in actual practice, statin treatment is cost-effective for primary prevention in patients newly diagnosed with type 2 diabetes. Because of large differences in cost-effectiveness according to different risk and age groups, the efficiency of the treatment could be increased by targeting patients with relatively higher cardiovascular risk and higher ages. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Healthcare professionals' views of group structured education for people with newly diagnosed Type 2 diabetes.

PubMed

Winkley, K; Upsher, R; Keij, S M; Chamley, M; Ismail, K; Forbes, A

2018-04-06

To determine healthcare professionals' (HCP) views of group structured education for people with newly diagnosed Type 2 diabetes. This was a qualitative study using semi-structured interviews to ascertain primary care HCPs' views and experiences of education for people with newly diagnosed Type 2 diabetes. A thematic framework method was applied to analyse the data. Participants were HCPs (N = 22) from 15 general practices in three south London boroughs. All but one HCP viewed diabetes education favourably and all identified that low attendance was a problem. Three key themes emerged from the qualitative data: (1) benefits of diabetes education, including the group mode of delivery, improved patient interactions, saving HCPs' time and improved patient outcomes; (2) factors limiting uptake of education, including patient-level problems such as access and the appropriateness of the programme for certain groups, and difficulties communicating the benefits to patients and integration of education management plans into ongoing diabetes care; and (3) suggestions for improvement, including strategies to improve attendance at education with more localized and targeted marketing and enhanced programme content including follow-up sessions and support for people with pre-existing psychological issues. Most HCPs valued diabetes education and all highlighted the lack of provision for people with different levels of health literacy. Because there was wide variation in terms of the level of knowledge regarding the education on offer, future studies may want to focus on how to help HCPs encourage their patients to attend. © 2018 Diabetes UK.

Early onset type 2 diabetes: risk factors, clinical impact and management

PubMed Central

Idris, Iskandar

2014-01-01

Early onset type 2 diabetes mellitus (T2DM) is increasingly prevalent with a significant impact on the individual, healthcare service delivery and planning. The individuals are likely to be obese, lead a sedentary lifestyle, have a strong family history of T2DM, be of black and minority ethnic (BME) origin and come from a less affluent socioeconomic group. They have a heightened risk of developing microvascular and macrovascular complications, often at an earlier stage and with greater frequency than seen in type 1 diabetes. As such, early and aggressive risk factor management is warranted. Early onset T2DM is complex and impacts on service delivery with a need for multidisciplinary care of complications and comorbidities’, in addition to adequate educational and psychological support. This review on the impact of early onset T2DM provides the latest insights into this emerging epidemic. PMID:25364491

Challenges in everyday life among recently diagnosed and more experienced adults with type 2 diabetes: a multistage focus group study.

PubMed

Gardsten, Cecilia; Blomqvist, Kerstin; Rask, Mikael; Larsson, Åse; Lindberg, Agneta; Olsson, Gith

2018-03-01

The aim of this study was to identify perceived challenges related to self-management among recently diagnosed adults and those with longer experience of type 2 diabetes as a foundation for the future development of a person-centred information and communication technology service. Learning self-management of type 2 diabetes includes mastering the skills required to complete complex emotional and physical tasks. A service developed with the participation of stakeholders may be an alternative way to meet rising needs for self-management. Qualitative descriptive design influenced by a participatory approach. Multistage focus group interviews among one group of recently diagnosed (≤3yrs, n=4) adults and one group with longer experience (≥5yrs, n=7) of type 2 diabetes. Challenges in self-management in everyday life with type 2 diabetes were identified: understanding; developing skills and abilities; and mobilizing personal strengths. Both groups described challenges in understanding the causes of fluctuating blood glucose and in, developing and mobilizing skills for choosing healthful food and eating regularly. The recently diagnosed group was more challenged by learning to accept the diagnosis and becoming motivated to change habits while the experienced group was mainly challenged by issues about complications and medications. Adults with diabetes have different needs for support during different phases of the disease. From a person-centred perspective, it would be desirable to meet individual needs for self-management on peoples' own terms through a technological service that could reach and connect to a large number of people. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Content validity of the PedsQL™ 3.2 Diabetes Module in newly diagnosed patients with Type 1 diabetes mellitus ages 8-45.

PubMed

Varni, James W; Curtis, Bradley H; Abetz, Linda N; Lasch, Kathryn E; Piault, Elisabeth C; Zeytoonjian, Andrea A

2013-10-01

The content validity of the 28-item PedsQL™ 3.0 Diabetes Module has not been established in research on pediatric and adult patients with newly diagnosed Type 1 diabetes across a broad age range. This study aimed to document the content validity of three age-specific versions (8-12 years, 13-18 years, and 18-45 years) of the PedsQL™ Diabetes Module in a population of newly diagnosed patients with Type 1 diabetes. The study included in-depth interviews with 31 newly diagnosed patients with Type 1 diabetes between the ages of 8 and 45 years, as well as 14 parents and/or caregivers of child and teenage patients between the ages of 8 and 18 years of age; grounded theory data collection and analysis methods; and review by clinical and measurement experts. Following the initial round of interviews, revisions reflecting patient feedback were made to the Child and Teen versions of the Diabetes Module, and an Adult version of the Diabetes Module was drafted. Cognitive interviews of the modified versions of the Diabetes Module were conducted with an additional sample of 11 patients. The results of these interviews support the content validity of the modified 33-item PedsQL™ 3.2 Diabetes Module for pediatric and adult patients, including interpretability, comprehensiveness, and relevance suitable for all patients with Type 1 Diabetes. Qualitative methods support the content validity of the modified PedsQL™ 3.2 Diabetes Module in pediatric and adult patients. It is recommended that the PedsQL™ 3.2 Diabetes Module replaces version 3.0 and is suitable for measuring patient-reported outcomes in all patients with newly diagnosed, stable, or long-standing diabetes in clinical research and practice.

Selective Attention in Early Dementia of Alzheimer Type

ERIC Educational Resources Information Center

Fernandez-Duque, Diego; Black, Sandra E.

2008-01-01

This study explored possible deficits in selective attention brought about by Dementia of Alzheimer Type (DAT). In three experiments, we tested patients with early DAT, healthy elderly, and young adults under low memory demands to assess perceptual filtering, conflict resolution, and set switching abilities. We found no evidence of impaired…

No evidence of early head circumference enlargements in children later diagnosed with autism in Israel.

PubMed

Dinstein, Ilan; Haar, Shlomi; Atsmon, Shir; Schtaerman, Hen

2017-01-01

Large controversy exists regarding the potential existence and clinical significance of larger brain volumes in toddlers who later develop autism. Assessing this relationship is important for determining the clinical utility of early head circumference (HC) measures and for assessing the validity of the early overgrowth hypothesis of autism, which suggests that early accelerated brain development may be a hallmark of the disorder. We performed a retrospective comparison of HC, height, and weight measurements between 66 toddlers who were later diagnosed with autism and 66 matched controls. These toddlers represent an unbiased regional sample from a single health service provider in the southern district of Israel. On average, participating toddlers had >8 measurements between birth and the age of two, which enabled us to characterize individual HC, height, and weight development with high precision and fit a negative exponential growth model to the data of each toddler with exceptional accuracy. The analyses revealed that HC sizes and growth rates were not significantly larger in toddlers with autism even when stratifying the autism group based on verbal capabilities at the time of diagnosis. In addition, there were no significant correlations between ADOS scores at the time of diagnosis and HC at any time-point during the first 2 years of life. These negative results add to accumulating evidence, which suggest that brain volume is not necessarily larger in toddlers who develop autism. We believe that conflicting results reported in other studies are due to small sample sizes, use of misleading population norms, changes in the clinical definition of autism over time, and/or inclusion of individuals with syndromic autism. While abnormally large brains may be evident in some individuals with autism and more clearly visible in MRI scans, converging evidence from this and other studies suggests that enlarged HC is not a common etiology of the entire autism population

Associations between content types of early media exposure and subsequent attentional problems.

PubMed

Zimmerman, Frederick J; Christakis, Dimitri A

2007-11-01

Television and video/DVD viewing among very young children has become both pervasive and heavy. Previous studies have reported an association between early media exposure and problems with attention regulation but did not have data on the content type that children watched. We tested the hypothesis that early television viewing of 3 content types is associated with subsequent attentional problems. The 3 different content types are educational, nonviolent entertainment, and violent entertainment. Participants were children in a nationally representative sample collected in 1997 and reassessed in 2002. The analysis was a logistic regression of a high score on a validated parent-reported measure of attentional problems, regressed on early television exposure by content and several important sociodemographic control variables. Viewing of educational television before age 3 was not associated with attentional problems 5 years later. However, viewing of either violent or non-violent entertainment television before age 3 was significantly associated with subsequent attentional problems, and the magnitude of the association was large. Viewing of any content type at ages 4 to 5 was not associated with subsequent problems. The association between early television viewing and subsequent attentional problems is specific to noneducational viewing and to viewing before age 3.

Young stellar populations in early-type galaxies in the Sloan Digital Sky Survey

NASA Astrophysics Data System (ADS)

Nolan, Louisa A.; Raychaudhury, Somak; Kabán, Ata

2007-02-01

We use a purely data-driven rectified factor analysis to identify early-type galaxies with recent star formation in Data Release 4 of the Sloan Digital Sky Survey Spectroscopic Catalogue. We compare the spectra and environment of these galaxies with those of `normal' early-type galaxies, and a sample of independently selected E+A galaxies. We calculate the projected local galaxy surface density from the nearest five and 10 neighbours (Σ5 and Σ10) for each galaxy in our sample, and find that the dependence on projected local density, of the properties of E+A galaxies, is not significantly different from that of early-type galaxies with young stellar populations, dropping off rapidly towards denser environments, and flattening off at densities <~0.1-0.3 Mpc-2. The dearth of E+A galaxies in dense environments confirms that E+A galaxies are most likely the products of galaxy-galaxy merging or interactions, rather than star-forming galaxies whose star formation has been quenched by processes unique to dense environments, such as ram-pressure stripping or galaxy harassment. We see a tentative peak in the number of E+A galaxies at Σ10 ~ 0.1-0.3 Mpc-2, which may represent the local galaxy density at which the rate of galaxy-galaxy merging or interaction rate peaks. Analysis of the spectra of our early-type galaxies with young stellar populations suggests that they have a stellar component dominated by F stars, ~1-4 Gyr old, together with a mature, metal-rich population characteristic of `typical' early-type galaxies. The young stars represent >~10 per cent of the stellar mass in these galaxies. This, together with the similarity of the environments in which this `E+F' population and the E+A galaxy sample are found, suggests that E+F galaxies used to be E+A galaxies, but have evolved by a further ~ one to a few Gyr. Our rectified factor analysis is sensitive enough to identify this hidden population, which allows us to study the global and intrinsic properties of early-type

A randomised trial of early palliative care for maternal stress in infants prenatally diagnosed with single-ventricle heart disease.

PubMed

Hancock, Hayley S; Pituch, Ken; Uzark, Karen; Bhat, Priya; Fifer, Carly; Silveira, Maria; Yu, Sunkyung; Welch, Suzanne; Donohue, Janet; Lowery, Ray; Aiyagari, Ranjit

2018-04-01

Children with single-ventricle disease experience high mortality and complex care. In other life-limiting childhood illnesses, paediatric palliative care may mitigate maternal stress. We hypothesised that early palliative care in the single-ventricle population may have the same benefit for mothers. In this pilot randomised trial of early palliative care, mothers of infants with prenatal single-ventricle diagnoses completed surveys measuring depression, anxiety, coping, and quality of life at a prenatal visit and neonatal discharge. Infants were randomised to receive early palliative care - structured evaluation, psychosocial/spiritual, and communication support before surgery - or standard care. Among 56 eligible mothers, 40 enrolled and completed baseline surveys; 38 neonates were randomised, 18 early palliative care and 20 standard care; and 34 postnatal surveys were completed. Baseline Beck Depression Inventory-II and State-Trait Anxiety Index scores exceeded normal pregnant sample scores (mean 13.76±8.46 versus 7.0±5.0 and 46.34±12.59 versus 29.8±6.35, respectively; p=0.0001); there were no significant differences between study groups. The early palliative care group had a decrease in prenatal to postnatal State-Trait Anxiety Index scores (-7.6 versus 0.3 in standard care, p=0.02), higher postnatal Brief Cope Inventory positive reframing scores (p=0.03), and a positive change in PedsQL Family Impact Module communication and family relationships scores (effect size 0.46 and 0.41, respectively). In conclusion, these data show that mothers of infants with single-ventricle disease experience significant depression and anxiety prenatally. Early palliative care resulted in decreased maternal anxiety, improved maternal positive reframing, and improved communication and family relationships.

Implicit and Explicit Communal Coping in Couples with Recently Diagnosed Type 2 Diabetes

PubMed Central

Helgeson, Vicki S.; Jakubiak, Brittany; Seltman, Howard; Hausmann, Leslie; Korytkowski, Mary

2016-01-01

When an individual in a close relationship is diagnosed with a chronic illness, coping can be the responsibility of the patient, or couple-members can cope communally. Communal coping reflects a shared appraisal of a stressor (our problem instead of my problem) and collaborative efforts to address the stressor. The current study examined whether patients’ and partners’ communal coping levels were associated with relational and health functioning among 70 couples in which one member was recently diagnosed with type 2 diabetes. We assessed explicit communal coping with self-reported “inclusion of the other in the self” in regard to diabetes management and implicit communal coping with first person plural pronoun usage during a diabetes discussion. We also assessed patient reports of support received from partners, patient and partner psychological distress, and patient self-care behavior. Results showed that patient explicit communal coping was related to better patient relationship quality and greater support receipt from partners. Patient and partner explicit communal coping also were related to reduced partner distress but not patient distress. Instead, partner implicit communal coping was related to reduced patient distress. Most noteworthy, partner implicit communal coping was related to better patient self-care behavior. These results suggest that communal coping may be beneficial for both relationships and health, but that the effects of explicit measures differ from those of implicit measures. Patients might benefit especially from partner communal coping efforts that are less obvious. PMID:29225393

Cooling flows and X-ray emission in early-type galaxies

NASA Technical Reports Server (NTRS)

Sarazin, Craig L.

1990-01-01

The X-ray properties of normal early-type galaxies and the limited theoretical understanding of the physics of the hot interstellar medium in these galaxies are reviewed. A number of simple arguments about the physical state of the gas are given. Steady-state cooling flow models for these galaxies are presented, and their time-dependent evolution is discussed. The X-ray emission found in early-type galaxies indicates that they contain significant amounts of hot interstellar gas, and that they are not the gas-poor systems they were previously thought to be. In the brighter X-ray galaxies, the amounts of hot gas observed are consistent with those expected given the present rates of stellar mass loss. The required rates of heating of the gas are consistent with those expected from the motions of gas-losing stars and supernovae. The X-ray observations are generally more consistent with a lower rate of Type I supernovae than was previously thought.

Early-onset facioscapulohumeral muscular dystrophy type 1 with some atypical features.

PubMed

Dorobek, Małgorzata; van der Maarel, Silvère M; Lemmers, Richard J L F; Ryniewicz, Barbara; Kabzińska, Dagmara; Frants, Rune R; Gawel, Malgorzata; Walecki, Jerzy; Hausmanowa-Petrusewicz, Irena

2015-04-01

Facioscapulohumeral muscular dystrophy cases with facial weakness before the age of 5 and signs of shoulder weakness by the age of 10 are defined as early onset. Contraction of the D4Z4 repeat on chromosome 4q35 is causally related to facioscapulohumeral muscular dystrophy type 1, and the residual size of the D4Z4 repeat shows a roughly inverse correlation with the severity of the disease. Contraction of the D4Z4 repeat on chromosome 4q35 is believed to induce a local change in chromatin structure and consequent transcriptional deregulation of 4qter genes. We present early-onset cases in the Polish population that amounted to 21% of our total population with facioscapulohumeral muscular dystrophy. More than 27% of them presented with severe phenotypes (wheelchair dependency). The residual D4Z4 repeat sizes ranged from 1 to 4 units. In addition, even within early-onset facioscapulohumeral muscular dystrophy type 1 phenotypes, some cases had uncommon features (head drop, early disabling contractures, progressive ptosis, and respiratory insufficiency and cardiomyopathy). © The Author(s) 2014.

How are self-rated health and diagnosed disease related to early or deferred retirement? A cross-sectional study of employees aged 55-64.

PubMed

Nilsson, Kerstin; Hydbom, Anna Rignell; Rylander, Lars

2016-08-26

More people will probably continue working into old age in the future due to the increased size of aging populations in many countries. We therefore need to know more about older workers' health in relation to their work situation and retirement. This study is a part of a theoretical development of older workers' situations. Older workers' situations are theoretically themed in nine areas by the authors of this study. The aims of the study were to investigate the relationship between: i) diagnosed disease and factors in older workers' situations, theoretically themed in nine areas; ii) self-rated health and factors in older workers' situations, theoretically themed in nine areas; iii) diagnosed disease and self-rated health; and iv) the relationships between these health measures and retirement. A questionnaire-based cross-sectional study, using logistic regression, with 1,756 health care personnel aged 55-64 years. The questionnaire used gave an overview of most different areas in the older workers' situations. There was a difference in the participants' frequency of objectively specified diagnosed disease and their subjectively experienced self-rated health. A bad self-rated health was related higher to early retirement than diagnosed diseases. In the multivariate model, having 'Diagnosed disease' was not significantly related to whether older workers thought they could not work beyond 65 years of age. A bad 'Self-rated health' was also more highly related to whether older workers thought they could not work beyond 65 years, than if the respondents stated that a 'Diagnosed disease is a hindrance in my daily work' in the multivariate model. This study showed an important difference between older workers' own experiences and the effect of their self-rated health and their diagnosed diseases. Subjective self-rated health seems to be more important to people's retirement planning than diagnosed disease. The most important factors affecting older workers' self

[Types of child rearing behavior of parents during early childhood: Q-methodological approach].

PubMed

Park, Sun-Jung; Kang, Kyung-Ah; Kim, Shin-Jeong

2013-08-01

The purpose of this study was to identify the awareness of child rearing among parents of children in early childhood and to provide fundamental data for parent education programs according to child rearing type. Q-methodology which provides a method of analyzing the subjectivity of each item was used. Forty Q items which were derived from a literature review and interviews with nurturing mothers were classified into a normal distribution using a 9-point scale. Collected data were analyzed using the QUANAL PC Program. Four types of parents' child rearing were identified. Type I was named 'affection-respect type', type II, 'concern-rule compliant type', type III, 'solicitude-model type', and type IV, 'geniality-encouragement type'. For proper growth and development during early childhood, parents should have rational information and awareness of their child rearing type. Results of this study can be used as essential data to develop child rearing education programs according to parents' child rearing attitude.

Autologous hematopoietic stem cell transplantation and conventional insulin therapy in the treatment of children with newly diagnosed type 1 diabetes: long term follow-up.

PubMed

Gu, Yi; Gong, Chunxiu; Peng, Xiaoxia; Wei, Liya; Su, Chang; Qin, Miao; Wang, Xi'ou; Li, Fengting

2014-01-01

It has been indicated that autologous hematopoietic stem cell transplantation (AHST) is a promising treatment to adults with type 1 diabetes, however, the application of AHST therapy to children with type 1 diabetes still needs more data. The aim of this study was to assess the clinical effect of immune intervention combined with AHST and conventional insulin therapy in the treatment of children with newly diagnosed type 1 diabetes. This 1:2 matched case-control study was comprised of 42 children who were newly diagnosed with type 1 diabetes in the Department of Endocrinology, Beijing Children's Hospital from 2009-2010. The case group included 14 patients, who were treated with AHST within the first 3 months after being diagnosed with diabetes at request of their parents during 2009-2010. The control group included 28 patients with newly diagnosed type 1 diabetes at the same period of hospitalization. We compared the baseline and follow-up data of them, including ketoacidosis onset, clinical variables (glycosylated hemoglobin (HbA1c), insulin dosage and serum C-peptide). The clinical characteristics of the patients was comparable between the case group and the control group. At 6-12 months ((10.7±4.2) months) after AHST treatment, we found 11 patients in the case group did not stop the insulin therapy, three cases stopped insulin treatment for 2, 3 and 11 months, respectively. No diabetic ketoacidosis (DKA) occurred after transplantation in all the patients in the case group. HbA1c in the control group was significant lower than that in the case group (P < 0.01), while the insulin dosage and serum C-peptide were not significant different between the two groups (P > 0.05). In order to eliminate the honeymoon effect, we performed final follow-up at the 3-5 years ((4.2±1.8) years) after AHST treatment, and found that HbA1c in the control group was still lower than that in the case group (P < 0.01); however, the insulin dosage and serum C-peptide were not

Equivalent mismatch negativity deficits across deviant types in early illness schizophrenia-spectrum patients.

PubMed

Hay, Rachel A; Roach, Brian J; Srihari, Vinod H; Woods, Scott W; Ford, Judith M; Mathalon, Daniel H

2015-02-01

Neurophysiological abnormalities in auditory deviance processing, as reflected by the mismatch negativity (MMN), have been observed across the course of schizophrenia. Studies in early schizophrenia patients have typically shown varying degrees of MMN amplitude reduction for different deviant types, suggesting that different auditory deviants are uniquely processed and may be differentially affected by duration of illness. To explore this further, we examined the MMN response to 4 auditory deviants (duration, frequency, duration+frequency "double deviant", and intensity) in 24 schizophrenia-spectrum patients early in the illness (ESZ) and 21 healthy controls. ESZ showed significantly reduced MMN relative to healthy controls for all deviant types (p<0.05), with no significant interaction with deviant type. No correlations with clinical symptoms were present (all ps>0.05). These findings support the conclusion that neurophysiological mechanisms underlying processing of auditory deviants are compromised early in illness, and these deficiencies are not specific to the type of deviant presented. Copyright © 2015 Elsevier B.V. All rights reserved.

Analysis of the Einstein sample of early-type galaxies

NASA Technical Reports Server (NTRS)

Eskridge, Paul B.; Fabbiano, Giuseppina

1993-01-01

The EINSTEIN galaxy catalog contains x-ray data for 148 early-type (E and SO) galaxies. A detailed analysis of the global properties of this sample are studied. By comparing the x-ray properties with other tracers of the ISM, as well as with observables related to the stellar dynamics and populations of the sample, we expect to determine more clearly the physical relationships that determine the evolution of early-type galaxies. Previous studies with smaller samples have explored the relationships between x-ray luminosity (L(sub x)) and luminosities in other bands. Using our larger sample and the statistical techniques of survival analysis, a number of these earlier analyses were repeated. For our full sample, a strong statistical correlation is found between L(sub X) and L(sub B) (the probability that the null hypothesis is upheld is P less than 10(exp -4) from a variety of rank correlation tests. Regressions with several algorithms yield consistent results.

The onset of galactic winds in early-type galaxies

NASA Technical Reports Server (NTRS)

Jones, Christine

1992-01-01

We completed the spectral analysis of 31 early-type galaxies to investigate whether their x-ray emission was predominantly due to thermal bremsstrahlung from a hot gaseous corona or emission from discrete, galactic sources such as x-ray binaries. If a corona dominates the x-ray emission, its spectra is expected to be relatively cool (0.5 - 1 keV) compared to the harder emission associated with x-ray binaries in our galaxy, the Magellanic Clouds and M31. While it is generally accepted that the x-ray emission in luminous E and S0 galaxies arises from hot coronae, the status of hot gas in lower luminosity (and hence lower mass) galaxies is less clear. Calculations show that, for a given supernova rate, a critical galaxy luminosity (mass) exists below which the gas cannot be gravitationally confined and a galactic wind is predicted to be effective in expelling gas from the galaxy. Since significant mass (a dark halo) is required to hold a hot, gaseous corona around a galaxy, we expect that the faintest, smallest galaxies will not have a hot corona, but their x-ray emission will be dominated by galactic sources or by an active galactic nuclei. In the sample we tested which spanned the absolute magnitude range from -21.5 to -19.5, we found that except for two galaxies whose x-ray emission was dominated by an active nucleus, that the others were consistent with emission from hot gas. We also found that there is a correlation between gas temperature and galaxy magnitude (mass), such that the brighter, more luminous galaxies have hotter gas temperatures. Thus even at relatively faint magnitudes, the dominant emission from early-type galaxies appears to be hot gas. We also carried out an investigation of the x-ray surface brightness distribution of the x-ray emission for about 100 early type galaxies to determine whether the x-ray emission from galaxies are extended. Extended x-ray emission is expected if the emission is due to a hot gaseous corona. We determined the ratio

Evolution of Late-type Galaxies in a Cluster Environment: Effects of High-speed Multiple Encounters with Early-type Galaxies

NASA Astrophysics Data System (ADS)

Hwang, Jeong-Sun; Park, Changbom; Banerjee, Arunima; Hwang, Ho Seong

2018-04-01

Late-type galaxies falling into a cluster would evolve being influenced by the interactions with both the cluster and the nearby cluster member galaxies. Most numerical studies, however, tend to focus on the effects of the former with little work done on those of the latter. We thus perform a numerical study on the evolution of a late-type galaxy interacting with neighboring early-type galaxies at high speed using hydrodynamic simulations. Based on the information obtained from the Coma cluster, we set up the simulations for the case where a Milky Way–like late-type galaxy experiences six consecutive collisions with twice as massive early-type galaxies having hot gas in their halos at the closest approach distances of 15–65 h ‑1 kpc at the relative velocities of 1500–1600 km s‑1. Our simulations show that the evolution of the late-type galaxy can be significantly affected by the accumulated effects of the high-speed multiple collisions with the early-type galaxies, such as on cold gas content and star formation activity of the late-type galaxy, particularly through the hydrodynamic interactions between cold disk and hot gas halos. We find that the late-type galaxy can lose most of its cold gas after the six collisions and have more star formation activity during the collisions. By comparing our simulation results with those of galaxy–cluster interactions, we claim that the role of the galaxy–galaxy interactions on the evolution of late-type galaxies in clusters could be comparable with that of the galaxy–cluster interactions, depending on the dynamical history.

GAD vaccine reduces insulin loss in recently diagnosed type 1 diabetes: findings from a Bayesian meta-analysis.

PubMed

Beam, Craig A; MacCallum, Colleen; Herold, Kevan C; Wherrett, Diane K; Palmer, Jerry; Ludvigsson, Johnny

2017-01-01

GAD is a major target of the autoimmune response that occurs in type 1 diabetes mellitus. Randomised controlled clinical trials of a GAD + alum vaccine in human participants have so far given conflicting results. In this study, we sought to see whether a clearer answer to the question of whether GAD65 has an effect on C-peptide could be reached by combining individual-level data from the randomised controlled trials using Bayesian meta-analysis to estimate the probability of a positive biological effect (a reduction in C-peptide loss compared with placebo approximately 1 year after the GAD vaccine). We estimate that there is a 98% probability that 20 μg GAD with alum administered twice yields a positive biological effect. The effect is probably a 15-20% reduction in the loss of C-peptide at approximately 1 year after treatment. This translates to an annual expected loss of between -0.250 and -0.235 pmol/ml in treated patients compared with an expected 2 h AUC loss of -0.294 pmol/ml at 1 year for untreated newly diagnosed patients. The biological effect of this vaccination should be developed further in order to reach clinically desirable reductions in insulin loss in patients recently diagnosed with type 1 diabetes.

VizieR Online Data Catalog: Massive early-type galaxies (Buitrago+, 2013)

NASA Astrophysics Data System (ADS)

Buitrago, F.; Trujillo, I.; Conselice, C. J.; Haussler, B.

2013-08-01

Present-day massive galaxies are composed mostly of early-type objects. It is unknown whether this was also the case at higher redshifts. In a hierarchical assembling scenario the morphological content of the massive population is expected to change with time from disc-like objects in the early Universe to spheroid-like galaxies at present. In this paper we have probed this theoretical expectation by compiling a large sample of massive (Mstellar>=1011h-270M⊙) galaxies in the redshift interval 0early-type galaxies among the massive galaxy population has changed from ~20-30 per cent at z~3 to~70 per cent at z=0. Early-type galaxies have been the predominant morphological class for massive galaxies since only z~1. (1 data file).

The ATLAS3D project - XXVII. Cold gas and the colours and ages of early-type galaxies

NASA Astrophysics Data System (ADS)

Young, Lisa M.; Scott, Nicholas; Serra, Paolo; Alatalo, Katherine; Bayet, Estelle; Blitz, Leo; Bois, Maxime; Bournaud, Frédéric; Bureau, Martin; Crocker, Alison F.; Cappellari, Michele; Davies, Roger L.; Davis, Timothy A.; de Zeeuw, P. T.; Duc, Pierre-Alain; Emsellem, Eric; Khochfar, Sadegh; Krajnović, Davor; Kuntschner, Harald; McDermid, Richard M.; Morganti, Raffaella; Naab, Thorsten; Oosterloo, Tom; Sarzi, Marc; Weijmans, Anne-Marie

2014-11-01

We present a study of the cold gas contents of the ATLAS3D early-type galaxies, in the context of their optical colours, near-ultraviolet colours and Hβ absorption line strengths. Early-type (elliptical and lenticular) galaxies are not as gas poor as previously thought, and at least 40 per cent of local early-type galaxies are now known to contain molecular and/or atomic gas. This cold gas offers the opportunity to study recent galaxy evolution through the processes of cold gas acquisition, consumption (star formation) and removal. Molecular and atomic gas detection rates range from 10 to 34 per cent in red sequence early-type galaxies, depending on how the red sequence is defined, and from 50 to 70 per cent in blue early-type galaxies. Notably, massive red sequence early-type galaxies (stellar masses >5 × 1010 M⊙, derived from dynamical models) are found to have H I masses up to M(H I)/M* ˜ 0.06 and H2 masses up to M(H2)/M* ˜ 0.01. Some 20 per cent of all massive early-type galaxies may have retained atomic and/or molecular gas through their transition to the red sequence. However, kinematic and metallicity signatures of external gas accretion (either from satellite galaxies or the intergalactic medium) are also common, particularly at stellar masses ≤5 × 1010 M⊙, where such signatures are found in ˜50 per cent of H2-rich early-type galaxies. Our data are thus consistent with a scenario in which fast rotator early-type galaxies are quenched former spiral galaxies which have undergone some bulge growth processes, and in addition, some of them also experience cold gas accretion which can initiate a period of modest star formation activity. We discuss implications for the interpretation of colour-magnitude diagrams.

Identifying the progenitors of present-day early-type galaxies in observational surveys: correcting `progenitor bias' using the Horizon-AGN simulation

NASA Astrophysics Data System (ADS)

Martin, G.; Kaviraj, S.; Devriendt, J. E. G.; Dubois, Y.; Pichon, C.; Laigle, C.

2018-03-01

As endpoints of the hierarchical mass-assembly process, the stellar populations of local early-type galaxies encode the assembly history of galaxies over cosmic time. We use Horizon-AGN, a cosmological hydrodynamical simulation, to study the merger histories of local early-type galaxies and track how the morphological mix of their progenitors evolves over time. We provide a framework for alleviating `progenitor bias' - the bias that occurs if one uses only early-type galaxies to study the progenitor population. Early types attain their final morphology at relatively early epochs - by z ˜ 1, around 60 per cent of today's early types have had their last significant merger. At all redshifts, the majority of mergers have one late-type progenitor, with late-late mergers dominating at z > 1.5 and early-early mergers becoming significant only at z < 0.5. Progenitor bias is severe at all but the lowest redshifts - e.g. at z ˜ 0.6, less than 50 per cent of the stellar mass in today's early types is actually in progenitors with early-type morphology, while, at z ˜ 2, studying only early types misses almost all (80 per cent) of the stellar mass that eventually ends up in local early-type systems. At high redshift, almost all massive late-type galaxies, regardless of their local environment or star formation rate, are progenitors of local early-type galaxies, as are lower mass (M⋆ < 1010.5 M_{⊙}) late-types as long as they reside in high-density environments. In this new era of large observational surveys (e.g. LSST, JWST), this study provides a framework for studying how today's early-type galaxies have been built up over cosmic time.

Emergence and early survival of early versus late seral species in Great Basin restoration in two different soil types

Treesearch

Shauna M. Uselman; Keirith A. Snyder; Elizabeth A. Leger; Sara E. Duke

2015-01-01

Comparing emergence and survival probabilities, early seral natives generally outperformed late seral natives when growing with exotics and had earlier emergence timing, although results differed among functional groups and soil types. In contrast, survival probabilities did not differ between the early and late seral mixes when growing without exotics. Within each...

Linagliptin plus metformin in patients with newly diagnosed type 2 diabetes and marked hyperglycemia.

PubMed

Ross, Stuart A; Caballero, A Enrique; Del Prato, Stefano; Gallwitz, Baptist; Lewis-D'Agostino, Diane; Bailes, Zelie; Thiemann, Sandra; Patel, Sanjay; Woerle, Hans-Juergen; von Eynatten, Maximilian

2016-11-01

Few studies of oral glucose-lowering drugs exist in newly diagnosed type 2 diabetes (T2D) patients with marked hyperglycemia, and insulin is often proposed as initial treatment. We evaluated the oral initial combination of metformin and linagliptin, a dipeptidyl peptidase-4 inhibitor, in this population. We performed a pre-specified subgroup analysis of a randomized study in which newly diagnosed T2D patients with glycated hemoglobin A1c (HbA1c) 8.5%-12.0% received linagliptin/metformin or linagliptin monotherapy. Subgroups of baseline HbA1c, age, body-mass index (BMI), renal function, race, and ethnicity were evaluated, with efficacy measured by HbA1c change from baseline after 24 weeks. HbA1c reductions from baseline (mean 9.7%) at week 24 in the overall population were an adjusted mean -2.81% ± 0.12% with linagliptin/metformin (n = 132) and -2.02% ± 0.13% with linagliptin (n = 113); treatment difference -0.79% (95% CI -1.13 to -0.46, P < 0.0001). In patients with baseline HbA1c ≥9.5%, HbA1c reduction was -3.37% with linagliptin/metformin (n = 76) and -2.53% with linagliptin (n = 61); difference -0.84% (95% CI -1.32 to -0.35). In those with baseline HbA1c <9.5%, HbA1c reduction was -2.08% with linagliptin/metformin (n = 56) and -1.39% with linagliptin (n = 52); difference -0.69% (95% CI -1.23 to -0.15). Changes in HbA1c and treatment differences between the linagliptin/metformin and linagliptin groups were of similar magnitudes to the overall population across patient subgroups based on age, BMI, renal function, and race. Drug-related adverse events occurred in 8.8% and 5.7% of linagliptin/metformin and linagliptin patients, respectively; no severe hypoglycemia occurred. Linagliptin/metformin combination in newly diagnosed T2D patients with marked hyperglycemia was well tolerated and elicited substantial improvements in glycemic control regardless of baseline HbA1c, age, BMI, renal function, or race. Thus, newly diagnosed, markedly

Chandra Early Type Galaxy Atals

NASA Astrophysics Data System (ADS)

Kim, Dong-Woo; Anderson, Craig; Burke, Douglas J.; Fabbiano, Giuseppina; Fruscione, Antonella; Lauer, Jennifer; McCollough, Michael; Morgan, Douglas; Mossman, Amy; O'Sullivan, Ewan; Paggi, Alessandro; Vrtilek, Saeqa Dil; Trinchieri, Ginevra

2017-08-01

The hot gas in early type galaxies (ETGs) plays a crucial role in understanding their formation and evolution. As the hot gas is often extended to the outskirts beyond the optical size, the large scale structural features identified by Chandra (including jets, cavities, cold fronts, filaments and tails) point to key evolutionary mechanisms, e.g., AGN feedback, merging history, accretion, stripping and star formation and its quenching. We have systematically analyzed the archival Chandra data of ~100 ETGs to study the hot ISM. We produce the uniformly derived data products with spatially resolved spectral information and will make them accessible via a public web site. With 2D spectral infomation, we further discuss gas morphology, scaling relations, X-ray based mass profiles and their implications related to various physical mechanisms (e.g., stellar and AGN feedback).

The Impact of Sleep Debt on Excess Adiposity and Insulin Sensitivity in Patients with Early Type 2 Diabetes Mellitus

PubMed Central

Arora, Teresa; Chen, Mimi Z.; Cooper, Ashley R.; Andrews, Rob C.; Taheri, Shahrad

2016-01-01

Study Objectives: We examined cross-sectional and prospective associations between sleep debt and adiposity measures, as well as homeostatic model assessment-insulin resistance (HOMA-IR) in early type 2 diabetes. Methods: Prospective data analysis from participants of a randomized controlled trial based on an intensive lifestyle intervention (usual care, diet, or diet and physical activity). Data were collected at baseline, 6 months, and 12 months post-intervention. The study was performed across five secondary care centers in the United Kingdom. Patients (n = 593) with a recent diagnosis of type 2 diabetes were recruited. Objective height and weight were ascertained for obesity status (body mass index [BMI]; ≥ 30 kg/m2), waist circumference (cm) for central adiposity, and fasting blood samples drawn to examine insulin resistance (IR). Seven-day sleep diaries were used to calculate weekday sleep debt at baseline, calculated as average weekend sleep duration minus average weekday sleep duration. Results: At baseline, compared to those without weekday sleep debt, those with weekday sleep debt were 72% more likely to be obese (OR = 1.72 [95% CI:1.03–2.88]). At six months, weekday sleep debt was significantly associated with obesity and IR after adjustment, OR = 1.90 (95% CI:1.10–3.30), OR = 2.07 (95% CI:1.02–4.22), respectively. A further increase at 12 months was observed for sleep debt with obesity and IR: OR = 2.10 (95% CI:1.14–3.87), OR = 3.16 (95% CI:1.38–7.24), respectively. For every 30 minutes of weekday sleep debt, the risk of obesity and IR at 12 months increased by 18% and 41%, respectively. Conclusions: Sleep debt resulted in long-term metabolic disruption, which may promote the progression of type 2 diabetes in newly diagnosed patients. Sleep hygiene/education could be an important factor for future interventions to target early diabetes. Citation: Arora T, Chen MZ, Cooper AR, Andrews RC, Taheri S. The impact of sleep debt on excess adiposity

[Vertebral fractures in children with Type I Osteogenesis imperfecta].

PubMed

Sepúlveda, Andrea M; Terrazas, Claudia V; Sáez, Josefina; Reyes, María L

2017-06-01

Osteogenesis imperfecta (OI) is an hereditary disease affecting conective tissue, mainly associated to growth retardation and pathological fractures. OI type I (OI type I), is the mildest, most often, and homogeneous in its fenotype. Vertebral fractures are the most significant complications, associated to skeletical and cardiopulmonary morbidity. To characterize clinically a cohort of children with OI type I. A cohort of OI type I children younger than 20 year old was evaluated. Demographic, clinical, biochemical and radiological data were registered. Sixty seven patients were included, 55% male, 69% resident in the Metropolitan Region. The mean age of diagnose was 2.9 years, 70% presented vertebral fractures on follow-up, mostly thoracic, and 50% before the age of 5 years. Fifty percentage presented vertebral fractures at diagnose, which was about the age of 5 years. Bone metabolic parameters were in the normal range, without significant change at the moment of vertebral fractures. Calcium intake was found to be below American Academy of Pediatrics recommendations at the time of the first fracture. In this study OI type I has an early diagnose, and vertebral fractures show a high incidence, mostly in toddlers. Calcium intake was found to be below reccomended values, and should be closely supervised in these patients.

The Outer Halos of Early-Type Galaxies

NASA Astrophysics Data System (ADS)

Gerhard, Ortwin; Arnaboldi, Magda; Longobardi, Alessia

2015-04-01

The outer halos of massive early-type galaxies (ETGs) are dark matter dominated and may have formed by accretion of smaller systems during galaxy evolution. Here a brief report is given of some recent work on the kinematics, angular momentum, and mass distributions of simulated ETG halos, and of corresponding properties of observed halos measured with planetary nebulae (PNe) as tracers. In the outermost regions of the Virgo-central galaxy M87, the PN data show that the stellar halo and the co-spatial intracluster light are distinct kinematic components.

Protocol for the ADDITION-Plus study: a randomised controlled trial of an individually-tailored behaviour change intervention among people with recently diagnosed type 2 diabetes under intensive UK general practice care.

PubMed

Griffin, Simon J; Simmons, Rebecca K; Williams, Kate M; Prevost, A Toby; Hardeman, Wendy; Grant, Julie; Whittle, Fiona; Boase, Sue; Hobbis, Imogen; Brage, Soren; Westgate, Kate; Fanshawe, Tom; Sutton, Stephen; Wareham, Nicholas J; Kinmonth, Ann Louise

2011-04-04

-to-treat analysis of the effect of the intervention on these measures, an assessment of cost-effectiveness, and analyse predictors of behaviour change in the cohort. The ADDITION-Plus trial will establish the medium-term effectiveness and cost-effectiveness of adding an externally facilitated intervention tailored to support change in multiple behaviours among intensively-treated individuals with recently diagnosed type 2 diabetes in primary care. Results will inform policy recommendations concerning the management of patients early in the course of diabetes. Findings will also improve understanding of the factors influencing change in multiple behaviours, and their association with health outcomes.

Novel ZBTB24 Mutation Associated with Immunodeficiency, Centromere Instability, and Facial Anomalies Type-2 Syndrome Identified in a Patient with Very Early Onset Inflammatory Bowel Disease.

PubMed

Conrad, Máire A; Dawany, Noor; Sullivan, Kathleen E; Devoto, Marcella; Kelsen, Judith R

2017-12-01

Very early onset inflammatory bowel disease, diagnosed in children ≤5 years old, can be the initial presentation of some primary immunodeficiencies. In this study, we describe a 17-month-old boy with recurrent infections, growth failure, facial anomalies, and inflammatory bowel disease. Immune evaluation, whole-exome sequencing, karyotyping, and methylation array were performed to evaluate the child's constellation of symptoms and examination findings. Whole-exome sequencing revealed that the child was homozygous for a novel variant in ZBTB24, the gene associated with immunodeficiency, centromere instability, and facial anomalies type-2 syndrome. This describes the first case of inflammatory bowel disease associated with immunodeficiency, centromere instability, and facial anomalies type-2 syndrome in a child with a novel disease-causing mutation in ZBTB24 found on whole-exome sequencing.

Academic skills in children with early-onset type 1 diabetes: the effects of diabetes-related risk factors.

PubMed

Hannonen, Riitta; Komulainen, Jorma; Riikonen, Raili; Ahonen, Timo; Eklund, Kenneth; Tolvanen, Asko; Keskinen, Päivi; Nuuja, Anja

2012-05-01

The study aimed to assess the effects of diabetes-related risk factors, especially severe hypoglycaemia,on the academic skills of children with early-onset type 1 diabetes mellitus (T1DM). The study comprised 63 children with T1DM (31 females, 32 males; mean age 9 y 11 mo,SD 4 mo) and 92 comparison children without diabetes (40 females, 52 males;mean age 9 y 9 mo,SD 3 mo). Children were included if T1DM had been diagnosed before the age of 5 years and if they were aged between 9 and 10 years at the time of study. Children were not included if their native language was not Finnish and if they had a diagnosed neurological disorder that affected their cognitive development. Among the T1DM group, 37 had and 26 had not experienced severe hypoglycaemia and 26 had avoided severe hypoglycaemia. Severe hypoglycaemia, diabetic ketoacidosis(DKA), and glycaemic control were used as T1DM-related factors. Task performance in reading, spelling, and mathematics was compared among the three groups, and the effects of the T1DM-related factors were analysed with general linear models. The groups with (p<0.001) and without (p=0.001) severe hypoglycaemia demonstrated a poorer performance than the comparison group in spelling, and the group without severe hypoglycaemia showed a poorer performance than the comparison group in mathematics (p=0.003).Severe hypoglycaemia, DKA, and recent glycaemic control were not associated with poorer skills,but poorer first-year glycaemic control was associated with poorer spelling (p=0.013). An early onset of T1DM can increase the risk of learning problems, independently of the history of severe hypoglycaemia or DKA. Poorer glycaemic control after the first year of T1DM is associated with a poorer acquisition of academic skills indicating the effect of the timing of metabolic aberrations on cognitive development.

On a connection between supernova occurrence and tidal interaction in early type galaxies

NASA Technical Reports Server (NTRS)

Kochhar, R. K.

1990-01-01

There are three types of supernovae: two subtypes SNIa and Ib; and SNII. Late type galaxies produce all types of SN, whereas early types (E, SO, and non-Magellanic irregulars IO) have hosted only SNIa. The recently identified SNIb, like SNII, have massive stars as their progenitors. Reviving Oemler and Tinsley's (1979) suggestion that SNIa also come from short-lived stars, the author asserts that they need not occur in all early-type galaxies. SNIa occur only in those galaxies that have access to gas and can form stars in their main body. (SN in nuclear regions are a different matter altogether). In this model, SNIa are not associated with typical stellar population of E/SOs but with regions of localized star formation. Note that data on SNIa from spirals is already consistent with this model.

[Detection of early neoplasia in Barrett's oesophagus: focus attention on index endoscopy in short-segment-Barrett's oesophagus with random biopsies].

PubMed

Behrens, A; Pech, O; Wuthnow, E; Manner, H; Pohl, J; May, A; Ell, C

2015-06-01

Detecting early neoplasias in Barrett's oesophagus (BE) is challenging. Recent publications have been focusing on improving the detection of such lesions during Barrett's surveillance. However in a recently published Danish register study calculating the risk for cancer-development in BE two-thirds of the diagnosed tumors were identified during the first examination or in the first year. This means that index endoscopy might be more effective than surveillance in detecting early neoplasia in BE.  In the period from January 2010 to April 2011, all patients who consecutively presented with a diagnosis of early neoplastic changes in BE were recorded prospectively. The analysis included data for 121 patients. In patients with short-segment BE (SSBE), neoplasia was only diagnosed in 6 % of cases in the surveillance examination, compared with 44 % of cases in long-segment BE (LSBE). The neoplastic lesion was identified visually in 43 patients (36 %) during the external EGD. Type II tumours were detected in 40 % (39/98) and were correctly assessed as neoplastic in 25 % of cases (24/98). 1. in patients with SSBE almost all early tumours are diagnosed by index endoscopy and not by Barrett's surveillance; 2. around 40 % of all early neoplasias are endoscopically invisible and are only diagnosed using four-quadrant biopsies; 3. the macroscopic tumour type has a substantial influence on the detection rate for neoplasia. If efforts to increase the detection rate for early neoplasia in BE are focused solely on the Barrett's surveillance method, then only a minority of patients - 20 % in the present group - will benefit from the measure. German clinical trials register, DRKS00 004 168. © Georg Thieme Verlag KG Stuttgart · New York.

Early-phase prandial insulin secretion: its role in the pathogenesis of type 2 diabetes mellitus and its modulation by repaglinide.

PubMed

Owens, D R; Cozma, L S; Luzio, S D

2002-12-01

The major contributory factor to increasing hyperglycaemia in established Type 2 diabetes mellitus (T2DM) appears to be the progressive delay and attenuation of the prandial insulin response. An important consequence of this derangement is that hepatic glucose production is no longer suppressed during times of prandial glucose intake. Together with a relative impairment in the rate of peripheral glucose disposal, this leads to supra-physiological plasma glucose excursions, which may damage the vasculature. An obvious therapeutic strategy, therefore, would be to increase insulin availability when most needed--in the early prandial phase. In experiments with exogenous insulin interventions, peak post-prandial blood glucose increments were curtailed without undue increases in total insulin exposure. However, available evidence suggests that the sulphonylurea glibenclamide does not effectively alter early-phase prandial insulin release but predominately increases late-phase and basal insulin output, thus incurring the risk of hypoglycaemia. The novel insulin secretagogue repaglinide, by contrast, augments early-phase prandial insulin secretion when taken before meals, as shown by studies in non-diabetic people and patients with newly diagnosed, previously untreated T2DM. Repaglinide exerts its greatest effect on the insulin secretion rate during the first 30 min after a meal is started, thereby going some way to restoring the early insulin secretion curve seen after a meal in non-diabetic people. No residual secretagogue activity is seen 4 hr after taking a single dose of up to 2 mg. Prandial glucose regulation with repaglinide could be associated with lower post-prandial glucose excursions and less risk of post-prandial hypoglycaemia than glibenclamide.

Accounting for the dispersion in the x ray properties of early-type galaxies

NASA Technical Reports Server (NTRS)

White, Raymond E., III; Sarazin, Craig L.

1990-01-01

The x ray luminosities of early-type galaxies are correlated with their optical (e.g., blue) luminosities (L sub X approx. L sub B exp 1.6), but the x ray luminosities exhibit considerable scatter for a given optical luminosity L sub B. This dispersion in x ray luminosity is much greater than the dispersion of other properties of early-type galaxies (for a given L sub B), such as luminosity scale-length, velocity dispersion, color, and metallicity. Here, researchers consider several possible sources for the dispersion in x ray luminosity. Some of the scatter in x ray luminosity may result from stellar population variations between galaxies with similar L sub B. Since the x ray emitting gas is from accumulated stellar mass loss, the L sub X dispersion may be due to variations in integrated stellar mass loss rates. Another possible cause of the L sub X dispersion may be variations in the amount of cool material in the galaxies; cool gas may act as an energy sink for the hot gas. Infrared emission may be used to trace such cool material, so researchers look for a correlation between the infrared emission and the x ray emission of early-type galaxies at fixed L sub B. Velocity dispersion variations between galaxies of similar L sub B may also contribute to the L sub X dispersion. The most likely a priori source of the dispersion in L sub X is probably the varying amount of ram-pressure stripping in a range of galaxy environments. The hot gaseous halos of early-type galaxies can be stripped in encounters with other galaxies or with ambient cluster gas if the intracluster gas is sufficiently dense. Researchers find that the most likely cause of dispersion in the x ray properties of early type galaxies is probably the ram-pressure stripping of gaseous halos from galaxies. For a sample of 81 early-type galaxies with x ray luminosities or upper limits derived from Einstein Observatory observations (CFT) researchers calculated the cumulative distribution of angular distances

Study of the Blood Supply Fraction of the Ascending Aorta and Its Effect in Diagnosing Early Ascending Aortic Atherosclerosis.

PubMed

Wang, Kun; Cao, Tiesheng; Zhao, Lianbi; Yang, Yong; Feng, Yang; Duan, Yunyou; Yuan, Lijun; Xing, Changyang; Ren, Huari

2016-03-01

To investigate the capacity of blood storage of certain large arteries during diastole, we first studied the ascending aorta by echocardiography. The concept of the blood supply fraction of the ascending aorta was then introduced to evaluate elastic retraction of the ascending aortic wall and determine its role in diagnosing early atherosclerosis of the ascending aorta. First, we enrolled 120 healthy volunteers and divided them into 3 groups according to age: 20 to 35 years (B1 group), 36 to 50 years (B2 group), and 51 to 65 years (B3 group); there were 40 volunteers in each group. We used echocardiography to measure the blood supply fraction in each volunteer and compared the results for each group. Then we enrolled 40 patients (51-65 years) with early atherosclerosis of the ascending aorta, measured the blood supply fraction of each, and compared the results with the B3 group. The mean blood supply fractions ± SD in the B1, B2, and B3 groups were 21.75% ± 1.53%, 20.76% ± 1.62%, and 18.44% ± 1.19%, respectively. The fraction in the B3 group was significantly lower than those in the B1 and B2 groups (P < .01). The fraction in the patients with early atherosclerosis was 14.92% ± 1.01%, which was obviously lower than that in the B3 group (P < .01). The blood supply fraction of the ascending aorta decreases with age, and it could be used as a parameter for diagnosis of early atherosclerosis of the ascending aorta. © 2016 by the American Institute of Ultrasound in Medicine.

Nursing diagnoses in pemphigus vulgaris: a case study.

PubMed

Pena, Silvana B; Guimarães, Heloísa C Q C P; Bassoli, Sidinéia R B; Casarin, Santina N A; Herdman, Trace Heather; de Barros, Alba L B L

2013-10-01

This case study illustrates the use of the nursing process based upon the standardized nursing diagnoses approved by NANDA International (NANDA-I), and using the Nursing Outcomes Classification (NOC) and the Nursing Interventions Classification (NIC) in the care of a patient with pemphigus vulgaris (PV). The published literature on PV and the experience and expertise of the authors in working with people with impaired skin integrity and PV were used to develop this case study. The accuracy of nursing diagnoses and appropriateness of the nursing interventions were supported by the positive health outcomes of the patient. Impaired skin integrity is a human response diagnosed by nurses, and early treatment is important due to the vulnerability of these patients. The case study contributes to nursing knowledge for professionals who care for patients with PV. © 2013 NANDA International.

Young, metal-enriched cores in early-type dwarf galaxies in the Virgo cluster based on colour gradients

NASA Astrophysics Data System (ADS)

Urich, Linda; Lisker, Thorsten; Janz, Joachim; van de Ven, Glenn; Leaman, Ryan; Boselli, Alessandro; Paudel, Sanjaya; Sybilska, Agnieszka; Peletier, Reynier F.; den Brok, Mark; Hensler, Gerhard; Toloba, Elisa; Falcón-Barroso, Jesús; Niemi, Sami-Matias

2017-10-01

Early-type dwarf galaxies are not simply featureless, old objects, but were found to be much more diverse, hosting substructures and a variety of stellar population properties. To explore the stellar content of faint early-type galaxies, and to investigate in particular those with recent central star formation, we study colours and colour gradients within one effective radius in optical (g - r) and near-infrared (I - H) bands for 120 Virgo cluster early-type galaxies with - 19 mag early-type galaxies. The metallicity gradients of these blue-cored early-type dwarf galaxies are, however, in the range of most normal faint early-type galaxies, which we find to have non-zero gradients with higher central metallicity. The blue central regions are consistent with star formation activity within the last few 100 Myr. We discuss whether these galaxies could be explained by environmental quenching of star formation in the outer galaxy regions while the inner star formation activity continued.

Trace elements in early phase type 2 diabetes mellitus-A population-based study. The HUNT study in Norway.

PubMed

Hansen, Ailin Falkmo; Simić, Anica; Åsvold, Bjørn Olav; Romundstad, Pål Richard; Midthjell, Kristian; Syversen, Tore; Flaten, Trond Peder

2017-03-01

Differences in trace elements levels between individuals with type 2 diabetes and controls have been reported in several studies in various body fluids and tissues, but results have been inconsistent. In order to examine trace element levels in the early phase of type 2 diabetes, we investigated the association between whole blood levels of 26 trace elements and the prevalence of previously undiagnosed, screening-detected type 2 diabetes. The study was conducted as a case-control study nested within the third survey of the population-based Nord-Trøndelag Health Study (HUNT3 Survey). Among participants without previously known diabetes, 128 cases of type 2 diabetes were diagnosed in people with a high diabetes risk score (FINDRISC≥15), and frequency-matched for age and sex with 755 controls. Blood samples were analyzed by high resolution inductively coupled plasma mass spectrometry. Associations between trace element levels and the prevalence of previously undiagnosed type 2 diabetes were evaluated with multivariable conditional logistic regression controlling for age, sex, body mass index, waist-to-hip ratio, education, income, smoking and family history of diabetes. The prevalence of previously undiagnosed type 2 diabetes increased across tertiles/quartiles for cadmium, chromium, iron, nickel, silver and zinc, and decreased with increasing quartiles of bromine (P trend <0.05). After corrections for multiple testing, associations for chromium remained significant (Q trend <0.05), while associations for iron and silver were borderline significant. No associations were found for arsenic, boron, calcium, cesium, copper, gallium, gold, indium, lead, magnesium, manganese, mercury, molybdenum, rubidium, selenium, strontium, tantalum, thallium and tin. Our results suggest a possible role of bromine, cadmium, chromium, iron, nickel, silver and zinc in the development of type 2 diabetes. Copyright © 2016 Elsevier GmbH. All rights reserved.

Urinary Glucose Screening for Early Detection of Asymptomatic Type 2 Diabetes in Jeonbuk Province Korean Schoolchildren.

PubMed

Kim, Min Sun; Lee, Dae Yeol

2017-06-01

This study aimed to investigate the prevalence of glucosuria and the characteristics of diabetes in schoolchildren as detected by a school urine glucose screening program implemented from 2010 to 2013 in the Jeonbuk province area of Korea. A total of 110 children without known diabetes were analyzed. They were checked with an oral glucose tolerance test (OGTT) with other laboratory tests and their clinical data were collected. A total of 707,238 schoolchildren from a school population of 1,064,999 were screened for glucosuria. In total, over a 4-year period, 545 schoolchildren (0.077%) were positive for glucosuria on the second urine test. The prevalence of glucosuria was more common among middle and high schoolchildren than among elementary schoolchildren. Among 110 students who completed the OGTT to confirm diabetes, 40 were diagnosed with diabetes mellitus (DM); 39 children, type 2 diabetes mellitus (T2DM) and 1 child, slowly progressive insulin dependent diabetes mellitus (SPIDDM). The mean annual incidence of diabetes was 5.6 per 100,000 schoolchildren and adolescents. The subjects with diabetes diagnosed through the urine screening test showed minimal or no symptoms of diabetes. The students with diabetes were more likely to be woman and obese, and they have a higher body mass index, higher cholesterol, triglyceride, insulin, C-peptide, and fasting glucosuria values than the students with normal glucose tolerance. We identified 40 new cases of diabetes in the Korean schoolchildren with asymptomatic glucosuria on urine glucose screening. This finding shows that school urine glucose screening is a feasible and simple method for early detection of asymptomatic T2DM. © 2017 The Korean Academy of Medical Sciences.

Urinary Glucose Screening for Early Detection of Asymptomatic Type 2 Diabetes in Jeonbuk Province Korean Schoolchildren

PubMed Central

2017-01-01

This study aimed to investigate the prevalence of glucosuria and the characteristics of diabetes in schoolchildren as detected by a school urine glucose screening program implemented from 2010 to 2013 in the Jeonbuk province area of Korea. A total of 110 children without known diabetes were analyzed. They were checked with an oral glucose tolerance test (OGTT) with other laboratory tests and their clinical data were collected. A total of 707,238 schoolchildren from a school population of 1,064,999 were screened for glucosuria. In total, over a 4-year period, 545 schoolchildren (0.077%) were positive for glucosuria on the second urine test. The prevalence of glucosuria was more common among middle and high schoolchildren than among elementary schoolchildren. Among 110 students who completed the OGTT to confirm diabetes, 40 were diagnosed with diabetes mellitus (DM); 39 children, type 2 diabetes mellitus (T2DM) and 1 child, slowly progressive insulin dependent diabetes mellitus (SPIDDM). The mean annual incidence of diabetes was 5.6 per 100,000 schoolchildren and adolescents. The subjects with diabetes diagnosed through the urine screening test showed minimal or no symptoms of diabetes. The students with diabetes were more likely to be woman and obese, and they have a higher body mass index, higher cholesterol, triglyceride, insulin, C-peptide, and fasting glucosuria values than the students with normal glucose tolerance. We identified 40 new cases of diabetes in the Korean schoolchildren with asymptomatic glucosuria on urine glucose screening. This finding shows that school urine glucose screening is a feasible and simple method for early detection of asymptomatic T2DM. PMID:28480657

Comparison of Acarbose and Metformin on Albumin Excretion in Patients With Newly Diagnosed Type 2 Diabetes: A Randomized Controlled Trial.

PubMed

Pan, Qingrong; Xu, Yuan; Yang, Ning; Gao, Xia; Liu, Jia; Yang, Wenying; Wang, Guang

2016-04-01

Increased urinary albumin excretion in diabetes not only signals nephropathy but also serves as a risk marker for cardiovascular disease. The data of MARCH (Metformin and AcaRbose in Chinese as the initial Hypoglycaemic treatment) trial demonstrated that acarbose and metformin were similarly efficacious at lowering blood glucose and blood pressure, as well as improving insulin sensitivity in Chinese patients newly diagnosed with type 2 diabetes mellitus. The purpose of this study was to identify the effects of acarbose and metformin therapy on albumin excretion in MARCH study.Baseline urine albumin/creatinine ratio (ACR) of 762 newly diagnosed, drug-naïve patients with type 2 diabetes mellitus was measured. Included patients were randomized to receive either acarbose or metformin and followed for 48 weeks. In addition to change in ACR, the estimated glomerular filtration rates (eGFR) and frequency of metabolic syndrome (MetS) were also assessed.Elevated ACR levels (≥30 mg/g) were present at baseline in 21.9% of all participants. A significant decline in urine ACR was observed in both the acarbose and metformin groups at week 24 and 48 (all P < 0.001). The proportion of patients with elevated ACRs was also reduced in both treatment groups at week 24 and 48 compared with baseline values (all P < 0.05). The change in urine ACR at week 48 was significantly greater in patients prescribed acarbose than in those prescribed metformin (P = 0.01). Both acarbose and metformin significantly decreased the frequency of MetS at week 24 and 48 (both P < 0.05). Neither treatment affected eGFR.In sum, both acarbose and metformin decreased urine ACR levels and reduced the frequency of elevated ACR and MetS in Chinese patients with newly diagnosed type 2 diabetes mellitus without affecting eGFR. After 48 weeks' intervention, acarbose therapy resulted in a greater reduction in urine ACR compared with metformin.

Some Clinical Diagnoses are More Reliable than Others

DTIC Science & Technology

1989-03-29

a more reliable measure than diagnostic type (e.g., schizophrenia versus personality disor- der). Diagnostic type, in turn, was a more reliable...measure than diagnostic subtype (e.g., chronic catatonic schizophrenic). And, certain diagnostic types aild Suutypes wete consistently more reliable across...diagnoses included thie following diagnostic typesý: 1) organic psychoses, 2) schizophrenia , 3) affective psychoses, 4) pala- 4 noia, 5) other

The hELENa project - II. Abundance distribution trends of early-type galaxies: from dwarfs to giants

NASA Astrophysics Data System (ADS)

Sybilska, A.; Kuntschner, H.; van de Ven, G.; Vazdekis, A.; Falcón-Barroso, J.; Peletier, R. F.; Lisker, T.

2018-06-01

In this second paper of The role of Environment in shaping Low-mass Early-type Nearby galaxies (hELENa) series we study [Mg/Fe] abundance distribution trends of early-type galaxies (ETGs) observed with the Spectrographic Areal Unit for Research on Optical Nebulae integral field unit, spanning a wide range in mass and local environment densities: 20 low-mass early types (dEs) of Sybilska et al. and 258 massive early types (ETGs) of the ATLAS3D project, all homogeneously reduced and analysed. We show that the [Mg/Fe] ratios scale with velocity dispersion (σ) at fixed [Fe/H] and that they evolve with [Fe/H] along similar paths for all early types, grouped in bins of increasing local and global σ, as well as the second velocity moment Vrms, indicating a common inside-out formation pattern. We then place our dEs on the [Mg/Fe] versus [Fe/H] diagram of Local Group galaxies and show that dEs occupy the same region and show a similar trend line slope in the diagram as the high-metallicity stars of the Milky Way and the Large Magellanic Cloud. This finding extends the similar trend found for dwarf spheroidal versus dwarf irregular galaxies and supports the notion that dEs have evolved from late-type galaxies that have lost their gas at a point of their evolution, which likely coincided with them entering denser environments.

Revealing the origin of the cold ISM in massive early-type galaxies

NASA Astrophysics Data System (ADS)

Davis, T. A.; Alatalo, K.; Bureau, M.; Young, L.; Blitz, L.; Crocker, A.; Bayet, E.; Bois, M.; Bournaud, F.; Cappellari, M.; Davies, R. L.; Duc, P.-A.; de Zeeuw, P. T.; Emsellem, E.; Falcon-Barroso, J.; Khochfar, S.; Krajnovic, D.; Kuntschner, H.; Lablanche, P.-Y.; McDermid, R. M.; Morganti, R.; Naab, T.; Sarzi, M.; Scott, N.; Serra, P.; Weijmans, A.

2013-07-01

Recently, massive early-type galaxies have shed their red-and-dead moniker, thanks to the discovery that many host residual star formation. As part of the ATLAS-3D project, we have conducted a complete, volume-limited survey of the molecular gas in 260 local early-type galaxies with the IRAM-30m telescope and the CARMA interferometer, in an attempt to understand the fuel powering this star formation. We find that around 22% of early-type galaxies in the local volume host molecular gas reservoirs. This detection rate is independent of galaxy luminosity and environment. Here we focus on how kinematic misalignment measurements and gas-to-dust ratios can be used to put constraints on the origin of the cold ISM in these systems. The origin of the cold ISM seems to depend strongly on environment, with misaligned, dust poor gas (indicative of externally acquired material) being common in the field but completely absent in rich groups and in the Virgo cluster. Very massive galaxies also appear to be devoid of accreted gas. This suggests that in the field mergers and/or cold gas accretion dominate the gas supply, while in clusters internal secular processes become more important. This implies that environment has a strong impact on the cold gas properties of ETGs.

Measurements of eight early-type stars angular diameters using VEGA/CHARA interferometer

NASA Astrophysics Data System (ADS)

Challouf, M.; Nardetto, N.; Mourard, D.; Aroui, H.; Delaa, O.

2014-12-01

The surface brightness color (SBC) relation is an important tool to derive the distance of extragalatic eclipsing binaries. We determined the uniform disc angular diameter of the eight following early-type stars using VEGA/CHARA interferometric observations: θ_{UD}[δ Cyg] = 0.766 ± 0.047 mas, θ_{UD}[γ Lyr] = 0.742& ± 0.010 mas, θ_{UD}[γ Ori] = 0.701 ± 0.005 mas, θ_{UD}[ζ Peg] = 0.539 ± 0.009 mas, θ_{UD}[λ Aql] = 0.529 ± 0.003 mas, θ_{UD}[ζ Per] = 0.531 ± 0.007 mas, θ_{UD}[ι Her] = 0.304 ± 0.010 mas and θ_{UD}[8 Cyg] = 0.229 ± 0.011 mas (by extending V-K range from -0.76 to 0.02) with typical precision of about 1.5%. By combining these data with previous angular diameter determinations available in the literature, Challouf et al. (2014) provide for the very first time a SBC relation for early-type stars (-1≤V-K≤0) with a precision of about 0.16 magnitude or 7% in term of angular diameter (when using this SBC relation to derive the angular diameter of early-type stars).

Demography of SDSS Early-type Galaxies from the Perspective of Radial Color Gradients

NASA Astrophysics Data System (ADS)

Suh, Hyewon; Jeong, H.; Oh, K.; Yi, S. K.; Ferreras, I.; Schawinski, K.

2010-01-01

We have investigated the radial g-r color gradients of early-type galaxies in the Sloan Digital Sky Survey (SDSS) DR6 in the redshift range 0.00 < z < 0.06. The majority of massive early-type galaxies show a negative color gradient (centers being redder). On the other hand, roughly 30 percent of the galaxies in this sample show positive color gradients (centers being bluer). These positive-gradient galaxies often show strong Hβ absorption line strengths and/or emission line ratios that are consistent with containing young stellar populations. Combining the optical data with Galaxy Evolution Explorer (GALEX) UV photometry, we find that all positive-gradient galaxies show blue UV-optical colors. This implies that the residual star formation in early-type galaxies is centrally concentrated. These positive-gradient galaxies tend to live in lower density regions. They are also a bit more likely to have a late-type companion galaxy, hinting at a possible role of interactions with a gas-rich companion. A simplistic population analysis shows that these positive color gradients are visible only for half a billion years after a star burst. Moreover, the positive-gradient galaxies occupy different regions in the fundamental planes from the outnumbering negative-gradient galaxies. However, the positions of the positive-gradient galaxies on the fundamental planes cannot be attributed to any reasonable amount of recent star formation alone but require substantially lower velocity dispersions to begin with. Our results based on the optical data are consistent with the residual star formation interpretation which was based on the GALEX UV data. A low-level residual star formation seems continuing in most of the less-massive early-type galaxies in their centers.

The Cool Stellar Populations of Early-Type Galaxies and the Galactic Bulge

NASA Astrophysics Data System (ADS)

Houdashelt, Mark Lee

1995-01-01

Red (6800-9200 A) and near-infrared (K-band) spectra have been obtained for 34 early-type galaxies in the Virgo cluster, the Coma cluster and the field. The strengths of the Ca II triplet (lambdalambda 8498, 8542, 8662 A), the Na I doublet ( lambdalambda8183, 8195 A), the Mg I lambda8807 A line, and molecular bands of TiO and VO were measured from the red spectra. Absorption due to the CO band with bandhead at 2.29 mu m was measured from the near-infrared spectra. The behavior of the spectral indices was examined for the Virgo galaxy nuclei as functions of luminosity and color. Overall, the CO, TiO and Na I indices were found to be stronger in redder and brighter galaxies. The Mg I and the Ca II triplet lines did not vary significantly among galaxies of different color or brightness. These trends are consistent with a change in chemical composition producing the well-known color-magnitude relation for early -type galaxies. No significant differences were detected among galaxies of similar luminosity in the Virgo cluster, the Coma cluster and the field. To simulate the stellar population changes implied by the radial color gradients observed in early-type galaxies, models were constructed to represent the integrated light of the Galactic bulge as a function of latitude. A field in Baade's Window (BW) was studied first and the stellar population there was found to be quite inhomogeneous. The BW model indicated that the integrated light of BW is giant -dominated, and the BW spectral energy distribution is very similar to that of the nucleus of a low-luminosity early -type galaxy. From models of BW and a field at b = -8^circ, radial gradients were estimated for the Galactic bulge and compared to the changes which occur along a luminosity sequence of early -type galaxies in the Virgo cluster. This comparison showed that: (1) the Na I and I(8197) indices increase steeply with redder colors in the Virgo galaxies but appear to decrease with color in the Galactic bulge

Early prediction of autoimmune (type 1) diabetes.

PubMed

Regnell, Simon E; Lernmark, Åke

2017-08-01

Underlying type 1 diabetes is a genetic aetiology dominated by the influence of specific HLA haplotypes involving primarily the class II DR-DQ region. In genetically predisposed children with the DR4-DQ8 haplotype, exogenous factors, yet to be identified, are thought to trigger an autoimmune reaction against insulin, signalled by insulin autoantibodies as the first autoantibody to appear. In children with the DR3-DQ2 haplotype, the triggering reaction is primarily against GAD signalled by GAD autoantibodies (GADA) as the first-appearing autoantibody. The incidence rate of insulin autoantibodies as the first-appearing autoantibody peaks during the first years of life and declines thereafter. The incidence rate of GADA as the first-appearing autoantibody peaks later but does not decline. The first autoantibody may variably be followed, in an apparently non-HLA-associated pathogenesis, by a second, third or fourth autoantibody. Although not all persons with a single type of autoantibody progress to diabetes, the presence of multiple autoantibodies seems invariably to be followed by loss of functional beta cell mass and eventually by dysglycaemia and symptoms. Infiltration of mononuclear cells in and around the islets appears to be a late phenomenon appearing in the multiple-autoantibody-positive with dysglycaemia. As our understanding of the aetiology and pathogenesis of type 1 diabetes advances, the improved capability for early prediction should guide new strategies for the prevention of type 1 diabetes.

Association between Triglyceride to HDL-C Ratio (TG/HDL-C) and Insulin Resistance in Chinese Patients with Newly Diagnosed Type 2 Diabetes Mellitus

PubMed Central

Ren, Xingxing; Chen, Zeng.ai; Zheng, Shuang; Han, Tingting; Li, Yangxue; Liu, Wei; Hu, Yaomin

2016-01-01

Objectives To explore the association between the triglyceride to HDL-C ratio (TG/HDL-C) and insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus. Methods Patients with newly diagnosed type 2 diabetes mellitus (272 men and 288 women) were enrolled and divided into three groups according to TG/HDL-C tertiles. Insulin resistance was defined by homeostatic model assessment of insulin resistance (HOMA-IR). Demographic information and clinical characteristics were obtained. Spearman’s correlation was used to estimate the association between TG/HDL-C and other variables. Multiple logistic regression analyses were adopted to obtain probabilities of insulin resistance. A receiver operating characteristic analysis was conducted to evaluate the ability of TG/HDL-C to discriminate insulin resistance. Results TG/HDL-C was associated with insulin resistance in Chinese patients with newly diagnosed T2DM (Spearman’s correlation coefficient = 0.21, P < 0.01). Patients in the higher tertiles of TG/HDL-C had significantly higher HOMA-IR values than patients in the lower tertiles [T1: 2.68(1.74–3.70); T2: 2.96(2.29–4.56); T3: 3.09(2.30–4.99)]. Multiple logistic regression analysis showed that TG/HDL-C was significantly associated with HOMA-IR, and patients in the higher TG/HDL-C tertile had a higher OR than those in the lower TG/HDL-C tertile, after adjusting for multiple covariates including indices for central obesity [T1: 1; T2: 4.02(1.86–8.71); T3: 4.30(1.99–9.29)]. Following stratification of waist circumference into quartiles, the effect of TG/HDL-C on insulin resistance remained significant irrespective of waist circumference. Conclusions TG/HDL-C was associated with insulin resistance independent of waist circumference. Whether it could be a surrogate marker for insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus still needs to be confirmed by more researches. PMID:27115999

Association between Triglyceride to HDL-C Ratio (TG/HDL-C) and Insulin Resistance in Chinese Patients with Newly Diagnosed Type 2 Diabetes Mellitus.

PubMed

Ren, Xingxing; Chen, Zeng Ai; Zheng, Shuang; Han, Tingting; Li, Yangxue; Liu, Wei; Hu, Yaomin

2016-01-01

To explore the association between the triglyceride to HDL-C ratio (TG/HDL-C) and insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus. Patients with newly diagnosed type 2 diabetes mellitus (272 men and 288 women) were enrolled and divided into three groups according to TG/HDL-C tertiles. Insulin resistance was defined by homeostatic model assessment of insulin resistance (HOMA-IR). Demographic information and clinical characteristics were obtained. Spearman's correlation was used to estimate the association between TG/HDL-C and other variables. Multiple logistic regression analyses were adopted to obtain probabilities of insulin resistance. A receiver operating characteristic analysis was conducted to evaluate the ability of TG/HDL-C to discriminate insulin resistance. TG/HDL-C was associated with insulin resistance in Chinese patients with newly diagnosed T2DM (Spearman's correlation coefficient = 0.21, P < 0.01). Patients in the higher tertiles of TG/HDL-C had significantly higher HOMA-IR values than patients in the lower tertiles [T1: 2.68(1.74-3.70); T2: 2.96(2.29-4.56); T3: 3.09(2.30-4.99)]. Multiple logistic regression analysis showed that TG/HDL-C was significantly associated with HOMA-IR, and patients in the higher TG/HDL-C tertile had a higher OR than those in the lower TG/HDL-C tertile, after adjusting for multiple covariates including indices for central obesity [T1: 1; T2: 4.02(1.86-8.71); T3: 4.30(1.99-9.29)]. Following stratification of waist circumference into quartiles, the effect of TG/HDL-C on insulin resistance remained significant irrespective of waist circumference. TG/HDL-C was associated with insulin resistance independent of waist circumference. Whether it could be a surrogate marker for insulin resistance in Chinese patients with newly diagnosed type 2 diabetes mellitus still needs to be confirmed by more researches.

Early Observations of the Type Ia Supernova iPTF 16abc

NASA Astrophysics Data System (ADS)

Miller, Adam; iPTF Collaboration

2018-01-01

Early observations of Type Ia supernovae (SNe) provide a unique probe of their progenitor systems and explosion physics. Here, we report the intermediate Palomar Transient Factory (iPTF) discovery of an extraordinarily young SN Ia, iPTF 16abc. By fitting a power law to our early light curve, we infer that first light for the SN only occurred 0.15 +0.15-0.07 d before our first detection. In the ~24 hr after discovery, iPTF 16abc rose by ~2 mag, following a near-linear rise in flux for ~3 d. Strong C II absorption is detected in the early spectra of iPTF 16abc, before disappearing after ~7 d. Unlike the extensively-observed Type Ia SN 2011fe, the (B-V)_0 colors of iPTF 16abc are blue and nearly constant in the days after explosion. We show that our early observations of iPTF 16abc cannot be explained by either SN shock breakout and the associated, subsequent cooling, or the SN ejecta colliding with a stellar companion. Instead, we argue that the early characteristics of iPTF 16abc, including: (i) the rapid, near-linear rise, (ii) the non-evolving blue colors, and (iii) the strong absorption from ionized carbon, are the result of either vigorous mixing of radioactive-Ni in the SN ejecta, or ejecta interaction with diffuse material, or a combination of the two. In the next few years, dozens of very young normal SNe Ia will be discovered, and observations similar to those presented here will constrain the white dwarf explosion mechanism.

Achilles tendon and plantar fascia in recently diagnosed type II diabetes: role of body mass index.

PubMed

Abate, Michele; Schiavone, Cosima; Di Carlo, Luigi; Salini, Vincenzo

2012-07-01

Previous research has shown that plantar fascia and Achilles tendon thickness is increased in diabetes. The aims of present study were to assess whether tendon changes can occur in the early stages of the disease and to evaluate the extent of the influence of body mass index (BMI). The study population included 51 recent-onset type II diabetic subjects, who were free from diabetic complications, divided according to BMI into three groups (normal weight, overweight, and obese). Eighteen non-diabetic, normal-weight subjects served as controls. Plantar fascia and Achilles tendon thickness was measured by means of sonography. The groups were well balanced for age and sex. In all the diabetic subjects, plantar fascia and Achilles tendon thickness was increased compared to the controls (p < 0.001, p = 0.01, p = 0.003, respectively). A significant relationship was found between plantar fascia thickness and BMI values (r = 0.749, p < 0.0001), while the correlation between BMI and Achilles tendon was weaker (r = 0.399, p = 0.004). This study shows that plantar fascia and Achilles tendon thickness is increased in the early stages of type II diabetes and that BMI is related more to plantar fascia than Achilles tendon thickness. Further longitudinal studies are needed to evaluate whether these early changes can overload the metatarsal heads and increase the stress transmitted to plantar soft tissues, thus representing an additional risk factor for foot ulcer development.

Environmental Effects on the Metallicities of Early-Type Galaxies

NASA Technical Reports Server (NTRS)

Jones, Christine; Oliversen, Ronald (Technical Monitor)

2004-01-01

We completed and published two papers in the Astrophysical Journal based on research from grant. In the first paper we analyzed nine X-ray-bright Virgo early-type galaxies observed by both ASCA and ROSAT. Through spatially resolved spectroscopy, we determined the radial temperature profiles and abundances of Mg, Si, and Fe for six galaxies. The temperature profiles are consistent with isothermal temperatures outside of cooler regions at the galaxies' centers. We present new evidence for iron abundance gradients in NGC 4472 and NGC 4649 and confirm the previous results on NGC 4636. Mg and Si abundance gradients on average are flatter than those of iron and correspond to an underabundance of α-process elements at high Fe values, while at low iron the element ratios favor enrichment by Type II supernovae (SNe). We explain the observed trend using the metallicity dependence of SN Ia metal production and present constraints on the available theoretical modeling for low-metallicity inhibition of SNe Ia. In the second paper We analyzed nine X-ray-bright Virgo early-type galaxies observed by both ASCA and ROSAT. Through spatially resolved spectroscopy, we determined the radial temperature profiles and abundances of Mg, Si, and Fe for six galaxies. The temperature profiles are consistent with isothermal temperatures outside of cooler regions at the galaxies' centers. We present new evidence for iron abundance gradients in NGC 4472 and NGC 4649 and confirm the previous results on NGC 4636. Mg and Si abundance gradients on average are flatter than those of iron and correspond to an underabundance of α-process elements at high Fe values, while at low iron the element ratios favor enrichment by Type I1 supernovae (SNe). We explain the observed trend using the metallicity dependence of SN Ia metal production and present constraints on the available theoretical modeling for low-metallicity inhibition of SNe Ia.

GALEX studies on UV properties of Nearby Early-type Galaxies

NASA Astrophysics Data System (ADS)

Rhee, J.; Rich, R. M.; Sohn, Y.-J.; Lee, Y.-W.; Gil de Paz, A.; Deharveng, J.-M.; Donas, J.; Boselli, A.; Rey, S.-C.; Yi, S. K.; GALEX Team

2005-12-01

We present the results of surface photometry on the far-UV (FUV) and near-UV (NUV) images of 23 nearby elliptical galaxies and spiral bulges taken from the GALEX (Galaxy Evolution Explorer). Surface brightness profiles of most galaxies are consistent with de Vaucouleurs' r1/4 law except for some cases more consistent with exponential profiles. We analyze the radial profiles of UV color, (FUV - NUV), and Mg2 line index to investigate a correlation between the gradients of UV color and metal abundance for early-type galaxies. UV color gradients are calculated by applying least square fitting to UV color profile up to effective radius, while Mg2 line strength gradients are compiled for 12 galaxies from previous works. For the 12 early-type galaxies, we find that UV color profiles have a trend to become bluer inward and there is a weak correlation between the gradients of UV color and Mg2 line strength in the sense that galaxies with larger UV color gradients tend to have stronger metal abundance gradients. We also explore the properties of the GALEX-measured ultraviolet rising flux in 96 nearby elliptical galaxies, as a function Lick Mg2 index and velocity dispersion. We include 36 galaxies in the Virgo cluster from the sample of Boselli et al (2005). We find no correlation between the Mg2 index, and log σ and FUV-r. This confirms the findings of Rich et al (2005) for a sample of GALEX/SDSS quiescent early-type galaxies. This is true both for the integrated light, and for nuclear colors. We find a weak correlation between Mg2 and FUV-NUV. We gratefully acknowledge NASA's support for construction, operation, and science analysis for the GALEX mission, developed in cooperation with the Centre National d'Etudes Spatiales of France and the Korean Ministry of Science and Technology.

Leukocyte telomere length correlates with glucose control in adults with recently diagnosed type 2 diabetes.

PubMed

Rosa, Erica Carine Campos Caldas; Dos Santos, Renan Renato Cruz; Fernandes, Luis Fernando Amarante; Neves, Francisco de Assis Rocha; Coelho, Michella Soares; Amato, Angelica Amorim

2018-01-01

We investigated leukocyte relative telomere length (TL) in patients with type 2 diabetes (T2D) diagnosed for no longer than five years and its association with clinical and biochemical variables. Peripheral blood leukocyte relative TL was investigated in 108 patients with T2D (87 women, 21 men) and 125 (37 women, 88 men) age-matched control subjects with normal glucose tolerance, by quantitative polymerase chain reaction. Multiple linear regression analysis was used to examine the association between relative TL and demographic, anthropometric and biochemical indicators of metabolic control among patients with T2D. Patients with T2D had a median time since diagnosis of 1 year and most were on metformin monotherapy, with satisfactory glucose control determined by HbA1c levels. Median relative TL was not different between patients with T2D and control subjects. However, multiple linear regression analyses showed that relative TL was inversely associated with time since T2D diagnosis, fasting plasma glucose levels and HbA1c levels, but not with HbA1c levels assessed in the preceding 5-12 months, after adjustment for age, sex and body mass index. This study suggests that relative TL is not shorter in patients with recently diagnosed T2D, but is inversely correlated with glucose levels, even among patients with overall satisfactory glucose control. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence of Cognitive Impairment in Recently Diagnosed Type 2 Diabetes Patients: Are Chronic Inflammatory Diseases Responsible for Cognitive Decline?

PubMed

Lavielle, Pilar; Talavera, Juan O; Reynoso, Nancy; González, Marissa; Gómez-Díaz, Rita A; Cruz, Miguel; Vázquez, Felipe; Wacher, Niels H

2015-01-01

To estimate the prevalence of cognitive impairment (CI) among patients recently diagnosed with type 2 diabetes (RDD) and to identify any relationships between CI and RDD comorbidities. One thousand seven hundred twelve patients with RDD participated in a cross-sectional study. The patients' sociodemographic and clinical data were registered. The sample population had an average age of 51 ± 11 years, and 63.26% of the patients were female. CI was diagnosed in 38 patients (2.2%) and was more common among both females (2.8% vs. 1.3%, p = 0.063) and the elderly (0% at an age ≤ 30 years vs. 10.4% at an age > 70 years, p = 0.0001). Rheumatoid arthritis (present in 15.8% vs. absent in 2.1%) and asthma (13% vs. 2.1%) correlated significantly with CI based on the results of our logistic regression analysis. Age, female gender, rheumatoid arthritis and asthma are risk factors for CI in the setting of RDD.

Characteristics related to early secondary amenorrhoea and pregnancy among women diagnosed with systemic lupus erythematosus: an analysis using the GOAL study.

PubMed

Knight, Jessica H; Howards, Penelope P; Spencer, Jessica B; Tsagaris, Katina C; Lim, Sam S

2016-01-01

Systemic lupus erythematosus (SLE) disproportionately affects women and often develops during their reproductive years. Research suggests that some women who receive cyclophosphamide as treatment for SLE experience earlier decline in menstrual function, but reproductive health among women with SLE who have not taken this drug is less well understood. This study aims to better understand the relation between SLE and reproduction by assessing early secondary amenorrhoea and pregnancy in women treated with and without cyclophosphamide from a population-based cohort with large numbers of African-Americans. Female patients with SLE, ages 20-40 at time of diagnosis, who were 40 years or older at the time of the survey were included in this analysis (N=147). Participants in the Georgians Organized Against Lupus (GOAL) study were asked about their reproductive histories including early secondary amenorrhoea, defined as loss of menstruation before age 40. Women who were cyclophosphamide naïve had an increased prevalence of early secondary amenorrhoea compared with population estimates, 13-17% compared with 1-5%. Factors associated with early secondary amenorrhoea in women not treated with cyclophosphamide were marital status and receipt of a kidney transplant. Treatment with cyclophosphamide doubled the prevalence after adjustment for patient characteristics. Over 88% of women reported being pregnant at least once, and about 83% of these had a child, but the majority of pregnancies occurred before diagnosis. SLE diagnosed in early adulthood may affect women's reproductive health even if they are not treated with cyclophosphamide. Better understanding of other factors related to reproductive health in this population will improve clinicians' and patients' abilities to make treatment and family planning decisions.

Characteristics related to early secondary amenorrhoea and pregnancy among women diagnosed with systemic lupus erythematosus: an analysis using the GOAL study

PubMed Central

Knight, Jessica H; Howards, Penelope P; Spencer, Jessica B; Tsagaris, Katina C; Lim, Sam S

2016-01-01

Objective Systemic lupus erythematosus (SLE) disproportionately affects women and often develops during their reproductive years. Research suggests that some women who receive cyclophosphamide as treatment for SLE experience earlier decline in menstrual function, but reproductive health among women with SLE who have not taken this drug is less well understood. This study aims to better understand the relation between SLE and reproduction by assessing early secondary amenorrhoea and pregnancy in women treated with and without cyclophosphamide from a population-based cohort with large numbers of African-Americans. Methods Female patients with SLE, ages 20–40 at time of diagnosis, who were 40 years or older at the time of the survey were included in this analysis (N=147). Participants in the Georgians Organized Against Lupus (GOAL) study were asked about their reproductive histories including early secondary amenorrhoea, defined as loss of menstruation before age 40. Results Women who were cyclophosphamide naïve had an increased prevalence of early secondary amenorrhoea compared with population estimates, 13–17% compared with 1–5%. Factors associated with early secondary amenorrhoea in women not treated with cyclophosphamide were marital status and receipt of a kidney transplant. Treatment with cyclophosphamide doubled the prevalence after adjustment for patient characteristics. Over 88% of women reported being pregnant at least once, and about 83% of these had a child, but the majority of pregnancies occurred before diagnosis. Conclusions SLE diagnosed in early adulthood may affect women's reproductive health even if they are not treated with cyclophosphamide. Better understanding of other factors related to reproductive health in this population will improve clinicians' and patients' abilities to make treatment and family planning decisions. PMID:27752335

Prevalence of Immediate-Type Food Allergy in Early Childhood in Seoul

PubMed Central

Park, Miran; Kim, Dosoo; Ahn, Kangmo

2014-01-01

Purpose There are scanty epidemiologic data on the prevalence of food allergy (FA) among preschool children in Asia. We performed this study to determine the prevalence and causative foods of immediate-type FA in early childhood in Korea. Methods A questionnaire-based, cross-sectional study was performed between September and October 2011. Children aged 0-6 years were recruited from 301 public child care centers in Seoul. Parents were asked to complete a questionnaire on FA. Children with FA were classified into "perceived FA, ever," "immediate-type FA, ever," and "immediate-type FA, current" according to the algorithm. Results A total of 16,749 children were included in this study. The prevalence of "perceived FA, ever," "immediate-type FA, ever," and "immediate-type FA, current" was 15.1%, 7.0%, and 3.7%, respectively. "Immediate-type FA, current" was reported by 182 (4.9%) out of 3,738 children aged ≤2 years, 262 (3.4%) of 7,648 children aged 3-4 years, and 177 (3.3%) of 5,363 children aged 5-6 years. Hen's egg (126/621) was the most frequent cause as the individual food item, followed by cow's milk (82/621) and peanut (58/621). Among the food groups, fruits (114/621), tree nuts (90/621) and crustaceans (85/621) were the most common offending foods. The three leading causes of food-induced anaphylaxis were hen's egg (22/47), cow's milk (15/47), and peanut (14/47). Conclusions The prevalence of immediate-type FA in early childhood is 3.7%, and is higher in younger children. The most common offending foods differed with age. PMID:24587949

[Association between body weight change during early and middle adulthood and the risk of type 2 diabetes in middle aged and elderly population].

PubMed

Hu, Q; Jiang, C Q; Zhang, W S; Cheng, J J; Xu, L; Jin, Y L; Shen, Z M; Zhu, F; Lam, D Q

2017-12-10

Objective: To examine the association between weight changes during early and middle adulthood and the risk of type 2 diabetes mellitus in middle aged and elderly population. Methods: Based on the Guangzhou Biobank Cohort Study (GBCS), 28 736 residents aged ≥50 years were included in Guangzhou. Multivariate logistic regression was used to analyze the association between body weight changes during early or middle adulthood and age when the heaviest weight reaching the threshold on the risk of type 2 diabetes mellitus in middle age or elderly population. Adjustments on age, smoking, alcohol consumption, physical activity, education level, occupation, district of residence and body mass index etc ., were made. Results: The mean age was 64.3 (standard deviation=6.7) years in men and 61.0 (standard deviation=7.0) years in women, with the prevalence rates of diabetes as 13.1% and 13.7% in men and women, respectively. Compared to those with stable body weight, the risk of diabetes increased with weight gain during early and middle adulthood in both men and women (both P values for trend<0.01). Participants who gained more than 20 kg during early and middle adulthood were associated with the highest risk of diabetes in men ( OR =2.83, 95% CI :1.99-4.02) and women ( OR =3.13, 95% CI : 2.47-3.96). Compared to those who reached the highest weight at age 20, those who reaching the highest weight at 40 to 49 years were associated with the highest risk of diabetes, with OR being 5.32 (95% CI : 1.92-14.8) in men and 3.41 (95% CI : 2.49-4.67) in women, respectively. Weight loss in adulthood was associated with self-reported but not newly diagnosed diabetic cases in both middle and older aged men and women. Conclusion: Weight gain during early and middle adulthood may increase the risk of diabetes in middle and older aged population. The detrimental effect of obesity on diabetes might become significantly visible in the next decades.

Substance use and mental diagnoses among adults with and without type 2 diabetes: Results from electronic health records data.

PubMed

Wu, Li-Tzy; Ghitza, Udi E; Batch, Bryan C; Pencina, Michael J; Rojas, Leoncio Flavio; Goldstein, Benjamin A; Schibler, Tony; Dunham, Ashley A; Rusincovitch, Shelley; Brady, Kathleen T

2015-11-01

Comorbid diabetes and substance use diagnoses (SUD) represent a hazardous combination, both in terms of healthcare cost and morbidity. To date, there is limited information about the association of SUD and related mental disorders with type 2 diabetes mellitus (T2DM). We examined the associations between T2DM and multiple psychiatric diagnosis categories, with a focus on SUD and related psychiatric comorbidities among adults with T2DM. We analyzed electronic health record (EHR) data on 170,853 unique adults aged ≥18 years from the EHR warehouse of a large academic healthcare system. Logistic regression analyses were conducted to estimate the strength of an association for comorbidities. Overall, 9% of adults (n=16,243) had T2DM. Blacks, Hispanics, Asians, and Native Americans had greater odds of having T2DM than whites. All 10 psychiatric diagnosis categories were more prevalent among adults with T2DM than among those without T2DM. Prevalent diagnoses among adults with T2MD were mood (21.22%), SUD (17.02%: tobacco 13.25%, alcohol 4.00%, drugs 4.22%), and anxiety diagnoses (13.98%). Among adults with T2DM, SUD was positively associated with mood, anxiety, personality, somatic, and schizophrenia diagnoses. We examined a large diverse sample of individuals and found clinical evidence of SUD and psychiatric comorbidities among adults with T2DM. These results highlight the need to identify feasible collaborative care models for adults with T2DM and SUD related psychiatric comorbidities, particularly in primary care settings, that will improve behavioral health and reduce health risk. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The Origin of Dwarf Early-Type Galaxies

NASA Astrophysics Data System (ADS)

Toloba, Elisa; Boselli, A.; Gorgas, J.

2013-01-01

The physical mechanisms involved in the formation and evolution of dwarf early-type galaxies (dEs) are not well understood yet. Whether these objects, that outnumber any other class of object in clusters, are the low luminosity extension of massive early-type galaxies, i.e. formed through similar processes, or are a different group of objects possibly formed through the transformation of low luminosity spiral galaxies, is still an open debate. Studying the kinematic properties of dEs is a powerful way to distinguish between these two scenarios. In my PhD, awarded with a Fulbright postdoctoral Fellowship and with the 2011 prize to the best Spanish PhD dissertation in Astronomy, we used this technique to make a spectrophotometric analysis of 18 dEs in the Virgo cluster. I found some differences for these dEs within the cluster. The dEs in the outer parts of Virgo have rotation curves with shapes and amplitudes similar to late-type galaxies of the same luminosity. They are rotationally supported, have disky isophotes, and younger ages than those dEs in the center of Virgo, which are pressure supported, often have boxy isophotes and are older. Ram pressure stripping, which removes the gas of galaxies leaving the stars untouched, explains the properties of the dEs located in the outskirts of Virgo. However, the dEs in the central cluster regions, which have lost their angular momentum, must have suffered a more violent transformation. A combination of ram pressure stripping and harassment is not enough to remove the rotation and the disky structures of these galaxies. I am conducting new analysis with 20 new dEs to throw some light in this direction. I also analysed the Faber-Jackson and the Fundamental Plane relations, and I found that dEs deviate from the trends of massive elliptical galaxies towards the position of dark matter dominated systems such as the dwarf spheroidal satellites of the Milky Way and M31. This indicates that dEs have a non-negligible dark matter

Psychosocial and Moral Development of PTSD-Diagnosed Combat Veterans

ERIC Educational Resources Information Center

Taylor, John G.; Baker, Stanley B.

2007-01-01

Two related studies were conducted in order to investigate whether psychosocial and moral development appeared to have been disrupted and arrested in veterans diagnosed as having posttraumatic stress disorder (PTSD). Study 1 was devoted to developing a measure of late adolescence, early adulthood, and adulthood stages of psychosocial…

Clinical and genetic characteristics of GAD-antibody positive patients initially diagnosed as having type 2 diabetes.

PubMed

Hamaguchi, Kazuyuki; Kimura, Akinori; Kusuda, Yoichiro; Yamashita, Tsutomu; Yasunami, Michio; Takahasi, Megumi; Abe, Nobuyuki; Yoshimatsu, Hironobu

2004-11-01

The present study was conducted to clarify the clinical and genetic characteristics of the diabetic patients who have antibodies to glutamic acid decarboxylase (GADab) but are diagnosed initially as type 2 diabetes because of the slow progression. Fifty-five GADab+ patients and 137 GADab- patients were recruited. The GADab+ patients were divided into two subgroups according to their antibody titers. The high-titer subgroup (Ab > or = 20 U/ml) had lower urinary C-peptide concentrations, and was assigned insulin therapy more often than the GADab- patients. In contrast to the high-titer subgroup, clinical parameters in the low-titer subgroup were similar to the GADab- diabetic patients. The urinary C-peptide levels correlated negatively with the GADab titer in the GADab+ patients. Analysis of type 1 diabetes-susceptible HLA alleles revealed high frequencies of the B54 and DRB1*0405 allele, but not the B61 and DRB1*0901 alleles, in the high-titer subgroup, whereas the frequency of the protective DRB1*1502 allele was decreased. The GADab+ patients with the B54 allele had higher GADab titers and lower urinary C-peptide excretion than patients without this allele. These data indicated that patients with a high-GADab titer share the autoimmune background characteristic of type 1 diabetes.

Early Implantation of Primary Prevention Implantable Cardioverter Defibrillators for Patients with Newly Diagnosed Severe Nonischemic Cardiomyopathy.

PubMed

Voskoboinik, Aleksandr; Bloom, Jason; Taylor, Andrew; Mariani, Justin

2016-09-01

Primary prevention implantable cardioverter defibrillators (ICDs) reduce mortality in selected patients with severe systolic dysfunction. Current guidelines suggest a 3- to 6-month waiting period before implantation. We retrospectively studied 29 consecutive patients with newly diagnosed nonischemic cardiomyopathy (NICM) who underwent primary prevention ICD implantation within 6 months of diagnosis between January 2008 and April 2014. Cardiac MRI (CMR) evaluated left ventricular ejection fraction (LVEF) and regional fibrosis preimplant. The primary end point was "failure to qualify for an ICD at 12 months postimplant," either due to LVEF ≥ 35% or deterioration necessitating mechanical support or transplantation, without appropriate ICD therapy. Secondary end points were appropriate and inappropriate ICD therapy. Baseline mean age was 44.2 ± 14.8 years and median LVEF 16.4%. Median time from diagnosis to implant was 32 days. At 12 months, 17 patients (58.6%) no longer qualified for an ICD, mainly due to LVEF improvement. At follow-up (mean 32.0 ± 20.6 months), three patients received appropriate therapy (one for ventricular fibrillation). All three had CMR late gadolinium enhancement (LGE) and nonsustained ventricular tachycardia (NSVT) preimplant. Cardiac resynchronization at implant predicted LVEF improvement. Early appropriate therapy, particularly for ventricular fibrillation, is infrequent for patients with very severe NICM who have ICDs implanted within 6 months of diagnosis. The majority of these patients would not qualify for an ICD at 12 months postinsertion. In the absence of a multimodality risk score, early ICD insertion should only be considered in selected cases (presence of LGE and NSVT). Wearable cardioverter defibrillators may have a role as a bridge to ICD decision. © 2016 Wiley Periodicals, Inc.

Touchscreen typing-pattern analysis for detecting fine motor skills decline in early-stage Parkinson's disease.

PubMed

Iakovakis, Dimitrios; Hadjidimitriou, Stelios; Charisis, Vasileios; Bostantzopoulou, Sevasti; Katsarou, Zoe; Hadjileontiadis, Leontios J

2018-05-16

Parkinson's disease (PD) is a degenerative movement disorder causing progressive disability that severely affects patients' quality of life. While early treatment can produce significant benefits for patients, the mildness of many early signs combined with the lack of accessible high-frequency monitoring tools may delay clinical diagnosis. To meet this need, user interaction data from consumer technologies have recently been exploited towards unsupervised screening for PD symptoms in daily life. Similarly, this work proposes a method for detecting fine motor skills decline in early PD patients via analysis of patterns emerging from finger interaction with touchscreen smartphones during natural typing. Our approach relies on low-/higher-order statistical features of keystrokes timing and pressure variables, computed from short typing sessions. Features are fed into a two-stage multi-model classification pipeline that reaches a decision on the subject's status (PD patient/control) by gradually fusing prediction probabilities obtained for individual typing sessions and keystroke variables. This method achieved an AUC = 0.92 and 0.82/0.81 sensitivity/specificity (matched groups of 18 early PD patients/15 controls) with discriminant features plausibly correlating with clinical scores of relevant PD motor symptoms. These findings suggest an improvement over similar approaches, thereby constituting a further step towards unobtrusive early PD detection from routine activities.

The ESO Nearby Abell Cluster Survey. VI. Spatial distribution and kinematics of early- and late-type galaxies

NASA Astrophysics Data System (ADS)

de Theije, P. A. M.; Katgert, P.

1999-01-01

Analysis of the data obtained in the ESO Nearby Abell Cluster Survey (ENACS) has shown that the space distribution and kinematics of galaxies with detectable emission lines in their spectra differ significantly from those of galaxies without emission lines. This result, and details of the kinematics, were considered as support for the idea that at least the spirals with emission lines are on orbits that are not isotropic. This might indicate that this subset of late-type galaxies either has `first approach'-orbits towards the dense core of their respective clusters, or has orbits that `avoid' the core. The galaxies with emission lines are essentially all late-type galaxies. On the other hand, the emission-line galaxies represent only about a third of the late-type galaxies, the majority of which do not show detectable emission lines. The galaxies without emission lines are therefore a mix of early- and late-type galaxies. In this paper we attempt to separate early- and late-type galaxies, and we study possible differences in distribution and kinematics of the two galaxy classes. For only about 10% of the galaxies in the ENACS, the morphology is known from imaging. Here, we describe our classification on the basis of the ENACS spectrum. The significant information in each spectrum is compressed into 15 Principal Components, which are used as input for an Artificial Neural Network. The latter is `trained' with 150 of the 270 galaxies for which a morphological type is available from Dressler, and subsequently used to classify each galaxy. This yields a classification for two-thirds of the ENACS galaxies. The Artificial Neural Network has two output classes: early-type (E+S0) and late-type (S+I) galaxies. We do not distinguish E and S0 galaxies, because these cannot be separated very robustly on the basis of the spectrum. The success rate of the classification is estimated from the sample of 120 galaxies with Dressler morphologies which were not used to train the ANN

Role of EEG as Biomarker in the Early Detection and Classification of Dementia

PubMed Central

Al-Qazzaz, Noor Kamal; Ali, Sawal Hamid Bin MD.; Ahmad, Siti Anom; Chellappan, Kalaivani; Islam, Md. Shabiul; Escudero, Javier

2014-01-01

The early detection and classification of dementia are important clinical support tasks for medical practitioners in customizing patient treatment programs to better manage the development and progression of these diseases. Efforts are being made to diagnose these neurodegenerative disorders in the early stages. Indeed, early diagnosis helps patients to obtain the maximum treatment benefit before significant mental decline occurs. The use of electroencephalogram as a tool for the detection of changes in brain activities and clinical diagnosis is becoming increasingly popular for its capabilities in quantifying changes in brain degeneration in dementia. This paper reviews the role of electroencephalogram as a biomarker based on signal processing to detect dementia in early stages and classify its severity. The review starts with a discussion of dementia types and cognitive spectrum followed by the presentation of the effective preprocessing denoising to eliminate possible artifacts. It continues with a description of feature extraction by using linear and nonlinear techniques, and it ends with a brief explanation of vast variety of separation techniques to classify EEG signals. This paper also provides an idea from the most popular studies that may help in diagnosing dementia in early stages and classifying through electroencephalogram signal processing and analysis. PMID:25093211

Role of EEG as biomarker in the early detection and classification of dementia.

PubMed

Al-Qazzaz, Noor Kamal; Ali, Sawal Hamid Bin Md; Ahmad, Siti Anom; Chellappan, Kalaivani; Islam, Md Shabiul; Escudero, Javier

2014-01-01

The early detection and classification of dementia are important clinical support tasks for medical practitioners in customizing patient treatment programs to better manage the development and progression of these diseases. Efforts are being made to diagnose these neurodegenerative disorders in the early stages. Indeed, early diagnosis helps patients to obtain the maximum treatment benefit before significant mental decline occurs. The use of electroencephalogram as a tool for the detection of changes in brain activities and clinical diagnosis is becoming increasingly popular for its capabilities in quantifying changes in brain degeneration in dementia. This paper reviews the role of electroencephalogram as a biomarker based on signal processing to detect dementia in early stages and classify its severity. The review starts with a discussion of dementia types and cognitive spectrum followed by the presentation of the effective preprocessing denoising to eliminate possible artifacts. It continues with a description of feature extraction by using linear and nonlinear techniques, and it ends with a brief explanation of vast variety of separation techniques to classify EEG signals. This paper also provides an idea from the most popular studies that may help in diagnosing dementia in early stages and classifying through electroencephalogram signal processing and analysis.

Perceptions of academic skills of children diagnosed with ADHD.

PubMed

Eisenberg, Daniel; Schneider, Helen

2007-05-01

This study investigates how the academic skills of children diagnosed with ADHD are perceived by teachers, parents, and the children themselves. The authors analyze data collected for third graders in spring 2002 in the nationally representative Early Childhood Longitudinal Survey. They use linear regressions to estimate independent associations between perceptions of academic abilities and parent-reported ADHD diagnoses, controlling for scores on standardized reading and math tests, assessments of externalizing behaviors, and other factors. Results show that for ADHD-diagnosed girls compared to other girls, both parents' and teachers' perceptions are substantially more negative. For ADHD-diagnosed boys, the differentials are also negative but less pronounced. Self-perceptions are not significantly different by ADHD status, except for boys' more negative self-perceptions related to math. Given the potentially damaging effects of these negative perceptions and expectations on self-esteem, motivation, and performance, efforts may be needed to bring perceptions of ADHD children more in line with the abilities they demonstrate on objective assessments. (J. of Att. Dis. 2007; 10(4) 390-397).

Early Vocabulary in Relation to Gender, Bilingualism, Type, and Duration of Childcare

PubMed Central

Stolarova, M.; Brielmann, A. A.; Wolf, C.; Rinker, T.; Burke, T; Baayen, H.

2016-01-01

This study investigates the predictive value of child-related and environmental characteristics for early lexical development. The German productive vocabulary of 51 2-year-olds (27 girls), assessed via parental report, was analyzed taking children’s gender, the type of early care they experienced, and their mono- versus bilingual language composition into consideration. The children were from an educationally homogeneous group of families and state-regulated daycare facilities with high structural quality. All investigated subgroups exhibited German vocabulary size within the expected normative range. Gender differences in vocabulary composition, but not in size, were observed. There were no general differences in vocabulary size or composition between the 2 care groups. An interaction between the predictors gender and care arrangement showed that girls without regular daycare experience before the age of 2 years had a somewhat larger vocabulary than all other investigated subgroups of children. The vocabulary size of the 2-year-old children in daycare correlated positively with the duration of their daycare experience prior to testing. The small subgroup of bilingual children investigated exhibited slightly lower but still normative German expressive vocabulary size and a different vocabulary composition compared to the monolingual children. This study expands current knowledge about relevant predictors of early vocabulary. It shows that in the absence of educational disadvantages the duration of early daycare experience of high structural quality is positively associated with vocabulary size but also points to the fact that environmental characteristics, such as type of care, might affect boys’ and girls’ early vocabulary in different ways. PMID:28127412

[Ehler-Danlos syndrome type VIII].

PubMed

Ciarloni, L; Perrigouard, C; Lipsker, D; Cribier, B

2010-03-01

Ehlers-Danlos syndrome (EDS) comprises a heterogeneous group of diseases involving genetic collagen fibre impairment. We describe a case of a patient presenting the rare type VIII, in which dermatitis ocre was associated with parodontal disease, and which was diagnosed late. A 29-year-old man consulted for a pretibial ulcer present for seven years, resulting from a post-traumatic haematoma that had failed to heal. In view of the longiliner morphology, it had previously been diagnosed as Marfan syndrome. Subsequently, edentation was observed as well as "alveolar bone fragility". Examination revealed a marfanoid morphotype, a pretibial ulcer set within long-standing bilateral dermatitis ocre and papyraceous scars, but no joint hyperlaxity or cutaneous hyperelasticity. The diagnosis was consequently corrected to EDS type VIII. Type VIII is a rare form of EDS, and the molecular mechanism is poorly understood. The involvement of parodontal connective tissue suggests impairment of collagen I and III proteins. It is important to identify this type of the disease since it involves parodontal disease for which early treatment is required in order to try to prevent edentation. The present case demonstrates the importance of diagnosis, which may be based upon appearance of bilateral dermatitis ocre from the age of 15 years associated with skin fragility. This sign is not part of the classical picture of Marfan syndrome, with which EDS type VIII is often confounded. Copyright 2009 Elsevier Masson SAS. All rights reserved.

Nursing diagnoses in children with congenital heart disease: a survival analysis.

PubMed

Martins da Silva, Viviane; Lopes, Marcos Venícios de Oliveira; Leite de Araujo, Thelma

2007-01-01

To analyze the relationship between nursing diagnoses and survival rates in children with congenital heart disease. A total of 270 observations were carried out in 45 children with congenital heart disease who were followed for 15 days. Differences in mean survival times were identified in children not more than 4 months of age with respect to the following diagnoses: impaired gas exchange, ineffective breathing pattern, activity intolerance, delayed growth and development, and decreased cardiac output. The main diagnoses are identified early in the hospitalization period and are conditions resulting from hemodynamic alterations and prescribed medical treatment. Congenital heart disease provokes serious hemodynamic alterations that generate human responses, which should be treated proactively.

Early detection of hospitalized patients with previously diagnosed obstructive sleep apnea using computer decision support alerts.

PubMed

Evans, R Scott; Flint, Vrena B; Cloward, Tom V; Beninati, William; Lloyd, James F; Megwalu, Kimberly; Simpson, Kathy J; Alsharit, Ahmed M; Balls, Shayna B; Farney, Robert J

2013-01-01

Obstructive sleep apnea (OSA) is a worldwide problem affecting 2-14% of the general population and most patients remain undiagnosed. OSA patients are at elevated risk for hypoxemia, cardiac arrhythmias, cardiorespiratory arrest, hypoxic encephalopathy, stroke and death during hospitalization. Clinical screening questionnaires are used to identify hospitalized patients with OSA; especially before surgery. However, current screening questionnaires miss a significant number of patients and require more definitive testing before specific therapy can be started. Moreover, many patients are admitted to the hospital with a previous diagnosis of OSA that is not reported. Thus, many patients with OSA do not receive appropriate therapy during hospitalization due to the lack of information from previous inpatient and outpatient encounters. Large enterprise data warehouses provide the ability to monitor patient encounters over wide geographical areas. This study found that previously diagnosed OSA is highly prevalent and undertreated in hospitalized patients and the use of early computer alerts by respiratory therapists resulted in significantly more OSA patients receiving appropriate medical care (P < 0.002) which resulted in significantly fewer experiencing hypoxemia (P < 0.006). The impact was greater for non-surgery patients compared to surgery patients.

Nutritional Factors and Preservation of C-Peptide in Youth With Recently Diagnosed Type 1 Diabetes

PubMed Central

Mayer-Davis, Elizabeth J.; Dabelea, Dana; Crandell, Jamie L.; Crume, Tessa; D’Agostino, Ralph B.; Dolan, Lawrence; King, Irena B.; Lawrence, Jean M.; Norris, Jill M.; Pihoker, Catherine; The, Natalie

2013-01-01

OBJECTIVE To test the novel hypothesis that nutritional factors previously associated with type 1 diabetes etiology or with insulin secretion are prospectively associated with fasting C-peptide (FCP) concentration among youth recently diagnosed with type 1 diabetes. RESEARCH DESIGN AND METHODS Included were 1,316 youth with autoantibody-positive type 1 diabetes who participated in the SEARCH for Diabetes in Youth study (baseline disease duration, 9.9 months; SD, 6.3). Nutritional exposures included breastfeeding and age at introduction of complementary foods, baseline plasma long-chain omega-3 fatty acids including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), vitamin D, vitamin E, and, from a baseline food frequency questionnaire, estimated intake of the branched-chain amino acid leucine and total carbohydrate. Multiple linear regression models were conducted to relate each nutritional factor to baseline FCP adjusted for demographics, disease-related factors, and other confounders. Prospective analyses included the subset of participants with preserved β-cell function at baseline (baseline FCP ≥0.23 ng/mL) with additional adjustment for baseline FCP and time (mean follow-up, 24.3 months; SD, 8.2; n = 656). FCP concentration was analyzed as log(FCP). RESULTS In adjusted prospective analyses, baseline EPA (P = 0.02), EPA plus DHA (P = 0.03), and leucine (P = 0.03) were each associated positively and significantly with FCP at follow-up. Vitamin D was unexpectedly inversely associated with FCP (P = 0.002). CONCLUSIONS Increased intake of branched-chain amino acids and long-chain omega-3 fatty acids may support preservation of β-cell function. This represents a new direction for research to improve prognosis for type 1 diabetes. PMID:23801797

Early type galaxies: Mapping out the two-dimensional space of galaxy star formation histories

NASA Astrophysics Data System (ADS)

Graves, Genevieve J.

Early type galaxies form a multi-parameter family, as evidenced by the two- dimensional (2-D) Fundamental Plane relationship. However, their star formation histories are often treated as a one-dimensional mass sequence. This dissertation presents a systematic study of the relationship between the multi- parameter structural properties of early type galaxies and their star formation histoires. We demonstrate that the stellar populations of early type galaxies span a 2-D space, which means that their star formation histories form a two- parameter family. This 2-D family is then mapped onto several familiar early type galaxy scaling relations, including the color-magnitude relation, the Fundamental Plane, and a cross-section through the Fundamental Plane. We find that the stellar population properties, and therefore the star formation histories of early type galaxies depend most strongly on galaxy velocity dispersion (s), rather than on luminosity ( L ), stellar mass ( M [low *] ), or dynamical mass ( M dyn ). Interestingly, stellar populations are independent of the radius ( R e ) of the galaxies. At fixed s, they show correlated residuals through the thickness of the Fundamental Plane (FP) in the surface-brightness ( I e ) dimension, such that low-surface-brightness galaxies are older, less metal-enriched, and more enhanced in Mg relative to Fe than their counterparts at the same s and R e on the FP midplane. Similarly, high- surface-brightness galaxies are younger, more metal-rich, and less Mg-enhanced than their counterparts on the FP midplane. These differences suggest that the duration of star formation varies through the thickness of the FP. If the dynamical mass-to-light ratios of early type galaxies ( M dyn /L ) were constant for all such galaxies, the FP would be equivalent to the plane predicted by the virial relation. However, the observed FP does not exactly match the virial plane. The FP is tilted from the virial plane, indicating that M dyn /L varies

Investigation of Times of Minima of Selected Early-Type Eclipsing Binaries

NASA Astrophysics Data System (ADS)

Mayer, Pavel; Wolf, Marek; Niarchos, P. G.; Gazeas, K. D.; Manimanis, V. N.; Chochol, Drahomír

2006-08-01

New precise times of minimum light for several early-type eclipsing binaries were obtained at three observatories. The changes of period of the following measured binaries are discussed: V1182 Aql, LY Aur, SZ Cam, FZ CMa, QZ Car, LZ Cen, V606 Cen, AH Cep and TU~Mus.

Mass and size growth of early-type galaxies by dry mergers in cluster environments

NASA Astrophysics Data System (ADS)

Oogi, Taira; Habe, Asao; Ishiyama, Tomoaki

2016-02-01

We perform dry merger simulations to investigate the role of dry mergers in the size growth of early-type galaxies in high-density environments. We replace the virialized dark matter haloes obtained by a large cosmological N-body simulation with N-body galaxy models consisting of two components, a stellar bulge and a dark matter halo, which have higher mass resolution than the cosmological simulation. We then resimulate nine cluster-forming regions, whose masses range from 1 × 1014 to 5 × 1014 M⊙. Masses and sizes of stellar bulges are also assumed to satisfy the stellar mass-size relation of high-z compact massive early-type galaxies. We find that dry major mergers considerably contribute to the mass and size growth of central massive galaxies. One or two dry major mergers double the average stellar mass and quadruple the average size between z = 2 and 0. These growths favourably agree with observations. Moreover, the density distributions of our simulated central massive galaxies grow from the inside-out, which is consistent with recent observations. The mass-size evolution is approximated as R∝ M_{{ast }}^{α }, with α ˜ 2.24. Most of our simulated galaxies are efficiently grown by dry mergers, and their stellar mass-size relations match the ones observed in the local Universe. Our results show that the central galaxies in the cluster haloes are potential descendants of high-z (z ˜ 2-3) compact massive early-type galaxies. This conclusion is consistent with previous numerical studies which investigate the formation and evolution of compact massive early-type galaxies.

Early Cretaceous MORB-type basalt and A-type rhyolite in northern Tibet: Evidence for ridge subduction in the Bangong-Nujiang Tethyan Ocean

NASA Astrophysics Data System (ADS)

Fan, Jian-Jun; Li, Cai; Sun, Zhen-Ming; Xu, Wei; Wang, Ming; Xie, Chao-Ming

2018-04-01

New zircon U-Pb ages, major- and trace-element data, and Hf isotopic compositions are presented for bimodal volcanic rocks of the Zhaga Formation (ZF) in the western-middle segment of the Bangong-Nujiang suture zone (BNSZ), northern Tibet. The genesis of these rocks is described, and implications for late-stage evolution of the Bangong-Nujiang Tethyan Ocean (BNTO) are considered. Detailed studies show that the ZF bimodal rocks, which occur as layers within a typical bathyal to abyssal flysch deposit, comprise MORB-type basalt that formed at a mid-ocean ridge, and low-K calc-alkaline A-type rhyolite derived from juvenile crust. The combination of MORB-type basalt, calc-alkaline A-type rhyolite, and bathyal to abyssal flysch deposits in the ZF leads us to propose that they formed as a result of ridge subduction. The A-type ZF rhyolites yield LA-ICP-MS zircon U-Pb ages of 118-112 Ma, indicating formation during the Early Cretaceous. Data from the present study, combined with regional geological data, indicate that the BNTO underwent conversion from ocean opening to ocean closure during the Late Jurassic-Early Cretaceous. The eastern segment of the BNTO closed during this period, while the western and western-middle segments were still at least partially open and active during the Early Cretaceous, accompanied by ridge subduction within the Bangong-Nujiang Tethyan Ocean.

The Impact of Sleep Debt on Excess Adiposity and Insulin Sensitivity in Patients with Early Type 2 Diabetes Mellitus.

PubMed

Arora, Teresa; Chen, Mimi Z; Cooper, Ashley R; Andrews, Rob C; Taheri, Shahrad

2016-05-15

We examined cross-sectional and prospective associations between sleep debt and adiposity measures, as well as homeostatic model assessment-insulin resistance (HOMA-IR) in early type 2 diabetes. Prospective data analysis from participants of a randomized controlled trial based on an intensive lifestyle intervention (usual care, diet, or diet and physical activity). Data were collected at baseline, 6 months, and 12 months post-intervention. The study was performed across five secondary care centers in the United Kingdom. Patients (n = 593) with a recent diagnosis of type 2 diabetes were recruited. Objective height and weight were ascertained for obesity status (body mass index [BMI]; ≥ 30 kg/m(2)), waist circumference (cm) for central adiposity, and fasting blood samples drawn to examine insulin resistance (IR). Seven-day sleep diaries were used to calculate weekday sleep debt at baseline, calculated as average weekend sleep duration minus average weekday sleep duration. At baseline, compared to those without weekday sleep debt, those with weekday sleep debt were 72% more likely to be obese (OR = 1.72 [95% CI:1.03-2.88]). At six months, weekday sleep debt was significantly associated with obesity and IR after adjustment, OR = 1.90 (95% CI:1.10-3.30), OR = 2.07 (95% CI:1.02-4.22), respectively. A further increase at 12 months was observed for sleep debt with obesity and IR: OR = 2.10 (95% CI:1.14-3.87), OR = 3.16 (95% CI:1.38-7.24), respectively. For every 30 minutes of weekday sleep debt, the risk of obesity and IR at 12 months increased by 18% and 41%, respectively. Sleep debt resulted in long-term metabolic disruption, which may promote the progression of type 2 diabetes in newly diagnosed patients. Sleep hygiene/education could be an important factor for future interventions to target early diabetes. © 2016 American Academy of Sleep Medicine.

Supernovae in Early-Type Galaxies: Directly Connecting Age and Metallicity with Type Ia Luminosity

NASA Astrophysics Data System (ADS)

Gallagher, Joseph S.; Garnavich, Peter M.; Caldwell, Nelson; Kirshner, Robert P.; Jha, Saurabh W.; Li, Weidong; Ganeshalingam, Mohan; Filippenko, Alexei V.

2008-10-01

We have obtained optical spectra of 29 early-type (E/S0) galaxies that hosted Type Ia supernovae (SNe Ia). We have measured absorption-line strengths and compared them to a grid of models to extract the relations between the supernova properties and the luminosity-weighted age/composition of the host galaxies. Such a direct measurement is a marked improvement over existing analyses that tend to rely on general correlations between the properties of stellar populations and morphology. We find a strong correlation suggesting that SNe Ia in galaxies whose populations have a characteristic age greater than 5 Gyr are ~1 mag fainter at Vmax than those found in galaxies with younger populations. We find that SN Ia distance residuals in the Hubble diagram are correlated with host-galaxy metal abundance with higher iron abundance galaxies hosting less-luminous supernovae. We thus conclude that the time since progenitor formation primarily determines the radioactive Ni production while progenitor metal abundance has a weaker influence on peak luminosity, but one not fully corrected by light-curve shape and color fitters. This result, particularly the secondary dependence on metallicity, has significant implications for the determination of the equation-of-state parameter, w = P/(ρ c2) , and could impact planning for future dark-energy missions such as JDEM. Assuming no selection effects in discovering SNe Ia in local early-type galaxies, we find a higher specific SN Ia rate in E/S0 galaxies with ages below 3 Gyr than in older hosts. The higher rate and brighter luminosities seen in the youngest E/S0 hosts may be a result of recent star formation and represents a tail of the "prompt" SN Ia progenitors.

Initial combination of linagliptin and metformin compared with linagliptin monotherapy in patients with newly diagnosed type 2 diabetes and marked hyperglycaemia: a randomized, double-blind, active-controlled, parallel group, multinational clinical trial.

PubMed

Ross, S A; Caballero, A E; Del Prato, S; Gallwitz, B; Lewis-D'Agostino, D; Bailes, Z; Thiemann, S; Patel, S; Woerle, H-J; von Eynatten, M

2015-02-01

To evaluate glucose-lowering treatment strategies with linagliptin and metformin in people with newly diagnosed type 2 diabetes and marked hyperglycaemia, a prevalent population for which few dedicated studies of oral antidiabetes drugs have been conducted. A total of 316 patients, with type 2 diabetes diagnosed for ≤12 months and with glycated haemoglobin (HbA1c) concentration in the range 8.5-12.0%, were randomized 1:1 to double-blind, free-combination treatment with linagliptin 5 mg once daily and metformin twice daily (uptitrated to 2000 mg/day maximum) or to linagliptin monotherapy. The primary endpoint was change in HbA1c concentration from baseline at week 24 (per-protocol completers' cohort: n = 245). The mean (standard deviation) age and HbA1c at baseline were 48.8 (11.0) years and 9.8 (1.1)%, respectively. At week 24, the mean ± standard error (s.e.) HbA1c decreased from baseline by -2.8 ± 0.1% with linagliptin/metformin and -2.0 ± 0.1% with linagliptin; a treatment difference of -0.8% (95% confidence interval -1.1 to -0.5; p <0.0001). Similar results were observed in a sensitivity analysis based on intent-to-treat principles: adjusted mean ± s.e. changes in HbA1c of -2.7 ± 0.1% and -1.8 ± 0.1%, respectively; treatment difference of -0.9% (95% CI -1.3 to -0.6; p <0.0001). A treatment response of HbA1c <7.0% was achieved by 61 and 40% of patients in the linagliptin/metformin and linagliptin groups, respectively. Few patients experienced drug-related adverse events (8.8 and 5.7% of patients in the linagliptin/metformin and linagliptin groups, respectively). Hypoglycaemia occurred in 1.9 and 3.2% of patients in the linagliptin/metformin and linagliptin groups, respectively (no severe episodes). Body weight decreased significantly with the combination therapy (-1.3 kg between-group difference; p =0.0033). Linagliptin in initial combination with metformin in patients with newly diagnosed type 2 diabetes and marked

The ultraviolet variability of early-type supergiants

NASA Technical Reports Server (NTRS)

Underhill, A. B.

1984-01-01

Four early-type supergiants - HD 79186 (B5 Ia), HD 96919 (B9 Ia), HD 105056 (ON9.7 Iae), and HD 148379 (B2 Iae) - have been observed with the low-resolution spectrographs of IUE in the large aperture on 14 days. The behavior of the ultraviolet fluxes with time is studied. The light from all four stars seems to vary. Typically the dispersion about the mean magnitude at any wavelength corresponds to + or - 0.085, + or - 0.080, + or - 0.101, and + or - 0.106 mag, respectively. These amplitudes exceed the typical uncertainty in an IUE measurement of flux by about a factor of 3; they are somewhat larger than the variations known in the visible wavelength range. There are insufficient data to investigate periodicity in the observed light changes. The effective temperatures and angular diameters of the stars have been estimated using the present ultraviolet photometry, published UBV and uvby photometry, and the model-atmosphere fluxes reported by Kurucz in 1979. The program stars have dimensions typical for their spectral types. A brief discussion is given of possible causes of the variability of hot supergiants.

The assembly of stellar haloes in massive Early-Type Galaxies

NASA Astrophysics Data System (ADS)

Buitrago, F.

2017-03-01

Massive (Mstellar >= 5×1010 M⊙) Early-Type Galaxies (ETGs) must build an outer stellar envelope over cosmic time in order to account for their remarkable size evolution. This is similar to what occurs to nearby Late-Type Galaxies (LTGs), which create their stellar haloes out of the debris of lower mass systems. We analysed the outer parts of massive ETGs at z < 1 by exploiting the Hubble Ultra Deep Field imaging. These galaxies store 10-30% of their stellar mass at distances 10 < R/kpc < 50, in contrast to the low percentages (< 5%) found for LTGs. We find evidence for a progressive outskirt development with redshift driven solely via merging.

Sample Size Requirements for Studies of Treatment Effects on Beta-Cell Function in Newly Diagnosed Type 1 Diabetes

PubMed Central

Lachin, John M.; McGee, Paula L.; Greenbaum, Carla J.; Palmer, Jerry; Gottlieb, Peter; Skyler, Jay

2011-01-01

Preservation of -cell function as measured by stimulated C-peptide has recently been accepted as a therapeutic target for subjects with newly diagnosed type 1 diabetes. In recently completed studies conducted by the Type 1 Diabetes Trial Network (TrialNet), repeated 2-hour Mixed Meal Tolerance Tests (MMTT) were obtained for up to 24 months from 156 subjects with up to 3 months duration of type 1 diabetes at the time of study enrollment. These data provide the information needed to more accurately determine the sample size needed for future studies of the effects of new agents on the 2-hour area under the curve (AUC) of the C-peptide values. The natural log(), log(+1) and square-root transformations of the AUC were assessed. In general, a transformation of the data is needed to better satisfy the normality assumptions for commonly used statistical tests. Statistical analysis of the raw and transformed data are provided to estimate the mean levels over time and the residual variation in untreated subjects that allow sample size calculations for future studies at either 12 or 24 months of follow-up and among children 8–12 years of age, adolescents (13–17 years) and adults (18+ years). The sample size needed to detect a given relative (percentage) difference with treatment versus control is greater at 24 months than at 12 months of follow-up, and differs among age categories. Owing to greater residual variation among those 13–17 years of age, a larger sample size is required for this age group. Methods are also described for assessment of sample size for mixtures of subjects among the age categories. Statistical expressions are presented for the presentation of analyses of log(+1) and transformed values in terms of the original units of measurement (pmol/ml). Analyses using different transformations are described for the TrialNet study of masked anti-CD20 (rituximab) versus masked placebo. These results provide the information needed to accurately evaluate the

Sample size requirements for studies of treatment effects on beta-cell function in newly diagnosed type 1 diabetes.

PubMed

Lachin, John M; McGee, Paula L; Greenbaum, Carla J; Palmer, Jerry; Pescovitz, Mark D; Gottlieb, Peter; Skyler, Jay

2011-01-01

Preservation of β-cell function as measured by stimulated C-peptide has recently been accepted as a therapeutic target for subjects with newly diagnosed type 1 diabetes. In recently completed studies conducted by the Type 1 Diabetes Trial Network (TrialNet), repeated 2-hour Mixed Meal Tolerance Tests (MMTT) were obtained for up to 24 months from 156 subjects with up to 3 months duration of type 1 diabetes at the time of study enrollment. These data provide the information needed to more accurately determine the sample size needed for future studies of the effects of new agents on the 2-hour area under the curve (AUC) of the C-peptide values. The natural log(x), log(x+1) and square-root (√x) transformations of the AUC were assessed. In general, a transformation of the data is needed to better satisfy the normality assumptions for commonly used statistical tests. Statistical analysis of the raw and transformed data are provided to estimate the mean levels over time and the residual variation in untreated subjects that allow sample size calculations for future studies at either 12 or 24 months of follow-up and among children 8-12 years of age, adolescents (13-17 years) and adults (18+ years). The sample size needed to detect a given relative (percentage) difference with treatment versus control is greater at 24 months than at 12 months of follow-up, and differs among age categories. Owing to greater residual variation among those 13-17 years of age, a larger sample size is required for this age group. Methods are also described for assessment of sample size for mixtures of subjects among the age categories. Statistical expressions are presented for the presentation of analyses of log(x+1) and √x transformed values in terms of the original units of measurement (pmol/ml). Analyses using different transformations are described for the TrialNet study of masked anti-CD20 (rituximab) versus masked placebo. These results provide the information needed to accurately

Potential role of immunoablation and hematopoietic cell transplantation in the treatment of early diabetes type 1.

PubMed

Snarski, Emilian; Milczarczyk, Alicja; Franek, Edward; Jedrzejczak, Wieslaw

2010-01-01

Immunoablation with autologous hematopoietic cell transplantation has shown some effectiveness in the treatment of autoimmune diseases as diverse as aplastic anemia, systemic lupus erythematosus, multiple sclerosis and Crohn's disease. It has been recently shown that this treatment might prevent or delay development of diabetes type 1. The majority of more than 30 patients with early diabetes type 1 who underwent immunoablation and hematopoietic cell transplantation in various centers in the world achieved durable remission of diabetes and independence of exogenous insulin. This review summarizes advantages and risks of this treatment of early diabetes type 1.

HAIR FOLLICLE CHARACTERISTICS AS EARLY MARKER OF TYPE 2 DIABETES

PubMed Central

Miranda, J. Jaime; Taype-Rondan, Alvaro; Tapia, Jose Carlos; Gastanadui-Gonzalez, Maria Gabriela; Roman-Carpio, Ricardo

2016-01-01

Type 2 Diabetes mellitus (DM2) includes a continuum of metabolic disorders characterized by hyperglycemia that causes several chronic long-term complications such as coronary artery disease, peripheral arterial disease, nephropathy, and neuropathy. The hair follicle could reveal signs of early vascular impairment, yet its relationship to early metabolic injuries has been largely ignored. We propose that in earlier stages of the continuum of DM2-related metabolic disorders, a group of susceptible patients who do not yet meet the diagnostic criteria to be considered as persons with DM2 may present chronic vascular impairment and end organ damage, including hair follicle damage, which can be evaluated to identify an early risk marker. This hypothesis is based in the association found between insulin resistance and alopecia in non-diabetic persons, and the hair loss on the lower limbs as a manifestation of long-term peripheral arterial disease among subjects with DM2. In order to test this hypothesis, studies are required to evaluate if hair follicle characteristics are related to and can predict hyperglycemic complications, and if they do so, which feature of the hair follicle, such as hair growth, best characterizes such DM2-related conditions. If this hypothesis were proven to be true, significant advances towards a personalized approach for early prevention strategies and management of DM2 would be made. By focusing on the hair follicles, early stages of metabolic-related organ damage could be identified using non-invasive low-cost techniques. In so doing, this approach could provide early identification of DM2-susceptible individuals and lead to the early initiation of adequate primary prevention strategies to reduce or avoid the onset of large internal organ damage. PMID:27692164

Hair follicle characteristics as early marker of Type 2 Diabetes.

PubMed

Miranda, J Jaime; Taype-Rondan, Alvaro; Tapia, Jose Carlos; Gastanadui-Gonzalez, Maria Gabriela; Roman-Carpio, Ricardo

2016-10-01

Type 2 Diabetes mellitus (DM2) includes a continuum of metabolic disorders characterized by hyperglycemia that causes several chronic long-term complications such as coronary artery disease, peripheral arterial disease, nephropathy, and neuropathy. The hair follicle could reveal signs of early vascular impairment, yet its relationship to early metabolic injuries has been largely ignored. We propose that in earlier stages of the continuum of DM2-related metabolic disorders, a group of susceptible patients who do not yet meet the diagnostic criteria to be considered as persons with DM2 may present chronic vascular impairment and end organ damage, including hair follicle damage, which can be evaluated to identify an early risk marker. This hypothesis is based in the association found between insulin resistance and alopecia in non-diabetic persons, and the hair loss on the lower limbs as a manifestation of long-term peripheral arterial disease among subjects with DM2. In order to test this hypothesis, studies are required to evaluate if hair follicle characteristics are related to and can predict hyperglycemic complications, and if they do so, which feature of the hair follicle, such as hair growth, best characterizes such DM2-related conditions. If this hypothesis were proven to be true, significant advances towards a personalized approach for early prevention strategies and management of DM2 would be made. By focusing on the hair follicles, early stages of metabolic-related organ damage could be identified using non-invasive low-cost techniques. In so doing, this approach could provide early identification of DM2-susceptible individuals and lead to the early initiation of adequate primary prevention strategies to reduce or avoid the onset of large internal organ damage. Copyright © 2016 Elsevier Ltd. All rights reserved.

Results of early thyroidectomy for medullary thyroid carcinoma in children with multiple endocrine neoplasia type 2.

PubMed

Telander, R L; Zimmerman, D; van Heerden, J A; Sizemore, G W

1986-12-01

Children with multiple endocrine neoplasia type 2 (MEN2) often develop medullary carcinoma of the thyroid (MCT) or its precursor, C-cell hyperplasia. Survival results are improved if malignancy is diagnosed early from the results of plasma immunoreactive calcitonin (iCT) measurement. The effect of early detection and thyroidectomy in children with MEN2 syndrome was determined by reviewing the experience between 1975 and 1985. Seventeen children with MEN2 who were 12 years old or younger underwent a total thyroidectomy for MCT or C-cell hyperplasia. iCT was measured in all patients preoperatively and postoperatively. Of the 17 children, 14 (82%) had MEN2a and 3 (18%) had MEN2b. There were 14 (82%) female and three (18%) male patients; their mean age was 6.97 years (range 1.5 to 12 years). In all patients, the diagnosis of MCT was made from initial elevated levels of iCT after stimulation with pentagastrin. Three patients had clinical evidence of disease preoperatively. All patients underwent a total thyroidectomy and lymph nodes were removed from the central zone; a neck dissection was performed in the three with clinically obvious disease. MCT with C-cell hyperplasia was found in 11 children and C-cell hyperplasia alone in six. Of the 11 with carcinoma, eight had bilateral disease and three unilateral. Six children had bilateral C-cell hyperplasia. All 17 children were alive and feeling well at the time of this report; however, three had evidence of metastatic disease according to iCT measurements. None of the children had recurrent nerve injuries; one had evidence of hypoparathyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)

Maternal Type A behavior during pregnancy, neonatal crying, and early infant temperament: do type A women have type A babies?

PubMed

Parker, S J; Barrett, D E

1992-03-01

It was hypothesized that type A behavior in pregnant women would be associated with increased neonatal crying and differential reports of infant temperament at 3 months. Type A behaviors during pregnancy were measured in a self-selected cohort of 72 healthy, primiparous, middle-class women. Their newborns were assessed at 48 hours of age and the women completed an infant temperament questionnaire at 3 months. Women who were classified as type A on the Job Involvement scale of the Jenkins Activity Survey had infants who cried more during a standardized neurobehavioral assessment compared with infants of women who were type B on the same scale. Women who were type A for Job Involvement rated their 3-month-old infants as more intense and less predictable in their responses to the environment. They were also more likely to be breast-feeding their infants at 3 months. This is the first study to examine the prevalence and nature of maternal type A behaviors during pregnancy and to show their relationship to neonatal crying behavior, to maternal report of early infant temperament, and to maternal breast-feeding.

Assessment of text documentation accompanying uncoded diagnoses in computerized health insurance claims in Japan.

PubMed

Tanihara, Shinichi

2015-01-01

Uncoded diagnoses in health insurance claims (HICs) may introduce bias into Japanese health statistics dependent on computerized HICs. This study's aim was to identify the causes and characteristics of uncoded diagnoses. Uncoded diagnoses from computerized HICs (outpatient, inpatient, and the diagnosis procedure-combination per-diem payment system [DPC/PDPS]) submitted to the National Health Insurance Organization of Kumamoto Prefecture in May 2010 were analyzed. The text documentation accompanying the uncoded diagnoses was used to classify diagnoses in accordance with the International Classification of Diseases-10 (ICD-10). The text documentation was also classified into four categories using the standard descriptions of diagnoses defined in the master files of the computerized HIC system: 1) standard descriptions of diagnoses, 2) standard descriptions with a modifier, 3) non-standard descriptions of diagnoses, and 4) unclassifiable text documentation. Using these classifications, the proportions of uncoded diagnoses by ICD-10 disease category were calculated. Of the uncoded diagnoses analyzed (n = 363 753), non-standard descriptions of diagnoses for outpatient, inpatient, and DPC/PDPS HICs comprised 12.1%, 14.6%, and 1.0% of uncoded diagnoses, respectively. The proportion of uncoded diagnoses with standard descriptions with a modifier for Diseases of the eye and adnexa was significantly higher than the overall proportion of uncoded diagnoses among every HIC type. The pattern of uncoded diagnoses differed by HIC type and disease category. Evaluating the proportion of uncoded diagnoses in all medical facilities and developing effective coding methods for diagnoses with modifiers, prefixes, and suffixes should reduce number of uncoded diagnoses in computerized HICs and improve the quality of HIC databases.

Acarbose compared with metformin as initial therapy in patients with newly diagnosed type 2 diabetes: an open-label, non-inferiority randomised trial.

PubMed

Yang, Wenying; Liu, Jie; Shan, Zhongyan; Tian, Haoming; Zhou, Zhiguang; Ji, Qiuhe; Weng, Jianping; Jia, Weiping; Lu, Juming; Liu, Jing; Xu, Yuan; Yang, Zhaojun; Chen, Wei

2014-01-01

Metformin is the only first-line oral hypoglycaemic drug for type 2 diabetes recommended by international guidelines with proven efficacy, safety, and cost-effectiveness. However, little information exists about its use in Asian populations. We aimed to ascertain the effectiveness of the α-glucosidase inhibitor acarbose, extensively adopted in China, compared with metformin as the alternative initial therapy for newly diagnosed type 2 diabetes. In this 48-week, randomised, open-label, non-inferiority trial, patients who were newly diagnosed with type 2 diabetes, with a mean HbA1c of 7·5%, were enrolled from 11 sites in China. After a 4-week lifestyle modification run-in, patients were assigned to 24 weeks of monotherapy with metformin or acarbose as the initial treatment, followed by a 24-week therapy phase during which add-on therapy was used if prespecified glucose targets were not achieved. Primary endpoints were to establish whether acarbose was non-inferior to metformin in HbA1c reduction at week 24 and week 48 timepoints. The non-inferiority margin was 0·3%, with an expected null difference in the change from baseline to week 48 in HbA1c. Analysis was done on a modified intention-to-treat population. This study was registered with Chinese Clinical Trial Registry, number ChiCTR-TRC-08000231. Of the 788 patients randomly assigned to treatment groups, 784 patients started the intended study drug. HbA1c reduction at week 24 was -1·17% in the acarbose group and -1·19% in the metformin group. At week 48, the HbA1c reduction was -1·11% (acarbose) and -1·12% (metformin) with difference 0·01% (95% CI -0·12 to 0·14, p=0·8999). Six (2%) patients in the acarbose group and seven (2%) patients in the metformin group had serious adverse events, and two (1%) and four (1%) had hypoglycaemic episodes. This study provides evidence that acarbose is similar to metformin in efficacy, and is therefore a viable choice for initial therapy in Chinese patients newly

Improved outcomes for newly diagnosed AL amyloidosis between 2000 and 2014: cracking the glass ceiling of early death.

PubMed

Muchtar, Eli; Gertz, Morie A; Kumar, Shaji K; Lacy, Martha Q; Dingli, David; Buadi, Francis K; Grogan, Martha; Hayman, Suzanne R; Kapoor, Prashant; Leung, Nelson; Fonder, Amie; Hobbs, Miriam; Hwa, Yi Lisa; Gonsalves, Wilson; Warsame, Rahma; Kourelis, Taxiarchis V; Russell, Stephen; Lust, John A; Lin, Yi; Go, Ronald S; Zeldenrust, Steven; Kyle, Robert A; Rajkumar, S Vincent; Dispenzieri, Angela

2017-04-13

In light of major advances in immunoglobulin light chain (AL) amyloidosis, we evaluated the trends in presentation, management, and outcome among 1551 newly diagnosed AL amyloidosis patients seen in our institution from 2000 to 2014. As compared with the 2 intervals 2000-2004 and 2005-2009, patients diagnosed in 2010-2014 were less likely to have >2 involved organs. Utilization of autologous stem cell transplant (ASCT) was similar across all periods, about one-third of patients, but there was an increase in the use of pre-ASCT bortezomib induction and of unattenuated melphalan conditioning in 2010-2014 compared with earlier periods. Non-ASCT first-line regimen changed with 65% of patients in 2010-2014 received bortezomib-based therapy, 79% of patients in 2005-2009 received melphalan-dexamethasone, and 64% of patients in 2000-2004 received melphalan-prednisone. The rate of better than very good partial response (VGPR) was higher in more recent periods (66% vs 58% vs 51%; P = .001), a change largely driven by improved VGPR rates in the non-ASCT population. Overall survival (OS) has improved, with inflection points for improvement differing for the ASCT and non-ASCT groups. In the ASCT population, the greatest gains were after 2010 (4-year OS, 91% compared with 73% and 65%). In the non-ASCT group, greatest gains were after 2005 (4-year OS, 38%, 32%, and 16%). Fewer patients died within 6 months of diagnosis in the 2 later periods (24% vs 25% vs 37%; P < .001). Overall, outcomes among patients with AL amyloidosis have improved with earlier diagnosis, higher rates of VGPR, lower early mortality, and improved OS. © 2017 by The American Society of Hematology.

The value of early wireless esophageal pH monitoring in diagnosing functional heartburn in refractory gastroesophageal reflux disease.

PubMed

Park, Eun-Young; Choi, Myung-Gyu; Baeg, Meonggi; Lim, Chul-Hyun; Kim, Jinsu; Cho, Yukyung; Park, Jaemyung; Lee, Inseok; Kim, Sangwoo; Choi, Kyuyong

2013-10-01

It is difficult to differentiate functional heartburn from proton pump inhibitor (PPI) failure. The aims of this study were to assess the role of early wireless esophageal pH monitoring in patients referred with gastroesophageal reflux disease (GERD) and to identify differences in the clinical spectrum among GERD subtypes. We enrolled consecutive referred patients with suspected GERD. After endoscopy on the first visit, all underwent wireless esophageal pH monitoring when off the PPI. Two hundred thirty patients were enrolled. These patients were classified into a reflux esophagitis group (20, 8.7 %) and a normal endoscopic findings group (210, 91.3 %). Among the 210 patients in the normal endoscopic findings group, 63 (27.4 %) were diagnosed with pathological reflux, 35 (15.2 %) with hypersensitive esophagus, 87 (37.8 %) with normal acid exposure with negative symptom association, and 25 (10.9 %) with test failure. These groups did not differ in age, body mass index, smoking habit, alcohol consumption, symptom severity, quality of life, presence of atypical symptoms, overlap with irritable bowel syndrome, and the frequency of somatization, depression, and anxiety. PPI responses were evaluated in 135 patients. Fifty patients (37.0 %) were not responsive to the 4-week treatment; 26 (19.3 %) were diagnosed with refractory non-erosive gastroesophageal disease, and 24 (17.8 %) with functional heartburn. The demographics and clinical and psychological characteristics did not differ between the two groups. Demographic characteristics and symptom patterns alone cannot differentiate functional heartburn from various subtypes of GERD. Wireless esophageal pH monitoring should be considered for the initial evaluation of GERD in the tertiary referral setting.

Ethical dilemma and moral distress: proposed new NANDA diagnoses.

PubMed

Kopala, Beverly; Burkhart, Lisa

2005-01-01

To propose two NANDA diagnoses--ethical dilemma and moral distress--and to distinguish between the NANDA diagnosis decisional conflict and the proposed nursing diagnosis of ethical dilemma. Journal articles, books, and focus group research findings. Moral/ethical situations exist in health care. Nurses' experiences of ethical dilemmas and moral distress are extrapolated to the types and categories of ethical dilemmas and moral distress that patients experience and are used as the basis for development of two new nursing diagnoses. The two proposed NANDA diagnoses fill a void in current standardized terminology. It is important that nurses have the ability to diagnose ethical or moral situations in health care. Currently, NANDA does not offer a means to document this important phenomenon. The creation of two sets of nursing diagnoses, ethical dilemma and moral distress, will enable nurses to recognize and track nursing care related to ethical or moral situations.

Interstellar matter in early-type galaxies. II - The relationship between gaseous components and galaxy types

NASA Technical Reports Server (NTRS)

Bregman, Joel N.; Hogg, David E.; Roberts, Morton S.

1992-01-01

Interstellar components of early-type galaxies are established by galactic type and luminosity in order to search for relationships between the different interstellar components and to test the predictions of theoretical models. Some of the data include observations of neutral hydrogen, carbon monoxide, and radio continuum emission. An alternative distance model which yields LX varies as LB sup 2.45, a relation which is in conflict with simple cooling flow models, is discussed. The dispersion of the X-ray luminosity about this regression line is unlikely to result from stripping. The striking lack of clear correlations between hot and cold interstellar components, taken together with their morphologies, suggests that the cold gas is a disk phenomenon while the hot gas is a bulge phenomenon, with little interaction between the two. The progression of galaxy type from E to Sa is not only a sequence of decreasing stellar bulge-to-disk ratio, but also of hot-to-cold-gas ratio.

Age Dating Merger Events in Early Type Galaxies via the Detection of AGB Light

NASA Technical Reports Server (NTRS)

Bothun, G.

2005-01-01

A thorough statistical analysis of the J-H vs. H-K color plane of all detected early type galaxies in the 2MASS catalog with velocities less than 5000 km/s has been performed. This all sky survey is not sensitive to one particular galactic environment and therefore a representative range of early type galaxy environments have been sampled. Virtually all N-body simulation so major mergers produces a central starburst due to rapid collection of gas. This central starburst is of sufficient amplitude to change the stellar population in the central regions of the galaxy. Intermediate age populations are given away by the presence of AGB stars which will drive the central colors redder in H-K relative to the J- H baseline. This color anomaly has a lifetime of 2-5 billion years depending on the amplitude of the initial starburst Employing this technique on the entire 2MASS sample (several hundred galaxies) reveals that the AGB signature occurs less than 1% of the time. This is a straightforward indication that virtually all nearby early type galaxies have not had a major merger occur within the last few billion years.

Effects of Liraglutide on Weight Loss, Fat Distribution, and β-Cell Function in Obese Subjects With Prediabetes or Early Type 2 Diabetes.

PubMed

Santilli, Francesca; Simeone, Paola G; Guagnano, Maria T; Leo, Marika; Maccarone, Marica T; Di Castelnuovo, Augusto; Sborgia, Cristina; Bonadonna, Riccardo C; Angelucci, Ermanno; Federico, Virginia; Cianfarani, Stefano; Manzoli, Lamberto; Davì, Giovanni; Tartaro, Armando; Consoli, Agostino

2017-11-01

Obesity is associated with an increased risk of type 2 diabetes and cardiovascular complications. The risk depends significantly on adipose tissue distribution. Liraglutide, a glucagon-like peptide 1 analog, is associated with weight loss, improved glycemic control, and reduced cardiovascular risk. We determined whether an equal degree of weight loss by liraglutide or lifestyle changes has a different impact on subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in obese subjects with prediabetes or early type 2 diabetes. Sixty-two metformin-treated obese subjects with prediabetes or newly diagnosed type 2 diabetes, were randomized to liraglutide (1.8 mg/day) or lifestyle counseling. Changes in SAT and VAT levels (determined by abdominal MRI), insulin sensitivity (according to the Matsuda index), and β-cell function (β-index) were assessed during a multiple-sampling oral glucose tolerance test; and circulating levels of IGF-I and IGF-II were assessed before and after a comparable weight loss (7% of initial body weight). After comparable weight loss, achieved by 20 patients per arm, and superimposable glycemic control, as reflected by HbA 1c level ( P = 0.60), reduction in VAT was significantly higher in the liraglutide arm than in the lifestyle arm ( P = 0.028), in parallel with a greater improvement in β-index ( P = 0.021). No differences were observed in SAT reduction ( P = 0.64). IGF-II serum levels were significantly increased ( P = 0.024) only with liraglutide administration, and the increase in IGF-II levels correlated with both a decrease in VAT (ρ = -0.435, P = 0.056) and an increase in the β-index (ρ = 0.55, P = 0.012). Liraglutide effects on visceral obesity and β-cell function might provide a rationale for using this molecule in obese subjects in an early phase of glucose metabolism dysregulation natural history. © 2017 by the American Diabetes Association.

[Phenylketonuria diagnosed during the neonatal period and breast feeding].

PubMed

Cornejo, Verónica; Manríquez, Viviana; Colombo, Marta; Mabe, Paulina; Jiménez, Mónica; De la Parra, Alicia; Valiente, Alf; Raimann, Erna

2003-11-01

Phenylketonuria (PKU) is due to of a defect in the phenylalanine hydroxylase gene (12q22-24.1) leading to hyperphenylalaninemia. Treatment consists in a low phenylalanine (Phe) diet. To evaluate the evolution of early diagnosed PKU children, receiving direct breast feeding, and a special formula without Phe, during their first six months of life. Nineteen PKU children diagnosed in the neonatal period (19.29 +/- 13.8 days of age), treated with breast feeding and formula without Phe since diagnosis, were studied. Intake of calories, proteins and dietary Phe were quantified. Blood Phe, nutritional status and psychomotor development were also measured. The diet that these children received during the 6 months period of study, had a mean of 127 +/- 19.9 Kcal/kg/day, 1.95 +/- 0.3 g protein/kg/day and 35.3 +/- 9.5 mg Phe/kg/day. Fifteen children maintained the blood level of Phe under 8 mg/dl, considered an excellent metabolic control. Only 4 cases had intermittently high levels, between 10-12 mg/dl. At 6 months of age, 74% of the children maintained breast feeding as the only source of Phe. Sixty three percent had a normal nutritional status, 5.2% were at nutritional risk and 31.6% were overweight. Eighty one percent had a normal mental development. The use of direct breast feeding allows a good metabolic control and improves growth and development of early diagnosed PKU children.

Prevalence by sex of preclinical carotid atherosclerosis in newly diagnosed type 2 diabetes.

PubMed

Catalan, M; Herreras, Z; Pinyol, M; Sala-Vila, A; Amor, A J; de Groot, E; Gilabert, R; Ros, E; Ortega, E

2015-08-01

There is clinical trial evidence that only early, intensive risk factor control can reduce cardiovascular disease (CVD) morbidity and mortality in type 2 diabetes (T2DM). However, there is little information regarding preclinical atherosclerosis at diabetes diagnosis. We assessed carotid atherosclerosis in new-onset T2DM and control individuals without prior CVD. In a cross-sectional case-control study, we determined intima-media thickness (IMT) and plaque (IMT ≥1.5 mm) by ultrasound at all carotid sites in new-onset T2DM patients and controls. We assessed 106 T2DM patients, median age 62 years, 46% women, 19% smokers, 54% with hypertension, and 41% with dyslipidemia and 99 non-diabetic subjects matched by age, sex, and cardiovascular risk factors. Compared to controls, T2DM patients had higher common carotid artery (CCA)-IMT (median 0.725 vs. 0.801 mm, p = 0.01), bulb-IMT (0.976 vs. 1.028 mm, p = 0.12), and internal carotid artery (ICA)-IMT (0.727 vs. 0.802 mm, p = 0.04). The prevalence of total plaque (60% vs. 72%, p = 0.06), ICA plaque (20% vs. 42%, p < 0.01), and harboring ≥3 plaques (16% vs. 35% p < 0.01) was also higher in T2DM. Plaque score (sum of maximum plaque heights) was also higher (p < 0.01) in T2DM. Diabetic women showed more advanced carotid atherosclerosis than diabetic men when they were compared with their respective non-diabetic counterparts. There is a high prevalence of preclinical atherosclerosis (carotid plaque presence and burden) in new-onset T2DM subjects, especially in women. Early, still reversible, preclinical atherosclerosis may explain in part why early intervention is effective to prevent CVD in this patient population. Copyright © 2015 Elsevier B.V. All rights reserved.

Working memory and fine motor skills predict early numeracy performance of children with cerebral palsy.

PubMed

Van Rooijen, Maaike; Verhoeven, Ludo; Steenbergen, Bert

2016-01-01

Early numeracy is an important precursor for arithmetic performance, academic proficiency, and work success. Besides their apparent motor difficulties, children with cerebral palsy (CP) often show additional cognitive disturbances. In this study, we examine whether working memory, non-verbal intelligence, linguistic skills, counting and fine motor skills are positively related to the early numeracy performance of 6-year-old children with CP. A total of 56 children (M = 6.0, SD = 0.61, 37 boys) from Dutch special education schools participated in this cross-sectional study. Of the total group, 81% of the children have the spastic type of CP (33% unilateral and 66% bilateral), 9% have been diagnosed as having diskinetic CP, 8% have been diagnosed as having spastic and diskinetic CP and 2% have been diagnosed as having a combination of diskinetic and atactic CP. The children completed standardized tests assessing early numeracy performance, working memory, non-verbal intelligence, sentence understanding and fine motor skills. In addition, an experimental task was administered to examine their basic counting performance. Structural equation modeling showed that working memory and fine motor skills were significantly related to the early numeracy performance of the children (β = .79 and p < .001, β = .41 and p < .001, respectively). Furthermore, counting was a mediating variable between working memory and early numeracy (β = .57, p < .001). Together, these findings highlight the importance of working memory for early numeracy performance in children with CP and they warrant further research into the efficacy of intervention programs aimed at working memory training.

Performance of HbA1c as an Early Diagnostic Indicator of Type 1 Diabetes in Children and Youth

PubMed Central

Vehik, Kendra; Cuthbertson, David; Boulware, David; Beam, Craig A.; Rodriguez, Henry; Legault, Laurent; Hyytinen, Mila; Rewers, Marian J.; Schatz, Desmond A.; Krischer, Jeffrey P.

2012-01-01

OBJECTIVE The aim of this study was to evaluate HbA1c as an alternative criterion for impaired glucose tolerance (IGT) or type 1 diabetes (T1D) in high-risk subjects <21 years of age. RESEARCH DESIGN AND METHODS Subjects <21 years of age who participated in the prospective DPT-1, TEDDY, TRIGR, and Type 1 Diabetes TrialNet Natural History (TrialNet) studies and had an HbA1c within 90 days of an OGTT with a 2-h plasma glucose (2-hPG) measure were included. An OGTT of 140–199 mg/dL defined IGT, and an OGTT with 2-hPG ≥200 mg/dL or fasting plasma glucose ≥126 mg/dL defined diabetes. HbA1c ≥5.7% defined IGT, and HbA1c ≥ 6.5% defined diabetes. Receiver-operating characteristic curve analysis was used to assess diagnostic accuracy of HbA1c compared with OGTT. RESULTS There were 587 subjects from DPT-1, 884 from TrialNet, 91 from TEDDY, and 420 from TRIGR. As an indicator for IGT, HbA1c sensitivity was very low across the studies (8–42%), and specificity was variable (64–95%). With HbA1c ≥6.5% threshold used for T1D diagnosis, the sensitivity was very low and specificity was high (sensitivity and specificity: DPT-1 24 and 98%, TrialNet 28 and 99%, TEDDY 34 and 98%, and TRIGR 33 and 99%, respectively). The positive predictive value of HbA1c ≥6.5% for the development of T1D was variable (50–94%) across the four studies. CONCLUSIONS HbA1c ≥6.5% is a specific but not sensitive early indicator for T1D in high-risk subjects <21 years of age diagnosed by OGTT or asymptomatic hyperglycemia. Redefining the HbA1c threshold is recommended if used as an alternative criterion in diagnosing T1D. PMID:22699293

Performance of HbA1c as an early diagnostic indicator of type 1 diabetes in children and youth.

PubMed

Vehik, Kendra; Cuthbertson, David; Boulware, David; Beam, Craig A; Rodriguez, Henry; Legault, Laurent; Hyytinen, Mila; Rewers, Marian J; Schatz, Desmond A; Krischer, Jeffrey P

2012-09-01

The aim of this study was to evaluate HbA(1c) as an alternative criterion for impaired glucose tolerance (IGT) or type 1 diabetes (T1D) in high-risk subjects <21 years of age. Subjects <21 years of age who participated in the prospective DPT-1, TEDDY, TRIGR, and Type 1 Diabetes TrialNet Natural History (TrialNet) studies and had an HbA(1c) within 90 days of an OGTT with a 2-h plasma glucose (2-hPG) measure were included. An OGTT of 140-199 mg/dL defined IGT, and an OGTT with 2-hPG ≥200 mg/dL or fasting plasma glucose ≥126 mg/dL defined diabetes. HbA(1c) ≥5.7% defined IGT, and HbA(1c) ≥ 6.5% defined diabetes. Receiver-operating characteristic curve analysis was used to assess diagnostic accuracy of HbA(1c) compared with OGTT. There were 587 subjects from DPT-1, 884 from TrialNet, 91 from TEDDY, and 420 from TRIGR. As an indicator for IGT, HbA(1c) sensitivity was very low across the studies (8-42%), and specificity was variable (64-95%). With HbA(1c) ≥6.5% threshold used for T1D diagnosis, the sensitivity was very low and specificity was high (sensitivity and specificity: DPT-1 24 and 98%, TrialNet 28 and 99%, TEDDY 34 and 98%, and TRIGR 33 and 99%, respectively). The positive predictive value of HbA(1c) ≥6.5% for the development of T1D was variable (50-94%) across the four studies. HbA(1c) ≥6.5% is a specific but not sensitive early indicator for T1D in high-risk subjects <21 years of age diagnosed by OGTT or asymptomatic hyperglycemia. Redefining the HbA(1c) threshold is recommended if used as an alternative criterion in diagnosing T1D.

Snapshot Survey of the Globular Cluster Populations of Isolated Early Type Galaxies

NASA Astrophysics Data System (ADS)

Gregg, Michael

2017-08-01

We propose WFC3/UVIS snapshot observations of a sample of 75 isolated early type galaxiesresiding in cosmic voids or extremely low density regions. The primary aim is to usetheir globular cluster populations to reconstruct their evolutionary history, revealingif, how, and why void ellipticals differ from cluster ellipticals. The galaxies span arange of luminosities, providing a varied sample for comparison with the well-documentedglobular cluster populations in denser environments. This proposed WFC3 study of isolatedearly type galaxies breaks new ground by targeting a sample which has thus far receivedlittle attention, and, significantly, this will be the first such study with HST.Characterizing early type galaxies in voids and their GC systems promises to increase ourunderstanding of galaxy formation and evolution of galaxies in general because isolatedobjects are the best approximation to a control sample that we have for understanding theinfluence of environment on formation and evolution. Whether these isolated objects turnout to be identical to or distinct from counterparts in other regions of the Universe,they will supply insight into the formation and evolution of all galaxies. Parallel ACSimaging will help to characterize the near field environments of the sample.

The chemical abundance analysis of normal early A- and late B-type stars

NASA Astrophysics Data System (ADS)

Fossati, L.; Ryabchikova, T.; Bagnulo, S.; Alecian, E.; Grunhut, J.; Kochukhov, O.; Wade, G.

2009-09-01

Context: Modern spectroscopy of early-type stars often aims at studying complex physical phenomena such as stellar pulsation, the peculiarity of the composition of the photosphere, chemical stratification, the presence of a magnetic field, and its interplay with the stellar atmosphere and the circumstellar environment. Comparatively less attention is paid to identifying and studying the “normal” A- and B-type stars and testing how the basic atomic parameters and standard spectral analysis allow one to fit the observations. By contrast, this kind of study is paramount for eventually allowing one to correctly quantify the impact of the various physical processes that occur inside the atmospheres of A- and B-type stars. Aims: We wish to establish whether the chemical composition of the solar photosphere can be regarded as a reference for early A- and late B-type stars. Methods: We have obtained optical high-resolution, high signal-to-noise ratio spectra of three slowly rotating early-type stars (HD 145788, 21 Peg and π Cet) that show no obvious sign of chemical peculiarity, and performed a very accurate LTE abundance analysis of up to 38 ions of 26 elements (for 21 Peg), using a vast amount of spectral lines visible in the spectral region covered by our spectra. Results: We provide an exhaustive description of the abundance characteristics of the three analysed stars with a critical review of the line parameters used to derive the abundances. We compiled a table of atomic data for more than 1100 measured lines that may be used in the future as a reference. The abundances we obtained for He, C, Al, S, V, Cr, Mn, Fe, Ni, Sr, Y, and Zr are compatible with the solar ones derived with recent 3D radiative-hydrodynamical simulations of the solar photosphere. The abundances of the remaining studied elements show some degree of discrepancy compared to the solar photosphere. Those of N, Na, Mg, Si, Ca, Ti, and Nd may well be ascribed to non-LTE effects; for P, Cl, Sc and

Effect of intensive insulin treatment on plasma levels of lipoprotein-associated phospholipase A2 and secretory phospholipase A2 in patients with newly diagnosed type 2 diabetes.

PubMed

Lin, Xiu-Hong; Xu, Ming-Tong; Tang, Jv-Ying; Mai, Li-Fang; Wang, Xiao-Yi; Ren, Meng; Yan, Li

2016-11-23

China has the highest absolute disease burden of diabetes worldwide. For diabetic patients, diabetes-related vascular complications are major causes of morbidity and mortality. The roles of lipoprotein-associated phospholipase A 2 (Lp-PLA 2 ) and secretory phospholipase A 2 (sPLA 2 ) as inflammatory markers have been recently evaluated in the pathogenesis of both diabetes and atherosclerosis. We aimed to determine the mechanism through which patients with newly diagnosed type 2 diabetes gain long-term vascular benefit from intensive insulin therapy by evaluating the change in Lp-PLA 2 and sPLA 2 levels after early intensive insulin treatment and its relevance with insulin resistance and pancreatic β-cell function. In total, 90 patients with newly diagnosed type 2 diabetes mellitus were enrolled. All patients received continuous subcutaneous insulin infusion (CSII) for approximately 2 weeks. Intravenous glucose-tolerance test (IVGTT) and oral glucose-tolerance test (OGTT) were performed, and plasma concentrations of Lp-PLA 2 and sPLA 2 were measured before and after CSII. Levels of Lp-PLA 2 and sPLA 2 were significantly higher in diabetic patients with macroangiopathy than in those without (P < 0.05). After CSII, the sPLA 2 level decreased significantly in all diabetic patients (P < 0.05), while the Lp-PLA2 level changed only in those with macroangiopathy (P < 0.05). The area under the curve of insulin in IVGTT and OGTT, the acute insulin response (AIR 3-5 ), early phase of insulin secretion (ΔIns30/ΔG30), modified β-cell function index, and homeostatic model assessment for β-cell function (HOMA-β) increased after treatment even when adjusted for the influence of insulin resistance (IR; P < 0.001). The HOMA-IR was lower after treatment, and the three other indicators adopted to estimate insulin sensitivity (ISI ced , IAI, and QUICKI) were higher after treatment (P < 0.05). Correlation analysis showed that the decrease in the Lp-PLA 2 and s

Early development influences ontogeny of personality types in young laboratory rats.

PubMed

Rödel, Heiko G; Meyer, Susann

2011-09-01

Features of an individual's early development are frequently reported to alter the postnatal ontogeny in litter-bearing mammals with respect to various physiological parameters. We hypothesized that such effects might also apply to the ontogeny of personality types. On the one hand, litter size effects by means of more contacts with littermates, might lead to the development of more offensive types. On the other hand, smaller and less developed young from larger litters might be less offensive due to their lower physical capabilities to deal with challenging situations. We studied these contrasting hypotheses in young rats, which we tested in a battery of emotionality tests. There were clear indications for the existence of distinct behavioral types by means of consistencies in behavioral responses within and across contexts. Based on these responses, we calculated three new variables by PCA, which we interpreted to mainly reflect boldness, exploration, and anxiety. Overall, our results strongly suggest that the early development alters the ontogeny of personality types, with heavier individuals being bolder and more explorative. Furthermore, body mass and litter size influenced the changes in the behavioral responses in successive tests, further supporting the importance of the litter size-dependent body mass for the ontogeny of personalities. Anxiety also depended on litter size, however, in a nonlinear way. Animals born to litters of small or large sizes had higher scores, whereas individuals from medium-sized litters were less anxious. This optimum curve indicates that opposing effects of litter size are involved in shaping personalities in young rats. Copyright © 2011 Wiley Periodicals, Inc.

Milk fatty acids as possible biomarkers to early diagnose elevated concentrations of blood plasma nonesterified fatty acids in dairy cows.

PubMed

Jorjong, S; van Knegsel, A T M; Verwaeren, J; Lahoz, M Val; Bruckmaier, R M; De Baets, B; Kemp, B; Fievez, V

2014-11-01

Most cows encounter a state of negative energy balance during the periparturient period, which may lead to metabolic disorders and impaired fertility. The aim of this study was to assess the potential of milk fatty acids as diagnostic tools of detrimental levels of blood plasma nonesterified fatty acids (NEFA), defined as NEFA concentrations beyond 0.6 mmol/L, in a data set of 92 early lactating cows fed a glucogenic or lipogenic diet and subjected to 0-, 30-, or 60-d dry period before parturition. Milk was collected in wk 2, 3, 4, and 8 (n = 368) and blood was sampled weekly from wk 2 to 8 after parturition. Milk was analyzed for milk fatty acids and blood plasma for NEFA. Data were classified as "at risk of detrimental blood plasma NEFA" (NEFA ≥ 0.6 mmol/L) and "not at risk of detrimental blood plasma NEFA" (NEFA <0.6 mmol/L). Concentrations of 45 milk fatty acids and milk fat C18:1 cis-9-to-C15:0 ratio were subjected to a discriminant analysis. Milk fat C18:1 cis-9 revealed the most discriminating variable to identify detrimental blood plasma NEFA. A false positive rate of 10% allowed us to diagnose 46% of the detrimental blood plasma NEFA cases based on a milk fat C18:1 cis-9 concentration of at least 230 g/kg of milk fatty acids. Additionally, it was assessed whether the milk fat C18:1 cis-9 concentrations of wk 2 could be used as an early warning for detrimental blood plasma NEFA risk during the first 8 wk in lactation. Cows with at least 240 g/kg of C18:1 cis-9 in milk fat had about 50% chance to encounter blood plasma NEFA values of 0.6 mmol/L or more during the first 8 wk of lactation, with a false positive rate of 11.4%. Profit simulations were based on costs for cows suffering from detrimental blood plasma NEFA, and costs for preventive treatment based on daily dosing of propylene glycol for 3 wk. Given the relatively low incidence rate (8% of all observations), continuous monitoring of milk fatty acids during the first 8 wk of lactation to diagnose

Insulin autoantibodies: evidence of autoimmune disease among a group of Puerto Rican children with newly diagnosed type 1 diabetes mellitus.

PubMed

González de Pijem, L; Nieves-Rivera, F

2001-06-01

Type 1 diabetes is a chronic disease caused by a cell-specific destruction of the insulin producing cells of the pancreas. Although Puerto Rico has the highest incidence of type 1 diabetes among Latin American countries, there is scanty data on the presence of antibodies against insulin producing cells. To this end, 20 children (8 males, 12 females), ages 1-15 years, admitted to the University Pediatric Hospital with type 1 diabetes de novo between November 2000 and April 2001 were prospectively studied to determine the presence of serum antibodies against Islet cells (ICA), glutamic acid decarboxylase (GAD-65) and insulin autoantibodies (IAA). IAA was found to be present in 45% of the subjects with 85% of positive rate in subjects under age 5. GAD-65 was present in 66% and ICA was present in 23% of the subjects. We found evidence of autoimmunity against islet cell surface and intracellular components among a cohort of Puerto Rican children with newly diagnosed type 1 diabetes. These findings compared favorably with reports from other ethnicities.

[Clinical and genetic special features of Niemann-Pick disease, type C].

PubMed

Zakharova, E Iu; Mikhaĭlova, S V; Proshliakova, T Iu; Rudenskaia, G E

2012-01-01

Niemann-Pick disease, type C is a rare hereditary disorder of the group of lisosomal storage diseases, caused by mutations in the genes NPC1 or NPC2. Depending on the onset age, several clinical forms of this disease, which differs by manifestation age, main clinical signs and clinical course, are distinguished. Niemann-Pick disease type C can imitate other hereditary and acquired diseases, which complicates its early diagnostics. Clinical and genetic diversity of this disorder, considered on the clinical cases diagnosed at the FSI "RCMG" of RAMS, are discussed in this review.

Systematic variation of the stellar initial mass function in early-type galaxies.

PubMed

Cappellari, Michele; McDermid, Richard M; Alatalo, Katherine; Blitz, Leo; Bois, Maxime; Bournaud, Frédéric; Bureau, M; Crocker, Alison F; Davies, Roger L; Davis, Timothy A; de Zeeuw, P T; Duc, Pierre-Alain; Emsellem, Eric; Khochfar, Sadegh; Krajnović, Davor; Kuntschner, Harald; Lablanche, Pierre-Yves; Morganti, Raffaella; Naab, Thorsten; Oosterloo, Tom; Sarzi, Marc; Scott, Nicholas; Serra, Paolo; Weijmans, Anne-Marie; Young, Lisa M

2012-04-25

Much of our knowledge of galaxies comes from analysing the radiation emitted by their stars, which depends on the present number of each type of star in the galaxy. The present number depends on the stellar initial mass function (IMF), which describes the distribution of stellar masses when the population formed, and knowledge of it is critical to almost every aspect of galaxy evolution. More than 50 years after the first IMF determination, no consensus has emerged on whether it is universal among different types of galaxies. Previous studies indicated that the IMF and the dark matter fraction in galaxy centres cannot both be universal, but they could not convincingly discriminate between the two possibilities. Only recently were indications found that massive elliptical galaxies may not have the same IMF as the Milky Way. Here we report a study of the two-dimensional stellar kinematics for the large representative ATLAS(3D) sample of nearby early-type galaxies spanning two orders of magnitude in stellar mass, using detailed dynamical models. We find a strong systematic variation in IMF in early-type galaxies as a function of their stellar mass-to-light ratios, producing differences of a factor of up to three in galactic stellar mass. This implies that a galaxy's IMF depends intimately on the galaxy's formation history.

Using HIV Sequence and Epidemiologic Data to Assess the Effect of Self-referral Testing for Acute HIV Infection on Incident Diagnoses in San Diego, California

PubMed Central

Mehta, Sanjay R.; Murrell, Ben; Anderson, Christy M.; Kosakovsky Pond, Sergei L.; Wertheim, Joel O.; Young, Jason A.; Freitas, Lorri; Richman, Douglas D.; Mathews, W. Chris; Scheffler, Konrad; Little, Susan J.; Smith, Davey M.

2016-01-01

Background. Because recently infected individuals disproportionately contribute to the spread of human immunodeficiency virus (HIV), we evaluated the impact of a primary HIV screening program (the Early Test) implemented in San Diego. Methods. The Early Test program used combined nucleic acid and serology testing to screen for primary infection targeting local high-risk individuals. Epidemiologic, HIV sequence, and geographic data were obtained from the San Diego County Department of Public Health and the Early Test program. Poisson regression analysis was performed to determine whether the Early Test program was temporally and geographically associated with changes in incident HIV diagnoses. Transmission chains were inferred by phylogenetic analysis of sequence data. Results. Over time, a decrease in incident HIV diagnoses was observed proportional to the number primary HIV infections diagnosed in each San Diego region (P < .001). Molecular network analyses also showed that transmission chains were more likely to terminate in regions where the program was marketed (P = .002). Although, individuals in these zip codes had infection diagnosed earlier (P = .08), they were not treated earlier (P = .83). Conclusions. These findings suggests that early HIV diagnoses by this primary infection screening program probably contributed to the observed decrease in new HIV diagnoses in San Diego, and they support the expansion and evaluation of similar programs. PMID:27174704

Evolution of the early-type galaxy fraction in clusters since z = 0.8

NASA Astrophysics Data System (ADS)

Simard, L.; Clowe, D.; Desai, V.; Dalcanton, J. J.; von der Linden, A.; Poggianti, B. M.; White, S. D. M.; Aragón-Salamanca, A.; De Lucia, G.; Halliday, C.; Jablonka, P.; Milvang-Jensen, B.; Saglia, R. P.; Pelló, R.; Rudnick, G. H.; Zaritsky, D.

2009-12-01

We study the morphological content of a large sample of high-redshift clusters to determine its dependence on cluster mass and redshift. Quantitative morphologies are based on PSF-convolved, 2D bulge+disk decompositions of cluster and field galaxies on deep Very Large Telescope FORS2 images of eighteen, optically-selected galaxy clusters at 0.45 < z < 0.80 observed as part of the ESO Distant Cluster Survey (“EDisCS”). Morphological content is characterized by the early-type galaxy fraction f_et, and early-type galaxies are objectively selected based on their bulge fraction and image smoothness. This quantitative selection is equivalent to selecting galaxies visually classified as E or S0. Changes in early-type fractions as a function of cluster velocity dispersion, redshift and star-formation activity are studied. A set of 158 clusters extracted from the Sloan Digital Sky Survey is analyzed exactly as the distant EDisCS sample to provide a robust local comparison. We also compare our results to a set of clusters from the Millennium Simulation. Our main results are: (1) the early-type fractions of the SDSS and EDisCS clusters exhibit no clear trend as a function of cluster velocity dispersion. (2) Mid-z EDisCS clusters around σ = 500 km s-1 have f_et ≃ 0.5 whereas high-z EDisCS clusters have f_et ≃ 0.4. This represents a ~25% increase over a time interval of 2 Gyr. (3) There is a marked difference in the morphological content of EDisCS and SDSS clusters. None of the EDisCS clusters have early-type galaxy fractions greater than 0.6 whereas half of the SDSS clusters lie above this value. This difference is seen in clusters of all velocity dispersions. (4) There is a strong and clear correlation between morphology and star formation activity in SDSS and EDisCS clusters in the sense that decreasing fractions of [OII] emitters are tracked by increasing early-type fractions. This correlation holds independent of cluster velocity dispersion and redshift even

Evaluation of electrocardiographic parameters for early diagnosis of autonomic dysfunction in children and adolescents with type-1 diabetes mellitus.

PubMed

Uysal, Fahrettin; Ozboyaci, Evren; Bostan, Ozlem; Saglam, Halil; Semizel, Evren; Cil, Ergun

2014-10-01

The aim of this study was to identify the sensitivity of electrocardiogram (ECG) in early diagnosis of cardiac autonomic function disorder in children with type 1 diabetes mellitus. A total of 150 children and adolescents with type 1 diabetes mellitus were enrolled between June 2009 and June 2010, as well as 100 age- and sex-matched healthy control children. Twelve-lead ECG was done in all cases and heart rate, QT and QTc interval, dispersion of P wave (Pd), and of QT (QTd) and QTc interval (QTcd) were measured. The clinical and demographic features such as age, gender, duration of follow up and level of HbA1c and fasting glucose were obtained and the effects of these parameters on ECG measurements were investigated. The mean age of the patients and controls was 11.61 ± 3.72 years and 10.92 ± 3.2 years, respectively. QT and QTc interval and QTcd interval were significantly higher in diabetic children compared to healthy controls but these ECG findings were not associated with the duration of diabetes or glycemic state. Pd was significantly higher in the diabetic patients with HbA1c >7.5% compared to control, and this was also found in patients that were followed up >1 year. Cardiac autonomic function disorder, which is one of the most important causes of morbidity and mortality, may emerge in the course of type 1 diabetes mellitus. It can be diagnosed on ECG even when the patients are asymptomatic. © 2014 Japan Pediatric Society.

Patterns of treatment response in newly diagnosed epilepsy

PubMed Central

Brodie, M.J.; Barry, S.J.E.; Bamagous, G.A.; Norrie, J.D.

2012-01-01

Objective: To delineate the temporal patterns of outcome and to determine the probability of seizure freedom with successive antiepileptic drug regimens in newly diagnosed epilepsy. Methods: Patients in whom epilepsy was diagnosed and the first antiepileptic drug prescribed between July 1, 1982, and April 1, 2006, were followed up until March 31, 2008. Outcomes were categorized into 4 patterns: A) early and sustained seizure freedom; B) delayed but sustained seizure freedom; C) fluctuation between periods of seizure freedom and relapse; and D) seizure freedom never attained. Probability of seizure freedom with successive drug regimens was compared. Seizure freedom was defined as no seizures for ≥1 year. Results: A total of 1,098 patients were included (median age 32 years, range 9–93). At the last clinic visit, 749 (68%) patients were seizure-free, 678 (62%) on monotherapy. Outcome pattern A was observed in 408 (37%), pattern B in 246 (22%), pattern C in 172 (16%), and pattern D in 272 (25%) patients. There was a higher probability of seizure freedom in patients receiving 1 compared to 2 drug regimens, and 2 compared to 3 regimens (p < 0.001). The difference was greater among patients with symptomatic or cryptogenic than with idiopathic epilepsy. Less than 2% of patients became seizure-free on subsequent regimens but a few did so on their sixth or seventh regimen. Conclusions: Most patients with newly diagnosed epilepsy had a constant course which could usually be predicted early. The chance of seizure freedom declined with successive drug regimens, most markedly from the first to the third and among patients with localization-related epilepsies. PMID:22573629

Blood pressure circadian rhythms and adverse outcomes in type 2 diabetes patients diagnosed with orthostatic hypotension.

PubMed

Chang, Jing; Hou, Yuan-Ping; Wu, Jin-Ling; Fang, Xiang-Yang; Li, Sheng-Li; Liu, Miao-Bing; Sun, Qian-Mei

2018-03-01

Patients with diabetes frequently develop orthostatic hypotension (OH). The present study was designed to examine the relationship of blood pressure (BP) circadian rhythms and outcomes in diabetes with OH. In the present study, 173 inpatients with type 2 diabetes were enrolled. Patients were divided into an OH group and a non-OH group according to the BP changes detected in the supine and standing position. Then, 24-h ambulatory BP was monitored. Patients were followed up for an average of 45 ± 10 months post-discharge. Outcomes - death and major adverse cardiac and cerebrovascular events, including heart failure, myocardial infarction and stroke - were recorded. There were 61 patients (35.26%) in the OH group and 112 patients (64.74%) in the non-OH group. In the OH group, the night-time systolic BP and night-time diastolic BP were higher, the blood BP rhythms were predominantly of the riser type (67.21%). OH was as an independent marker of riser type circadian rhythm (adjusted odds ratio 4.532, 95% confidence interval 2.579-7.966). In the OH group, the incidence rates of mortality, and major adverse cardiac and cerebrovascular events were increased significantly compared with those in the non-OH group (11.48 vs 2.68%, P = 0.014; 37.70 vs 8.93%, P < 0.01). In patients who had type 2 diabetes diagnosed with OH, the BP circadian rhythm usually showed riser patterns, and they had increased rates of mortality, and major adverse cardiac and cerebrovascular events. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

A New Sauropodomorph Dinosaur from the Early Jurassic of Patagonia and the Origin and Evolution of the Sauropod-type Sacrum

PubMed Central

Pol, Diego; Garrido, Alberto; Cerda, Ignacio A.

2011-01-01

Background The origin of sauropod dinosaurs is one of the major landmarks of dinosaur evolution but is still poorly understood. This drastic transformation involved major skeletal modifications, including a shift from the small and gracile condition of primitive sauropodomorphs to the gigantic and quadrupedal condition of sauropods. Recent findings in the Late Triassic–Early Jurassic of Gondwana provide critical evidence to understand the origin and early evolution of sauropods. Methodology/Principal Findings A new sauropodomorph dinosaur, Leonerasaurus taquetrensis gen. et sp. nov., is described from the Las Leoneras Formation of Central Patagonia (Argentina). The new taxon is diagnosed by the presence of anterior unserrated teeth with a low spoon-shaped crown, amphicoelous and acamerate vertebral centra, four sacral vertebrae, and humeral deltopectoral crest low and medially deflected along its distal half. The phylogenetic analysis depicts Leonerasaurus as one of the closest outgroups of Sauropoda, being the sister taxon of a clade of large bodied taxa composed of Melanorosaurus and Sauropoda. Conclusions/Significance The dental and postcranial anatomy of Leonerasaurus supports its close affinities with basal sauropods. Despite the small size and plesiomorphic skeletal anatomy of Leonerasaurus, the four vertebrae that compose its sacrum resemble that of the large-bodied primitive sauropods. This shows that the appearance of the sauropod-type of sacrum predated the marked increase in body size that characterizes the origins of sauropods, rejecting a causal explanation and evolutionary linkage between this sacral configuration and body size. Alternative phylogenetic placements of Leonerasaurus as a basal anchisaurian imply a convergent acquisition of the sauropod-type sacrum in the new small-bodied taxon, also rejecting an evolutionary dependence of sacral configuration and body size in sauropodomorphs. This and other recent discoveries are showing that the

Inverse Association of Plasma Chromium Levels with Newly Diagnosed Type 2 Diabetes: A Case-Control Study

PubMed Central

Chen, Sijing; Jin, Xiaoling; Shan, Zhilei; Li, Shuzhen; Yin, Jiawei; Sun, Taoping; Luo, Cheng; Yang, Wei; Yao, Ping; Yu, Kaifeng; Zhang, Yan; Cheng, Qian; Cheng, Jinquan; Bao, Wei; Liu, Liegang

2017-01-01

Chromium has long been known as an enhancer of insulin action. However, the role of chromium in the development of type 2 diabetes mellitus (T2DM) in humans remains controversial. The current study aimed to examine the associations of plasma chromium levels with T2DM and pre-diabetes mellitus (pre-DM). We conducted a case-control study involving 1471 patients with newly diagnosed T2DM, 682 individuals with newly diagnosed pre-DM, and 2290 individuals with normal glucose tolerance in a Chinese population from 2009 to 2014. Plasma chromium was measured by inductively coupled plasma mass spectrometry. Plasma chromium levels were lower in the T2DM and pre-DM groups than in the control group (median: 3.68 μg/L, 3.61 μg/L, 3.97 μg/L, respectively, p < 0.001). After adjustment for potential confounding factors, the odds ratios (95% confidence interval) for T2DM across increasing quartiles of plasma chromium levels were 1 (referent), 0.67 (0.55–0.83), 0.64 (0.51–0.79), and 0.58 (0.46–0.73), respectively (p for trend <0.001). The corresponding odds ratios (95% confidence interval) for pre-DM were 1 (referent), 0.70 (0.54–0.91), 0.67 (0.52–0.88), and 0.58 (0.43–0.78), respectively (p for trend < 0.001). Our results indicated that plasma chromium concentrations were inversely associated with T2DM and pre-DM in Chinese adults. PMID:28304331

Inverse Association of Plasma Chromium Levels with Newly Diagnosed Type 2 Diabetes: A Case-Control Study.

PubMed

Chen, Sijing; Jin, Xiaoling; Shan, Zhilei; Li, Shuzhen; Yin, Jiawei; Sun, Taoping; Luo, Cheng; Yang, Wei; Yao, Ping; Yu, Kaifeng; Zhang, Yan; Cheng, Qian; Cheng, Jinquan; Bao, Wei; Liu, Liegang

2017-03-17

Chromium has long been known as an enhancer of insulin action. However, the role of chromium in the development of type 2 diabetes mellitus (T2DM) in humans remains controversial. The current study aimed to examine the associations of plasma chromium levels with T2DM and pre-diabetes mellitus (pre-DM). We conducted a case-control study involving 1471 patients with newly diagnosed T2DM, 682 individuals with newly diagnosed pre-DM, and 2290 individuals with normal glucose tolerance in a Chinese population from 2009 to 2014. Plasma chromium was measured by inductively coupled plasma mass spectrometry. Plasma chromium levels were lower in the T2DM and pre-DM groups than in the control group (median: 3.68 μg/L, 3.61 μg/L, 3.97 μg/L, respectively, p < 0.001). After adjustment for potential confounding factors, the odds ratios (95% confidence interval) for T2DM across increasing quartiles of plasma chromium levels were 1 (referent), 0.67 (0.55-0.83), 0.64 (0.51-0.79), and 0.58 (0.46-0.73), respectively ( p for trend <0.001). The corresponding odds ratios (95% confidence interval) for pre-DM were 1 (referent), 0.70 (0.54-0.91), 0.67 (0.52-0.88), and 0.58 (0.43-0.78), respectively ( p for trend < 0.001). Our results indicated that plasma chromium concentrations were inversely associated with T2DM and pre-DM in Chinese adults.

Types of neural cells in the spinal ganglia of human embryos and early fetuses.

PubMed

Olszewska, B; Woźniak, W; Gardner, E; O'Rahilly, R

1979-01-01

Spinal ganglial of human embryos and fetuses ranging in C.-R. length from 15 to 74 mm and in age from 6 1/2 to 11 postovulatory weeks were studied by light and electron microscopy. A sequence of events in differentiation and maturation enabled five types of cells to be distinguished: 1. apolar, undifferentiated neuroblasts are the main cells at 6 1/2 to 7 1/2 weeks; 2. early bipolar neuroblasts (strictly speaking, types 2 to 5 are immature neurons) predominate at the end of the embryonic period proper (8 postovulatory weeks); 3. intermediate bipolar neuroblasts are characteristic of the early fetal period; 4. late bipolar neuroblasts, in which two proceses arise separately from one pole of the cell, appear at about 10 postovulatory weeks; 5. unipolar neuroblasts are found within another week and, by that time, cells of types 1 and 2 are no longer present.

Insulin requirement profiles of short-term intensive insulin therapy in patients with newly diagnosed type 2 diabetes and its association with long-term glycemic remission.

PubMed

Liu, Liehua; Ke, Weijian; Wan, Xuesi; Zhang, Pengyuan; Cao, Xiaopei; Deng, Wanping; Li, Yanbing

2015-05-01

To investigate the insulin requirement profiles during short-term intensive continuous subcutaneous insulin infusion (CSII) in patients with newly diagnosed type 2 diabetes and its relationship with long-term glycemic remission. CSII was applied in 104 patients with newly diagnosed type 2 diabetes. Daily insulin doses were titrated and recorded to achieve and maintain euglycemia for 2 weeks. Measurements of blood glucose, lipid profiles as well as intravenous glucose tolerance tests were performed before and after the therapy. Afterwards, patients were followed up for 1 year. Total daily insulin dose (TDD) was 56.6±16.1IU at the first day when euglycemia was achieved (TDD-1). Thereafter, TDD progressively decreased at a rate of 1.4±1.0IU/day to 36.2±16.5IU at the end of the therapy. TDD-1 could be estimated with body weight, FPG, triglyceride and waist circumference in a multiple linear regression model. Decrement of TDD after euglycemia was achieved (ΔTDD) was associated with reduction of HOMA-IR (r=0.27, P=0.008) but not with improvement in β cell function. Patients in the lower tertile of ΔTDD had a significantly higher risk of hyperglycemia relapse than those in the upper tertile within 1 year (HR 3.4, 95%CI [1.4, 8.4], P=0.008). There is a steady decline of TDD after euglycemia is achieved in patients with newly diagnosed type 2 diabetes treated with CSII, and ΔTDD is associated with a better long-term glycemic outcome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Comparison of repaglinide and metformin monotherapy as an initial therapy in Chinese patients with newly diagnosed type 2 diabetes mellitus.

PubMed

Fang, Fu-Sheng; Gong, Yan-Ping; Li, Chun-Lin; Li, Jian; Tian, Hui; Huang, Wei; Wang, Liang-Chen; Li, Lin

2014-06-01

We aimed to compare the effect of repaglinide and metformin monotherapy as an initial therapy in Chinese patients with newly diagnosed type 2 diabetes mellitus (T2DM). In this 15-week, open-labelled, parallel-controlled, randomised study, 60 Chinese drug-naive patients with newly diagnosed T2DM were randomised (2:1) to receive repaglinide or metformin monotherapy. Primary endpoint was change in HbA1c from baseline to the end of the trial. Secondary endpoints included changes in glycaemic variability, insulin sensitivity and β-cell function. Patients in both repaglinide and metformin groups achieved significant reductions in HbA1c (-1.8 ± 1.5 vs -1.6 ± 1.5%), FPG (fasting blood glucose) (-1.7 ± 1.7 vs -2.1 ± 1.7  mmol/l) and 2-h PPG (post-prandial glucose) (-3.8 ± 3.1 vs -3.8 ± 3.6  mmol/l), with no statistical differences between the groups. Glycaemic variability, glucose infusion rate and β-cell function were all significantly improved from baseline in the two groups (all P<0.05), without any statistical differences in the improvement between the groups. Repaglinide and metformin achieved comparable efficacy in improving glycaemic control, reducing glycaemic variability, enhancing insulin sensitivity and ameliorating β-cell function. Therefore, repaglinide is an optional agent for initial therapy in Chinese patients with newly diagnosed T2DM. © 2014 European Society of Endocrinology.

Diagnosis of early gastric cancer using narrow band imaging and acetic acid

PubMed Central

Matsuo, Ken; Takedatsu, Hidetoshi; Mukasa, Michita; Sumie, Hiroaki; Yoshida, Hikaru; Watanabe, Yasutomo; Akiba, Jun; Nakahara, Keita; Tsuruta, Osamu; Torimura, Takuji

2015-01-01

AIM: To determine whether the endoscopic findings of depressed-type early gastric cancers (EGCs) could precisely predict the histological type. METHODS: Ninety depressed-type EGCs in 72 patients were macroscopically and histologically identified. We evaluated the microvascular (MV) and mucosal surface (MS) patterns of depressed-type EGCs using magnifying endoscopy (ME) with narrow-band imaging (NBI) (NBI-ME) and ME enhanced by 1.5% acetic acid, respectively. First, depressed-type EGCs were classified according to MV pattern by NBI-ME. Subsequently, EGCs unclassified by MV pattern were classified according to MS pattern by enhanced ME (EME) images obtained from the same angle. RESULTS: We classified the depressed-type EGCs into the following 2 MV patterns using NBI-ME: a fine-network pattern that indicated differentiated adenocarcinoma (25/25, 100%) and a corkscrew pattern that likely indicated undifferentiated adenocarcinoma (18/23, 78.3%). However, 42 of the 90 (46.7%) lesions could not be classified into MV patterns by NBI-ME. These unclassified lesions were then evaluated for MS patterns using EME, which classified 33 (81.0%) lesions as MS patterns, diagnosed as differentiated adenocarcinoma. As a result, 76 of the 90 (84.4%) lesions were matched with histological diagnoses using a combination of NBI-ME and EME. CONCLUSION: A combination of NBI-ME and EME was useful in predicting the histological type of depressed-type EGC. PMID:25632201

Effect of Mindfulness Based Stress Reduction on Immune Function, Quality of Life and Coping In Women Newly Diagnosed with Early Stage Breast Cancer

PubMed Central

Witek-Janusek, Linda; Albuquerque, Kevin; Chroniak, Karen Rambo; Chroniak, Christopher; Durazo, Ramon; Mathews, Herbert L.

2008-01-01

This investigation used a non-randomized controlled design to evaluate the effect and feasibility of a mindfulness based stress reduction (MBSR) program on immune function, quality of life (QOL), and coping in women recently diagnosed with breast cancer. Early stage breast cancer patients, who did not receive chemotherapy, self-selected into an 8-week MBSR program or into an assessment only, control group. Outcomes were evaluated over time. The first assessment was at least 10 days after surgery and prior to adjuvant therapy, as well as before the MBSR start-up. Further assessments were mid-MBSR, at completion of MBSR, and at 4-weeks post MBSR completion. Women with breast cancer enrolled in the control group (Non-MBSR) were assessed at similar times. At the first assessment (i.e., before MBSR start), reductions in peripheral blood mononuclear cell NK cell activity (NKCA) and IFN gamma production with increases in IL-4, IL-6, and IL-10 production and plasma cortisol levels were observed for both the MBSR and Non-MBSR groups of breast cancer patients. Over time women in the MBSR group re-established their NKCA and cytokine production levels. In contrast, breast cancer patients in the Non-MBSR group exhibited continued reductions in NKCA and IFN gamma production with increased IL-4, IL-6, and IL-10 production. Moreover, women enrolled in the MBSR program had reduced cortisol levels, improved QOL, and increased coping effectiveness compared to the Non-MBSR group. In summary, MBSR is a program that is feasible for women recently diagnosed with early stage breast cancer and the results provide preliminary evidence of beneficial effects of MBSR on immune function, QOL, and coping effectiveness. PMID:18359186

Primary site and regional lymph node involvement are independent prognostic factors for early-stage extranodal nasal-type natural killer/T cell lymphoma.

PubMed

Niu, Shao-Qing; Yang, Yong; Li, Yi-Yang; Wen, Ge; Wang, Liang; Li, Zhi-Ming; Wang, Han-Yu; Zhang, Lu-Lu; Xia, Yun-Fei; Zhang, Yu-Jing

2016-04-04

Nasal-type extranodal natural killer/T-cell lymphoma (ENKTCL) originates primarily in the nasal cavity or extra-nasal sites within the upper aerodigestive tract. However, it is unclear whether the primary site can serve as an independent prognostic factor or whether the varying clinical outcomes observed with different primary sites can be attributed merely to their propensities of regional lymph node involvement. The aim of this study was to investigate the prognostic implications of the primary site and regional lymph node involvement in patients with early-stage nasal-type ENKTCL. To develop a nomogram, we reviewed the clinical data of 215 consecutively diagnosed patients with early-stage nasal-type ENKTCL who were treated in Sun Yat-sen University Cancer Center with chemotherapy and radiotherapy between 2000 and 2011. The predictive accuracy and discriminative ability of the nomogram were determined using a concordance index (C-index) and calibration curve. The 5-year overall survival (OS) and progression-free survival (PFS) rates of patients with nasal ENKTCL were higher than those of patients with extra-nasal ENKTCL (OS: 68.2% vs. 46.0%, P = 0.030; PFS: 53.4% vs. 26.6%, P = 0.010). The 5-year OS and PFS rates of patients with Ann Arbor stage IE ENKTCL were higher than those of patients with Ann Arbor stage IIE ENKTCL (OS: 66.3% vs. 59.2%, P = 0.003; PFS: 51.4% vs. 40.3%, P = 0.009). Multivariate analysis showed that age >60 years, ECOG performance status score ≥2, elevated lactate dehydrogenase (LDH) level, extra-nasal primary site, and regional lymph node involvement were significantly associated with lower 5-year OS rate; age >60 years, elevated LDH level, extra-nasal primary site, and regional lymph node involvement were significantly associated with lower 5-year PFS rate. The nomogram included the primary site and regional lymph node involvement based on multivariate analysis. The calibration curve showed good agreement between the predicted and actual

Diagnosing Homo sapiens in the fossil record.

PubMed

Stringer, Christopher Brian; Buck, Laura Tabitha

2014-01-01

Diagnosing Homo sapiens is a critical question in the study of human evolution. Although what constitutes living members of our own species is straightforward, in the fossil record this is still a matter of much debate. The issue is complicated by questions of species diagnoses and ideas about the mode by which a new species is born, by the arguments surrounding the behavioural and cognitive separateness of the species, by the increasing appreciation of variation in the early African H. sapiens record and by new DNA evidence of hybridization with extinct species. This study synthesizes thinking on the fossils, archaeology and underlying evolutionary models of the last several decades with recent DNA results from both H. sapiens and fossil species. It is concluded that, although it may not be possible or even desirable to cleanly partition out a homogenous morphological description of recent H. sapiens in the fossil record, there are key, distinguishing morphological traits in the cranium, dentition and pelvis that can be usefully employed to diagnose the H. sapiens lineage. Increasing advances in retrieving and understanding relevant genetic data provide a complementary and perhaps potentially even more fruitful means of characterizing the differences between H. sapiens and its close relatives.

Physician reasons for nonpharmacologic treatment of hyperglycemia in older patients newly diagnosed with type 2 diabetes mellitus.

PubMed

Marrett, Elizabeth; Zhang, Qiaoyi; Kanitscheider, Claudia; Davies, Michael J; Radican, Larry; Feinglos, Mark N

2012-11-01

To identify reasons why primary care physicians (PCPs) do not treat older patients newly diagnosed with type 2 diabetes mellitus (T2DM) with antihyperglycemic agents following diagnosis. US PCPs were surveyed via the internet regarding their reasons for not treating patients aged >65 years diagnosed with T2DM and had not yet initiated antihyperglycemic therapy for ≥6 months after diagnosis. PCPs were requested to provide relevant clinical information for untreated older patients and select applicable reasons for not initiating treatment from a list of 35 possibilities, grouped into five categories. A total of 508 PCPs completed the online survey and provided complete clinical data for 770 patients. The reasons provided by the first-ranked physician for not initiating antihyperglycemic therapy were related to diet and exercise (57.5%); mild hyperglycemia (23.8%); patient's concerns (13.4%); concerns about antihyperglycemic agents (3.0%); and comorbidities and polypharmacy (2.3%). The "diet and exercise" category was the most common first-ranked non-treatment reason, regardless of recent hemoglobin A(1c) (HbA(1c)) stratum. Reasons within the "patient's concerns," "concerns related to antihyperglycemic agents," and "comorbidities and polypharmacy" categories tended to be selected more often as first-ranked reasons by physicians for patients with higher HbA(1c) values. Of the 158 patients whose physicians planned to initiate antihyperglycemic therapy within the next month, 54.4% already had a most recent HbA(1c) value above their physician-stated threshold for treatment initiation. In the PCPs studied, there was a tendency to select appropriate reasons for non-treatment with antihyperglycemic agents given their patients' glycemic status. However, there was inertia related to the initiation of pharmacological therapy in some older patients with newly diagnosed T2DM. Important factors included physicians' perceptions of "mild" hyperglycemia and the HbA(1c) threshold

Early Experience after Developing a Pathology Laboratory in Malawi, with Emphasis on Cancer Diagnoses

PubMed Central

Horner, Marie-Josephe; Shores, Carol G.; Alide, Noor; Kamiza, Steve; Kampani, Coxcilly; Chimzimu, Fred; Fedoriw, Yuri; Dittmer, Dirk P.; Hosseinipour, Mina C.; Hoffman, Irving F.

2013-01-01

Background Despite increasing cancer burden in Malawi, pathology services are limited. We describe operations during the first 20 months of a new pathology laboratory in Lilongwe, with emphasis on cancer diagnoses. Methods and Findings We performed a cross-sectional study of specimens from the Kamuzu Central Hospital pathology laboratory between July 1, 2011 and February 28, 2013. Patient and specimen characteristics, and final diagnoses are summarized. Diagnoses were categorized as malignant, premalignant, infectious, other pathology, normal or benign, or nondiagnostic. Patient characteristics associated with premalignancy and malignancy were assessed using logistic regression. Of 2772 specimens, 2758 (99%) with a recorded final diagnosis were included, drawn from 2639 unique patients. Mean age was 38 years and 63% were female. Of those with documented HIV status, 51% had unknown status, and 36% with known status were infected. Histologic specimens comprised 91% of cases, and cytologic specimens 9%. Malignant diagnoses were most common overall (n = 861, 31%). Among cancers, cervical cancer was most common (n = 117, 14%), followed by lymphoma (n = 91, 11%), esophageal cancer (n = 86, 10%), sarcoma excluding Kaposi sarcoma (n = 75, 9%), and breast cancer (n = 61, 7%). HIV status was known for 95 (11%) of malignancies, with HIV prevalence ranging from 9% for breast cancer to 81% for cervical cancer. Increasing age was consistently associated with malignancy [bivariable odds ratio 1.24 per decade increase (95% CI 1.19–1.29) among 2685 patients with known age; multivariable odds ratio 1.33 per decade increase (95% CI 1.14–1.56) among 317 patients with known age, gender, and HIV status], while HIV infection and gender were not. Conclusions Despite selection and referral bias inherent in these data, a new pathology laboratory in Lilongwe has created a robust platform for cancer care and research. Strategies to effectively capture clinical

Progression of early features of spinocerebellar ataxia type 2 in individuals at risk: a longitudinal study.

PubMed

Velázquez-Pérez, Luis; Rodríguez-Labrada, Roberto; Canales-Ochoa, Nalia; Montero, Jacqueline Medrano; Sánchez-Cruz, Gilberto; Aguilera-Rodríguez, Raúl; Almaguer-Mederos, Luis E; Laffita-Mesa, José M

2014-05-01

The effects of ATXN2 expansion on the nervous system arise before the cerebellar syndrome can be diagnosed; however, progression of the underlying early clinical manifestations is unknown. We aimed to assess progression of the main clinical features in early stages of the spinocerebellar ataxia type 2 (SCA2). We did this longitudinal study between Aug 12, 1986, and Sept 3, 2013, in carriers and non-carriers of the SCA2 mutation. We enrolled participants aged 6-60 years who were asymptomatic offspring or siblings of patients with SCA2. Participants were repeatedly assessed (two to seven times) until they presented definite cerebellar syndrome. All participants underwent standardised neurological examinations and electrophysiological (nerve conduction tests and somatosensory evoked potentials) and genetic assessments. We enrolled 40 (73%) of 55 eligible participants to the baseline assessment, of whom 21 (13 women and eight men) were carriers of the SCA2 mutation, and 19 (14 women and five men) were non-carriers. Muscle cramps and sensory abnormalities were the most common clinical features in carriers (n=17 [81%] for both features) compared with controls (n=3 [16%] and n=4 [21%], respectively; χ(2)=84·58; p<0.0001, and χ(2)=72·03; p<0·0001, respectively) Both features showed a notable worsening over time and, in 17 (81%) carriers, age at onset was inversely correlated to CAG repeats (cramps: r -0·76, p=0·0004; sensory abnormalities: r -0·77, p=0·0004). Hyper-reflexia was associated with long time to ataxia onset (mean 5·71 years [SD 5·03]), whereas hyporeflexia was associated with short time (median 1·29 years [range 1-3]). Electrophysiological recordings obtained between 5 and 8 years before ataxia in 11 (52%) carriers showed reduced sensory amplitudes for median nerve (10·34 uV [SD 5·07]) and prolonged mean P40 latency (39·31 ms [2·40]) compared with age-matched and sex-matched controls (20·72 uV [9·08 uV]; p=0·0085, and 35·60 ms [2·05]; p=0�

Socio-economic patterning in early mortality of patients aged 0-49 years diagnosed with primary bone cancer in Great Britain, 1985-2008.

PubMed

Blakey, Karen; Feltbower, Richard G; James, Peter W; Libby, Gillian; Stiller, Charles; Norman, Paul; Gerrand, Craig; McNally, Richard J Q

2018-04-01

Studies have shown marked improvements in survival between 1981 and 2000 for Ewing sarcoma patients but not for osteosarcoma. This study aimed to explore socio-economic patterning in early mortality rates for both tumours. The study analysed all 2432 osteosarcoma and 1619 Ewing sarcoma cases, aged 0-49 years, diagnosed in Great Britain 1985-2008 and followed to 31/12/2009. Logistic regression models were used to calculate risk of dying within three months, six months, one year, three years and five years after diagnosis. Associations with Townsend deprivation score and its components were examined at small-area level. Urban/rural status was studied at larger regional level. For osteosarcoma, after age adjustment, mortality at three months, six months and one year was associated with higher area unemployment, OR = 1.05 (95% CI 1.00, 1.10), OR = 1.04 (95% CI 1.01, 1.08) and OR = 1.04 (95% CI 1.02, 1.06) respectively per 1% increase in unemployment. Mortality at six months was associated with greater household non-car ownership, OR = 1.02 (95% CI 1.00, 1.03). For Ewing sarcoma, there were no significant associations between mortality and overall Townsend score, nor its components for any time period. For both tumours increasing mortality was associated with less urban and more remote rural areas. This study found that for osteosarcoma, early mortality was associated with residence at diagnosis in areas of higher unemployment, suggesting risk of early death may be socio-economically determined. For both tumours, distance from urban centres may lead to greater risk of early death. Copyright © 2018 Elsevier Ltd. All rights reserved.

Early Family System Types Predict Children's Emotional Attention Biases at School Age

ERIC Educational Resources Information Center

Lindblom, Jallu; Peltola, Mikko J.; Vänskä, Mervi; Hietanen, Jari K.; Laakso, Anu; Tiitinen, Aila; Tulppala, Maija; Punamäki, Raija-Leena

2017-01-01

The family environment shapes children's social information processing and emotion regulation. Yet, the long-term effects of early family systems have rarely been studied. This study investigated how family system types predict children's attentional biases toward facial expressions at the age of 10 years. The participants were 79 children from…

Quantitative Raman characterization of cross-linked collagen thin films as a model system for diagnosing early osteoarthritis

NASA Astrophysics Data System (ADS)

Wang, Chao; Durney, Krista M.; Fomovsky, Gregory; Ateshian, Gerard A.; Vukelic, Sinisa

2016-03-01

The onset of osteoarthritis (OA)in articular cartilage is characterized by degradation of extracellular matrix (ECM). Specifically, breakage of cross-links between collagen fibrils in the articular cartilage leads to loss of structural integrity of the bulk tissue. Since there are no broadly accepted, non-invasive, label-free tools for diagnosing OA at its early stage, Raman spectroscopyis therefore proposed in this work as a novel, non-destructive diagnostic tool. In this study, collagen thin films were employed to act as a simplified model system of the cartilage collagen extracellular matrix. Cross-link formation was controlled via exposure to glutaraldehyde (GA), by varying exposure time and concentration levels, and Raman spectral information was collected to quantitatively characterize the cross-link assignments imparted to the collagen thin films during treatment. A novel, quantitative method was developed to analyze the Raman signal obtained from collagen thin films. Segments of Raman signal were decomposed and modeled as the sum of individual bands, providing an optimization function for subsequent curve fitting against experimental findings. Relative changes in the concentration of the GA-induced pyridinium cross-links were extracted from the model, as a function of the exposure to GA. Spatially resolved characterization enabled construction of spectral maps of the collagen thin films, which provided detailed information about the variation of cross-link formation at various locations on the specimen. Results showed that Raman spectral data correlate with glutaraldehyde treatment and therefore may be used as a proxy by which to measure loss of collagen cross-links in vivo. This study proposes a promising system of identifying onset of OA and may enable early intervention treatments that may serve to slow or prevent osteoarthritis progression.

[Value of mDIXON-Quant sequence, diffusion-weighted imaging in quantitatively diagnosing the sacroiliitis stages].

PubMed

An, Y Y; Li, H X; Zhan, Y; Lei, X W

2017-10-10

Objective: To evaluate the value of mDIXON-Quant sequence, diffusion-weighted imaging (DWI) in quantitative diagnosing of the sacroiliitis stages in patients with ankylosing spondylitis (AS). Methods: Based on the Bath Ankylosing Spondylitis Activity Index (BASDAI) and laboratory parameters, a total of 51 patients were diagnosed with AS. They were divided into two groups as early active group ( n =20) and chronic active group ( n =31), and at the same time, 25 healthy people from Tianjin were included as control group. The regular MRI sequences and mDIXON-Quant sequence, DWI were obtained. The apparent diffusion coefficient (ADC) and fat-signal fraction (FF) value of bone marrow with edema of the sacroiliac joints in early active group and chronic active group and of subchondral bone marrow of sacroiliac joint in control group all were measured by ADC maps and FF maps. Mean (FF, ADC) values were compared between groups. Results: The ADC value of the early active group, chronic active group and the control group is (1.07±0.20)×10(-3)mm(2)/s, (1.00±0.22)×10(-3)mm(2)/s, (0.25±0.07)×10(-3)mm(2)/s, respectively, and the differences of ADC value between early active group and control group, chronic active group and control group were significant ( P <0.01), but the difference of the ADC value between early active group and chronic active group was not significant ( P =0.394). That is to say, the ADC value can't distinguish the early active group and chronic active group. The differences of FF value between groups was significant ( P <0.01), and the FF value of bone marrow with edema in chronic active group were higher than that in early active group. Conclusions: The mDIXON-Quant sequence can quantitatively diagnose early active group and chronic active group, and the diagnostic value is better than DWI. Thus, it can provide guidance for clinical treatment and prognosis.

Using HIV Sequence and Epidemiologic Data to Assess the Effect of Self-referral Testing for Acute HIV Infection on Incident Diagnoses in San Diego, California.

PubMed

Mehta, Sanjay R; Murrell, Ben; Anderson, Christy M; Kosakovsky Pond, Sergei L; Wertheim, Joel O; Young, Jason A; Freitas, Lorri; Richman, Douglas D; Mathews, W Chris; Scheffler, Konrad; Little, Susan J; Smith, Davey M

2016-07-01

Because recently infected individuals disproportionately contribute to the spread of human immunodeficiency virus (HIV), we evaluated the impact of a primary HIV screening program (the Early Test) implemented in San Diego. The Early Test program used combined nucleic acid and serology testing to screen for primary infection targeting local high-risk individuals. Epidemiologic, HIV sequence, and geographic data were obtained from the San Diego County Department of Public Health and the Early Test program. Poisson regression analysis was performed to determine whether the Early Test program was temporally and geographically associated with changes in incident HIV diagnoses. Transmission chains were inferred by phylogenetic analysis of sequence data. Over time, a decrease in incident HIV diagnoses was observed proportional to the number primary HIV infections diagnosed in each San Diego region (P < .001). Molecular network analyses also showed that transmission chains were more likely to terminate in regions where the program was marketed (P = .002). Although, individuals in these zip codes had infection diagnosed earlier (P = .08), they were not treated earlier (P = .83). These findings suggests that early HIV diagnoses by this primary infection screening program probably contributed to the observed decrease in new HIV diagnoses in San Diego, and they support the expansion and evaluation of similar programs. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Early diagnosis of diabetic retinopathy in primary care.

PubMed

Jimenez-Baez, Maria Valeria; Marquez-Gonzalez, Horacio; Barcenas-Contreras, Rodolfo; Morales Montoya, Carlos; Espinosa-Garcia, Laura Fatima

2015-01-01

To evaluate the impact of a strategy for early detection of diabetic retinopathy in patients with type 2 diabetes mellitus (DMT2) in Quintana Roo, México. Study transversal, observational, prospective, analytical, eight primary care units from Mexican Social Security Institute in the northern delegation of the State of Quintana Roo, Mexico were included. A program for early detection of diabetic retinopathy (DR) in adult 376,169 was designed. Were diagnosed 683 cases of type 2 diabetes, in 105 patients randomized was conducted to direct ophthalmoscopy were subjected to a secondary hospital were assigned. Will determine the degree of diabetic retinopathy and macular edema was performed. In population were 55.2% female, mean age 48+11.1 years, 23.8 % had some degree of DR, 28.0% with mild non- proliferative diabetic retinopathy 48.0 % moderate 16.0% and severe and 8.0% showed proliferative diabetic retinopathy. Those over age 30 are 2.8 times more risk of developing DR, OR= 2.8; 95%CI: 0.42-18.0, and OR= 1.7; 95%CI: 1.02-2.95 women. The implementation of programs aimed at the early detection of debilitating conditions such as diabetic retinopathy health impact beneficiaries, effective links between primary care systems and provide second level positive health outcomes for patient diseases.

Strategies to Screen for Diabetic Retinopathy in Chinese Patients with Newly Diagnosed Type 2 Diabetes: A Cost-Effectiveness Analysis.

PubMed

Wu, Bin; Li, Jin; Wu, Haixiang

2015-11-01

To investigate the cost-effectiveness of different screening intervals for diabetic retinopathy (DR) in Chinese patients with newly diagnosed type 2 diabetes mellitus (T2DM). Chinese healthcare system.Chinese general clinical setting. A cost-effectiveness model was developed to simulate the disease course of Chinese population with newly diagnosed with diabetes. Different DR screening programs were modeled to project economic outcomes. To develop the economic model, we calibrated the progression rates of DR that fit Chinese epidemiologic data derived from the published literature. Costs were estimated from the perspective of the Chinese healthcare system, and the analysis was run over a lifetime horizon. One-way and probabilistic sensitivity analyses were performed. Total costs, vision outcomes, costs per quality-adjusted life year (QALY), the incremental cost-effectiveness ratio (ICER) of screening strategies compared to no screening. DR screening is effective in Chinese patients with newly diagnosed T2DM, and screen strategies with ≥4-year intervals were cost-effective (ICER <$7,485 per QALY) compared to no screening. Screening every 4 years produced the greatest increase in QALYs (11.066) among the cost-effective strategies. The screening intervals could be varied dramatically by age at T2DM diagnosis. Probabilistic sensitivity analyses demonstrated the consistency and robustness of the cost-effectiveness of the 4-year interval screening strategy. The findings suggest that a 4-year interval screening strategy is likely to be more cost-effective than screening every 1 to 3 years in comparison with no screening in the Chinese setting. The screening intervals might be tailored according to the age at T2DM diagnosis.

Central stellar mass deficits of early-type galaxies

NASA Astrophysics Data System (ADS)

Tsige Dullo, Bililign; Graham, Alister

2016-01-01

The centers of giant galaxies display stellar mass deficits (Mdef) which are thought to be a signature left by inspiraling supermassive black holes (SMBHs) from pre-merged galaxies. We quantify these deficits using the core-Sérsic model for the largest ever sample of early-type galaxies and find Mdef ˜ 0.5 to 4 MBH (SMBH mass). We find that lenticular disc galaxies with bulge magnitudes MV ≤ -21.0 mag also have central stellar deficits, suggesting that their bulges may have formed from major merger events while their surroundingdisc was subsequently built up, perhaps via cold gas accretion scenarios. Interestingly, these bulges have sizes and mass densities comparable to the compact galaxies found at z ˜ 1.5 to 2.

The role of ultrasound in diagnosing rheumatoid arthritis, what do we know? An updated review.

PubMed

Lage-Hansen, Philip Rask; Lindegaard, Hanne; Chrysidis, Stavros; Terslev, Lene

2017-02-01

To clarify if musculoskeletal ultrasound (MSUS) improves early diagnosis of RA when added to the clinical examination of patients with possible arthritis. We performed a systematic literature review of original studies dealing with the value of MSUS in the early diagnosis of RA. Studies were identified using the databases of PubMed, EMBASE and Cochrane library. Only studies in English investigating populations with non-classified arthritis or arthralgia were included. Fifteen original studies investigating the added value of MSUS in diagnosing RA were identified. They differed in sample size, study population, serology status, number of joints investigated and regarding the ultrasound machines and probes used. Thirteen out of 15 studies concluded that use of MSUS had an added value compared to clinical examination and laboratory evaluation alone for diagnosing RA. One study found that MSUS did not add substantial discriminatory value for predicting RA in an early arthritis cohort when added to routine assessment. However, in this study only 16 joints were examined (wrists and MTP 3-5 were not included). One study investigated only seropositive patients and found no significant advantage of MSUS on patient level although a trend was noted. Accordingly, two other studies found MSUS to be useful especially in seronegative patients. The use of MSUS adds value in diagnosing early RA, especially in seronegative arthritis. However, no study to date has documented any effect of DMARD initiation based on MSUS findings (subclinical arthritis) alone. More studies investigating this matter are warranted.

Otoacoustic emissions measured in children diagnosed with attention-deficit/hyperactivity disorder

NASA Astrophysics Data System (ADS)

McFadden, Dennis; Westhafer, J. Gregory; Pasanen, Edward G.; Tucker, David M.; Carlson, Caryn L.

2003-10-01

Attention-deficit/hyperactivity disorder (ADHD) is generally acknowledged to be more prevalent in males than in females. Further, some precursors to ADHD appear early in life. Together these facts suggest that ADHD may be influenced by androgenic mechanisms operating early in development. This reasoning raises the question of whether the otoacoustic emissions (OAEs) of children with ADHD are masculinized. Click-evoked OAEs were measured for one click level in 8 boys and 3 girls diagnosed as ADHD/Combined, in 11 males and 5 females diagnosed as ADHD/Inattentive (IA), and in 17 male and 18 female controls. The ages of these samples ranged between 7 and 15. As in adults, the CEOAEs of the control males were weaker than those of the control females. Further, the CEOAEs of the ADHD/IA males were weaker than in the control males (a hypermasculinization) and the CEOAEs of the IA females were weaker than in the female controls (a masculinization). The CEOAEs of the Combined groups were slightly stronger (feminized) than those of the control males and females. One interpretation is that the IA subgroup of ADHD boys and girls (but not the Combined subgroup) was exposed to higher-than-normal levels of androgens sometime early in development. [Work supported by NIDCD.

Getting Diagnosed

MedlinePlus

... also for those with related disorders. How is Marfan syndrome diagnosed? getting_diagnosed.jpg A Marfan diagnosis can ... spinal column). Is there a genetic test for Marfan syndrome? Genetic testing can provide helpful information in some ...

Development of terahertz otoscope for diagnosing otitis media (Conference Presentation)

NASA Astrophysics Data System (ADS)

Jeon, Tae-In; Ji, Young Bin; Bark, Hyeon Sang; Noh, Sam Kyu; Oh, Seung Jae

2017-03-01

A novel terahertz (THz) otoscope is designed and fabricated to help physicians to diagnose otitis media (OM) with both THz diagnostics and conventional optical diagnostics. The inclusion of indium tin oxide (ITO) glass in the THz otoscope allows physicians to diagnose OM with both THz and conventional optical diagnostics. To determine THz diagnostics for OM, we observed reflection signals from samples behind a thin dielectric film and found that the presence of water behind the membrane could be distinguished based on THz pulse shape. We verified the potential of this tool for diagnosing OM using mouse skin tissue and a human tympanic membrane samples prior to clinical application. The presence of water absorbed by the human membrane was easily distinguished based on differences in pulse shapes and peak-to-peak amplitudes of reflected THz pulses. The potential for early OM diagnosis using the THz otoscope was confirmed by alteration of THz pulse depending on water absorption level.

The impact of human immunodeficiency virus-related diseases on pigmented skin types.

PubMed

Ameen, M

2013-10-01

Infection with human immunodeficiency virus (HIV) remains a significant problem globally. Early diagnosis and treatment with antiretroviral drugs has considerably improved health outcomes and decreased disease-related morbidity. HIV infection is associated with a wide range of skin disorders enabling dermatologists to diagnose HIV as well as associated opportunistic infections early in the course of disease. Despite concerted efforts by international health organizations to limit disease incidence, the prevalence of HIV infection remains high and is highest in sub-Saharan Africa. The diagnosis of HIV-related skin diseases is challenging as immunosuppression often results in atypical disease presentation. In addition, the clinical presentation will vary in pigmented skin types. The aim of this article is to describe disease variation in pigmented skin types. © 2013 The Author BJD © 2013 British Association of Dermatologists.

Diagnosing Lupus

MedlinePlus

... Lupus.org Sign Up for Our Newsletter Donate Diagnosing Lupus Learn about lab tests, lupus symptoms, and how ... doctor's appointment article Reducing time to diagnosis blog Diagnosing lupus Getting a lupus diagnosis is challenging. Here’s what ...

Early Antiretroviral Therapy Initiation and Mortality Among Infants Diagnosed With HIV in the First 12 Weeks of Life: Experiences From Kinshasa, DR Congo and Blantyre, Malawi.

PubMed

Sheahan, Anna; Feinstein, Lydia; Dube, Queen; Edmonds, Andrew; Chirambo, Chawanangwa Mahebere; Smith, Emily; Behets, Frieda; Heyderman, Robert; Van Rie, Annelies

2017-07-01

Based on clinical trial results, the World Health Organization recommends infant HIV testing at age 4-6 weeks and immediate antiretroviral therapy (ART) initiation in all HIV-infected infants. Little is known about the outcomes of HIV-infected infants diagnosed with HIV in the first weeks of life in resource-limited settings. We assessed ART initiation and mortality in the first year of life among infants diagnosed with HIV by 12 weeks of age. Cohort of HIV-infected infants in Kinshasa and Blantyre diagnosed before 12 weeks to estimate 12-month cumulative incidences of ART initiation and mortality, accounting for competing risks. Multivariate models were used to estimate associations between infant characteristics and timing of ART initiation. One hundred and twenty-one infants were diagnosed at a median age of 7 weeks (interquartile range, 6-8). The cumulative incidence of ART initiation was 46% [95% confidence interval (CI), 36%, 55%] at 6 months and 70% (95% CI 60%, 78%) at 12 months. Only age at HIV diagnosis was associated with ART initiation by age 6 months, with a subdistribution hazard ratio of 0.70 (95% CI 0.52, 0.91) for each week increase in age at DNA polymerase chain reaction test. The 12-month cumulative incidence of mortality was 20% (95% CI 13%, 28%). Despite early diagnosis of HIV, ART initiation was slow and mortality remained high, underscoring the complexity in translating clinical trial findings and World Health Organization's guidance into real-life practice. Novel and creative health system interventions will be required to ensure that all HIV-infected infants achieve optimal treatment outcomes under routine care settings.

Hypochondriasis as an early manifestation of dementia with Lewy bodies: an autopsied case report.

PubMed

Fujishiro, Hiroshige; Iritani, Shuji; Sekiguchi, Hirotaka; Habuchi, Chikako; Torii, Youta; Matsunaga, Shinji; Ozaki, Norio; Yoshida, Mari; Fujita, Kiyoshi

2016-03-01

Discrepancies between clinical and pathological diagnoses of dementia with Lewy bodies (DLB) may occur because the full disease progression remains unclear, especially during the early stage. Herein, we report the case of a 78-year-old Japanese man with hypochondriasis who had autopsy-confirmed limbic-type DLB pathology. He exhibited no core clinical features of DLB. We attempted to identify the clinicopathological correlations in the early stages of DLB. At the age of 77, he became hypochondriacal and exhibited progressive cognitive decline after the death of his wife. He was concerned about his poor physical condition, but hospital examinations did not identify any overtly abnormal findings. At 78 years of age, he consulted a neurologist with complaints of facial numbness and irritability. Neurological examination revealed no overt abnormality, and he scored 21 points on the Mini-Mental State Examination. Magnetic resonance imaging of the brain showed mild bilateral ventricular enlargement. The patient was clinically diagnosed as having possible Alzheimer's disease. Approximately 1 month after his consult, he died of acute pneumonia in a psychiatric hospital to which he had been admitted for severe aggressive behaviour. He exhibited no core clinical features pointing towards a clinical diagnosis of DLB. Neuropathological investigation revealed limbic-type Lewy body disease with concurrent minimum Alzheimer-type pathology, which corresponds to high-likelihood DLB pathology based on the Third Consortium DLB pathological criteria. The patient had minimum nigral degeneration, which is consistent with the absence of parkinsonism. This autopsied case suggests that some DLB patients exhibit hypochondriasis in the early stage of the disease, even if they lack the core clinical features of DLB. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

Development and testing of a mobile application to support diabetes self-management for people with newly diagnosed type 2 diabetes: a design thinking case study.

PubMed

Petersen, Mira; Hempler, Nana F

2017-06-26

Numerous mobile applications have been developed to support diabetes-self-management. However, the majority of these applications lack a theoretical foundation and the involvement of people with diabetes during development. The aim of this study was to develop and test a mobile application (app) supporting diabetes self-management among people with newly diagnosed type 2 diabetes using design thinking. The app was developed and tested in 2015 using a design-based research approach involving target users (individuals newly diagnosed with type 2 diabetes), research scientists, healthcare professionals, designers, and app developers. The research approach comprised three major phases: inspiration, ideation, and implementation. The first phase included observations of diabetes education and 12 in-depth interviews with users regarding challenges and needs related to living with diabetes. The ideation phrase consisted of four interactive workshops with users focusing on app needs, in which ideas were developed and prioritized. Finally, 14 users tested the app over 4 weeks; they were interviewed about usability and perceptions about the app as a support tool. A multifunctional app was useful for people with newly diagnosed type 2 diabetes. The final app comprised five major functions: overview of diabetes activities after diagnosis, recording of health data, reflection games and goal setting, knowledge games and recording of psychological data such as sleep, fatigue, and well-being. Users found the app to be a valuable tool for support, particularly for raising their awareness about their psychological health and for informing and guiding them through the healthcare system after diagnosis. The design thinking processes used in the development and implementation of the mobile health app were crucial to creating value for users. More attention should be paid to the training of professionals who introduce health apps. Danish Data Protection Agency: 2012-58-0004. Registered 6

Early retirement and income loss in patients with early and advanced Parkinson's disease.

PubMed

Johnson, Scott; Davis, Matthew; Kaltenboeck, Anna; Birnbaum, Howard; Grubb, Elizabeth; Tarrants, Marcy; Siderowf, Andrew

2011-11-01

The indirect costs of Parkinson's disease (PD) may be larger than direct healthcare costs, and the largest component of indirect costs is income loss related to early retirement. No recent retrospective analysis details PD-related early retirement and income loss in the US. We used an observational, matched cohort to study wages and labour force participation over 4 years and to simulate lifetime income losses conditional on being newly diagnosed with PD (naive) or having evidence of increasing disability. Actively employed primary beneficiaries of private insurance policies aged 18-64 years with more than two PD diagnoses (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM]: 332.x) or one diagnosis and a prescription of an antiparkinsonian drug were selected from a privately insured claims database. Continuous health coverage during analysis periods was required. Naive patients were defined as having no claims history indicative of PD during the year prior to first diagnosis or prescription use. A PD with ambulatory assistance devices (PDAAD) cohort was also followed from the date of first evidence of a wheelchair or walker. Controls without PD were matched on age, sex and region. Survival analysis and Wilcoxon rank sum tests were used to compare rates of early retirement and income loss. A simulation of projected economic loss was conducted for PD cohorts diagnosed at different ages using Bureau of Labor Statistics labour force participation and income data. Naive PD patients (n = 278) and PDAAD patients (n = 28) were on average aged 53 years and had significantly higher rates of co-morbidities at baseline versus controls. Conditional on being employed, there was no statistical difference in earnings. However, the hazard of early retirement associated with PD was 2.08 (p < 0.001) for the naive cohort and 5.01 (p < 0.001) for the PDAAD cohort. From age 40 to 79 years, earnings losses in year 2009 values were

The star formation history of early-type galaxies as a function of mass and environment

NASA Astrophysics Data System (ADS)

Clemens, M. S.; Bressan, A.; Nikolic, B.; Alexander, P.; Annibali, F.; Rampazzo, R.

2006-08-01

Using the third data release of the Sloan Digital Sky Survey (SDSS), we have rigorously defined a volume-limited sample of early-type galaxies in the redshift range 0.005 < z <= 0.1. We have defined the density of the local environment for each galaxy using a method which takes account of the redshift bias introduced by survey boundaries if traditional methods are used. At luminosities greater than our absolute r-band magnitude cut-off of -20.45, the mean density of environment shows no trend with redshift. We calculate the Lick indices for the entire sample and correct for aperture effects and velocity dispersion in a model-independent way. Although we find no dependence of redshift or luminosity on environment, we do find that the mean velocity dispersion, σ, of early-type galaxies in dense environments tends to be higher than in low-density environments. Taking account of this effect, we find that several indices show small but very significant trends with environment that are not the result of the correlation between indices and velocity dispersion. The statistical significance of the data is sufficiently high to reveal that models accounting only for α-enhancement struggle to produce a consistent picture of age and metallicity of the sample galaxies, whereas a model that also includes carbon enhancement fares much better. We find that early-type galaxies in the field are younger than those in environments typical of clusters but that neither metallicity, α-enhancement nor carbon enhancement are influenced by the environment. The youngest early-type galaxies in both field and cluster environments are those with the lowest σ. However, there is some evidence that the objects with the largest σ are slightly younger, especially in denser environments. Independent of environment both the metallicity and α-enhancement grow monotonically with σ. This suggests that the typical length of the star formation episodes which formed the stars of early-type galaxies

Early Emission from Type Ia Supernovae

NASA Astrophysics Data System (ADS)

Rabinak, Itay; Livne, Eli; Waxman, Eli

2012-09-01

A unique feature of deflagration-to-detonation (DDT) white dwarf explosion models of supernovae of type Ia is the presence of a strong shock wave propagating through the outer envelope. We consider the early emission expected in such models, which is produced by the expanding shock-heated outer part of the ejecta and precedes the emission driven by radioactive decay. We expand on earlier analyses by considering the modification of the pre-detonation density profile by the weak shocks generated during the deflagration phase, the time evolution of the opacity, and the deviation of the post-shock equation of state from that obtained for radiation pressure domination. A simple analytic model is presented and shown to provide an acceptable approximation to the results of one-dimensional numerical DDT simulations. Our analysis predicts a ~103 s long UV/optical flash with a luminosity of ~1 to ~3 × 1039 erg s-1. Lower luminosity corresponds to faster (turbulent) deflagration velocity. The luminosity of the UV flash is predicted to be strongly suppressed at t > t drop ~ 1 hr due to the deviation from pure radiation domination.

EARLY: a pilot study on early diagnosis of atrial fibrillation in a primary healthcare centre.

PubMed

Benito, Luisa; Coll-Vinent, Blanca; Gómez, Eva; Martí, David; Mitjavila, Joan; Torres, Ferran; Miró, Òscar; Sisó, Antoni; Mont, Lluís

2015-11-01

Atrial fibrillation (AF) is associated with high morbidity and mortality. Early diagnosis is likely to improve therapy and prognosis. The study objective was to evaluate the usefulness of a programme for early diagnosis of AF in patients from an urban primary care centre. Participants were recruited from a randomized sample of patients not diagnosed with AF but having relevant risk factors: age ≥ 65 years, ischaemic and/or valvular heart disease, congestive heart failure, hypertension, and/or diabetes. Patients were randomly assigned to the intervention group (IG) or control group (CG). The intervention included (i) initial visit with clinical history, electrocardiogram, and instruction about pulse palpation and warning signs and (ii) electrocardiogram every 6 months during a 2-year follow-up. The main endpoint of the study was the proportion of new cases diagnosed at 6 months. Secondary endpoints were number of new AF diagnoses and complications associated with the arrhythmia in both groups. A total of 928 patients were included (463 IG and 465 CG). At 6 months, AF was diagnosed in 8 IG patients and 1 CG patient (1.7 vs. 0.2%, respectively, P = 0.018). After 2 years of follow-up, 11 IG patients and 6 CG patients had newly diagnosed AF (2.5 vs. 1.3%, respectively, P = 0.132). Time to first diagnosis of AF was shorter in IG patients [median (inter-quartile range): 7 (192) days vs. 227 (188.5) days in CG, P = 0.029]. The simple screening proposed could be useful for the early detection of AF in primary care. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Protocol for systematic review of evidence on the determinants and influence of early glycaemic control in childhood-onset type 1 diabetes.

PubMed

Mazarello Paes, Veena; Charalampopoulos, Dimitrios; Khanolkar, Amal R; Taylor-Robinson, David; Viner, Russell; Edge, Julie; Stephenson, Terence; Amin, Rakesh

2015-11-12

Landmark studies in adult-onset type 1 diabetes (T1D) populations indicate that improved glycaemic control through use of intensive insulin therapy is strongly associated with reduced risk for the development of diabetes-related complications and mortality in later years. However, it is unclear whether these associations can be extrapolated to childhood-onset T1D, given the influence of other important biological and psychosocial determinants of glycaemic control, particularly during adolescence. The aims of the review are (1) to investigate the impact of early glycaemic control (within the first 2 years after diagnosis) on subsequent glycaemic trends and risk of complications during the life course of childhood-onset T1D and (2) to identify the predictors of early glycaemic control in children and young people (0-25 years). The methods used in this study are systematic identification, review and mapping of quantitative (intervention and observational) and qualitative literature; assessing the effect and predictors of early glycaemic control in T1D (diagnosed ≤18 years) on risk or prevalence of later complications. An iterated search strategy, with no language or period restrictions, was applied to identify studies from six electronic databases. This will be supplemented by hand-searching (reference lists and contacting authors of studies meeting the inclusion criteria). Studies assessing glycaemic control within the first 2 years of diagnosis in children (at baseline) will be quality-assessed against predefined criteria and mapped descriptively to future health outcomes. Extracted data will be analysed and synthesised using narrative and forest plots or harvest plots for quantitative evidence and thematic analyses for qualitative studies. To get a deeper understanding of the predictors of early glycaemic control in reducing complications in childhood and adult life, we will integrate qualitative and quantitative evidence using mixed methods or parallel synthesis

A case of lean polycystic ovary syndrome with early stage of type 1 diabetes successfully treated with metformin.

PubMed

Shigiyama, Fumika; Kumashiro, Naoki; Rikitake, Takayuki; Usui, Shuki; Saegusa, Michiko; Kitamura, Mamoru; Uchino, Hiroshi; Hirose, Takahisa

2016-01-01

Polycystic ovary syndrome (PCOS) is common in obese women with insulin resistant type 2 diabetes for which metformin treatment is getting established in addition to clomiphene. However, lean PCOS patients are sometimes accompanied with type 1 diabetes. It remains unclear whether these patients are insulin resistant and whether metformin is effective for them. A 32-year-old woman, who suffered from acne, hirsutism, and menstrual disorders since age 29, was diagnosed as PCOS by serum high LH levels and polycystic ovary on echography. Interestingly, her body mass index (BMI) had consistently been 21.0 kg/m2 since age 20. She was first treated with clomiphene for one year for infertility but it did not improve her menstrual cycle nor did she get pregnant during that period. She was then assessed with diabetes mellitus and subsequently diagnosed as type 1 diabetes with mild hyperglycemia (HbA1c 6.0%). Since her insulin secretion was still well preserved, to assess insulin sensitivity, hyperinsulinemic-euglycemic clamp test was performed and showed her to be insulin resistant. Low dose insulin and low dose metformin treatment was started without clomiphene. After her ovulation and menstrual cycle were ameliorated only one month later, her treatment was supplemented with clomiphene for the next three months enabling her to at last become pregnant. This report highlights the efficacy of metformin in lean PCOS with type 1 diabetes. Insulin therapy is essential for type 1 diabetes but hyperinsulinemia potentially exacerbates PCOS through hyperandrogenism. Metformin is therefore recommended for treatment of lean PCOS with type 1 diabetes as well as common obese PCOS with type 2 diabetes.

Early reduced myocardial diastolic function in children and adolescents with type 1 diabetes mellitus a population-based study.

PubMed

Brunvand, Leif; Fugelseth, Drude; Stensaeth, Knut Håkon; Dahl-Jørgensen, Knut; Margeirsdottir, Hanna Dis

2016-05-25

Reduced diastolic myocardial function is an early sign of diabetic cardiomyopathy. The aim of this study was to test the hypothesis that children and adolescents with type 1 diabetes mellitus (T1D), but without other known complications, have early reduced diastolic myocardial function diagnosed with echocardiographic color tissue Doppler imaging (cTDI). cTDI examination was carried out in 173 T1D patients and 62 age-matched controls. The T1D-patients were 8-18 years old with (mean (SD)) diabetes duration of 5.6 (3.4) years and HbA1c of 8.4 (1.3). All were treated with either insulin pumps or 4-6 daily insulin injections. cTDI early (E') and late (A') peak diastolic velocities and systolic peak velocity were measured from the lateral, septal, anterior and posterior mitral annulus and from the lateral tricuspidal annulus. Myocardial diastolic function was reduced in the T1D-patients with higher peak A'-velocity and lower E'/A'-ratio in all registrations. Overall mean (SD) mitral E'/A'-ratio was 2.3 (0.5) in T1D and 2.7 (0.6) in the controls (p < 0001). The overall mitral E'/A'-ratio was negative associated with blood pressure (BP) and body mass index (BMI). Stratifying all participants into three groups according to BMI (<25, 25-75, >75 centile, respectively), the T1D had lower E'/A'-values in all stratified groups, except for in the highest BMI-group where both T1D and controls had the lowest E'/A'-ratio. Systolic function did not differ in any of the measurements. There were no associations with sex, diabetes duration, carotid artery intima-media-thickness, vessel elasticity or HbA1c. Diabetic children and adolescents using modern intensive insulin treatment had echocardiographic signs of reduced diastolic myocardial function despite short duration of disease. The reduced function was associated with higher BP and higher BMI.

Multiple behaviour change intervention and outcomes in recently diagnosed type 2 diabetes: the ADDITION-Plus randomised controlled trial.

PubMed

Griffin, Simon J; Simmons, Rebecca K; Prevost, A Toby; Williams, Kate M; Hardeman, Wendy; Sutton, Stephen; Brage, Søren; Ekelund, Ulf; Parker, Richard A; Wareham, Nicholas J; Kinmonth, Ann Louise

2014-07-01

The aim of this study was to assess whether or not a theory-based behaviour change intervention delivered by trained and quality-assured lifestyle facilitators can achieve and maintain improvements in physical activity, dietary change, medication adherence and smoking cessation in people with recently diagnosed type 2 diabetes. An explanatory randomised controlled trial was conducted in 34 general practices in Eastern England (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care-Plus [ADDITION-Plus]). In all, 478 patients meeting eligibility criteria (age 40 to 69 years with recently diagnosed screen or clinically detected diabetes) were individually randomised to receive either intensive treatment (n = 239) or intensive treatment plus a theory-based behaviour change intervention led by a facilitator external to the general practice team (n = 239). Randomisation was central and independent using a partial minimisation procedure to balance stratifiers between treatment arms. Facilitators taught patients skills to facilitate change in and maintenance of key health behaviours, including goal setting, self-monitoring and building habits. Primary outcomes included physical activity energy expenditure (individually calibrated heart rate monitoring and movement sensing), change in objectively measured fruit and vegetable intake (plasma vitamin C), medication adherence (plasma drug levels) and smoking status (plasma cotinine levels) at 1 year. Measurements, data entry and laboratory analysis were conducted with staff unaware of participants' study group allocation. Of 475 participants still alive, 444 (93%; intervention group 95%, comparison group 92%) attended 1-year follow-up. There were no significant differences between groups in physical activity (difference: +1.50 kJ kg(-1) day(-1); 95% CI -1.74, 4.74), plasma vitamin C (difference: -3.84 μmol/l; 95% CI -8.07, 0.38), smoking (OR 1.37; 95% CI 0.77, 2.43) and

Non-contrast magnetic resonance imaging for diagnosing shoulder injuries.

PubMed

Arnold, Heino

2012-12-01

To compare preoperative non-contrast magnetic resonance imaging (MRI) with arthroscopy findings in diagnosing labral and rotator cuff tears. 86 men and 60 women aged 21 to 70 (mean, 52) years underwent non-contrast MRI before arthroscopic operations on the glenohumeral joint. Slices were made in a transverse, parasagittal, and paracoronar orientation. The sequences used were T2- and proton-weighted for paracoronar imaging, T1- and T2-weighted for transverse and parasagittal imaging, and T2-weigthed sequences with fat suppression and short tau inversion recovery sequences. MRI was evaluated with the surgeon to eliminate interobserver bias. Arthroscopic surgery was performed by a single surgeon. If a labral or rotator cuff tear was found, surgery was performed using corkscrew anchors. For full thickness rotator cuff tears, MRI and arthroscopy detected them in 76 and 82 patients, respectively. One such tear found by MRI could not be confirmed by arthroscopy. MRI missed 4 subscapularis and 3 supraspinatus tears. The sensitivity and specificity of MRI in diagnosing full thickness rotator cuff tears were 0.90 and 0.91, respectively. For labral tears, MRI and arthroscopy detected them in 16 and 31 patients, respectively. One anterior labral tear detected by MRI could not be verified by arthroscopy. All 16 labral tears detected by MRI were Bankart type-I tears (of the anterior glenoid) except for one superior labral tear from anterior to posterior (SLAP tear). All 13 SLAP tears (10 type 2 and 3 type 3) except for one could be found by arthroscopy only. The sensitivity and specificity of MRI in diagnosing labral tears were 0.52 and 0.89, respectively. Non-contrast MRI is reliable only for diagnosing full thickness rotator cuff tears and anterior labral tears. Direct or indirect contrast enhancement is recommended for more differentiation. Special scan orientation is necessary for SLAP tears.

Enviromental Effects on Internal Color Gradients of Early-Type Galaxies

NASA Astrophysics Data System (ADS)

La Barbera, F.; de Carvalho, R. R.; Gal, R. R.; Busarello, G.; Haines, C. P.; Mercurio, A.; Merluzzi, P.; Capaccioli, M.; Djorgovski, S. G.

2007-05-01

One of the most debated issues of observational and theoretical cosmology is that of how the environment affects the formation and evolution of galaxies. To gain new insight into this subject, we have derived surface photometry for a sample of 3,000 early-type galaxies belonging to 163 clusters with different richness, spanning a redshift range of 0.05 to 0.25. This large data-set is used to analyze how the color distribution inside galaxies depends on several parameters, such as cluster richness, local galaxy density, galaxy luminosity and redshift. We find that the internal color profile of galaxies strongly depends on the environment where galaxies reside. Galaxies in poor and rich clusters are found to follow two distinct trends in the color gradient vs. redshift diagram, with color gradients beeing less steep in rich rather than in poor clusters. No dependence of color gradients on galaxy luminosity is detected both for poor and rich clusters. We find that color gradients strongly depend on local galaxy density, with more shallow gradients in high density regions. Interestingly, this result holds only for low richness clusters, with color gradients of galaxies in rich clusters showing no dependence on local galaxy density. Our results support a reasonable picture whereby young early-type galaxies form in a dissipative collapse process, and then undergo increased (either major or minor) merging activity in richer rather than in poor clusters.

The Environmental Impact of Intra-Cluster Medium on the Interstellar Medium in Early Type Galaxies

NASA Technical Reports Server (NTRS)

Trinchieri, Ginevra

1993-01-01

Draft versions of three articles submitted for publication are presented. The first two articles address high resolution X-ray images of early type galaxies observed with the ROSAT HRI and PSPC. Data for NGC 1553 and NGC 5846 indicate that the emission is highly irregular, with interesting features at different scales. The gas temperatures also vary both with the galactocentric radius and in correspondence to regions of higher emission and denser material. Strikingly similar features are observed in the X-ray and H-alpha morphologies of NGC 1553 and NGC 5846, while smooth, regular isophotes are observed in NGC 4649 at both wavelengths. The third article addresses ROSAT PSPC observations of 5 X-ray bright early type galaxies.

Herschel-ATLAS: Dusty early-type galaxies

NASA Astrophysics Data System (ADS)

Rowlands, K.; Dunne, L.; Maddox, S.

2015-03-01

Early-type galaxies (ETGs) are thought to be devoid of dust and star-formation, having formed most of their stars at early epochs. We present the detection of the dustiest ETGs in a large-area blind submillimetre survey with Herschel (H-ATLAS, Eales et al. 2010), where the lack of pre-selection in other bands makes it the first unbiased survey for cold dust in ETGs. The parent sample of 1087 H-ATLAS galaxies in this study have a >= 5σ detection at 250μm, a reliable optical counterpart to the submillimetre source (Smith et al. 2011) and a spectroscopic redshift from the GAMA survey (Driver et al. 2011). Additionally, we construct a control sample of 1052 optically selected galaxies undetected at 250μm and matched in stellar mass to the H-ATLAS parent sample to eliminate selection effects. ETGs were selected from both samples via visual classifications using SDSS images. Further details can be found in Rowlands et al. (2012). Physical parameters are derived for each galaxy using the multiwavelength spectral energy distribution (SED) fitting code of da Cunha, Charlot and Elbaz (2008), Smith et al. 2012, using an energy balance argument. We investigate the differences between the dusty ETGs and the general ETG population, and find that the H-ATLAS ETGs are more than an order of magnitude dustier than the control ETGs. The mean dust mass of the 42 H-ATLAS ETGs is 5.5 × 107M⊙ (comparable to the dust mass of spirals in our sample), whereas the dust mass of the 233 control ETGs inferred from stacking at optical positions on the 250μm map is (0.8 - 4.0) × 106M⊙ for 25-15 K dust. The average star-formation rate of the H-ATLAS ETGs is 1.0 dex higher than that of control ETGs, and the mean r-band light-weighted age of the H-ATLAS ETGs is 1.8 Gyr younger than the control ETGs. The rest-frame NUV - r colours of the H-ATLAS ETGs are 1.0 magnitudes bluer than the control ETGs, and some ETGs may be transitioning from the blue cloud to the red sequence. Some H-ATLAS ETGs

Early diagnostic suggestions improve accuracy of family physicians: a randomized controlled trial in Greece.

PubMed

Kostopoulou, Olga; Lionis, Christos; Angelaki, Agapi; Ayis, Salma; Durbaba, Stevo; Delaney, Brendan C

2015-06-01

In a recent randomized controlled trial, providing UK family physicians with 'early support' (possible diagnoses to consider before any information gathering) was associated with diagnosing hypothetical patients on computer more accurately than control. Another group of physicians, who gathered information, gave a diagnosis, and subsequently received a list of possible diagnoses to consider ('late support'), were no more accurate than control, despite being able to change their initial diagnoses. To replicate the UK study findings in another country with a different primary health care system. All study materials were translated into Greek. Greek family physicians were randomly allocated to one of three groups: control, early support and late support. Participants saw nine scenarios in random order. After reading some information about the patient and the reason for encounter, they requested more information to diagnose. The main outcome measure was diagnostic accuracy. One hundred fifty Greek family physicians participated. The early support group was more accurate than control [odds ratio (OR): 1.67 (1.21-2.31)]. Like their UK counterparts, physicians in the late support group rarely changed their initial diagnoses after receiving support. The pooled OR for the early support versus control comparison from the meta-analysis of the UK and Greek data was 1.40 (1.13-1.67). Using the same methodology with a different sample of family physicians in a different country, we found that suggesting diagnoses to consider before physicians start gathering information was associated with more accurate diagnoses. This constitutes further supportive evidence of a generalizable effect of early support. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Type 3 secretion system effector genotype and secretion phenotype of longitudinally collected Pseudomonas aeruginosa isolates from young children diagnosed with cystic fibrosis following newborn screening.

PubMed

Hu, H; Harmer, C; Anuj, S; Wainwright, C E; Manos, J; Cheney, J; Harbour, C; Zablotska, I; Turnbull, L; Whitchurch, C B; Grimwood, K; Rose, B

2013-03-01

Studies of the type 3 secretion system (T3SS) in Pseudomonas aeruginosa isolates from chronically infected older children and adults with cystic fibrosis (CF) show a predominantly exoS+/exoU- (exoS+) genotype and loss of T3SS effector secretion over time. Relatively little is known about the role of the T3SS in the pathogenesis of early P. aeruginosa infection in the CF airway. In this longitudinal study, 168 P. aeruginosa isolates from 58 children diagnosed with CF following newborn screening and 47 isolates from homes of families with or without children with CF were genotyped by pulsed-field gel electrophoresis (PFGE) and T3SS genotype and phenotype determined using multiplex PCR and western blotting. Associations were sought between T3SS data and clinical variables and comparisons made between T3SS data of clinical and environmental PFGE genotypes. Seventy-seven of the 92 clinical strains were exoS+ (71% secretors (ExoS+)) and 15 were exoU+ (93% secretors (ExoU+)). Initial exoS+ strains were five times more likely to secrete ExoS than subsequent exoS+ strains at first isolation. The proportion of ExoS+ strains declined with increasing age at acquisition. No associations were found between T3SS characteristics and gender, site of isolation, exacerbation, a persistent strain or pulmonary outcomes. Fourteen of the 23 environmental strains were exoS+ (79% ExoS+) and nine were exoU+ (33% ExoU+). The exoU+ environmental strains were significantly less likely to secrete ExoU than clinical strains. This study provides new insight into the T3SS characteristics of P. aeruginosa isolated from the CF airway early in life. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

IgG Avidity Test in Congenital Toxoplasmosis Diagnoses in Newborns

PubMed Central

Cardoso Fonseca, Zulmirene; Xavier Rodrigues, Isolina Maria; Cruz e Melo, Natália; Boaventura Avelar, Juliana; Castro, Ana Maria; Martins Avelino, Mariza

2017-01-01

The goal of this study was to investigate the importance of IgG avidity testing in newborns (NBs) diagnosed with early congenital toxoplasmosis. We collected samples from 88 puerperae infected by Toxoplasma gondii (T. gondii) and their NBs (48 acutely-infected puerperae (AIP) and 40 chronically-infected puerperae (CIP)), from two public maternity hospitals in Goiania city, Goias, Brazil, from 2010 to 2015. Specific anti-T. gondii IgM and IgG serum levels and IgG avidity tests were evaluated using chemiluminescence. Congenital toxoplasmosis was observed in 66.66% (n = 32) of NBs with AIP, 94.1% presenting low avidity (LA) and 51.61% presenting high avidity (HA) test results. The IgG and IgM levels of NBs with LA and their puerperae were higher in comparison with HA NBs and puerperae (p = 0.0001). The avidity tests showed 100% specificity and 50% sensitivity (p = 0.0001). NBs with LA had a 15-fold increased risk of developing congenital toxoplasmosis in comparison with HA NBs. The IgG avidity test could be used to assist in early congenital toxoplasmosis diagnoses in NBs and LA, identifying a greater probability of vertical transmission. PMID:28629167

Extended nebular emission in CALIFA early-type galaxies

NASA Astrophysics Data System (ADS)

Gomes, J. M.; Papaderos, P.; Kehrig, C.; Vílchez, J. M.; Lehnert, M. D.

2015-02-01

The morphological, spectroscopic and kinematical properties of the warm interstellar medium ( wim ) in early-type galaxies (ETGs) hold key observational constraints to nuclear activity and the buildup history of these massive quiescent systems. High-quality integral field spectroscopy (IFS) data with a wide spectral and spatial coverage, such as those from the CALIFA survey, offer a precious opportunity for advancing our understanding in this respect. We use deep IFS data from CALIFA (califa.caha.es) to study the wim over the entire extent and optical spectral range of 32 nearby ETGs. We find that all ETGs in our sample show faint (Hα equivalent width EW(Hα)~0.5 ... 2 Å) extranuclear nebular emission extending out to >=2 Petrosian50 radii. Confirming and strengthening our conclusions in Papaderos et al. (2013, hereafter P13) we argue that ETGs span a broad continuous sequence with regard to the properties of their wim , and they can be roughly subdivided into two characteristic classes. The first one (type i) comprises ETGs with a nearly constant EW(Hα)~1-3 Å in their extranuclear component, in quantitative agreement with (even though, no proof for) the hypothesis of photoionization by the post-AGB stellar component being the main driver of extended wim emission. The second class (type ii) consists of virtually wim -evacuated ETGs with a large Lyman continuum (Ly c) photon escape fraction and a very low (<=0.5 Å) EW(Hα) in their nuclear zone. These two ETG classes appear indistinguishable from one another by their LINER-specific emission-line ratios. Additionally, here we extend the classification by P13 by the class i+ which stands for a subset of type i ETGs with low-level star-forming activity in contiguous spiral-arm like features in their outermost periphery. These faint features, together with traces of localized star formation in several type i&i+ systems point to a non-negligible contribution from young massive stars to the global ionizing photon

GALAXY ZOO: THE FUNDAMENTALLY DIFFERENT CO-EVOLUTION OF SUPERMASSIVE BLACK HOLES AND THEIR EARLY- AND LATE-TYPE HOST GALAXIES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schawinski, Kevin; Urry, C. Megan; Virani, Shanil

We use data from the Sloan Digital Sky Survey and visual classifications of morphology from the Galaxy Zoo project to study black hole growth in the nearby universe (z < 0.05) and to break down the active galactic nucleus (AGN) host galaxy population by color, stellar mass, and morphology. We find that the black hole growth at luminosities L[O{sub III}]>10{sup 40} erg s{sup -1} in early- and late-type galaxies is fundamentally different. AGN host galaxies as a population have a broad range of stellar masses (10{sup 10}-10{sup 11} M{sub sun}), reside in the green valley of the color-mass diagram andmore » their central black holes have median masses around 10{sup 6.5} M{sub sun}. However, by comparing early- and late-type AGN host galaxies to their non-active counterparts, we find several key differences: in early-type galaxies, it is preferentially the galaxies with the least massive black holes that are growing, while in late-type galaxies, it is preferentially the most massive black holes that are growing. The duty cycle of AGNs in early-type galaxies is strongly peaked in the green valley below the low-mass end (10{sup 10} M{sub sun}) of the red sequence at stellar masses where there is a steady supply of blue cloud progenitors. The duty cycle of AGNs in late-type galaxies on the other hand peaks in massive (10{sup 11} M{sub sun}) green and red late-types which generally do not have a corresponding blue cloud population of similar mass. At high-Eddington ratios (L/L{sub Edd}>0.1), the only population with a substantial fraction of AGNs are the low-mass green valley early-type galaxies. Finally, the Milky Way likely resides in the 'sweet spot' on the color-mass diagram where the AGN duty cycle of late-type galaxies is highest. We discuss the implications of these results for our understanding of the role of AGNs in the evolution of galaxies.« less

Racial/ethnic disparities in the risk of posttraumatic stress disorder symptoms among mothers of children diagnosed with cancer and Type-1 diabetes mellitus.

PubMed

Greening, Leilani; Stoppelbein, Laura; Cheek, Kara

2017-05-01

Research findings have indicated that mothers of children diagnosed with life-threatening illnesses can be at risk for posttraumatic stress disorder (PTSD) symptoms (PTSS), with African American mothers being especially vulnerable because of evidence suggesting higher rates of PTSD among both African Americans and women. Race/ethnicity, past trauma exposure and the interaction of these variables were evaluated as risk factors for PTSS, depression, and state and trait anxiety among African American and Caucasian mothers of chronically ill children. Mothers of children (N = 91) diagnosed with a life-threatening illness (i.e., cancer or Type-I diabetes mellitus [T1DM]) completed standardized measures and provided a salivary cortisol sample while attending medical appointments for their ill children. A MANCOVA revealed that mothers of children diagnosed with T1DM had higher cortisol levels than mothers of children with cancer. There was no racial or ethnic disparity in the risk of PTSS among the mothers. These findings suggest that mothers of children with T1DM may be vulnerable to stress reactions, as reflected by cortisol, a biological marker. Clinicians and researchers might consider illness-specific features when evaluating the risk of stress reactions among mothers of children with life-threatening illnesses. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The expression of podoplanin protein is a diagnostic marker to distinguish the early infiltration of esophageal squamous cell carcinoma.

PubMed

Chen, Guangyong; Xu, Rui; Yue, Bing; Mei, Xue; Li, Peng; Zhou, Xiaoge; Huang, Shoufang; Gong, Liping; Zhang, Shutian

2017-03-21

The esophageal squamous cell carcinoma (ESCC) is usually develped from low-grade intraepithelial neoplasia (LGIEN) and high-grade intraepithelial neoplasia (HGIEN) to infiltrative squamous cell carcinoma. Till now, it remains hard to screen for infiltration at earlier stages, especially the differentiation between HGEIN and early infiltrative carcinoma. The purpose of this study is to determine a role of podoplanin in differentiating between HGEIN and early infiltrative squamous cell carcinoma. Totally 133 patients pathologically diagnosed with early ESCC and/or precancerous lesions were enrolled.The EnVision two-step IHC staining technique was applied using the monoclonal mouse anti-human Podoplanin antibody (clone number: D2-40). The expressions of PDPN protein on the basal layer of squamous epithelium lesions could be divided into three different patterns: complete type, incomplete (non-continuous) type, or missing type. A diagnosis of HGEIN can be made if the basal layer showed non-continuous or complete expression of PDPN and a diagnosis of early infiltration can be made if the expression of PDPN is completely missing. Our study confirmed that PDPN was a potential biomarker to identify the presence of early infiltrative squamous cell carcinoma.

The expression of podoplanin protein is a diagnostic marker to distinguish the early infiltration of esophageal squamous cell carcinoma

PubMed Central

Chen, Guangyong; Xu, Rui; Yue, Bing; Mei, Xue; Li, Peng; Zhou, Xiaoge; Huang, Shoufang; Gong, Liping; Zhang, Shutian

2017-01-01

The esophageal squamous cell carcinoma (ESCC) is usually develped from low-grade intraepithelial neoplasia (LGIEN) and high-grade intraepithelial neoplasia (HGIEN) to infiltrative squamous cell carcinoma. Till now, it remains hard to screen for infiltration at earlier stages, especially the differentiation between HGEIN and early infiltrative carcinoma. The purpose of this study is to determine a role of podoplanin in differentiating between HGEIN and early infiltrative squamous cell carcinoma. Totally 133 patients pathologically diagnosed with early ESCC and/or precancerous lesions were enrolled.The EnVision two-step IHC staining technique was applied using the monoclonal mouse anti-human Podoplanin antibody (clone number: D2-40). The expressions of PDPN protein on the basal layer of squamous epithelium lesions could be divided into three different patterns: complete type, incomplete (non-continuous) type, or missing type. A diagnosis of HGEIN can be made if the basal layer showed non-continuous or complete expression of PDPN and a diagnosis of early infiltration can be made if the expression of PDPN is completely missing. Our study confirmed that PDPN was a potential biomarker to identify the presence of early infiltrative squamous cell carcinoma. PMID:28086225

Cytomegalovirus peritonitis after kidney transplantation diagnosed through histopathological examination.

PubMed

Hotta, Kiyohiko; Fukasawa, Yuichiro; Wada, Yoshiki; Fukuzawa, Nobuyuki; Seki, Toshimori; Harada, Hiroshi

2017-08-01

Among organ transplant recipients, cytomegalovirus (CMV) commonly results in various types of infection such as pneumonitis, hepatitis, and enterocolitis. However, CMV peritonitis is very rare and difficult to diagnose owing to lack of visible clinical signs. We present a case of a 35-year-old female kidney recipient who developed abdominal pain and urinary retention caused by CMV peritonitis. To our knowledge, this is the first case report of CMV peritonitis after organ transplantation to be diagnosed through histopathological examination. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Influence of muscle fiber type composition on early fat accumulation under high-fat diet challenge.

PubMed

Hua, Ning; Takahashi, Hirokazu; Yee, Grace M; Kitajima, Yoichiro; Katagiri, Sayaka; Kojima, Motoyasu; Anzai, Keizo; Eguchi, Yuichiro; Hamilton, James A

2017-01-01

To investigate whether differences in muscle fiber types affect early-stage fat accumulation, under high fat diet challenge in mice. Twelve healthy male C57BL/6 mice experienced with short-term (6 weeks) diet treatment for the evaluation of early pattern changes in muscular fat. The mice were randomly divided into two groups: high fat diet (n = 8) and normal control diet (n = 4). Extra- and intra-myocellular lipid (EMCL and IMCL) in lumbar muscles (type I fiber predominant) and tibialis anterior (TA) muscle (type II fiber predominant) were determined using magnetic resonance spectroscopy (MRS). Correlation of EMCL, IMCL and their ratio between TA and lumbar muscles was evaluated. EMCL increased greatly in both muscle types after high fat diet. IMCL in TA and lumbar muscles increased to a much lower extent, with a slightly greater increase in TA muscles. EMCLs in the 2 muscles were positively correlated (r = 0.84, p = 0.01), but IMCLs showed a negative relationship (r = -0.84, p = 0.01). In lumbar muscles, high fat diet significantly decreased type I fiber while it increased type II fiber (all p≤0.001). In TA muscle, there was no significant fiber type shifting (p>0.05). Under short-time high fat diet challenge, lipid tends to initially accumulate extra-cellularly. In addition, compared to type II dominant muscle, Type I dominant muscle was less susceptible to IMCL accumulation but more to fiber type shifting. These phenomena might reflect compensative responses of skeletal muscle to dietary lipid overload in order to regulate metabolic homeostasis.

Malignancy during pregnancy in Japan: an exceptional opportunity for early diagnosis.

PubMed

Sekine, Masayuki; Kobayashi, Yoshiyuki; Tabata, Tsutomu; Sudo, Tamotsu; Nishimura, Ryuichiro; Matsuo, Koji; Grubbs, Brendan H; Enomoto, Takayuki; Ikeda, Tomoaki

2018-02-08

Malignancy during pregnancy has become a significant cause of maternal death in developed countries, likely due to both an older pregnant population, and increases of cervical cancer in younger women. Our aim is to investigate the clinical aspects of malignancy during pregnancy in Japan and to use this information to identify opportunities for earlier detection and treatment. We provided a questionnaire to 1508 secondary or tertiary care hospitals in Japan. We reviewed the clinical characteristics of cases with malignancy during pregnancy for the period of January to December, 2008. From the 760 institutions which responded, we obtained clinical information for 227 unique cases. The questionnaire provided clinical information, including disease site, pregnancy outcome and how the disease was detected. The most common type of malignancy was cervical cancer (n = 162, 71.4%) followed by ovarian (n = 16, 7.0%) and breast cancer (n = 15, 6.6%). Leukemia (n = 7, 3.1%), colon cancer (n = 5, 2.2%), gastric cancer (n = 5, 2.2%), malignant lymphoma (n = 4, 1.8%), thyroid cancer (n = 3, 1.3%), brain cancer (n = 3, 1.3%), endometrial cancer (n = 2, 0.9%), and head and neck cancer (n = 2, 0.9%) accounted for the remaining cases. Overall, gynecological malignancies accounted for 79.3% (95% confidence interval 74.0-84.6) of pregnancy associated malignancies diagnosed in the present study. The majority of cervical cancers, 149 (92.0%) of 162, were diagnosed by a Pap (Papanicolaou) smear during early gestation. Ten (62.5%) of the ovarian cancer cases were diagnosed by ultrasonography during a prenatal checkup or at the time of initial pregnancy diagnosis. Out of 14 breast cancers, only one (7.1%) was diagnosed by screening breast exam. From this study, we reaffirm the clear and significant benefits of prenatal checkups starting at an early gestational age for the detection of gynecological cancers during pregnancy. Conversely, breast

Pseudohypoparathyroidism Type 1A-Subclinical Hypothyroidism and Rapid Weight Gain as Early Clinical Signs: A Clinical Review of 10 Cases

PubMed Central

Kayemba-Kay’s, Simon; Tripon, Cedric; Heron, Anne; Hindmarsh, Peter

2016-01-01

Objective: To evaluate the clinical signs and symptoms that would help clinicians to consider pseudohypoparathyroidism (PHP) type 1A as a diagnosis in a child. Methods: A retrospective review of the medical records of children diagnosed by erythrocyte Gsα activity and/or GNAS1 gene study and followed-up for PHP type 1A. Clinical and biochemical parameters along with epidemiological data were extracted and analyzed. Weight gain during infancy and early childhood was calculated as change in weight standard deviation score (SDS), using the French growth reference values. An upward gain in weight ≥0.67 SDS during these periods was considered indicative of overweight and/or obesity. Results: Ten cases of PHP type 1A were identified (mean age 41.1 months, range from 4 to 156 months). In children aged ≤2 years, the commonest clinical features were round lunar face, obesity (70%), and subcutaneous ossifications (60%). In older children, brachydactyly was present in 60% of cases. Seizures occurred in older children (3 cases). Short stature was common at all ages. Subclinical hypothyroidism was present in 70%, increased parathormone (PTH) in 83%, and hyperphosphatemia in 50%. Only one case presented with hypocalcemia. Erythrocyte Gsα activity tested in seven children was reduced; GNAS1 gene testing was performed in 9 children. Maternal transmission was the most common (six patients). In three other cases, the mutations were de novo, c.585delGACT in exon 8 (case 2) and c.344C>TP115L in exon 5 (cases 6&7). Conclusion: Based on our results, PHP type 1A should be considered in toddlers presenting with round face, rapid weight gain, subcutaneous ossifications, and subclinical hypothyroidism. In older children, moderate mental retardation, brachydactyly, afebrile seizures, short stature, and thyroid-stimulating hormone resistance are the most suggestive features. PMID:27467896

Open randomised prospective comparative multi-centre intervention study of patients with cystic fibrosis and early diagnosed diabetes mellitus

PubMed Central

2014-01-01

Background Diabetes mellitus may be present in patients with cystic fibrosis starting in the second decade of life. The prevalence increases rapidly with increasing age. As life-expectancy increases in cystic fibrosis, cystic fibrosis related diabetes will be diagnosed more frequently in the future. Up to date, no data are available to answer the question if cystic fibrosis related diabetes should always initially be treated by insulin therapy. Missing data regarding oral antidiabetic treatment of newly diagnosed cystic fibrosis related diabetes are an important reason to recommend insulin treatment. Several centres report the successful management of cystic fibrosis related diabetes using oral anti-diabetic drugs at least for some years. Oral therapies would be less invasive for a patient group which is highly traumatized by a very demanding therapy. Based on an initiative of the German Mukoviszidosis-Foundation, the present study tries to answer the question, whether oral therapy with repaglinide is as effective as insulin therapy in cystic fibrosis patients with early diagnosed diabetes mellitus. Methods/Design In all cystic fibrosis patients with an age of 10 years or older, an oral glucose tolerance test is recommended. The result of this test is classified according to the WHO cut off values. It is required to have two diabetes positive oral glucose tolerance tests for the diagnosis of diabetes mellitus. This study is a multi-national, multicentre, open labelled, randomized and prospective controlled parallel group’s trial, with 24 months treatment. The primary objective of this trial is to compare the glycaemic control of oral therapy with Repaglinide with insulin injections in patients with cystic fibrosis related diabetes after 2 years of treatment. The trial should include 74 subjects showing cystic fibrosis related diabetes newly diagnosed by oral glucose tolerance test during annual screening for cystic fibrosis related diabetes. Patients are

Interstellar matter in early-type galaxies. I. The catalog

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roberts, M.S.; Hogg, D.E.; Bregman, J.N.

1991-03-01

A catalog is given of the currently available measurements of interstellar matter in the 467 early-type galaxies listed in the second edition of the Revised Shapley-Ames Catalog of Bright Galaxies. The morphological type range is E, SO, and Sa. The ISM tracers are emission in the following bands: IRAS 100 micron, X-ray, radio, neutral hydrogen, and carbon monoxide. Nearly two-thirds of the Es and SOs have been detected in one or more of these tracers. Additional observed quantities that are tabulated include: magnitude, colors, radial velocity, central velocity dispersion, maximum of the rotation curve, angular size, 60 micron flux, andmore » supernovae. Qualitative statements as to the presence of dust or emission lines, when available in the literature, are given. Quantities derivative from the observed values are also listed and include masses of H I, CO, X-ray gas, and dust as well as an estimate of the total mass and mass-to-luminosity ratio of the individual galaxies. 204 refs.« less

Environmental Effects on the Metallicities of Early-Type Galaxies

NASA Technical Reports Server (NTRS)

Oliversen, Ronald J. (Technical Monitor); Jones, Christine

2004-01-01

In this multi-year project to investigate the metal enrichment of early-type galaxies, we have used ROSAT, ASCA and now Chandra observations to study samples of galaxies. We have published two papers and a third paper that incorporates Chandra archival observations is nearing completion. Below, we briefly describe our findings. Our first paper "SN IA Enrichment in Virgo Early-type Galaxies from ROSAT and ASCA Observations" was published in the Astrophysical Journal (vol 539, 603) reported on the properties of nine X-ray bright elliptical galaxies in the Virgo cluster observed by ROSAT and ASCA. We measured iron abundance gradients as a function of radius in three galaxies. We found that the magnesium and silicon abundance gradients were in general flatter than those of iron. We suggest this is due to a metallicity dependence in the metal production rates of SN Ia's. We calculate SN Ia rates in the center of these galaxies that are comparable to those measured optically. Our second paper "ASCA Observations of Groups at Radii of Low Overdensity: Implications for Cosmic Preheating" also was published in the Astrophysical Journal (vol 578, 74). This paper reported on the ASCA spectroscopy of nine groups of galaxies. We found that the entropy profile in groups is driven by nongravitational heating processes, and could be explained by a short period of preheating by galactic winds. The third paper (in preparation) uses a sample of about 200 galaxies from both ROSAT and Chandra observations. In this paper we characterize both the nuclear and the extended X-ray emission for this sample. We will use these observations to determine the "on-time" of the X-ray emitting AGN and the fraction of "fossil groups" as well as to investigate how large AGN outbursts can sweep the galaxy of its hot ISM, thus leading to changes in the ISM metal enrichment.

Proton and Fe Ion-Induced Early and Late Chromosome Aberrations in Different Cell Types

NASA Technical Reports Server (NTRS)

Wu, Honglu; Lu, Tao; Yeshitla, Samrawit; Zhang, Ye; Kadhim, Munira

2016-01-01

An early stage of cancer development is believed to be genomic instability (GI) which accelerates the mutation rate in the descendants of the cells surviving radiation exposure. To investigate GI induced by charged particles, we exposed human lymphocytes, human fibroblast cells, and human mammary epithelial cells to high energy protons and Fe ions. In addition, we also investigated GI in bone marrow cells isolated from CBA/CaH (CBA) and C57BL/6 (C57) mice, by analyzing cell survival and chromosome aberrations in the cells after multiple cell divisions. Results analyzed so far from the experiments indicated different sensitivities to charged particles between CBA/CaH (CBA) and C57BL/6 (C57) mouse strains, suggesting that there are two main types of response to irradiation: 1) responses associated with survival of damaged cells and 2) responses associated with the induction of non-clonal chromosomal instability in the surviving progeny of stem cells. Previously, we reported that the RBE for initial chromosome damages was high in human lymphocytes exposed to Fe ions. Our results with different cell types demonstrated different RBE values between different cell types and between early and late chromosomal damages. This study also attempts to offer an explanation for the varying RBE values for different cancer types.

Early-stage gastric cancers represented as dysplasia in a previous forceps biopsy: the importance of clinical management.

PubMed

Park, Jin Seok; Hong, Su Jin; Han, Jae Pil; Kang, Myung Soo; Kim, Hee Kyung; Kwak, Jeong Ja; Ko, Bong Min; Cho, Joo Young; Lee, Joon Seong; Lee, Moon Sung

2013-02-01

Because histological examination of gastric lesions by forceps biopsy is of limited accuracy, management on the basis of histological results is occasionally controversial. We examined the characteristics of early gastric cancers that presented as dysplasia resulting from a previous forceps biopsy. Between April 2007 and December 2010, 341 gastric adenocarcinoma lesions from 330 patients previously diagnosed histologically via endoscopic submucosal dissection were examined. We retrospectively assessed the characteristics of early gastric cancer according to their initial forceps biopsy results. In total, 183 EGCs were diagnosed as dysplasia (53.7%; 89 low-grade and 94 high-grade) and 158 (46.3%) as carcinoma by forceps biopsy before endoscopic submucosal dissection. Significant differences were noted with respect to histologic differentiation of carcinomas, Lauren histologic type, depth of invasion, lymphovascular invasion, and en bloc resection between the dysplastic group and carcinoma group, based on forceps biopsy results. A forceps biopsy result is not fully representative of the entire lesion and, thus, endoscopic submucosal dissection should be considered for lesions diagnosed as dysplasia via forceps biopsy in order to avoid the risk of missed carcinomas. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Prevalence and correlates of diagnosed and undiagnosed type 2 diabetes mellitus and pre-diabetes in older adults: Findings from the Irish Longitudinal Study on Ageing (TILDA).

PubMed

Leahy, S; O' Halloran, A M; O' Leary, N; Healy, M; McCormack, M; Kenny, R A; O' Connell, J

2015-12-01

The prevalence of type 2 diabetes and pre-diabetes has increased rapidly in recent decades and this trend will continue as the global population ages. This study investigates the prevalence of, and factors associated with, diagnosed and undiagnosed type 2 diabetes mellitus and pre-diabetes in older adults in Ireland. Cross-sectional data from 5377 men and women aged 50 and over from Wave 1 of the Irish Longitudinal Study on Ageing (TILDA) was analysed. Diagnosed diabetes was defined using self-reported doctors' diagnosis and medications data. Glycated haemoglobin (HbA1c) analysis was used to identify undiagnosed and pre-diabetes. Age and sex-specific prevalence estimates were generated. Logistic regression was used to investigate the association between diabetes classification and the demographic, health and lifestyle characteristics of the population. The prevalence of diagnosed and undiagnosed type 2 diabetes was 8.6% (95% confidence interval (CI): 7.6-9.5%) and 0.9% (95% CI: 0.6-1.1%) respectively. Diabetes was more prevalent in men than women and increased with age. The prevalence of pre-diabetes was 5.5% (95% CI: 4.8-6.3%) and increased with age. Diabetes and pre-diabetes were independently associated with male sex, central obesity and a history of hypertension, while undiagnosed diabetes was associated with geographic location and medical costs cover. Despite high rates of obesity and other undiagnosed health conditions, the prevalence of undiagnosed and pre-diabetes is relatively low in community-dwelling older adults in Ireland. Addressing lifestyle factors in this population may help to further reduce the prevalence of pre-diabetes and improve outcomes for those with a previous diagnosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

[Long term follow up of a patient with type I vitamin D-dependent rickets].

PubMed

Velásquez-Jones, Luis; Medeiros, Mara; Valverde-Rosas, Saúl; Jiménez-Triana, Clímaco; Del Moral-Espinosa, Irma; Romo-Vázquez, José Carlos; Franco-Alvarez, Isidro

Vitamin D dependent rickets type I is a rare hereditary disease due to a mutation in CYP27B1 encoding the 1α-hydroxylase gene. Clinically, the condition is characterized by hypocalcemic rickets in early infancy due to a deficit in the production of the vitamin D active metabolite 1,25-dihydroxy-vitamin D 3 . We report the case of a patient diagnosed at 11 months with follow-up until 9 years of age. The pathophysiology of the disease and the relevance of early diagnosis and management are discussed. Copyright © 2015. Publicado por Masson Doyma México S.A.

Serum Cystatin C as an Early Diagnostic Biomarker of Diabetic Kidney Disease in Type 2 Diabetic Patients.

PubMed

Qamar, Ayesha; Hayat, Asma; Ahmad, Tariq Mahmood; Khan, Alamgir; Hasnat, Mohammad Najam Ul; Tahir, Sufyan

2018-04-01

To determine the diagnostic accuracy and cut-off values of serum cystatin C as early diagnostic biomarker of diabetic kidney disease. Cross-sectional analytical study. Department of Pathology, Army Medical College, Rawalpindi in collaboration with Endocrinology Department, Military Hospital (MH), Rawalpindi from November 2015 to November 2016. One hundred and nineteen diagnosed patients of type 2 diabetes mellitus were enrolled in the study from the outpatient Endocrinology Department of the MH Rawalpindi. Fifty disease-free controls were also included. Fasting blood samples of the patients and controls were analysed for creatinine by Jaffé's kinetic method and estimated GFR was calculated using MDRD-based equation for GFR. Serum cystatin C was estimated by quantitative turbidimetric method. Serum cystatin C was higher in the diabetic group (mean = 1.022 ±0.33 mg/dl) as compared to the control group (mean = 0.63 ±0.14 mg/dl). ROC curve analysis, keeping less than 60 ml/min/1.73 m2 GFR (CKD-MDRD based) as reference value of the stat variable/gold standard; revealed an area under the curve of 0.914 (95% CI 0.85-0.98) and at optimal sensitivity of 88.2% and specificity of 84.8% the established cut-off of serum cystatin C was 1.26 mg/L. Cystatin C is an accurate biomarker of diabetic kidney disease with good sensitivity and specificity.

Probing the interstellar medium in early-type galaxies with Infrared Space Oberservatory observations

NASA Technical Reports Server (NTRS)

Malhotra, S.; Hollenbach, D.; Helou, D.; Silbermann, N.; Valjavec, E.; Rubin, R.; Dale, D.; Hunter, D.; Lu, N.; Lord, S.;

An outcomes evaluation of an emergency department early pregnancy assessment service and early pregnancy assessment protocol

PubMed Central

Wendt, Kim; Crilly, Julia; May, Chris; Bates, Kym; Saxena, Rakhee

2014-01-01

Background Complications in early pregnancy, such as threatened or actual miscarriage is a common occurrence resulting in many women presenting to the emergency department (ED). Early pregnancy service delivery models described in the literature vary in terms of approach, setting and outcomes. Our objective was to determine outcomes of women who presented to an Australian regional ED with diagnoses consistent with early pregnancy complications following the implementation of an early pregnancy assessment service (EPAS) and early pregnancy assessment protocol (EPAP) in July 2011. Methods A descriptive, comparative (6 months before and after) study was undertaken. Data were extracted from the hospital ED information system and medical healthcare records. Outcome measures included: time to see a clinician, ED length of stay, admission rate, re-presentation rate, hospital admission and types of pathology tests ordered. Results Over the 12 -month period, 584 ED presentations were made to the ED with complications of early pregnancy (268 PRE and 316 POST EPAS–EPAP). Outcomes that improved statistically and clinically following implementation included: time to see a clinician (decreased by 6 min from 35 to 29 min), admission rate (decreased 6% from 14.5% to 8.5%), increase in β-human chorionic gonadotrophin ordering by 10% (up to 80% POST), increase in ultrasound (USS) performed by 10% (up to 73% POST) and increase in pain score documentation by 23% (up to 36% POST). Conclusions The results indicate that patient and service delivery improvements can be achieved following the implementation of targeted service delivery models such as EPAS and EPAP in the ED. PMID:24136123

Early Syphilis Among Men Who Have Sex with Men in the US Pacific Northwest, 2008-2013: Clinical Management and Implications for Prevention.

PubMed

Petrosky, Emiko; Neblett Fanfair, Robyn; Toevs, Kim; DeSilva, Malini; Schafer, Sean; Hedberg, Katrina; Braxton, Jim; Walters, Jaime; Markowitz, Lauri; Hariri, Susan

2016-03-01

Substantial increases in syphilis during 2008-2013 were reported in the US Pacific Northwest state of Oregon, especially among men who have sex with men (MSM). The authors aimed to characterize the ongoing epidemic and identify possible gaps in clinical management of early syphilis (primary, secondary, and latent syphilis ≤1 year) among MSM in Multnomah County, Oregon to inform public health efforts. Administrative databases were used to examine trends in case characteristics during 2008-2013. Medical records were abstracted for cases occurring in 2013 to assess diagnosis, treatment, and screening practices. Early syphilis among MSM increased from 21 cases in 2008 to 229 in 2013. The majority of cases occurred in HIV-infected patients (range: 55.6%-69.2%) diagnosed with secondary syphilis (range: 36.2%-52.4%). In 2013, 119 (51.9%) cases were diagnosed in public sector medical settings and 110 (48.0%) in private sector settings. Over 80% of HIV-infected patients with syphilis were in HIV care. Although treatment was adequate and timely among all providers, management differed by provider type. Among HIV-infected patients, a larger proportion diagnosed by public HIV providers than private providers were tested for syphilis at least once in the previous 12 months (89.6% vs. 40.0%; p < 0.001). The characteristics of MSM diagnosed with early syphilis in Multnomah County remained largely unchanged during 2008-2013. Syphilis control measures were well established, but early syphilis among MSM continued to increase. The results suggest a need to improve syphilis screening among private clinics, but few gaps in clinical management were identified.

[Anxiety-phobic disorders in the early childhood stage].

PubMed

Volkova, O M; Kozlovskaia, G V; Proselkova, M O

2012-01-01

The complex of such phenomena as anxiety and fear in children of the early age and their relationship with risk factors for psychic pathology were investigated. Eighty cases of anxiety-phobic disorders in children of the first five years of life were studied. The types of behavioral and somatic reactions that allowed to reveal not only the clinically expressed phenomena of anxiety and fear but the higher readiness to them were described. The first anxiety-phobic reactions appeared at the age when emotional functions were not completely formed and might be considered as the presentations of emotional dysontogenesis. The authors assume that characteristics of fear expression in the early age allow to suspect a mental disease which might be timely diagnosed in case of its manifestation. The conclusions made in the paper may be useful for clinical practice of pediatricians, children neurologists, psychologists and psychiatrists.

The study of esophageal cancer in an early stage by using Raman spectroscopy

NASA Astrophysics Data System (ADS)

Ishigaki, Mika; Taketani, Akinori; Maeda, Yasuhiro; Andriana, Bibin B.; Ishihara, Ryu; Sato, Hidetoshi

2013-02-01

The esophageal cancer is a disease with a high mortality. In order to lead a higher survival rate five years after the cancer's treatment, we inevitably need a method to diagnose the cancer in an early stage and support the therapy. Raman spectroscopy is one of the most powerful techniques for the purpose. In the present study, we apply Raman spectroscopy to obtain ex vivo spectra of normal and early tumor human esophageal sample. The result of principal component analysis indicates that the tumor tissue is associated with a decrease in tryptophan concentration. Furthermore, we can predict the tissue type with 80% accuracy by linear discriminant analysis which model is made by tryptophan bands.

Mutations of maturity-onset diabetes of the young (MODY) genes in Thais with early-onset type 2 diabetes mellitus.

PubMed

Plengvidhya, Nattachet; Boonyasrisawat, Watip; Chongjaroen, Nalinee; Jungtrakoon, Prapaporn; Sriussadaporn, Sutin; Vannaseang, Sathit; Banchuin, Napatawn; Yenchitsomanus, Pa-thai

2009-06-01

Six known genes responsible for maturity-onset diabetes of the young (MODY) were analysed to evaluate the prevalence of their mutations in Thai patients with MODY and early-onset type 2 diabetes. Fifty-one unrelated probands with early-onset type 2 diabetes, 21 of them fitted into classic MODY criteria, were analysed for nucleotide variations in promoters, exons, and exon-intron boundaries of six known MODY genes, including HNF-4alpha, GCK, HNF-1alpha, IPF-1, HNF-1beta, and NeuroD1/beta2, by the polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) method followed by direct DNA sequencing. Missense mutations or mutations located in regulatory region, which were absent in 130 chromosomes of non-diabetic controls, were classified as potentially pathogenic mutations. We found that mutations of the six known MODY genes account for a small proportion of classic MODY (19%) and early-onset type 2 diabetes (10%) in Thais. Five of these mutations are novel including GCK R327H, HNF-1alpha P475L, HNF-1alphaG554fsX556, NeuroD1-1972 G > A and NeuroD1 A322N. Mutations of IPF-1 and HNF-1beta were not identified in the studied probands. Mutations of the six known MODY genes may not be a major cause of MODY and early-onset type 2 diabetes in Thais. Therefore, unidentified genes await discovery in a majority of Thai patients with MODY and early-onset type 2 diabetes.

Early detection of aging cartilage and osteoarthritis in mice and patient samples using atomic force microscopy

NASA Astrophysics Data System (ADS)

Stolz, Martin; Gottardi, Riccardo; Raiteri, Roberto; Miot, Sylvie; Martin, Ivan; Imer, Raphaël; Staufer, Urs; Raducanu, Aurelia; Düggelin, Marcel; Baschong, Werner; Daniels, A. U.; Friederich, Niklaus F.; Aszodi, Attila; Aebi, Ueli

2009-03-01

The pathological changes in osteoarthritis-a degenerative joint disease prevalent among older people-start at the molecular scale and spread to the higher levels of the architecture of articular cartilage to cause progressive and irreversible structural and functional damage. At present, there are no treatments to cure or attenuate the degradation of cartilage. Early detection and the ability to monitor the progression of osteoarthritis are therefore important for developing effective therapies. Here, we show that indentation-type atomic force microscopy can monitor age-related morphological and biomechanical changes in the hips of normal and osteoarthritic mice. Early damage in the cartilage of osteoarthritic patients undergoing hip or knee replacements could similarly be detected using this method. Changes due to aging and osteoarthritis are clearly depicted at the nanometre scale well before morphological changes can be observed using current diagnostic methods. Indentation-type atomic force microscopy may potentially be developed into a minimally invasive arthroscopic tool to diagnose the early onset of osteoarthritis in situ.

Type I intrinsically photosensitive retinal ganglion cells of early post-natal development correspond to the M4 subtype.

PubMed

Sexton, Timothy J; Bleckert, Adam; Turner, Maxwell H; Van Gelder, Russell N

2015-06-21

Intrinsically photosensitive retinal ganglion cells (ipRGCs) mediate circadian light entrainment and the pupillary light response in adult mice. In early development these cells mediate different processes, including negative phototaxis and the timing of retinal vascular development. To determine if ipRGC physiologic properties also change with development, we measured ipRGC cell density and light responses in wild-type mouse retinas at post-natal days 8, 15 and 30. Melanopsin-positive cell density decreases by 17% between post-natal days 8 and 15 and by 25% between days 8 and 30. This decrease is due specifically to a decrease in cells co-labeled with a SMI-32, a marker for alpha-on ganglion cells (corresponding to adult morphologic type M4 ipRGCs). On multi-electrode array recordings, post-natal day 8 (P8) ipRGC light responses show more robust firing, reduced adaptation and more rapid recovery from short and extended light pulses than do the light responses of P15 and P30 ipRGCs. Three ipRGC subtypes - Types I-III - have been defined in early development based on sensitivity and latency on multielectrode array recordings. We find that Type I cells largely account for the unique physiologic properties of P8 ipRGCs. Type I cells have previously been shown to have relatively short latencies and high sensitivity. We now show that Type I cells show have rapid and robust recovery from long and short bright light exposures compared with Type II and III cells, suggesting differential light adaptation mechanisms between cell types. By P15, Type I ipRGCs are no longer detectable. Loose patch recordings of P8 M4 ipRGCs demonstrate Type I physiology. Type I ipRGCs are found only in early development. In addition to their previously described high sensitivity and rapid kinetics, these cells are uniquely resistant to adaptation and recover quickly and fully to short and prolonged light exposure. Type I ipRGCs correspond to the SMI-32 positive, M4 subtype and largely lose

Early diagnosis of diabetic retinopathy in primary care

PubMed Central

Jimenez-Baez, Maria Valeria; Barcenas-Contreras, Rodolfo; Morales Montoya, Carlos; Espinosa-Garcia, Laura Fatima

2015-01-01

Objective: To evaluate the impact of a strategy for early detection of diabetic retinopathy in patients with type 2 diabetes mellitus (DMT2) in Quintana Roo, México. Methods: Study transversal, observational, prospective, analytical, eight primary care units from Mexican Social Security Institute in the northern delegation of the State of Quintana Roo, Mexico were included. A program for early detection of diabetic retinopathy (DR) in adult 376,169 was designed. Were diagnosed 683 cases of type 2 diabetes, in 105 patients randomized was conducted to direct ophthalmoscopy were subjected to a secondary hospital were assigned. Will determine the degree of diabetic retinopathy and macular edema was performed. Results: In population were 55.2% female, mean age 48+11.1 years, 23.8 % had some degree of DR, 28.0% with mild non- proliferative diabetic retinopathy 48.0 % moderate 16.0% and severe and 8.0% showed proliferative diabetic retinopathy. Those over age 30 are 2.8 times more risk of developing DR, OR= 2.8; 95%CI: 0.42-18.0, and OR= 1.7; 95%CI: 1.02-2.95 women. Conclusions: The implementation of programs aimed at the early detection of debilitating conditions such as diabetic retinopathy health impact beneficiaries, effective links between primary care systems and provide second level positive health outcomes for patient diseases. PMID:26019380

Training clinicians treating HIV to diagnose cytomegalovirus retinitis.

PubMed

Heiden, David; Tun, NiNi; Maningding, Ernest; Heiden, Matthew; Rose-Nussbaumer, Jennifer; Chan, Khin Nyein; Khizniak, Tamara; Yakubenko, Alexandra; Lewallen, Susan; Keenan, Jeremy D; Saranchuk, Peter

2014-12-01

Acquired immunodeficiency syndrome (AIDS)-related cytomegalovirus (CMV) retinitis continues to be a neglected source of blindness in resource-poor settings. The main issue is lack of capacity to diagnose CMV retinitis in the clinical setting where patients receive care and all other opportunistic infections are diagnosed. We developed and implemented a four-day workshop to train clinicians working in human immunodeficiency virus (HIV) clinics how to perform binocular indirect ophthalmoscopy and diagnose CMV retinitis. Workshops comprised both classroom didactic instruction and direct clinical eye examinations in patients with advanced AIDS. Between 2007 and 2013, 14 workshops were conducted in China, Myanmar and the Russian Federation. Workshops were held with local clinicians at HIV clinics supported by nongovernmental organizations, public-sector municipal hospitals and provincial infectious disease referral hospitals. Each setting had limited or no access to locally- trained ophthalmologists, and an HIV-infected population with advanced disease. Clinicians learnt how to do binocular indirect ophthalmoscopy and to diagnose CMV retinitis. One year after the workshop, 32/38 trainees in Myanmar did systematic eye examination for early diagnosis of CMV retinitis as standard care for at-risk patients. In China and the Russian Federation, the success rates were lower, with 10/15 and 3/5 trainees, respectively, providing follow-up data. Skills necessary for screening and diagnosis of CMV retinitis can be taught in a four-day task-oriented training workshop. Successful implementation depends on institutional support, ongoing training and technical support. The next challenge is to scale up this approach in other countries.

Conservative management of antenatally diagnosed cystic lung malformations.

PubMed

Ng, Christabella; Stanwell, Joanna; Burge, David M; Stanton, Michael P

2014-05-01

To review the outcome of all antenatally diagnosed conservatively managed congenital lung malformations (CLMs) managed at our centre. All patients diagnosed antenatally with cystic lung malformations from 2001 to 2011, at a tertiary referral paediatric surgical centre practising a policy of conservative management of asymptomatic cases, were retrospectively reviewed. Data were collected from medical case notes and radiology reports. Ethical approval was obtained from our institutional research and development department. The complete records of 74 fetuses antenatally diagnosed with CLM were reviewed. There were 72 live births, at a median gestation of 39.6 weeks. Emergency lobectomy was performed in one symptomatic neonate. Elective lobectomies were performed at parental request in three asymptomatic infants, one of whom had a family history of synovial sarcoma. Two patients developed pneumonia in the affected lobe during early childhood and proceeded to lobectomy at the age of 3 years. One patient with a bronchopulmonary sequestration required embolisation for cyanotic episodes. The remaining 65 patients have been conservatively managed to date, and none have required hospital admission. Less than a quarter report mild respiratory symptoms such as cough or wheeze. Median follow-up is 5 years. This retrospective cohort study of 74 consecutive CLMs diagnosed antenatally over a 10-year period demonstrates that most of these lesions will remain asymptomatic throughout childhood. Although the natural history of CLMs in later years remains to be elucidated, we hope that this report on medium-term outcomes will be useful to clinicians who undertake antenatal counselling and may inform the discussion on how best to manage these children.

Lifestyle and clinical factors associated with elevated C-reactive protein among newly diagnosed Type 2 diabetes mellitus patients: a cross-sectional study from the nationwide DD2 cohort.

PubMed

Svensson, Elisabeth; Mor, Anil; Rungby, Jørgen; Berencsi, Klara; Nielsen, Jens Steen; Stidsen, Jacob V; Friborg, Søren; Brandslund, Ivan; Christiansen, Jens Sandahl; Beck-Nielsen, Henning; Sørensen, Henrik Toft; Thomsen, Reimar W

2014-08-28

We aimed to examine the prevalence of and modifiable factors associated with elevated C-reactive Protein (CRP), a marker of inflammation, in men and women with newly diagnosed Type 2 Diabetes mellitus (DM) in a population-based setting. CRP was measured in 1,037 patients (57% male) with newly diagnosed Type 2 DM included in the prospective nationwide Danish Centre for Strategic Research in Type 2 Diabetes (DD2) project. We assessed the prevalence of elevated CRP and calculated relative risks (RR) examining the association of CRP with lifestyle and clinical factors by Poisson regression, stratified by gender. We used linear regression to examine the association of CRP with other biomarkers. The median CRP value was 2.1 mg/L (interquartile range, 1.0 - 4.8 mg/L). In total, 405 out of the 1,037 Type 2 DM patients (40%) had elevated CRP levels (>3.0 mg/L). More women (46%) than men (34%) had elevated CRP. Among women, a lower risk of elevated CRP was observed in patients receiving statins (adjusted RR (aRR) 0.7 (95% confidence interval (CI) 0.6-0.9)), whereas a higher risk was seen in patients with central obesity (aRR 2.3 (95% CI 1.0-5.3)). For men, CRP was primarily elevated among patients with no regular physical activity (aRR 1.5 (95% CI 1.1-1.9)), previous cardiovascular disease (aRR1.5 (95% CI 1.2-1.9) and other comorbidity. For both genders, elevated CRP was 1.4-fold increased in those with weight gain >30 kg since age 20 years. Sensitivity analyses showed consistent results with the full analysis. The linear regression analysis conveyed an association between high CRP and increased fasting blood glucose. Among newly diagnosed Type 2 DM patients, 40% had elevated CRP levels. Important modifiable risk factors for elevated CRP may vary by gender, and include low physical activity for men and central obesity and absence of statin use for women.

Massive Galaxies Are Larger in Dense Environments: Environmental Dependence of Mass-Size Relation of Early-type Galaxies

NASA Astrophysics Data System (ADS)

Yoon, Yongmin; Im, Myungshin; Kim, Jae-Woo

2017-01-01

Under the Λ cold dark matter (ΛCDM) cosmological models, massive galaxies are expected to be larger in denser environments through frequent hierarchical mergers with other galaxies. Yet, observational studies of low-redshift early-type galaxies have shown no such trend, standing as a puzzle to solve during the past decade. We analyzed 73,116 early-type galaxies at 0.1 ≤ z < 0.15, adopting a robust nonparametric size measurement technique and extending the analysis to many massive galaxies. We find for the first time that local early-type galaxies heavier than 1011.2 M⊙ show a clear environmental dependence in mass-size relation, in such a way that galaxies are as much as 20%-40% larger in the densest environments than in underdense environments. Splitting the sample into the brightest cluster galaxies (BCGs) and non-BCGs does not affect the result. This result agrees with the ΛCDM cosmological simulations and suggests that mergers played a significant role in the growth of massive galaxies in dense environments as expected in theory.

Cell kinetics and genetic instabilities in differentiated type early gastric cancers with different mucin phenotype.

PubMed

Shibata, Naomi; Watari, Jiro; Fujiya, Mikihiro; Tanno, Satoshi; Saitoh, Yusuke; Kohgo, Yutaka

2003-01-01

To clarify the biological impact and molecular pathogenesis of cellular phenotype in differentiated-type gastric cancers (DGCs), we investigated cell kinetics and genetic instabilities in early stage of DGCs. A total of 43 early gastric cancers (EGCs) were studied. EGCs were divided into 3 phenotypic categories: gastric (G type, n = 11), ordinary (O type, n = 20), and complete intestinal (CI type, n = 12) based on the combination of HGM, ConA, MUC2, and CD10. Proliferative index (PI), apoptotic index (AI), and p53 overexpression were investigated by immunohistochemical staining with anti-Ki-67, the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling method, and p53 antibody, respectively. Using a high-resolution fluorescent microsatellite analysis system, microsatellite instability (MSI) and loss of heterozygosity (LOH) were examined. Frameshift mutation analysis of transforming growth factor-beta type II receptor (TGF-betaRII) and bcl-2-associated X (BAX) in cancers with MSI was also performed. The mean AI/PI ratio values were 0.04 for G-type, 0.10 for O-type, and 0.13 for CI-type cancers--significantly lower in G type than in O and CI types (P = 0.02 and P = 0.001, respectively). No difference in the incidence of MSI and LOH was seen among the 3 cellular phenotypes. However, the major pattern of MSI, which showed drastic and widely dispersed changes and is related to an increased risk for cancer, was significantly higher in G and O types than in CI type (P <0.005). No frame shift mutations of TGF-betaRII or BAX were found in CI-type cancers. These results indicate that G-type cancers are likely to show more aggressive behaviors than CI-type cancers, and that O-type cancers show the intermediate characteristics of both types. However, the molecular pathogenesis of each phenotypic cancer is not associated with microsatellite alterations. Copyright 2003, Elsevier Science (USA). All rights reserved.

Early-type objects in NGC 6611 and the Eagle Nebula

NASA Astrophysics Data System (ADS)

Martayan, C.; Floquet, M.; Hubert, A. M.; Neiner, C.; Frémat, Y.; Baade, D.; Fabregat, J.

2008-10-01

Aims: An important question about Be stars is whether they are born as such or whether they have become Be stars during their evolution. It is necessary to observe young clusters to answer this question. Methods: To this end, observations of stars in NGC 6611 and the star-formation region of Eagle Nebula were carried out with the ESO-WFI in slitless spectroscopic mode and at the VLT-GIRAFFE (R ≃ 6400-17 000). The targets for the GIRAFFE observations were pre-selected from the literature and our catalogue of emission-line stars based on the WFI study. GIRAFFE observations allowed us to study the population of the early-type stars accurately both with and without emission lines. For this study, we determined the fundamental parameters of OBA stars thanks to the GIRFIT code. We also studied the status of the objects (main sequence or pre-main sequence stars) by using IR data, membership probabilities, and location in HR diagrams. Results: The nature of the early-type stars with emission-line stars in NGC 6611 and its surrounding environment is derived. The slitless observations with the WFI clearly indicate a small number of emission-line stars in M16. We observed with GIRAFFE 101 OBA stars, among them 9 are emission-line stars with circumstellar emission in Hα. We found that W080 could be a new He-strong star, like W601. W301 is a possible classical Be star, W503 is a mass-transfer eclipsing binary with an accretion disk, and the other ones are possible Herbig Ae/Be stars. We also found that the rotational velocities of main sequence B stars are 18% lower than those of pre-main sequence B stars, in good agreement with theory about the evolution of rotational velocities. Combining adaptive optics, IR data, spectroscopy, and radial velocity indications, we found that 27% of the B-type stars are binaries. We also redetermined the age of NGC 6611 found equal to 1.2-1.8 Myears, in good agreement with the most recent determinations.

N-terminal pro B-type natriuretic peptide in the early evaluation of suspected acute myocardial infarction.

PubMed

Haaf, Philip; Balmelli, Cathrin; Reichlin, Tobias; Twerenbold, Raphael; Reiter, Miriam; Meissner, Julia; Schaub, Nora; Stelzig, Claudia; Freese, Michael; Paniz, Patricia; Meune, Christophe; Drexler, Beatrice; Freidank, Heike; Winkler, Katrin; Hochholzer, Willibald; Mueller, Christian

2011-08-01

Myocardial ischemia is a strong trigger of N-terminal pro-B-type natriuretic peptide (NT-proBNP) release. As ischemia precedes necrosis in acute myocardial infarction, we hypothesized that NT-proBNP might be useful in the early diagnosis and risk stratification of patients with suspected acute myocardial infarction. In a prospective multicenter study, NT-proBNP was measured at presentation in 658 consecutive patients with acute chest pain. The final diagnosis was adjudicated by 2 independent cardiologists. Patients were followed long term regarding mortality. Acute myocardial infarction was the adjudicated final diagnosis in 117 patients (18%). NT-proBNP levels at presentation were significantly higher in acute myocardial infarction as compared with patients with other final diagnoses (median 886 pg/mL vs 135 pg/mL, P <.001). The diagnostic accuracy of NT-proBNP for acute myocardial infarction as quantified by the area under the receiver operating characteristic curve (AUC) was 0.79 (95% confidence interval [CI], 0.75-0.83). When added to cardiac troponin T, NT-proBNP significantly increased the AUC from 0.89 (95% CI, 0.84-0.93) to 0.91 (95% CI, 0.88-0.94; P=.033). Cumulative 24-month mortality rates were 0% in the first, 1.3% in the second, 8.3% in the third, and 23.3% in the fourth quartile of NT-proBNP (P <.001). NT-proBNP (AUC 0.85, 95% CI, 0.81-0.89) predicted all-cause mortality independently of and more accurately than both cardiac troponin T (AUC 0.66, 95% CI, 0.58-0.74; P <.001) and the Thrombolysis in Myocardial Infarction risk score (AUC 0.79, 95% CI, 0.74-0.84; P <.001). Net reclassification improvement (Thrombolysis in Myocardial Infarction vs additionally NT-proBNP) was 0.188 (P <.009), and integrated discrimination improvement was 0.100 (P <.001). Use of NT-proBNP improves the early diagnosis and risk stratification of patients with suspected acute myocardial infarction. Copyright © 2011 Elsevier Inc. All rights reserved.

Intensity-modulated radiation therapy followed by GDP chemotherapy for newly diagnosed stage I/II extranodal natural killer/T cell lymphoma, nasal type.

PubMed

Huang, Yu; Yang, Jianliang; Liu, Peng; Zhou, Shengyu; Gui, Lin; He, Xiaohui; Qin, Yan; Zhang, Changgong; Yang, Sheng; Xing, Puyuan; Sun, Yan; Shi, Yuankai

2017-09-01

Extranodal natural killer (NK)/T cell lymphoma, nasal type (ENKTL) is an aggressive non-Hodgkin lymphoma and the majority of ENKTL cases are diagnosed at the localized stage. Radiotherapy in combination with chemotherapy has been used for localized ENKTL, but the optimal combination treatment modality and the best first-line chemotherapy regimen have not been defined. In this retrospective study, 44 patients with newly diagnosed, stages I/II ENKTL were enrolled and received intensity-modulated radiation therapy (IMRT, 50-56 Gy) followed by GDP (gemcitabine, dexamethasone, and cisplatin) chemotherapy. The median number of chemotherapy cycles per patient was 4 (range, 2-6 cycles). At the end of treatment, the overall response rate was 95% (42/44), including 39 patients (89%) who attained complete response. Two patients developed systemic progression after IMRT. With a median follow-up of 37.5 months, the 3-year overall survival (OS) rate and progression-free survival (PFS) rate were 85% (95% CI, 74 to 96%) and 77% (95% CI, 64 to 91%), respectively. Locoregional and systemic failure rates for this treatment were 9% (4/44) and 14% (6/44), respectively. The most common grades 3 to 4 adverse events included leukopenia (37%), neutropenia (34%), and mucositis (25%). No treatment-related deaths were observed. This study suggested high efficacy and low toxicity of IMRT followed by GDP regimen chemotherapy for newly diagnosed stage I/II ENKTL patients. These results require further investigation in prospective trials.

Children diagnosed with type 1 diabetes: a randomized controlled trial comparing hospital versus home-based care.

PubMed

Tiberg, Irén; Katarina, Steen Carlsson; Carlsson, Annelie; Hallström, Inger

2012-10-01

  To compare two different regimens for children diagnosed with type 1 diabetes: hospital-based care or hospital-based home care (HBHC), referring to specialist care in a home-based setting.   The trial took place in Sweden with a randomized controlled design and included 60 children, aged 3-15 years. After 2-3 days with hospital-based care, children were randomized to either continued hospital-based care or to HBHC for 6 days. The primary outcome was the child's metabolic control after 2 years. Secondary outcomes were set to evaluate the family and child situation as well as the healthcare services. This article presents data 6 months after diagnosis.   Results showed equivalence between groups in terms of metabolic control, insulin dose, parents' employment and working hours as well as parents' and significant others' absence from work related to the child's diabetes. Parents in the HBHC were more satisfied with the received health care and showed less subsequent healthcare resource use. The level of risk for the family's psychosocial distress assessed at diagnosis was associated with the subsequent use of resources, but not with metabolic control.   HBHC was found to be an equally safe and effective way of providing care as hospital-based care at the onset of type 1 diabetes for children who are medically stable. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

Chromospherically active stars. IV - HD 178450 = V478 Lyr: An early-type BY Draconis type binary

NASA Technical Reports Server (NTRS)

Fekel, Francis C.

1988-01-01

It is shown that the variable star HD 178450 = V478 Lyr is a chromospherically active G8 V single-lined spectroscopic binary with a period of 2.130514 days. This star is characterized by strong UV emission features and a filled-in H-alpha absorption line which is variable in strength. Classified as an early-type BY Draconis system, it is similar to the BY Dra star HD 175742 = V775 Her. The unseen secondary of HD 178450 has a mass of about 0.3 solar masses and is believed to be an M2-M3 dwarf.

Structural analysis of star-forming blue early-type galaxies. Merger-driven star formation in elliptical galaxies

NASA Astrophysics Data System (ADS)

George, Koshy

2017-02-01

Context. Star-forming blue early-type galaxies at low redshift can give insight to the stellar mass growth of L⋆ elliptical galaxies in the local Universe. Aims: We wish to understand the reason for star formation in these otherwise passively evolving red and dead stellar systems. The fuel for star formation can be acquired through recent accretion events such as mergers or flyby. The signatures of such events should be evident from a structural analysis of the galaxy image. Methods: We carried out structural analysis on SDSS r-band imaging data of 55 star-forming blue elliptical galaxies, derived the structural parameters, analysed the residuals from best-fit to surface brightness distribution, and constructed the galaxy scaling relations. Results: We found that star-forming blue early-type galaxies are bulge-dominated systems with axial ratio >0.5 and surface brightness profiles fitted by Sérsic profiles with index (n) mostly >2. Twenty-three galaxies are found to have n< 2; these could be hosting a disc component. The residual images of the 32 galaxy surface brightness profile fits show structural features indicative of recent interactions. The star-forming blue elliptical galaxies follow the Kormendy relation and show the characteristics of normal elliptical galaxies as far as structural analysis is concerned. There is a general trend for high-luminosity galaxies to display interaction signatures and high star formation rates. Conclusions: The star-forming population of blue early-type galaxies at low redshifts could be normal ellipticals that might have undergone a recent gas-rich minor merger event. The star formation in these galaxies will shut down once the recently acquired fuel is consumed, following which the galaxy will evolve to a normal early-type galaxy.

A CONSTANT LIMITING MASS SCALE FOR FLAT EARLY-TYPE GALAXIES FROM z {approx} 1 TO z = 0: DENSITY EVOLVES BUT SHAPES DO NOT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holden, Bradford P.; Van der Wel, Arjen; Rix, Hans-Walter

2012-04-20

We measure the evolution in the intrinsic shape distribution of early-type galaxies from z {approx} 1 to z {approx} 0 by analyzing their projected axis-ratio distributions. We extract a low-redshift sample (0.04 < z < 0.08) of early-type galaxies with very low star formation rates from the Sloan Digital Sky Survey, based on a color-color selection scheme and verified through the absence of emission lines in the spectra. The inferred intrinsic shape distribution of these early-type galaxies is strongly mass dependent: the typical short-to-long intrinsic axis ratio of high-mass early-type galaxies (>10{sup 11} M{sub Sun }) is 2:3, whereas atmore » masses below 10{sup 11} M{sub Sun} this ratio narrows to 1:3, or more flattened galaxies. In an entirely analogous manner, we select a high-redshift sample (0.6 < z < 0.8) from two deep-field surveys with multi-wavelength and Hubble Space Telescope/Advanced Camera for Surveys imaging: GEMS and COSMOS. We find a seemingly universal mass of {approx}10{sup 11} M{sub Sun} for highly flattened early-type systems at all redshifts. This implies that the process that grows an early-type galaxy above this ceiling mass, irrespective of cosmic epoch, involves forming round systems. Using both parametric and non-parametric tests, we find no evolution in the projected axis-ratio distribution for galaxies with masses >3 Multiplication-Sign 10{sup 10} M{sub Sun} with redshift. At the same time, our samples imply an increase of 2-3 Multiplication-Sign in comoving number density for early-type galaxies at masses >3 Multiplication-Sign 10{sup 10} M{sub Sun }, in agreement with previous studies. Given the direct connection between the axis-ratio distribution and the underlying bulge-to-disk ratio distribution, our findings imply that the number density evolution of early-type galaxies is not exclusively driven by the emergence of either bulge- or disk-dominated galaxies, but rather by a balanced mix that depends only on the stellar mass of

Correlates and prevalence of hypogonadism in patients with early- and late-onset type 2 diabetes.

PubMed

Li, Y; Zhang, M; Liu, X; Cui, W; Rampersad, S; Li, F; Lin, Z; Yang, P; Li, H; Sheng, C; Cheng, X; Qu, S

2017-07-01

This study aims to compare the prevalence of hypogonadism between male patients with early-onset type 2 diabetes mellitus (T2DM) and late-onset type 2 diabetes. A total of 122 male patients with early-onset T2DM (diagnosis age ≤40 years) and 100 male patients with late-onset T2DM (diagnosis age >40 years) were recruited from our in-patient department between 1 January 2013 and 28 December 2015. Serum FSH, LH, testosterone, lipid profile, uric acid, HbA1c, and beta-cell function were determined in blood samples. The diagnosis of hypogonadism was based on the levels of LH, FSH, and total testosterone. The mean onset age was 29.86 ± 6.31 and 54.47 ± 9.97 years old in the early-onset group and late-onset group, respectively. Compared with late-onset T2DM, those with early-onset T2DM had a higher proportion of new-onset diabetes, were more likely to be obese, and had worse glycemic control, lipid control, and lower sex hormone-binding globulin (SHBG). The prevalence of hypogonadism was much higher in the early-onset group than in the late-onset group (48.0% vs. 26.7%, p < 0.05). The rate of secondary hypogonadism in the early-onset group and late-onset group were 44.3% and 25.0%, respectively (p < 0.05). Obesity, waist circumference, and SHBG were significantly associated with serum total testosterone level in all, early-onset, and late-onset T2DM. Both all and early-onset T2DM groups had positive correlations between total testosterone and fasting C-peptide, total cholesterol, triglycerides, and uric acid. Our results indicate that in a population of admission to a large urban hospital in China, the prevalence of hypogonadism was higher in the patients with early-onset T2DM than that of late-onset T2DM. This prevalence might be attributable to greater obesity, worse lipid control, and lower SHBG levels in those patients. © 2017 American Society of Andrology and European Academy of Andrology.

Effects of probiotic type, dose and treatment duration on irritable bowel syndrome diagnosed by Rome III criteria: a meta-analysis.

PubMed

Zhang, Yan; Li, Lixiang; Guo, Chuanguo; Mu, Dan; Feng, Bingcheng; Zuo, Xiuli; Li, Yanqing

2016-06-13

Irritable bowel syndrome (IBS) is one of the most common functional gastroenterological diseases, affecting 11.2 % of people worldwide. Previous studies have shown that probiotic treatment may benefit IBS patients. However, the effect of probiotics and the appropriate type, dose, and treatment duration for IBS are still unclear. The aim of the current study was to assess the efficacy of different probiotic types, doses and treatment durations in IBS patients diagnosed by Rome III criteria via a meta-analysis of randomized controlled trials (RCTs). Medline, EMBASE, and the Cochrane Central Register of Controlled Trials up to October 2015 were searched. RCTs including comparisons between the effects of probiotics and placebo on IBS patients diagnosed by Rome III criteria were eligible. Dichotomous data were pooled to obtain the relative risk (RR) with a 95 % confidence interval (CI), whereas continuous data were pooled using a standardized mean difference (SMD) with a 95 % CI. Twenty-one RCTs were included in this meta-analysis. Probiotic therapy was associated with more improvement than placebo administration in overall symptom response (RR: 1.82, 95 % CI 1.27 to 2.60) and quality of life (QoL) (SMD: 0.29, 95 % CI 0.08 to 0.50), but not in individual IBS symptoms. Single probiotics, a low dose, and a short treatment duration were more effective with respect to overall symptom response and QoL. No differences were detected in individual IBS symptoms in the subgroup analyses. Probiotics are an effective pharmacological therapy in IBS patients. Single probiotics at a low dose and with a short treatment duration appear to be more effective in improving overall symptom response and QoL, but more evidence for these effects is still needed.

Diseases of the Gastrointestinal Tract in Individuals Diagnosed as Children with Atypical Autism: A Danish Register Study Based on Hospital Diagnoses

ERIC Educational Resources Information Center

Mouridsen, Svend Erik; Isager, Torben; Rich, Bente

2013-01-01

The purpose of this study is to compare the prevalence and types of diseases (International Classification of Mental and Behavioural Disorders, 10th Edition codes K20-K93) relating to the gastrointestinal tract in a clinical sample of 89 individuals diagnosed as children with atypical autism/pervasive developmental disorder not otherwise specified…

EVIDENCE FOR A CONSTANT IMF IN EARLY-TYPE GALAXIES BASED ON THEIR X-RAY BINARY POPULATIONS

NASA Astrophysics Data System (ADS)

Zepf, Stephen E.; Maccarone, T. J.; Kundu, A.; Gonzalez, A. H.; Lehmer, B.; Maraston, C.

2014-01-01

A number of recent studies have proposed that the stellar initial mass function (IMF) of early type galaxies varies systematically as a function of galaxy mass, with higher mass galaxies having steeper IMFs. These steeper IMFs have more low-mass stars relative to the number of high mass stars, and therefore naturally result in proportionally fewer neutron stars and black holes. In this paper, we specifically predict the variation in the number of black holes and neutron stars in early type galaxies based on the IMF variation required to reproduce the observed mass-to-light ratio trends with galaxy mass. We then test whether such variations are observed by studying the field low-mass X-ray binary populations (LMXBs) of nearby early-type galaxies. These binaries are field neutron stars or black holes accreting from a low-mass donor star. We specifically compare the number of field LMXBs per K-band light in a well-studied sample of elliptical galaxies, and use this result to distinguish between an invariant IMF and one that is Kroupa/Chabrier-like at low masses and steeper at high masses. We discuss how these observations constrain the possible forms of the IMF variations and how future Chandra observations can enable sharper tests of the IMF.

Stages of syphilis in South China - a multilevel analysis of early diagnosis.

PubMed

Wong, Ngai Sze; Huang, Shujie; Zheng, Heping; Chen, Lei; Zhao, Peizhen; Tucker, Joseph D; Yang, Li Gang; Goh, Beng Tin; Yang, Bin

2017-01-31

Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015) accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21), adjusted for age at diagnosis and gender. Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

Relationship of Early Spontaneous Type V Blood Pressure Fluctuation after Thrombolysis in Acute Cerebral Infarction Patients and the Prognosis

PubMed Central

Zuo, Lian; Wan, Ting; Xu, Xiahong; Liu, Feifeng; Li, Changsong; Li, Ying; Zhang, Yue; Zhang, Jing; Bao, Huan; Li, Gang

2016-01-01

We examined the relationship between an early spontaneous type V blood pressure fluctuation and the post-thrombolysis prognosis of patients with acute cerebral infarction. Patients were admitted consecutively. All patients were categorized into the type V blood pressure fluctuation group or non-type V blood pressure group. Their blood pressure was monitored before thrombolysis and until 6 h after thrombolysis. Baseline data and clinical outcomes were compared. Of 170 patients, 43 (25.2%) had an early type V blood pressure fluctuation. The National Institute of Health Stroke Scale (NIHSS) score before thrombolysis and 24 h after thrombolysis, and the modified Rankin scale score at 90 days differed significantly between the two groups (P < 0.05). Multiple logistic regression analysis showed that an unfavorable prognosis at 3 months was associated with the NIHSS score before thrombolysis (P = 0.000) but probably not with this blood pressure fluctuation (P = 0.058). An early spontaneous type V blood pressure fluctuation is common in patients with acute cerebral infarction who received venous thrombolysis, especially if they have a higher NIHSS score before thrombolysis. The type V blood pressure fluctuation may not influence patients’ prognosis; however, this needs to be confirmed in future trials. PMID:27278121

Prevalence of diagnosed and undiagnosed type 2 diabetes mellitus among US adolescents: results from the continuous NHANES, 1999-2010.

PubMed

Demmer, Ryan T; Zuk, Aleksandra M; Rosenbaum, Michael; Desvarieux, Moïse

2013-10-01

Although prevalence and incidence of type 2 diabetes mellitus (T2DM) are reportedly increasing among adolescents, national data are lacking, particularly in regard to undiagnosed T2DM. To estimate the prevalence of diagnosed and undiagnosed T2DM among US adolescents, we analyzed a nationally representative cross-section of 11,888 adolescents aged 12-19 years who received a diabetes interview in the Continuous National Health and Nutrition Examination Survey during 1999-2010. Among them, a random subsample of 4,661 adolescents also had fasting blood samples collected. Persons who reported a previous diabetes diagnosis and were either taking no medication or taking an oral hypoglycemic agent (with or without insulin) were classified as having T2DM; persons who reported using insulin alone were classified as having type 1 diabetes. Undiagnosed diabetes was defined as a fasting plasma glucose concentration of ≥126 mg/dL and was assumed to be type 2. In the fasting subsample, 31 diabetes cases (types 1 and 2) were identified, representing a prevalence of 0.84% (weighted 95% confidence interval (CI): 0.51, 1.40) (276,638 cases; 95% CI: 134,255, 419,020). Estimates of the prevalences of type 1 and type 2 diabetes were 0.48% (95% CI: 0.23, 1.02) and 0.36% (95% CI: 0.20, 0.67), respectively, indicating that T2DM accounted for 43% of all cases. Further, undiagnosed T2DM prevalence was 0.12% (95% CI: 0.05, 0.31), representing 34% of T2DM cases (40,611 cases; 95% CI: 2,850, 78,373). T2DM accounts for approximately half of adolescent diabetes in the United States, and one-third of these cases are undiagnosed.

Early-Life Nutritional Programming of Type 2 Diabetes: Experimental and Quasi-Experimental Evidence.

PubMed

Vaiserman, Alexander M

2017-03-05

Consistent evidence from both experimental and human studies suggest that inadequate nutrition in early life can contribute to risk of developing metabolic disorders including type 2 diabetes (T2D) in adult life. In human populations, most findings supporting a causative relationship between early-life malnutrition and subsequent risk of T2D were obtained from quasi-experimental studies ('natural experiments'). Prenatal and/or early postnatal exposures to famine were demonstrated to be associated with higher risk of T2D in many cohorts around the world. Recent studies have highlighted the importance of epigenetic regulation of gene expression as a possible major contributor to the link between the early-life famine exposure and T2D in adulthood. Findings from these studies suggest that prenatal exposure to the famine may result in induction of persistent epigenetic changes that have adaptive significance in postnatal development but can predispose to metabolic disorders including T2D at the late stages of life. In this review, quasi-experimental data on the developmental programming of T2D are summarized and recent research findings on changes in DNA methylation that mediate these effects are discussed.

Early-Life Nutritional Programming of Type 2 Diabetes: Experimental and Quasi-Experimental Evidence

PubMed Central

Vaiserman, Alexander M.

2017-01-01

Consistent evidence from both experimental and human studies suggest that inadequate nutrition in early life can contribute to risk of developing metabolic disorders including type 2 diabetes (T2D) in adult life. In human populations, most findings supporting a causative relationship between early-life malnutrition and subsequent risk of T2D were obtained from quasi-experimental studies (‘natural experiments’). Prenatal and/or early postnatal exposures to famine were demonstrated to be associated with higher risk of T2D in many cohorts around the world. Recent studies have highlighted the importance of epigenetic regulation of gene expression as a possible major contributor to the link between the early-life famine exposure and T2D in adulthood. Findings from these studies suggest that prenatal exposure to the famine may result in induction of persistent epigenetic changes that have adaptive significance in postnatal development but can predispose to metabolic disorders including T2D at the late stages of life. In this review, quasi-experimental data on the developmental programming of T2D are summarized and recent research findings on changes in DNA methylation that mediate these effects are discussed. PMID:28273874

Diagnosing smallpox: would you know it if you saw it?

PubMed

Woods, Ryan; McCarthy, Tara; Barry, M Anita; Mahon, Barbara

2004-01-01

The intentional release of anthrax in the United States in 2001 and other recent acts of terrorism have highlighted the possibility of intentional release of smallpox by terrorists. Little is known about physicians' ability to diagnose smallpox, especially in the critical first days, when the potential for rapid control of transmission is greatest. During December 2002 and January 2003, primary care and emergency physicians at a large urban academic medical center were surveyed regarding the diagnosis and management of patients who present with vesicular rash illness. In addition to demographic and training-related questions, the questionnaire included items about perceived comfort in diagnosing and evaluating rashes, knowledge of the key differential diagnostic characteristics of chickenpox and smallpox, and the diagnostic interpretation of color photographs of patients with smallpox or chickenpox. Responses were summarized as a perceived comfort score, a differential diagnosis score, and a picture score. Of 266 eligible physicians, 178 (67%) responded. Of these, 95% thought clinicians need more education about bioterrorism; only 17% reported comfort in diagnosing smallpox. Although most physicians recognized pictures of smallpox and chickenpox, only 36% correctly answered 3 of 4 questions regarding differential diagnosis, an important aspect of identifying cases early. Those who were comfortable diagnosing rash illnesses had higher differential diagnosis scores. Strategies for bioterrorism-related training could take advantage of physicians' awareness of their own knowledge deficits.

Training clinicians treating HIV to diagnose cytomegalovirus retinitis

PubMed Central

Tun, NiNi; Maningding, Ernest; Heiden, Matthew; Rose-Nussbaumer, Jennifer; Chan, Khin Nyein; Khizniak, Tamara; Yakubenko, Alexandra; Lewallen, Susan; Keenan, Jeremy D; Saranchuk, Peter

2014-01-01

Abstract Problem Acquired immunodeficiency syndrome (AIDS)-related cytomegalovirus (CMV) retinitis continues to be a neglected source of blindness in resource-poor settings. The main issue is lack of capacity to diagnose CMV retinitis in the clinical setting where patients receive care and all other opportunistic infections are diagnosed. Approach We developed and implemented a four-day workshop to train clinicians working in human immunodeficiency virus (HIV) clinics how to perform binocular indirect ophthalmoscopy and diagnose CMV retinitis. Workshops comprised both classroom didactic instruction and direct clinical eye examinations in patients with advanced AIDS. Between 2007 and 2013, 14 workshops were conducted in China, Myanmar and the Russian Federation. Local setting Workshops were held with local clinicians at HIV clinics supported by nongovernmental organizations, public-sector municipal hospitals and provincial infectious disease referral hospitals. Each setting had limited or no access to locally- trained ophthalmologists, and an HIV-infected population with advanced disease. Relevant changes Clinicians learnt how to do binocular indirect ophthalmoscopy and to diagnose CMV retinitis. One year after the workshop, 32/38 trainees in Myanmar did systematic eye examination for early diagnosis of CMV retinitis as standard care for at-risk patients. In China and the Russian Federation, the success rates were lower, with 10/15 and 3/5 trainees, respectively, providing follow-up data. Lessons learnt Skills necessary for screening and diagnosis of CMV retinitis can be taught in a four-day task-oriented training workshop. Successful implementation depends on institutional support, ongoing training and technical support. The next challenge is to scale up this approach in other countries. PMID:25552774

Targeted next-generation sequencing identifies a homozygous nonsense mutation in ABHD12, the gene underlying PHARC, in a family clinically diagnosed with Usher syndrome type 3.

PubMed

Eisenberger, Tobias; Slim, Rima; Mansour, Ahmad; Nauck, Markus; Nürnberg, Gudrun; Nürnberg, Peter; Decker, Christian; Dafinger, Claudia; Ebermann, Inga; Bergmann, Carsten; Bolz, Hanno Jörn

2012-09-02

Usher syndrome (USH) is an autosomal recessive genetically heterogeneous disorder with congenital sensorineural hearing impairment and retinitis pigmentosa (RP). We have identified a consanguineous Lebanese family with two affected members displaying progressive hearing loss, RP and cataracts, therefore clinically diagnosed as USH type 3 (USH3). Our study was aimed at the identification of the causative mutation in this USH3-like family. Candidate loci were identified using genomewide SNP-array-based homozygosity mapping followed by targeted enrichment and next-generation sequencing. Using a capture array targeting the three identified homozygosity-by-descent regions on chromosomes 1q43-q44, 20p13-p12.2 and 20p11.23-q12, we identified a homozygous nonsense mutation, p.Arg65X, in ABHD12 segregating with the phenotype. Mutations of ABHD12, an enzyme hydrolyzing an endocannabinoid lipid transmitter, cause PHARC (polyneuropathy, hearing loss, ataxia, retinitis pigmentosa, and early-onset cataract). After the identification of the ABHD12 mutation in this family, one patient underwent neurological examination which revealed ataxia, but no polyneuropathy. ABHD12 is not known to be related to the USH protein interactome. The phenotype of our patient represents a variant of PHARC, an entity that should be taken into account as differential diagnosis for USH3. Our study demonstrates the potential of comprehensive genetic analysis for improving the clinical diagnosis.

A multi-disciplinary education process related to the discharging of children from hospital when the child has been diagnosed with type 1 diabetes--a qualitative study.

PubMed

Jönsson, Lisbeth; Hallström, Inger; Lundqvist, Anita

2010-05-27

Worldwide, insulin-dependent type 1 diabetes is one of the most frequently diagnosed long-term endocrine disorders found in children and the incidences of this diseased is still increasing. In Sweden the routines are, according to national guidelines, when the child is diagnosed with type 1 diabetes, the child and its family remains at the hospital for about two weeks. There is limited knowledge about how a diabetes team handles a child and its family from admission to discharge, therefore the purpose of this study was to seek a deeper understanding of how the diabetes team's parent/child education process works, from admission to discharge, among families with a child newly diagnosed with type 1 diabetes. Qualitative data collection was used. Four focus-group interviews, with a sample of three diabetes teams from different paediatric hospitals in the south western part of Sweden, were conducted and the data recorded on tape and then analysed using qualitative content analysis. The results indicate that achieving a status of self-care on the part of the patient is the goal of the diabetes education programme. Part of the programme is aimed at guiding the child and its parents towards self-help through the means of providing them with knowledge of the disease and its treatment to enable the whole family to understand the need for cooperation in the process. To do this requires an understanding, by the diabetes team, of the individualities of the family in order to gain an overall picture. The results of this study show that the diabetes education programme is specifically designed for each family using the internationally recommended clinical practice guidelines with its specific aims and objectives. Achieving the families' willingness to assist in the self-care of the child care is the goal of the parent education process. To achieve this, the paediatric diabetes specialist nurse and the diabetes specialist paediatrician immediately and deliberately start the

Diagnosed Eating Disorders in the U.S. Military: A Nine Year Review

DTIC Science & Technology

2008-09-01

The objective of this study was to determine the incidence of three types of eating disorders (ED) -- anorexia nervosa (AN), bulimia nervosa (BN) and... eating disorder not otherwise specified (EDNOS) -- diagnosed in the U.S. Military. Diagnosed cases of ED were obtained from the Defense Medical...Epidemiology Database for all Service Members (SM) from 1998-2006. The percentage per year of SM with an ED diagnosis was .30%. Eating disorders were

VizieR Online Data Catalog: Magnetic early B-type stars. I. (Shultz+, 2018)

NASA Astrophysics Data System (ADS)

Shultz, M.; Wade, G. A.; Rivinius, Th.; Neiner, C.; Alecian, E.; Bohlender, D.; Monin, D.; Sikora, J.; Mimes Collaboration; Binamics Collaboration

2018-03-01

Longitudinal magnetic field measurements of early B-type stars derived from 1) least-squares deconvolution profiles extracted from high-resolution spectropolarimetric data (ESPaDOnS, Narval, HARPSpol), using masks consisting of metallic lines, metallic + He lines, individual chemical elements, as well as single-line H measurements; and 2) from single-line low-resolution spectropolarimetric observations with dimaPol. (3 data files).

B-type natriuretic peptide measurement for early diagnosis of acute pulmonary edema during pregnancy.

PubMed

Seror, Jeremy; Lefevre, Guillaume; Berkane, Nathalie; Richard, Frederic; Bornes, Marie; Uzan, Serge; Berkane, Nadia

2014-12-01

Calcium-channel blockers administered to pregnant women as tocolytic agents can cause acute pulmonary edema. The first signs of this severe complication can be atypical and so delay introduction of appropriate therapy. We describe three cases in whom B-type natriuretic peptide measurements proved to be relevant in early diagnosis and monitoring of pregnant women with acute pulmonary edema. B-type natriuretic peptide measurement in this setting could contribute to timely diagnosis and improve follow-up. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

VEGAS-SSS: A VST Programme to Study the Satellite Stellar Systems around Bright Early-type Galaxies

NASA Astrophysics Data System (ADS)

Cantiello, M.; Capaccioli, M.; Napolitano, N.; Grado, A.; Limatola, L.; Paolillo, M.; Iodice, E.; Romanowsky, A. J.; Forbes, D. A.; Raimondo, G.; Spavone, M.; La Barbera, F.; Puzia, T. H.; Schipani, P.

2015-03-01

The VEGAS-SSS programme is devoted to studying the properties of small stellar systems (SSSs) in and around bright galaxies, built on the VLT Survey Telescope early-type galaxy survey (VEGAS), an ongoing guaranteed time imaging survey distributed over many semesters (Principal Investigator: Capaccioli). On completion, the VEGAS survey will have collected detailed photometric information of ~ 100 bright early-type galaxies to study the properties of diffuse light (surface brightness, colours, surface brightness fluctuations, etc.) and the distribution of clustered light (compact ''small'' stellar systems) out to previously unreached projected galactocentric radii. VEGAS-SSS will define an accurate and homogeneous dataset that will have an important legacy value for studies of the evolution and transformation processes taking place in galaxies through the fossil information provided by SSSs.

Clinical characteristics of vaginal discharge in bacterial vaginosis diagnosed by Nugent's criteria.

PubMed

Hapsari, E D; Hayashi, M; Matsuo, H

2006-01-01

To determine which clinical signs have an important contribution in bacterial vaginosis (BV) diagnosed by Nugent's criteria. This was a cross-sectional study of 58 women undergoing vaginal examination at Hayashi women's clinic, Hyogo Prefecture. Characteristics of vaginal discharge (color, amount, odor, and pH level) and the number of clue cells were compared among normal, intermediate, and BV groups. BV was diagnosed by using Nugent's criteria. The incidence of BV in our study population was 25.9%. Compared to the non-BV group, women in the BV group were found more often to have yellowish color and a moderate amount of discharge (66.67% vs 33.33%, NS; 55.56% vs 44.44%, NS), odorous discharge (100% vs 0%, p < 0.05) and furthermore, pH level and the number of clue cells were significantly higher. Odor, pH level and the number of clue cells in the vaginal discharge were helpful clinical signs for early detection of BV diagnosed by Nugent's criteria.

A new approach for diagnosing type 1 diabetes in autoantibody-positive individuals based on prediction and natural history.

PubMed

Sosenko, Jay M; Skyler, Jay S; DiMeglio, Linda A; Beam, Craig A; Krischer, Jeffrey P; Greenbaum, Carla J; Boulware, David; Rafkin, Lisa E; Matheson, Della; Herold, Kevan C; Mahon, Jeffrey; Palmer, Jerry P

2015-02-01

We assessed whether type 1 diabetes (T1D) can be diagnosed earlier using a new approach based on prediction and natural history in autoantibody-positive individuals. Diabetes Prevention Trial-Type 1 (DPT-1) and TrialNet Natural History Study (TNNHS) participants were studied. A metabolic index, the T1D Diagnostic Index60 (Index60), was developed from 2-h oral glucose tolerance tests (OGTTs) using the log fasting C-peptide, 60-min C-peptide, and 60-min glucose. OGTTs with Index60 ≥2.00 and 2-h glucose <200 mg/dL (Ind60+Only) were compared with Index60 <2.00 and 2-h glucose ≥200 mg/dL (2hglu+Only) OGTTs as criteria for T1D. Individuals were assessed for C-peptide loss from the first Ind60+Only OGTT to diagnosis. Areas under receiver operating characteristic curves were significantly higher for Index60 than for the 2-h glucose (P < 0.001 for both DPT-1 and the TNNHS). As a diagnostic criterion, sensitivity was higher for Ind60+Only than for 2hglu+Only (0.44 vs. 0.15 in DPT-1; 0.26 vs. 0.17 in the TNNHS) OGTTs. Specificity was somewhat higher for 2hglu+Only OGTTs in DPT-1 (0.97 vs. 0.91) but equivalent in the TNNHS (0.98 for both). Positive and negative predictive values were higher for Ind60+Only OGTTs in both studies. Postchallenge C-peptide levels declined significantly at each OGTT time point from the first Ind60+Only OGTT to the time of standard diagnosis (range -22 to -34% in DPT-1 and -14 to -27% in the TNNHS). C-peptide and glucose patterns differed markedly between Ind60+Only and 2hglu+Only OGTTs. An approach based on prediction and natural history appears to have utility for diagnosing T1D. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Association of a SLC30A8 genetic variant with monotherapy of repaglinide and rosiglitazone effect in newly diagnosed type 2 diabetes patients in China.

PubMed

Jiang, Feng; Li, Qing; Hu, Cheng; Zhang, Rong; Wang, Cong Rong; Yu, Wei Hui; Lu, Jing Yi; Tang, Shan Shan; Bao, Yu Qian; Xiang, Kun San; Jia, Wei Ping

2012-02-01

To investigate a potential relationship between Solute carrier family 30 (zinc transporter) member 8 (SLC30A8) rs13266634 variant and efficacy of rosiglitazone or repaglinide in treating newly diagnosed Chinese type 2 diabetes patients. A total of 209 diabetic patients without any antihyperglycemic history were recruited and treated with repaglinide or rosiglitazone randomly for 48 weeks (104 and 105 patients, respectively). Anthropometric measurements and clinical laboratory tests were carried out before and after the treatment. An non-synonymous variant rs13266634 was genotyped by matrix-assisted laser desorption ionization-time of flight mass spectroscopy. Ninety-one patients in repaglinide group and ninety-three patients in rosiglitazone group completed the study. Δ value of homeostasis model assessment of beta cell function (HOMA-B) and Δ value of fasting proinsulin levels were statistically significant between three genotype groups (P=0.0149 and 0.0246, respectively) after rosiglitazone treatment. However, no genotype association was observed in the repaglinide or rosiglitazone group with other parameters. The SLC30A8 variant was associated with the efficacy of insulin sensitizer monotherapy on insulin secretion in patients with newly diagnosed type 2 diabetes mellitus in Shanghai, China. Copyright © 2012 The Editorial Board of Biomedical and Environmental Sciences. Published by Elsevier B.V. All rights reserved.

A retrospective study on the etiological diagnoses of diarrhea in neonatal piglets in Ontario, Canada, between 2001 and 2010.

PubMed

Chan, Gloria; Farzan, Abdolvahab; DeLay, Josepha; McEwen, Beverly; Prescott, John F; Friendship, Robert M

2013-10-01

Laboratory surveillance data from the Animal Health Laboratory, University of Guelph, on the etiological diagnoses of neonatal diarrhea in piglets were analyzed to determine the relative importance and trends of different enteric pathogens in Ontario. A total of 237 cases, including live and dead 1- to 7-day-old piglets, were submitted for diagnosis of gastrointestinal illness between 2001 and 2010. The combined frequencies for cases of gastrointestinal illness involving Escherichia coli, Clostridium perfringens type A, rotavirus, and Clostridium difficile, either as single pathogens or a complex of pathogens, accounted for 56% of the total cases. In a total of 33% of cases of gastrointestinal illness, an etiological agent was not identified. The frequency of cases diagnosed with enterotoxigenic E. coli was decreased from 2007. Cases submitted in 2010 were more likely to be diagnosed with C. perfringens type A compared to cases submitted in 2002 to 2007 (P < 0.05). There was a significant trend for cases submitted in the winter to be diagnosed with C. perfringens type A, enterotoxigenic E. coli, rotavirus, and Cystoisospora suis (formerly Isospora suis) (P < 0.05). Enterotoxigenic E. coli was less likely diagnosed if C. difficile, C. perfringens, or rotavirus were detected (P < 0.05). Younger piglets were more likely to be diagnosed with C. perfringens type A (P < 0.05) and C. difficile (P < 0.05) than older piglets. This study shows that E. coli, C. perfringens type A, rotavirus, and C. difficile are enteric pathogens of concern for Ontario swine farrowing operations and further research is required to understand the reasons for the cases that are not diagnosed.

A retrospective study on the etiological diagnoses of diarrhea in neonatal piglets in Ontario, Canada, between 2001 and 2010

PubMed Central

Chan, Gloria; Farzan, Abdolvahab; DeLay, Josepha; McEwen, Beverly; Prescott, John F.; Friendship, Robert M.

2013-01-01

Laboratory surveillance data from the Animal Health Laboratory, University of Guelph, on the etiological diagnoses of neonatal diarrhea in piglets were analyzed to determine the relative importance and trends of different enteric pathogens in Ontario. A total of 237 cases, including live and dead 1- to 7-day-old piglets, were submitted for diagnosis of gastrointestinal illness between 2001 and 2010. The combined frequencies for cases of gastrointestinal illness involving Escherichia coli, Clostridium perfringens type A, rotavirus, and Clostridium difficile, either as single pathogens or a complex of pathogens, accounted for 56% of the total cases. In a total of 33% of cases of gastrointestinal illness, an etiological agent was not identified. The frequency of cases diagnosed with enterotoxigenic E. coli was decreased from 2007. Cases submitted in 2010 were more likely to be diagnosed with C. perfringens type A compared to cases submitted in 2002 to 2007 (P < 0.05). There was a significant trend for cases submitted in the winter to be diagnosed with C. perfringens type A, enterotoxigenic E. coli, rotavirus, and Cystoisospora suis (formerly Isospora suis) (P < 0.05). Enterotoxigenic E. coli was less likely diagnosed if C. difficile, C. perfringens, or rotavirus were detected (P < 0.05). Younger piglets were more likely to be diagnosed with C. perfringens type A (P < 0.05) and C. difficile (P < 0.05) than older piglets. This study shows that E. coli, C. perfringens type A, rotavirus, and C. difficile are enteric pathogens of concern for Ontario swine farrowing operations and further research is required to understand the reasons for the cases that are not diagnosed. PMID:24124267

Triglyceride to high-density lipoprotein cholesterol ratio and carotid intima-medial thickness in Chinese adolescents with newly diagnosed type 2 diabetes mellitus.

PubMed

Li, Xin; Deng, You-Ping; Yang, Miao; Wu, Yu-Wen; Sun, Su-Xin; Sun, Jia-Zhong

2016-03-01

To investigate the relationship between triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and carotid intima-medial thickness (CIMT) in Chinese youth and adolescents with newly diagnosed type 2 diabetes mellitus (T2DM). Ninety-eight subjects aged 10-24 yr with newly-diagnosed T2DM had general inflammation, anthropometric, laboratory and CIMT data collected, and were divided into three groups based on TG/HDL-C tertiles. There were no significant differences in gender, age, fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and carotid arterial diameter (CAD) among the groups based on TG/HDL-C tertiles. Across TG/HDL-C tertiles, there was a significant progressive increase in body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), homeostasis model assessment-estimated insulin resistance (HOMA-IR), TG, total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C) and CIMT (all P < 0.01 or P < 0.05), while HDL-C was decreased significantly across the groups (P < 0.01). In general linear regression model, TG/HDL-C was an independent determinant of CIMT even after adjusting for BMI, SBP, DBP, TG, TC, LDL-C, HDL-C, HbA1c and HOMA-IR. TG/HDL-C ratio, the marker of small dense LDL particles, is an independent determinant of CIMT in Chinese youth and adolescents with newly diagnosed T2DM, and may be a simple and helpful tool in predicting the increased CIMT in such patients. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Syphilis and HIV co-infection. Epidemiology, treatment and molecular typing of Treponema pallidum.

PubMed

Salado-Rasmussen, Kirsten

2015-12-01

The studies included in this PhD thesis examined the interactions of syphilis, which is caused by Treponema pallidum, and HIV. Syphilis reemerged worldwide in the late 1990s and hereafter increasing rates of early syphilis were also reported in Denmark. The proportion of patients with concurrent HIV has been substantial, ranging from one third to almost two thirds of patients diagnosed with syphilis some years. Given that syphilis facilitates transmission and acquisition of HIV the two sexually transmitted diseases are of major public health concern. Further, syphilis has a negative impact on HIV infection, resulting in increasing viral loads and decreasing CD4 cell counts during syphilis infection. Likewise, HIV has an impact on the clinical course of syphilis; patients with concurrent HIV are thought to be at increased risk of neurological complications and treatment failure. Almost ten per cent of Danish men with syphilis acquired HIV infection within five years after they were diagnosed with syphilis during an 11-year study period. Interestingly, the risk of HIV declined during the later part of the period. Moreover, HIV-infected men had a substantial increased risk of re-infection with syphilis compared to HIV-uninfected men. As one third of the HIV-infected patients had viral loads >1,000 copies/ml, our conclusion supported the initiation of cART in more HIV-infected MSM to reduce HIV transmission. During a five-year study period, including the majority of HIV-infected patients from the Copenhagen area, we observed that syphilis was diagnosed in the primary, secondary, early and late latent stage. These patients were treated with either doxycycline or penicillin and the rate of treatment failure was similar in the two groups, indicating that doxycycline can be used as a treatment alternative - at least in an HIV-infected population. During a four-year study period, the T. pallidum strain type distribution was investigated among patients diagnosed by PCR

The relative frequency of common neuromuscular diagnoses in a reference center.

PubMed

Cotta, Ana; Paim, Júlia Filardi; Carvalho, Elmano; da-Cunha-Júnior, Antonio Lopes; Navarro, Monica M; Valicek, Jaquelin; Menezes, Miriam Melo; Nunes, Simone Vilela; Xavier-Neto, Rafael; Baptista, Sidney; Lima, Luciano Romero; Takata, Reinaldo Issao; Vargas, Antonio Pedro

2017-11-01

The diagnostic procedure in neuromuscular patients is complex. Knowledge of the relative frequency of neuromuscular diseases within the investigated population is important to allow the neurologist to perform the most appropriate diagnostic tests. To report the relative frequency of common neuromuscular diagnoses in a reference center. A 17-year chart review of patients with suspicion of myopathy. Among 3,412 examinations, 1,603 (46.98%) yielded confirmatory results: 782 (48.78%) underwent molecular studies, and 821 (51.21%) had muscle biopsies. The most frequent diagnoses were: dystrophinopathy 460 (28.70%), mitochondriopathy 330 (20.59%), spinal muscular atrophy 158 (9.86%), limb girdle muscular dystrophy 157 (9.79%), Steinert myotonic dystrophy 138 (8.61%), facioscapulohumeral muscular dystrophy 99 (6.17%), and other diagnoses 261 (16.28%). Using the presently-available diagnostic techniques in this service, a specific limb girdle muscular dystrophy subtype diagnosis was reached in 61% of the patients. A neuromuscular-appropriate diagnosis is important for genetic counseling, rehabilitation orientation, and early treatment of respiratory and cardiac complications.

Early-type galaxies have been the predominant morphological class for massive galaxies since only z ˜ 1

NASA Astrophysics Data System (ADS)

Buitrago, Fernando; Trujillo, Ignacio; Conselice, Christopher J.; Häußler, Boris

2013-01-01

Present-day massive galaxies are composed mostly of early-type objects. It is unknown whether this was also the case at higher redshifts. In a hierarchical assembling scenario the morphological content of the massive population is expected to change with time from disc-like objects in the early Universe to spheroid-like galaxies at present. In this paper we have probed this theoretical expectation by compiling a large sample of massive (Mstellar ≥ 1011 h- 270 M⊙) galaxies in the redshift interval 0 < z < 3. Our sample of 1082 objects comprises 207 local galaxies selected from Sloan Digital Sky Survey plus 875 objects observed with the Hubble Space Telescope belonging to the Palomar Observatory Wide-field InfraRed/DEEP2 and GOODS NICMOS Survey surveys. 639 of our objects have spectroscopic redshifts. Our morphological classification is performed as close as possible to the optical rest frame according to the photometric bands available in our observations both quantitatively (using the Sérsic index as a morphological proxy) and qualitatively (by visual inspection). Using both techniques we find an enormous change on the dominant morphological class with cosmic time. The fraction of early-type galaxies among the massive galaxy population has changed from ˜20-30 per cent at z ˜ 3 to ˜70 per cent at z = 0. Early-type galaxies have been the predominant morphological class for massive galaxies since only z ˜ 1.

UIT Observations of Early-Type Galaxies and Analysis of the FUSE Spectrum of a Subdwarf B Star

NASA Technical Reports Server (NTRS)

Ohl, Raymond G.; Krebs, Carolyn (Technical Monitor)

2001-01-01

This work covers Ultraviolet Imaging Telescope (UIT) observations of early-type galaxies (155 nm) and Far Ultraviolet Spectroscopic Explorer (FUSE) spectra of a Galactic subdwarf B star (sdB). Early UV space astronomy missions revealed that early-type galaxies harbor a population of stars with effective temperatures greater than that of the main sequence turn-off (about 6,000 K) and UV emission that is very sensitive to characteristics of the stellar population. We present UV (155 nm) surface photometry and UV-B color profiles for 8 E and SO galaxies observed by UIT. Some objects have de Vaucouleurs surface brightness profiles, while others have disk-like profiles, but we find no other evidence for the presence of a disk or young, massive stars. There is a wide range of UV-B color gradients, but there is no correlation with metallicity gradients. SdB stars are the leading candidate UV emitters in old, high metallicity stellar populations (e.g., early-type galaxies). We observed the Galactic sdB star PG0749+658 with FUSE and derived abundances with the aim of constraining models of the heavy element distribution in sdB atmospheres. All of the elements measured are depleted with respect to solar, except for Cr and Mn, which are about solar, and Ni, which is enhanced. This work was supported in part by NASA grants NAG5-700 and NAG5-6403 to the University of Virginia and NAS5-32985 to Johns Hopkins University.

Links between sex-typed time use in middle childhood and gender development in early adolescence.

PubMed

McHale, Susan M; Kim, Ji-Yeon; Whiteman, Shawn; Crouter, Ann C

2004-09-01

The authors studied sex-typing in the kinds (e.g., sports, handicrafts) and social contexts (same- vs. other-sex companions) of children's free time activities, and the links between sex-typed activities and gender development over 2 years. Participants were 200 White, working- and middle-class children (103 girls, 97 boys; mean age = 10.86 years). In annual home interviews, children rated their self-esteem, gender role attitudes and sex-typed personality qualities, academic interests, and school grades. During 7 nightly phone interviews each year, children reported on their activities. Boys were more sex-typed than girls in their peer activities, and children were least sex-typed in their activities with siblings. Sex-typed activities in middle childhood predicted individual differences in gender development in early adolescence. Copyright 2004 American Psychological Association

EAG Eminent Speaker: Two types of Archean continental crust: plume and plate tectonics on early Earth

NASA Astrophysics Data System (ADS)

Van Kranendonk, M. J.

2012-04-01

Over 4.5 billion years, Earth has evolved from a molten ball to a cooler planet with large continental plates, but how and when continents grew and plate tectonics started remain poorly understood. In this paper, I review the evidence that 3.5-3.2 Ga continental nuclei of the Pilbara (Australia) and Kaapvaal (southern Africa) cratons formed as thick volcanic plateaux over hot, upwelling mantle and survived due to contemporaneous development of highly depleted, buoyant, unsubductable mantle roots. This type of crust is distinct from, but complimentary to, high-grade gneiss terranes, as exemplified by the North Atlantic Craton of West Greenland, which formed through subduction-accretion tectonics on what is envisaged as a vigorously convecting early Earth with small plates. Thus, it is proposed that two types of crust formed on early Earth, in much the same way as in modern Earth, but with distinct differences resulting from a hotter Archean mantle. Volcanic plateaux provided a variety of stable habitats for early life, including chemical nutrient rich, shallow-water hydrothermal systems and shallow marine carbonate platforms.

Multimodal Chiropractic Care for Pain and Disability in a Patient Diagnosed With Ehlers-Danlos Syndrome-Hypermobility Type: A Case Report.

PubMed

Strunk, Richard G

2017-06-01

The purpose of this article is to describe the clinical response to multimodal chiropractic treatment of a patient diagnosed with Ehlers-Danlos syndrome, hypermobility type (EDS-HT), and chronic pain. A 22-year-old woman presented with severe chronic neck and low back pain, headaches, and bilateral hand pain and stiffness. In addition to these pain complaints, the patient had a family history of EDS, weekly or daily recurring joint dislocations, and upper and lower extremity joint hypermobility. As a result of her significant history and examination findings, which met the Brighton and Villefranche criteria, she was diagnosed with EDS-HT. Treatment primarily consisted of low force joint manipulative therapy and soft tissue therapy intermittently over 21 months concurrently with conventional and complementary medical care. Multiple outcome questionnaires were administered pragmatically at follow-up intervals of 3, 5½, 8½, 19, and 21 months, including but not limited to the Headache and Neck Disability Indices and the Oswestry Low Back Questionnaire. The patient had clinically meaningful improvements on the Neck Disability Index, the Headache Disability Index, and the Revised Oswestry after 3, 5½, 8½, and 21 months from baseline. This patient with EDS-HT had clinically meaningful decreases in disability, headache, and spine pain after a course of multimodal chiropractic care combined with conventional and complementary medical care.

The effect of color type on early wound healing in farmed mink (Neovison vison).

PubMed

Jespersen, A; Jensen, H E; Agger, J F; Heegaard, P M H; Damborg, P; Aalbæk, B; Hammer, A S

2017-05-22

Individual differences of mink, including color type, are speculated to affect the course of wound healing, thereby impacting wound assessment and management on the farms, as well as the assessment of wounds in forensic cases. In this study, we examined the effect of color type on early wound healing in farmed mink. Full thickness excisional wounds (2 × 2 cm) were made on the back in 18 mink of the color types Brown, Silverblue and Blue Iris. Gross and microscopic pathology of the wounds was evaluated 2 days post-wounding together with degree of wound size reduction, presence of bacteria and blood analyses. Pathological examination on day 2 showed the greatest mean wound size reduction in Brown mink (11.0%) followed by Blue Iris (7.9%) and Silverblue (1.6%). Bacteria were cultured from all wounds, and predominantly Staphylococcus species were recovered in mixed or pure culture. Histopathology from day 2 wounds showed a scab overlying necrotic wound edges, which were separated from underlying vital tissue by a demarcation zone rich in polymorphonuclear leukocytes. Fibroblasts and plump endothelial cells were more numerous in the deeper tissues. Complete blood count parameters were within normal ranges in most cases, however, the mink showed mildly to markedly decreased hematocrit and six mink of the color types Silverblue and Blue Iris showed moderately elevated numbers of circulating segmented neutrophils on day 2. There was a marked increase in concentration of serum amyloid A from day 0 to day 2 in all color types. We have described differences in early wound healing between mink of the color types Brown, Silverblue and Blue Iris by use of an experimental wound model in farmed mink. The most pronounced difference pertained to the degree of wound size reduction which was greatest in Brown mink, followed by Blue Iris and Silverblue, respectively.

Breast Camps for Awareness and Early Diagnosis of Breast Cancer in Countries With Limited Resources: A Multidisciplinary Model From Kenya.

PubMed

Sayed, Shahin; Moloo, Zahir; Ngugi, Anthony; Allidina, Amyn; Ndumia, Rose; Mutuiri, Anderson; Wasike, Ronald; Wahome, Charles; Abdihakin, Mohamed; Kasmani, Riaz; Spears, Carol D; Oigara, Raymond; Mwachiro, Elizabeth B; Busarla, Satya V P; Kibor, Kibet; Ahmed, Abdulaziz; Wawire, Jonathan; Sherman, Omar; Saleh, Mansoor; Zujewski, Jo Anne; Dawsey, Sanford M

2016-09-01

Breast cancer is the most common cancer of women in Kenya. There are no national breast cancer early diagnosis programs in Kenya. The objective was to conduct a pilot breast cancer awareness and diagnosis program at three different types of facilities in Kenya. This program was conducted at a not-for-profit private hospital, a faith-based public hospital, and a government public referral hospital. Women aged 15 years and older were invited. Demographic, risk factor, knowledge, attitudes, and screening practice data were collected. Breast health information was delivered, and clinical breast examinations (CBEs) were performed. When appropriate, ultrasound imaging, fine-needle aspirate (FNA) diagnoses, core biopsies, and onward referrals were provided. A total of 1,094 women were enrolled in the three breast camps. Of those, 56% knew the symptoms and signs of breast cancer, 44% knew how breast cancer was diagnosed, 37% performed regular breast self-exams, and 7% had a mammogram or breast ultrasound in the past year. Of the 1,094 women enrolled, 246 (23%) had previously noticed a lump in their breast. A total of 157 participants (14%) had abnormal CBEs, of whom 111 had ultrasound exams, 65 had FNAs, and 18 had core biopsies. A total of 14 invasive breast cancers and 1 malignant phyllodes tumor were diagnosed Conducting a multidisciplinary breast camp awareness and early diagnosis program is feasible in different types of health facilities within a low- and middle-income country setting. This can be a model for breast cancer awareness and point-of-care diagnosis in countries with limited resources like Kenya. This work describes a novel breast cancer awareness and early diagnosis demonstration program in a low- and middle-income country within a limited resource setting. The program includes breast self-awareness and breast cancer education, clinical exams, and point-of-care diagnostics for women in three different types of health facilities in Kenya. This pilot

Evidence for Different Disk Mass Distributions between Early- and Late-type Be Stars in the BeSOS Survey

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arcos, C.; Kanaan, S.; Curé, M.

The circumstellar disk density distributions for a sample of 63 Be southern stars from the BeSOS survey were found by modeling their H α emission line profiles. These disk densities were used to compute disk masses and disk angular momenta for the sample. Average values for the disk mass are 3.4 × 10{sup −9} and 9.5 × 10{sup −10} M {sub ⋆} for early (B0–B3) and late (B4–B9) spectral types, respectively. We also find that the range of disk angular momentum relative to the star is (150–200) J {sub ⋆}/ M {sub ⋆} and (100–150) J {sub ⋆}/ M {submore » ⋆}, again for early- and late-type Be stars, respectively. The distributions of the disk mass and disk angular momentum are different between early- and late-type Be stars at a 1% level of significance. Finally, we construct the disk mass distribution for the BeSOS sample as a function of spectral type and compare it to the predictions of stellar evolutionary models with rapid rotation. The observed disk masses are typically larger than the theoretical predictions, although the observed spread in disk masses is typically large.« less

Early Syphilis Among Men Who Have Sex with Men in the US Pacific Northwest, 2008–2013: Clinical Management and Implications for Prevention

PubMed Central

Petrosky, Emiko; Fanfair, Robyn Neblett; Toevs, Kim; DeSilva, Malini; Schafer, Sean; Hedberg, Katrina; Braxton, Jim; Walters, Jaime; Markowitz, Lauri; Hariri, Susan

2016-01-01

Substantial increases in syphilis during 2008–2013 were reported in the US Pacific Northwest state of Oregon, especially among men who have sex with men (MSM). The authors aimed to characterize the ongoing epidemic and identify possible gaps in clinical management of early syphilis (primary, secondary, and latent syphilis ≤1 year) among MSM in Multnomah County, Oregon to inform public health efforts. Administrative databases were used to examine trends in case characteristics during 2008–2013. Medical records were abstracted for cases occurring in 2013 to assess diagnosis, treatment, and screening practices. Early syphilis among MSM increased from 21 cases in 2008 to 229 in 2013. The majority of cases occurred in HIV-infected patients (range: 55.6%–69.2%) diagnosed with secondary syphilis (range: 36.2%–52.4%). In 2013, 119 (51.9%) cases were diagnosed in public sector medical settings and 110 (48.0%) in private sector settings. Over 80% of HIV-infected patients with syphilis were in HIV care. Although treatment was adequate and timely among all providers, management differed by provider type. Among HIV-infected patients, a larger proportion diagnosed by public HIV providers than private providers were tested for syphilis at least once in the previous 12 months (89.6% vs. 40.0%; p < 0.001). The characteristics of MSM diagnosed with early syphilis in Multnomah County remained largely unchanged during 2008–2013. Syphilis control measures were well established, but early syphilis among MSM continued to increase. The results suggest a need to improve syphilis screening among private clinics, but few gaps in clinical management were identified. PMID:27308806

Multiple populations within globular clusters in Early-type galaxies Exploring their effect on stellar initial mass function estimates

NASA Astrophysics Data System (ADS)

Chantereau, W.; Usher, C.; Bastian, N.

2018-05-01

It is now well-established that most (if not all) ancient globular clusters host multiple populations, that are characterised by distinct chemical features such as helium abundance variations along with N-C and Na-O anti-correlations, at fixed [Fe/H]. These very distinct chemical features are similar to what is found in the centres of the massive early-type galaxies and may influence measurements of the global properties of the galaxies. Additionally, recent results have suggested that M/L variations found in the centres of massive early-type galaxies might be due to a bottom-heavy stellar initial mass function. We present an analysis of the effects of globular cluster-like multiple populations on the integrated properties of early-type galaxies. In particular, we focus on spectral features in the integrated optical spectrum and the global mass-to-light ratio that have been used to infer variations in the stellar initial mass function. To achieve this we develop appropriate stellar population synthesis models and take into account, for the first time, an initial-final mass relation which takes into consideration a varying He abundance. We conclude that while the multiple populations may be present in massive early-type galaxies, they are likely not responsible for the observed variations in the mass-to-light ratio and IMF sensitive line strengths. Finally, we estimate the fraction of stars with multiple populations chemistry that come from disrupted globular clusters within massive ellipticals and find that they may explain some of the observed chemical patterns in the centres of these galaxies.

UNDERSTANDING THE STRUCTURE OF THE HOT INTERSTELLAR MEDIUM IN NORMAL EARLY-TYPE GALAXIES.

NASA Astrophysics Data System (ADS)

Traynor, Liam; Kim, Dong-Woo; Chandra Galaxy Atlas

2018-01-01

The hot interstellar medium (ISM) of early-type galaxies (ETG's) provides crucial insight into the understanding of their formation and evolution. Mechanisms such as type Ia supernovae heating, AGN feedback, deepening potential depth through dark matter assembly and ramp-pressure stripping are known to affect the structure of the ISM. By using temperature maps and radial temperature profiles of the hot ISM from ~70 ETG's with archival Chandra data, it is possible to classify the galaxy's ISM into common structural types. This is extended by using 3D fitting of the radial temperature profile in order to provide models that further constrain the structural types. Five structural types are present, negative (temperature decreases with radii), positive (temperature increases with radii), hybrid-dip (temperature decreases at small radii and increases at large radii), hybrid-bump (inverse of hybrid-dip) and quasi-isothermal (temperature is constant at all radii). This work will be continued by 1) determining which mechanisms are present in which galaxies and 2) analysing the model parameters between galaxies within each structural type to determine whether each type can be described by a single set of model parameters, indicating that the same physical processes are responsible for creating that structural type.

HD 66051: the first eclipsing binary hosting an early-type magnetic star

NASA Astrophysics Data System (ADS)

Kochukhov, O.; Johnston, C.; Alecian, E.; Wade, G. A.

2018-05-01

Early-type magnetic stars are rarely found in close binary systems. No such objects were known in eclipsing binaries prior to this study. Here we investigated the eclipsing, spectroscopic double-lined binary HD 66051, which exhibits out-of-eclipse photometric variations suggestive of surface brightness inhomogeneities typical of early-type magnetic stars. Using a new set of high-resolution spectropolarimetric observations, we discovered a weak magnetic field on the primary and found intrinsic, element-dependent variability in its spectral lines. The magnetic field structure of the primary is dominated by a nearly axisymmetric dipolar component with a polar field strength Bd ≈ 600 G and an inclination with respect to the rotation axis of βd = 13°. A weaker quadrupolar component is also likely to be present. We combined the radial velocity measurements derived from our spectra with archival optical photometry to determine fundamental masses (3.16 and 1.75 M⊙) and radii (2.78 and 1.39 R⊙) with a 1-3% precision. We also obtained a refined estimate of the effective temperatures (13000 and 9000 K) and studied chemical abundances for both components with the help of disentangled spectra. We demonstrate that the primary component of HD 66051 is a typical late-B magnetic chemically peculiar star with a non-uniform surface chemical abundance distribution. It is not an HgMn-type star as suggested by recent studies. The secondary is a metallic-line star showing neither a strong, global magnetic field nor intrinsic spectral variability. Fundamental parameters provided by our work for this interesting system open unique possibilities for probing interior structure, studying atomic diffusion, and constraining binary star evolution.

EGFR mutations in early-stage and advanced-stage lung adenocarcinoma: Analysis based on large-scale data from China.

PubMed

Pi, Can; Xu, Chong-Rui; Zhang, Ming-Feng; Peng, Xiao-Xiao; Wei, Xue-Wu; Gao, Xing; Yan, Hong-Hong; Zhou, Qing

2018-05-02

EGFR-tyrosine kinase inhibitors play an important role in the treatment of advanced non-small cell lung cancer (NSCLC). EGFR mutations in advanced NSCLC occur in approximately 35% of Asian patients and 60% of patients with adenocarcinoma. However, the frequency and type of EGFR mutations in early-stage lung adenocarcinoma remain unclear. We retrospectively collected data on patients diagnosed with lung adenocarcinoma tested for EGFR mutation. Early stage was defined as pathological stage IA-IIIA after radical lung cancer surgery, and advanced stage was defined as clinical stage IIIB without the opportunity for curative treatment or stage IV according to the American Joint Committee on Cancer Staging Manual, 7th edition. A total of 1699 patients were enrolled in this study from May 2014 to May 2016; 750 were assigned to the early-stage and 949 to the advanced-stage group. Baseline characteristics of the two groups were balanced, except that there were more smokers in the advanced-stage group (P < 0.001). The total EGFR mutation rate in the early-stage group was similar to that in the advanced-stage group (53.6% vs. 51.4%, respectively; P = 0.379). There was no significant difference in EGFR mutation type between the two groups. In subgroup analysis of smoking history, there was no difference in EGFR mutation frequency or type between the early-stage and advanced-stage groups. Early-stage and advanced-stage groups exhibited the same EGFR mutation frequencies and types. © 2018 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.

The extent of CO in the early-type galaxy NGC 4472

NASA Technical Reports Server (NTRS)

Hutchtmeier, W. K.; Bregman, J. N.; Hogg, D. E.; Roberts, M. S.

1994-01-01

NGC 4472, and E/SO system, is the earliest type normal galaxy with detected CO emission, and here we present additional radio observations in the lines of CO(1-0) and CO(2-1) to determine the distribution and internal properties of this gas. The original detection is reconfirmed, but observations at five surrounding locations and at two other locations in the galaxy do not show the gas to be extended; the total H2 gas mass is estimated to be 4 x 10(exp 7) solar mass. A high CO(1-0)/CO(2-1) brightness temperature ratio is found (greater than 3), which is indicative of subthermal excitation of the CO(2-1) line that can occur at low gas temperatures and low gas densities. Also, upper limits are given for the CO(2-1) fluxes in four other early-type galaxies.

Diagnoses and Presenting Symptoms in an Infant Psychiatry Clinic: Comparison of Two Diagnostic Systems.

ERIC Educational Resources Information Center

Frankel, Karen A.; Boyum, Lisa A.; Harmon, Robert J.

2004-01-01

Objective: To present data from a general infant psychiatry clinic, including range and frequency of presenting symptoms, relationship between symptoms and diagnoses, and comparison of two diagnostic systems, DSM-IV and Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-3). Method: A…

Comparison of digital color fundus imaging and fluorescein angiographic findings for the early detection of diabetic retinopathy in young type 1 diabetic patients.

PubMed

Kapsala, Z; Anastasakis, A; Mamoulakis, D; Maniadaki, I; Tsilimbaris, M

2018-01-01

To compare the findings from digital 7-field color fundus (CF) photography and fundus fluorescein angiography (FFA) in young patients with diabetes mellitus (DM) type 1 without known diabetic retinopathy. In this prospective, observational cohort study, 54 type 1 diabetic patients were recruited. Participants had been diagnosed with diabetes mellitus (DM) for at least 6 years, had Best Corrected Visual Acuity of 20/25 or better and did not have any known retinal pathology. One hundred and seven eyes were analyzed. All patients underwent a complete ophthalmic examination in the Retina Service of a University Eye Clinic including digital CF imaging and FFA. The mean age of the patients was 18.6 years. Mean duration of DM was 11.3 years, and mean haemoglobin A1c (HbA1c) level was 8.6%. Of the 107 eyes, 8 eyes (7.5%) showed microvascular abnormalities on CF images, while FFA images revealed changes in 26 eyes (24.3%). Hence, 18 of the 26 eyes showing abnormalities on FFA did not show any abnormalities on CF images. Mean DM duration in the patient group with detectable microvascular changes was found to be significantly higher compared to patients without changes, while no difference in HbA1c levels, serum lipid levels or blood pressure was observed. Comparison of digital CF and FFA findings for the detection of diabetic microvascular changes in type 1 diabetic patients showed that FFA reveals more information about retinal vascular pathology for early detection of diabetic retinopathy. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Can near real-time monitoring of emergency department diagnoses facilitate early response to sporadic meningococcal infection? - prospective and retrospective evaluations

PubMed Central

2010-01-01

Background Meningococcal infection causes severe, rapidly progressing illness and reporting of cases is mandatory in New South Wales (NSW), Australia. The NSW Department of Health operates near real-time Emergency Department (ED) surveillance that includes capture and statistical analysis of clinical preliminary diagnoses. The system can provide alerts in response to specific diagnoses entered in the ED computer system. This study assessed whether once daily reporting of clinical diagnoses of meningococcal infection using the ED surveillance system provides an opportunity for timelier public health response for this disease. Methods The study involved a prospective and retrospective component. First, reporting of ED diagnoses of meningococcal infection from the ED surveillance system prospectively operated in parallel with conventional surveillance which requires direct telephone reporting of this scheduled medical condition to local public health authorities by hospitals and laboratories when a meningococcal infection diagnosis is made. Follow-up of the ED diagnoses determined whether meningococcal infection was confirmed, and the time difference between ED surveillance report and notification by conventional means. Second, cases of meningococcal infection reported by conventional surveillance during 2004 were retrospectively matched to ED visits to determine the sensitivity and positive predictive value (PPV) of ED surveillance. Results During the prospective evaluation, 31 patients were diagnosed with meningococcal infection in participating EDs. Of these, 12 had confirmed meningococcal disease, resulting in a PPV of 38.7%. All confirmed cases were notified earlier to public health authorities by conventional reporting. Of 149 cases of notified meningococcal disease identified retrospectively, 130 were linked to an ED visit. The sensitivity and PPV of the ED diagnosis for meningococcal infection was 36.2% and 36.7%, respectively. Conclusions Based on prospective

Early loss of the glucagon response to hypoglycemia in adolescents with type 1 diabetes.

PubMed

Siafarikas, Aris; Johnston, Robert J; Bulsara, Max K; O'Leary, Peter; Jones, Timothy W; Davis, Elizabeth A

2012-08-01

To assess the glucagon response to hypoglycemia and identify influencing factors in patients with type 1 diabetes compared with nondiabetic control subjects. Hyperinsulinemic hypoglycemic clamp studies were performed in all participants. The glucagon response to both hypoglycemia and arginine was measured, as well as epinephrine, cortisol, and growth hormone responses to hypoglycemia. Residual β-cell function was assessed using fasting and stimulated C-peptide. Twenty-eight nonobese adolescents with type 1 diabetes (14 female, mean age 14.9 years [range 11.2-19.8]) and 12 healthy control subjects (6 female, 15.3 years [12.8-18.7]) participated in the study. Median duration of type 1 diabetes was 0.66 years (range 0.01-9.9). The glucagon peak to arginine stimulation was similar between groups (P = 0.27). In contrast, the glucagon peak to hypoglycemia was reduced in the group with diabetes (95% CI): 68 (62-74) vs. 96 (87-115) pg/mL (P < 0.001). This response was greater than 3 SDs from baseline for only 7% of subjects with type 1 diabetes in comparison with 83% of control subjects and was lost at a median duration of diabetes of 8 months and as early as 1 month after diagnosis (R = -0.41, P < 0.01). There was no correlation in response with height, weight, BMI, and HbA(1c). Epinephrine, cortisol, and growth hormone responses to hypoglycemia were present in both groups. The glucagon response to hypoglycemia in adolescents with type 1 diabetes is influenced by the duration of diabetes and can be lost early in the course of the disease.

The Lyman-Continuum Fluxes and Stellar Parameters of O and Early B-Type Stars

NASA Technical Reports Server (NTRS)

Vacca, William D.; Garmany, Catherine D.; Shull, J. Michael

1996-01-01

Using the results of the most recent stellar atmosphere models applied to a sample of hot stars, we construct calibrations of effective temperature (T(sub eff)), and gravity (log(sub g)) with a spectral type and luminosity class for Galactic 0-type and early B-type stars. From the model results we also derive an empirical relation between the bolometric correction and T(sub eff) and log g. Using a sample of stars with known distances located in OB associations in the Galaxy and the Large Magellanic Cloud, we derive a new calibration of M(sub v) with spectral class. With these new calibrations and the stellar atmosphere models of Kurucz, we calculate the physical parameters and ionizing photon luminosities in the H(0) and He(0) continua for O and early B-type stars. We find substantial differences between our values of the Lyman- continuum luminosity and those reported in the literature. We also discuss the systematic discrepancy between O-type stellar masses derived from spectroscopic models and those derived from evolutionary tracks. Most likely, the cause of this 'mass discrepancy' lies primarily in the atmospheric models, which are plane parallel and hydrostatic and therefore do not account for an extended atmosphere and the velocity fields in a stellar wind. Finally, we present a new computation of the Lyman-continuum luminosity from 429 known O stars located within 2.5 kpc of the Sun. We find the total ionizing luminosity from this population ((Q(sub 0)(sup T(sub ot))) = 7.0 x 10(exp 51) photons/s) to be 47% larger than that determined using the Lyman continuum values tabulated by Panagia.

[Immune system aging rate in patients with early forms of chronic cerebrovascular diseases].

PubMed

Kochetkova, N G; Al'tman, D Sh; Teplova, S N

2009-01-01

Using the Bioage and Snake software the immune and cardiovascular system aging rate was diagnosed in patients having early forms of chronic cerebrovascular diseases (CCVD). The indicators of biological, cardiopulmonary and immunological age were studied in patients showing early symptoms of cerebrovascular insufficiency and dyscirculatory encephalopathy of the 1st stage. The rate of age-dependent physiological changes was diagnosed compared to general body aging rate. Some specific patterns of immune system aging were found in patients with early forms of CCVDs, the cardinal aging symptoms (heterotropia, heterochronia) were verified.

Towards accurate radial velocities from early type spectra in the framework of an ESO key programme

NASA Astrophysics Data System (ADS)

Verschueren, Werner; David, M.; Hensberge, Herman

In order to elucidate the internal kinematics in very young stellar groups, a dedicated machinery was set up, which made it possible to proceed from actual observations to reductions and correlation analysis to the ultimate derivation of early-type stellar radial velocities (RVs) with the requisite precision. The following ingredients are found to be essential to obtain RVs of early-type stars at the 1-km/s level of precision: high-resolution, high-S/N spectra covering a large wavelength range; maximal reduction of observational errors and the use of optimal reduction procedures; the intelligent use of a versatile cross-correlation package; and comparison of velocities derived from different regions of the spectrum in order to detect systematic mismatches between object and template spectrum in some of the lines.

Capillary blood islet autoantibody screening for identifying pre-type 1 diabetes in the general population: design and initial results of the Fr1da study

PubMed Central

Raab, Jennifer; Haupt, Florian; Scholz, Marlon; Matzke, Claudia; Warncke, Katharina; Lange, Karin; Assfalg, Robin; Weininger, Katharina; Wittich, Susanne; Löbner, Stephanie; Beyerlein, Andreas; Nennstiel-Ratzel, Uta; Lang, Martin; Laub, Otto; Dunstheimer, Desiree; Bonifacio, Ezio; Achenbach, Peter; Winkler, Christiane; Ziegler, Anette-G

2016-01-01

Introduction Type 1 diabetes can be diagnosed at an early presymptomatic stage by the detection of islet autoantibodies. The Fr1da study aims to assess whether early staging of type 1 diabetes (1) is feasible at a population-based level, (2) prevents severe metabolic decompensation observed at the clinical manifestation of type 1 diabetes and (3) reduces psychological distress through preventive teaching and care. Methods and analysis Children aged 2–5 years in Bavaria, Germany, will be tested for the presence of multiple islet autoantibodies. Between February 2015 and December 2016, 100 000 children will be screened by primary care paediatricians. Islet autoantibodies are measured in capillary blood samples using a multiplex three-screen ELISA. Samples with ELISA results >97.5th centile are retested using reference radiobinding assays. A venous blood sample is also obtained to confirm the autoantibody status of children with at least two autoantibodies. Children with confirmed multiple islet autoantibodies are diagnosed with pre-type 1 diabetes. These children and their parents are invited to participate in an education and counselling programme at a local diabetes centre. Depression and anxiety, and burden of early diagnosis are also assessed. Results Of the 1027 Bavarian paediatricians, 39.3% are participating in the study. Overall, 26 760 children have been screened between February 2015 and November 2015. Capillary blood collection was sufficient in volume for islet autoantibody detection in 99.46% of the children. The remaining 0.54% had insufficient blood volume collected. Of the 26 760 capillary samples tested, 0.39% were positive for at least two islet autoantibodies. Discussion Staging for early type 1 diabetes within a public health setting appears to be feasible. The study may set new standards for the early diagnosis of type 1 diabetes and education. Ethics dissemination The study was approved by the ethics committee of Technische Universit

Capillary blood islet autoantibody screening for identifying pre-type 1 diabetes in the general population: design and initial results of the Fr1da study.

PubMed

Raab, Jennifer; Haupt, Florian; Scholz, Marlon; Matzke, Claudia; Warncke, Katharina; Lange, Karin; Assfalg, Robin; Weininger, Katharina; Wittich, Susanne; Löbner, Stephanie; Beyerlein, Andreas; Nennstiel-Ratzel, Uta; Lang, Martin; Laub, Otto; Dunstheimer, Desiree; Bonifacio, Ezio; Achenbach, Peter; Winkler, Christiane; Ziegler, Anette-G

2016-05-18

Type 1 diabetes can be diagnosed at an early presymptomatic stage by the detection of islet autoantibodies. The Fr1da study aims to assess whether early staging of type 1 diabetes (1) is feasible at a population-based level, (2) prevents severe metabolic decompensation observed at the clinical manifestation of type 1 diabetes and (3) reduces psychological distress through preventive teaching and care. Children aged 2-5 years in Bavaria, Germany, will be tested for the presence of multiple islet autoantibodies. Between February 2015 and December 2016, 100 000 children will be screened by primary care paediatricians. Islet autoantibodies are measured in capillary blood samples using a multiplex three-screen ELISA. Samples with ELISA results >97.5th centile are retested using reference radiobinding assays. A venous blood sample is also obtained to confirm the autoantibody status of children with at least two autoantibodies. Children with confirmed multiple islet autoantibodies are diagnosed with pre-type 1 diabetes. These children and their parents are invited to participate in an education and counselling programme at a local diabetes centre. Depression and anxiety, and burden of early diagnosis are also assessed. Of the 1027 Bavarian paediatricians, 39.3% are participating in the study. Overall, 26 760 children have been screened between February 2015 and November 2015. Capillary blood collection was sufficient in volume for islet autoantibody detection in 99.46% of the children. The remaining 0.54% had insufficient blood volume collected. Of the 26 760 capillary samples tested, 0.39% were positive for at least two islet autoantibodies. Staging for early type 1 diabetes within a public health setting appears to be feasible. The study may set new standards for the early diagnosis of type 1 diabetes and education. The study was approved by the ethics committee of Technische Universität München (Nr. 70/14). Published by the BMJ Publishing Group Limited. For

SDSS-IV MaNGA: Probing the Kinematic Morphology–Density Relation of Early-type Galaxies with MaNGA

NASA Astrophysics Data System (ADS)

Greene, J. E.; Leauthaud, A.; Emsellem, E.; Goddard, D.; Ge, J.; Andrews, B. H.; Brinkman, J.; Brownstein, J. R.; Greco, J.; Law, D.; Lin, Y.-T.; Masters, K. L.; Merrifield, M.; More, S.; Okabe, N.; Schneider, D. P.; Thomas, D.; Wake, D. A.; Yan, R.; Drory, N.

2017-12-01

The “kinematic” morphology–density relation for early-type galaxies posits that those galaxies with low angular momentum are preferentially found in the highest-density regions of the universe. We use a large sample of galaxy groups with halo masses {10}12.5< {M}{halo}< {10}14.5 {h}-1 {M}ȯ observed with the Mapping Nearby Galaxies at APO (MaNGA) survey to examine whether there is a correlation between local environment and rotational support that is independent of stellar mass. We find no compelling evidence for a relationship between the angular momentum content of early-type galaxies and either local overdensity or radial position within the group at fixed stellar mass.

Neurocognitive status in patients with newly-diagnosed brain tumors in good neurological condition: The impact of tumor type, volume, and location.

PubMed

Hendrix, Philipp; Hans, Elisa; Griessenauer, Christoph J; Simgen, Andreas; Oertel, Joachim; Karbach, Julia

2017-05-01

Neurocognitive function is of great importance in patients with brain tumors. Even patients in good neurological condition may suffer from neurocognitive dysfunction that affects their daily living. The purpose of the present study was to identify risk factors for neurocognitive dysfunction in patients suffering from common supratentorial brain tumors with minor neurological deficits. A prospective study evaluating neurocognitive dysfunction in patients with a newly-diagnosed brain tumor in good neurological condition was performed at a major German academic institution. Patients underwent extensive neurocognitive testing assessing perceptual speed, executive function, visual-spatial and verbal working memory, short- and long-term memory, verbal fluency, fluid intelligence, anxiety, and depression. For each patient, a healthy control was pair-matched based on age, sex, handedness, and profession. A total of 46 patients and 46 healthy controls underwent neurocognitive testing. Patients suffered from glioblastoma multiforme (10), cerebral metastasis (10), pituitary adenoma (13), or meningioma (13). There was neither any difference in age, educational level, fluid intelligence, neurological deficits, and anxiety nor in any depression scores between tumor subgroups. Overall, neurocognitive performance was significantly worse in patients compared to healthy controls. Larger tumor volume, frontal location, and left/dominant hemisphere were associated with worse executive functioning and verbal fluency. Additionally, larger tumors and left/dominant location correlated with impairments on perceptual speed tasks. Frontal tumor location was related to worse performance in visual-spatial and short- and long-term memory. Tumor type, clinical presentation, and patient self-awareness were not associated with specific neurocognitive impairments. Patients suffering from newly-diagnosed brain tumors presenting in good neurological condition display neurocognitive impairments in

Afghanistan and Iraq War Veterans: Mental Health Diagnoses are Associated with Respiratory Disease Diagnoses.

PubMed

Slatore, Christopher G; Falvo, Michael J; Nugent, Shannon; Carlson, Kathleen

2018-05-01

Many veterans of the wars in Afghanistan and Iraq have concomitant respiratory conditions and mental health conditions. We wanted to evaluate the association of mental health diagnoses with respiratory disease diagnoses among post-deployment veterans. We conducted a retrospective cohort study of all Afghanistan and Iraq War veterans who were discharged from the military or otherwise became eligible to receive Veterans Health Administration services. The primary exposure was receipt of a mental health diagnosis and the primary outcome was receipt of a respiratory diagnosis as recorded in the electronic health record. We used multivariable adjusted logistic regression to measure the associations of mental health diagnoses with respiratory diagnoses and conducted several analyses exploring the timing of the diagnoses. Among 182,338 post-deployment veterans, 14% were diagnosed with a respiratory condition, 77% of whom had a concomitant mental health diagnosis. The incidence rates were 5,363/100,000 person-years (p-y), 587/100,000 p-y, 1,450/100,000 p-y, and 233/100,000 p-y for any respiratory disease diagnosis, bronchitis, asthma, and chronic obstructive lung disease diagnoses, respectively, after the date of first Veterans Health Administration utilization. Any mental health diagnosis was associated with increased odds for any respiratory diagnosis (adjusted odds ratio 1.41, 95% confidence interval 1.37-1.46). The association of mental health diagnoses and subsequent respiratory disease diagnoses was stronger and more consistent than the converse. Many Afghanistan and Iraq War veterans are diagnosed with both respiratory and mental illnesses. Comprehensive plans that include care coordination with mental health professionals and treatments for mental illnesses may be important for many veterans with respiratory diseases.

Pathways to diagnosis: a qualitative study of the experiences and emotional reactions of parents of children diagnosed with type 1 diabetes.

PubMed

Rankin, David; Harden, Jeni; Waugh, Norman; Noyes, Kathryn; Barnard, Katharine D; Stephen, John; Robertson, Kenneth J; Bath, Louise; Robertson, Linda; Lawton, Julia

2014-12-01

The aim of this study was to explore from parents' perspectives the circumstances and events which led to their child being diagnosed with type 1 diabetes (T1D). The objective was to understand reasons for delays in seeking treatment and parents' emotional reactions to diagnosis so others can be better informed and supported in future. In-depth interviews with 54 parents of children (aged ≤12 yr) with T1D were conducted. Data analysis used an inductive, thematic approach. Parents described a 'prompt' and a 'delayed' pathway to their child being diagnosed. Parents who considered the diagnosis to be 'prompt' reported how they, or other people, had recognized their child had developed symptoms of T1D which resulted in a rapid presentation to health care professionals. In contrast, parents who perceived their child's diagnosis to be 'delayed' did not recognize signs of T1D and attributed their child's deteriorating health to other conditions, being out of routines and/or their stage of development. These parents often only sought medical help when symptoms became extreme. All parents were distressed by their child's diagnosis; however, parents in the 'delayed' pathway expressed unresolved feelings of guilt, particularly when their child was diagnosed with diabetic ketoacidosis. Parents' and other people's knowledge about T1D can affect the duration between onset of their child's symptoms and diagnosis. Campaigns to raise awareness should ensure that parents are made aware of symptoms and that T1D can develop during childhood. Health care professionals could discuss with parents the events preceding their child's diagnosis to better determine their emotional support needs. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

An XMM Investigation of Non-Thermal Phenomena in the Winds of Early-Type Stars

NASA Technical Reports Server (NTRS)

Waldron, Wayne L.; Mushotzky, Richard (Technical Monitor)

2002-01-01

The X-ray emission from early-type stars is believed to arise from a stellar wind distribution of shocks. Hence, X-ray analyses of these stars must include the effects of stellar wind X-ray absorption, which, in general dominates the ISM absorption. Although the absorption cross sections for the wind and ISM are essentially identical above 1 keV, there is substantial differences below 1 keV. Typically, if one only uses ISM cross sections to obtain fits to X-ray spectra, the fits usually indicate a model deficiency at energies below 1 keV which is attributed to the large increase in ISM cross sections at these energies. This deficiency can be eliminated by using stellar wind absorption models with a fixed ISM component. Since all early-type stars have substantial X-ray emission below 1 keV, than inclusion of wind absorption has proven to be a critical component in fitting X-ray spectra at low energies, verifying that these X-rays are indeed arising from within the stellar wind.

Pregnancy outcomes in women with an early diagnosis of gestational diabetes mellitus.

PubMed

Feghali, Maisa N; Abebe, Kaleab Z; Comer, Diane M; Caritis, Steve; Catov, Janet M; Scifres, Christina M

2018-04-01

To examine pregnancy outcomes in women with gestational diabetes mellitus (GDM) based on the timing of diagnosis. We compared demographics, blood sugars and outcomes between women diagnosed before (n = 167) or after 24 weeks' gestation (n = 1202) in a single hospital between 2009 and 2012. Because early screening is risk-based we used propensity score modelling and conditional logistic regression to account for systematic differences. Women diagnosed with GDM before 24 weeks were more likely to be obese and they were less likely to have excess gestational weight gain (35 vs. 45%, p = 0.04). Early diagnosis was associated with more frequent therapy including glyburide (65 vs. 56%, p < 0.001) and insulin (19 vs 6%, p < 0.001). After propensity score modelling and accounting for covariates, early diagnosis was associated with an increased risk for macrosomia (OR 2, 95% 1-4.15, p = 0.0498). Early diagnosis was not associated with other adverse outcomes. In a subgroup analysis comparing women treated with glyburide prior to 24 weeks compared to those diagnosed after 24 weeks, early diagnosis in women treated with glyburide was associated with an increased risk for macrosomia (OR 2.3, 95% CI 1.1-5.4, P = 0.04). Women diagnosed with GDM before 24 weeks have unique features, are at risk for adverse outcomes, and require targeted approaches to therapy. Copyright © 2018 Elsevier B.V. All rights reserved.

Early-type galaxies: Automated reduction and analysis of ROSAT PSPC data

NASA Technical Reports Server (NTRS)

Mackie, G.; Fabbiano, G.; Harnden, F. R., Jr.; Kim, D.-W.; Maggio, A.; Micela, G.; Sciortino, S.; Ciliegi, P.

1996-01-01

Preliminary results of early-type galaxies that will be part of a galaxy catalog to be derived from the complete Rosat data base are presented. The stored data were reduced and analyzed by an automatic pipeline. This pipeline is based on a command language scrip. The important features of the pipeline include new data time screening in order to maximize the signal to noise ratio of faint point-like sources, source detection via a wavelet algorithm, and the identification of sources with objects from existing catalogs. The pipeline outputs include reduced images, contour maps, surface brightness profiles, spectra, color and hardness ratios.

Indicators of distress in newly diagnosed breast cancer patients

PubMed Central

Lucidi, Fabio; Mallia, Luca; D’Aiuto, Massimiliano; Merluzzi, Thomas V.

2015-01-01

Background. The diagnosis, treatment, and long-term management of cancer can present individuals with a multitude of stressors at various points in that trajectory. Psychosocial distress may appear early in the diagnostic process and have negative effects on compliance with treatment and subsequent quality of life. Purpose. The aim of the study was to determine early-phase predictors of distress before any medical treatment. Method. Consistent with the goals of the study, 123 newly diagnosed breast cancer patients (20 to 74 years old) completed multiple indicators of knowledge about breast cancer management and treatment, attitudes toward cancer, social support, coping efficacy, and distress. Results. SEM analysis confirmed the hypothesized model. Age was negatively associated with the patient’s knowledge (β = − 0.22), which, in turn, was positively associated with both attitudes toward breast cancer (β = 0.39) and coping self-efficacy (β = 0.36). Self-efficacy was then directly related to psychological distress (β = − 0.68). Conclusions. These findings establish indicators of distress in patients early in the cancer trajectory. From a practical perspective, our results have implications for screening for distress and for the development of early interventions that may be followed by healthcare professionals to reduce psychological distress. PMID:26244115

Retrospective review of lung cancers diagnosed in annual rounds of CT screening.

PubMed

Xu, Dong Ming; Yip, Rowena; Smith, James P; Yankelevitz, David F; Henschke, Claudia I

2014-11-01

The purpose of this study was to review the records of patients with diagnoses of lung cancer in annual repeat rounds of CT screening in the International Early Lung Cancer Action Program to determine whether the cancer could have been identified in the previous round of screening. Three radiologists reviewed the scans of 104 lung cancer patients and assigned the findings to one of three categories: 1, cancer was not visible at previous CT screening; 2, cancer was visible at previous CT screening but not identified; 3, abnormality was identified at previous CT screening but not classified as malignant. Nodule size, nodule consistency, cell type, and stage at the previous screening and when identified for further workup for each of the three categories were tabulated. Twenty-four (23%) patients had category 1 findings; 56 (54%) category 2; and 24 (23%) category 3. When diagnosed, seven (29%) category 1, 10 (18%) category 2, and four (17%) category three cancers had progressed beyond stage I. All cancers seen in retrospect were in clinical stage I at the previous screening. Category 1 cancers, compared with categories 2 and 3, had faster growth rates, were less frequently adenocarcinomas (29% vs 54% and 67%, p = 0.01), and were more often small cell carcinomas (29% vs 14% and 12%, p = 0.12). Lung cancers found on annual repeat screenings were frequently identified in the previous round of screening, suggesting that review of the varied appearance and incorporation of advanced image display may be useful for earlier detection.

Clinical presentations of Ehlers Danlos syndrome type IV.

PubMed Central

Pope, F M; Narcisi, P; Nicholls, A C; Liberman, M; Oorthuys, J W

1988-01-01

Ehlers Danlos syndrome type IV is an often lethal disease caused by various mutations of type III collagen genes. It presents in infancy and childhood in several ways, and the symptoms and signs include low birth weight, prematurity, congenital dislocation of the hips, easy inappropriate bruising (sometimes suspected as child battering), and a diagnostic facial phenotype. These features predict a lethal adult disease often complicated by fatal arterial rupture in early or middle adult life. Most affected patients can be diagnosed from radiolabelled collagen protein profiles by polyacrylamide gel electrophoresis. Prenatal diagnosis by specific type III collagen restriction fragment length polymorphisms is possible in some families, and will become increasingly important. Prenatal diagnosis and prevention of the disease in selected families is already possible and will be widely available in the future. Images Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 Fig 6 Fig 7 Fig 8 Fig 9 Fig 10 Fig 11 PMID:3178263

Outcome with lenalidomide plus dexamethasone followed by early autologous stem cell transplantation in patients with newly diagnosed multiple myeloma on the ECOG-ACRIN E4A03 randomized clinical trial: long-term follow-up.

PubMed

Biran, N; Jacobus, S; Vesole, D H; Callander, N S; Fonseca, R; Williams, M E; Abonour, R; Katz, M S; Rajkumar, S V; Greipp, P R; Siegel, D S

2016-09-02

In Eastern Cooperative Oncology Group-ACRIN E4A03, on completion of four cycles of therapy, newly diagnosed multiple myeloma patients had the option of proceeding to autologous peripheral blood stem cell transplant (ASCT) or continuing on their assigned therapy lenalidomide plus low-dose dexamethasone (Ld) or lenalidomide plus high-dose dexamethasone (LD). This landmark analysis compared the outcome of 431 patients surviving their first four cycles of therapy pursuing early ASCT to those continuing on their assigned therapy. Survival distributions were estimated using the Kaplan-Meier method and compared with log-rank test. Ninety patients (21%) opted for early ASCT. The 1-, 2-, 3-, 4- and 5-year survival probability estimates were higher for early ASCT versus no early ASCT at 99, 93, 91, 85 and 80% versus 94, 84, 75, 65 and 57%, respectively. The median overall survival (OS) in the early versus no early ASCT group was not reached (NR) versus 5.78 years. In patients <65 years of age, median OS in the early versus no early ASCT groups was NR in both, hazard ratio 0.79, 95% confidence interval: (0.50, 0.25). In patients ⩾65 years of age, median OS in the early versus no early ASCT was NR versus 5.11 years. ASCT dropped out of statistical significance (P=0.080). Patients opting for ASCT after induction Ld/LD had a higher survival probability and improvement in OS regardless of dexamethasone dose density.

Nutritional factors and preservation of C-peptide in youth with recently diagnosed type 1 diabetes: SEARCH Nutrition Ancillary Study.

PubMed

Mayer-Davis, Elizabeth J; Dabelea, Dana; Crandell, Jamie L; Crume, Tessa; D'Agostino, Ralph B; Dolan, Lawrence; King, Irena B; Lawrence, Jean M; Norris, Jill M; Pihoker, Catherine; The, Natalie

2013-07-01

To test the novel hypothesis that nutritional factors previously associated with type 1 diabetes etiology or with insulin secretion are prospectively associated with fasting C-peptide (FCP) concentration among youth recently diagnosed with type 1 diabetes. Included were 1,316 youth with autoantibody-positive type 1 diabetes who participated in the SEARCH for Diabetes in Youth study (baseline disease duration, 9.9 months; SD, 6.3). Nutritional exposures included breastfeeding and age at introduction of complementary foods, baseline plasma long-chain omega-3 fatty acids including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), vitamin D, vitamin E, and, from a baseline food frequency questionnaire, estimated intake of the branched-chain amino acid leucine and total carbohydrate. Multiple linear regression models were conducted to relate each nutritional factor to baseline FCP adjusted for demographics, disease-related factors, and other confounders. Prospective analyses included the subset of participants with preserved β-cell function at baseline (baseline FCP ≥0.23 ng/mL) with additional adjustment for baseline FCP and time (mean follow-up, 24.3 months; SD, 8.2; n = 656). FCP concentration was analyzed as log(FCP). In adjusted prospective analyses, baseline EPA (P = 0.02), EPA plus DHA (P = 0.03), and leucine (P = 0.03) were each associated positively and significantly with FCP at follow-up. Vitamin D was unexpectedly inversely associated with FCP (P = 0.002). Increased intake of branched-chain amino acids and long-chain omega-3 fatty acids may support preservation of β-cell function. This represents a new direction for research to improve prognosis for type 1 diabetes.

Early intervention for late-onset ornithine transcarbamylase deficiency.

PubMed

Fujisawa, Daisuke; Mitsubuchi, Hiroshi; Matsumoto, Shirou; Iwai, Masanori; Nakamura, Kimitoshi; Hoshide, Ryuji; Harada, Nawomi; Yoshino, Makoto; Endo, Fumio

2015-01-01

We report the case of a family with late-onset ornithine transcarbamylase deficiency (OTCD). Several family members had died from OTCD, and the c.221G>A, p.Lys221Lys mutation was detected at the 3' end of exon 6 of OTC in the X-chromosome of some members. We provided genetic counseling on pregnancy, delivery, and neonate management to a 4th-generation female carrier and decided on metabolic management of her child from birth. Two male patients were diagnosed with late-onset OTCD on the basis of blood amino acid and genetic analysis, and they received arginine supplementation from the asymptomatic, early neonatal period. These children grew and developed normally, without decompensation. Patients with late-onset OTCD can and should be diagnosed and treated in the early neonatal period, especially those from families already diagnosed with late-onset OTCD, and family members must be provided with genetic counseling. © 2015 Japan Pediatric Society.

Diagnosing, Conceptualizing, and Treating Eating Disorders Not Otherwise Specified: A Comprehensive Practice Model

ERIC Educational Resources Information Center

Schwitzer, Alan M.

2012-01-01

This article presents research and evidence-based practices for identifying, understanding, diagnosing, conceptualizing, and providing a continuum of treatment for the most commonly experienced types of eating-related counseling concerns--namely, eating disorders not otherwise specified--among the population most likely to present these types of…

Social Support to Empower Parents (STEP): an intervention for parents of young children newly diagnosed with type 1 diabetes.

PubMed

Sullivan-Bolyai, Susan; Bova, Carol; Leung, Katherine; Trudeau, Allison; Lee, Mary; Gruppuso, Philip

2010-01-01

The purpose of this study was to test the efficacy of a social support intervention with parents of children <13 years old newly diagnosed with type 1 diabetes mellitus (T1DM). For this randomized, controlled clinical trial, 10 parent mentors of children diagnosed with T1DM >or=1 year and 60 parent participants were recruited from 2 pediatric diabetes centers. Mentors were trained to provide social support (home visits and phone calls) for 12 months to families in the experimental arm (32 mothers). Control group parents (28 mothers) received the phone number of an experienced parent (not trained to give social support) to call as needed. Findings Mothers in the experimental and control arms differed at baseline only in birth order of the child with T1DM. The 2 groups did not differ significantly at 3, 6, or 12 months in parent concern, confidence, worry, impact on the family, or perceived social support. Mothers in the experimental arm identified the parent mentor as someone they would seek for advice and issues regarding growth and development, sleep, eating habits, and identification of community agencies. Parent mentors consistently referred mothers to health care providers for advice on medications and treatments but helped them incorporate this advice into day-to-day management. Mothers in the experimental arm valued the mentors' help in adjusting to the diagnosis, but this value was not measured by the study instruments. Focus group research is under way to clarify the concept of parent mentor social support and to develop a social support measurement tool.

A case of urinary retention in the early stages of herpes simplex virus type-1 encephalitis.

PubMed

Fukuoka, Takuya; Nakazato, Yoshihiko; Miyake, Akifumi; Tamura, Naotoshi; Araki, Nobuo; Yamamoto, Toshimasa

2017-06-01

A 70-year-old man developed urinary retention in the early stages of herpes simplex virus (HSV) type-1 encephalitis. A nerve conduction study suggested latent myeloradiculitis. This is the first report of human herpes simplex virus-1 encephalitis followed by urinary retention at early stage from the onset like the Elsberg syndrome. Although relatively few similar cases have been reported, we consider that urinary retention is common in HSV-1 encephalitis, in which disturbances of consciousness usually require bladder catheterization from the onset. We further emphasize that urinary retention may occasionally occur in early stages of HSV-1 encephalitis, with a significant possibility of recovery. Copyright © 2017. Published by Elsevier B.V.

The hELENa project - I. Stellar populations of early-type galaxies linked with local environment and galaxy mass

NASA Astrophysics Data System (ADS)

Sybilska, A.; Lisker, T.; Kuntschner, H.; Vazdekis, A.; van de Ven, G.; Peletier, R.; Falcón-Barroso, J.; Vijayaraghavan, R.; Janz, J.

2017-09-01

We present the first in a series of papers in The role of Environment in shaping Low-mass Early-type Nearby galaxies (hELENa) project. In this paper, we combine our sample of 20 low-mass early types (dEs) with 258 massive early types (ETGs) from the ATLAS3D survey - all observed with the SAURON integral field unit - to investigate early-type galaxies' stellar population scaling relations and the dependence of the population properties on local environment, extended to the low-σ regime of dEs. The ages in our sample show more scatter at lower σ values, indicative of less massive galaxies being affected by the environment to a higher degree. The shape of the age-σ relations for cluster versus non-cluster galaxies suggests that cluster environment speeds up the placing of galaxies on the red sequence. While the scaling relations are tighter for cluster than for the field/group objects, we find no evidence for a difference in average population characteristics of the two samples. We investigate the properties of our sample in the Virgo cluster as a function of number density (rather than simple clustrocentric distance) and find that dE ages correlate with the local density such that galaxies in regions of lower density are younger, likely because they are later arrivals to the cluster or have experienced less pre-processing in groups, and consequently used up their gas reservoir more recently. Overall, dE properties correlate more strongly with density than those of massive ETGs, which was expected as less massive galaxies are more susceptible to external influences.

Secondary-care costs associated with lung cancer diagnosed at emergency hospitalisation in the United Kingdom.

PubMed

Kennedy, Martyn P T; Hall, Peter S; Callister, Matthew E J

2017-10-01

Lung cancer diagnosis during emergency hospital admission has been associated with higher early secondary-care costs and lower longer-term costs than outpatient diagnoses. This retrospective cohort study analyses the secondary-care costs of 3274 consecutive patients with lung cancer. Patients diagnosed during emergency admissions incurred greater costs during the first month and had a worse prognosis compared with outpatient diagnoses. In patients who remained alive, costs after the first month were comparable between diagnostic routes. In addition to improving patient experience and outcome, strategies to increase earlier diagnosis may reduce the additional healthcare costs associated with this route to diagnosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A revision of Sanpasaurus yaoi Young, 1944 from the Early Jurassic of China, and its relevance to the early evolution of Sauropoda (Dinosauria)

PubMed Central

Upchurch, Paul; Mannion, Philip D.; Sullivan, Corwin; Butler, Richard J.

2016-01-01

The Early Jurassic of China has long been recognized for its diverse array of sauropodomorph dinosaurs. However, the contribution of this record to our understanding of early sauropod evolution is complicated by a dearth of information on important transitional taxa. We present a revision of the poorly known taxon Sanpasaurus yaoi Young, 1944 from the late Early Jurassic Ziliujing Formation of Sichuan Province, southwest China. Initially described as the remains of an ornithopod ornithischian, we demonstrate that the material catalogued as IVPP V156 is unambiguously referable to Sauropoda. Although represented by multiple individuals of equivocal association, Sanpasaurus is nonetheless diagnosable with respect to an autapomorphic feature of the holotypic dorsal vertebral series. Additional material thought to be collected from the type locality is tentatively referred to Sanpasaurus. If correctly attributed, a second autapomorphy is present in a referred humerus. The presence of a dorsoventrally compressed pedal ungual in Sanpasaurus is of particular interest, with taxa possessing this typically ‘vulcanodontid’ character exhibiting a much broader geographic distribution than previously thought. Furthermore, the association of this trait with other features of Sanpasaurus that are broadly characteristic of basal eusauropods underscores the mosaic nature of the early sauropod–eusauropod transition. Our revision of Sanpasaurus has palaeobiogeographic implications for Early Jurassic sauropods, with evidence that the group maintained a cosmopolitan Pangaean distribution. PMID:27781168

Glycomics Laboratory for the Early Detection of Epithelial Ovarian Cancer | Division of Cancer Prevention

Cancer.gov

Ovarian cancer is a silent killer with few early symptoms and advanced disease present at the time of diagnosis. This cancer is the most lethal of all gynecologic malignancies with over 20,000 new cases diagnosed each year. The 5 year survival rates for ovarian cancer dramatically improve when the disease is diagnosed at an early stage. Therefore, the long term goal of the

How Are Genetic Conditions Diagnosed?

MedlinePlus

... Consultation How are genetic conditions diagnosed? How are genetic conditions diagnosed? A doctor may suspect a diagnosis ... and advocacy resources. For more information about diagnosing genetic conditions: Genetics Home Reference provides information about genetic ...

Type 2 Diabetes Risk Test

MedlinePlus

... Risk? Home Prevention Diagnosing Diabetes and Learning About Prediabetes Type 2 Diabetes Risk Test Lower Your Risk ... Diabetes Risk Test Diagnosing Diabetes and Learning About Prediabetes Lower Your Risk donate en -- A Future Without ...

Demographic, Clinical, and Treatment Trends Among Women Diagnosed with Vulvar Cancer in the U.S.

PubMed Central

AM, Stroup; LC, Harlan; EL, Trimble

2008-01-01

Objective Describe the treatment and survival patterns among a population-based sample of vulvar cancer patients diagnosed in the U.S. in 1999. Methods Cases were identified for the National Cancer Institute’s Patterns of Care Study (POC) using Surveillance, Epidemiology, and End Results Program (SEER). A stratified random sample of non-Hispanic white, non-Hispanic black, and Hispanic women age 20 and older was selected from cases reported by eleven SEER registries. Analyses of the association between vulvar cancer and key demographic, clinical, and hospital characteristics by stage were performed. Cox proportional hazards was used to estimate the odds of death due to cancer. All estimates were weighted, and analyses were conducted with SUDAAN. Results 90% of cases were diagnosed with in situ or early stage invasive disease. Older patients were more likely to present at advanced stages. 25% of women with Stage III–IV vulvar cancer received chemotherapy plus radiation. We noted widespread use of radical local excision among women with Stage I/II cancer, but 46%–54% with invasive disease underwent a radical or total vulvectomy. Factors associated with cancer death were limited to age and stage. Women 75 years and older were at higher risk compared to women aged 20–49 and the risk of death increased with advancing stage. Conclusions Vulvar cancer is diagnosed at early stages. Late stage disease is associated with a significant increase in mortality. Radical surgery was still commonly performed in 1999. Radiation was more common in women diagnosed at late stage, while the use of chemoradiation remained limited. PMID:18155274

Chromium-Containing Traditional Chinese Medicine, Tianmai Xiaoke Tablet, for Newly Diagnosed Type 2 Diabetes Mellitus: A Meta-Analysis and Systematic Review of Randomized Clinical Trials.

PubMed

Gu, Yuming; Xu, Xuemin; Wang, Zhe; Xu, Yunsheng; Liu, Xiuzhi; Cao, Lejun; Wang, Xueyang; Li, Zhengxin; Feng, Bo

2018-01-01

Chromium-containing traditional Chinese medicine Tianmai Xiaoke tablet (TMXKT) is approved for treating newly diagnosed type 2 diabetes mellitus (T2DM) in China. This review aimed to compile the evidence from randomized clinical trials (RCTs) and quantify the effects of TMXKT on newly diagnosed T2DM. Seven online databases were investigated up to March 20, 2017. The meta-analysis included RCTs investigating the treatment of newly diagnosed T2DM, in which TMXKT combined with conventional therapy was compared with placebo or conventional therapy. The risk of bias was evaluated using the Cochrane Collaboration tool. The estimated mean difference (MD) and the standardized mean difference were within 95% confidence intervals (CI) with respect to the interstudy heterogeneity. The outcomes were measured using fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin A1c (HbA1c), and body mass index (BMI) levels. TMXKT combined with conventional therapy lowered FBG level (MD = -0.68, 95% CI -0.90 to -0.45, P < 0.00001), 2hPG (MD = -1.33, 95% CI -1.86 to -0.79, P < 0.00001), HbA1c (MD = -0.46, 95% CI -0.57 to -0.36, P < 0.00001), and BMI (MD = -0.77, 95% CI -1.12 to -0.41, P < 0.00001). TMXKT combined with conventional therapy is beneficial for patients with newly diagnosed T2DM. However, the effectiveness and safety of TMXKT are uncertain because of the limited number of trials and low methodological quality. Therefore, practitioners should be cautious when applying TMXKT in daily practice. Also, well-designed clinical trials are needed in the future.

The impact of patients' involvement in cooking on their mortality and morbidity: a 19-year follow-up of patients diagnosed with type 2 diabetes mellitus.

PubMed

Jandorf, Sofie; Siersma, Volkert; Køster-Rasmussen, Rasmus; de Fine Olivarius, Niels; Waldorff, Frans Boch

2015-03-01

This study explored the impact of involvement in cooking on long-term morbidity and mortality among patients newly diagnosed with type 2 diabetes mellitus (T2DM). Data are from the population-based study Diabetes Care in General Practice. In baseline questionnaires, 1348 patients newly diagnosed with T2DM gave information on how frequently they consumed a warm main meal and how often they cooked it themselves. The selected patients were followed up for 19 years in the Danish National Patient Registry and the Danish Register of Causes of Death. This study analysed the association between involvement in cooking and each of seven pre-specified outcomes was analysed in Cox regression models with stepwise adjustment for possible confounders and mediators. 92% of the patients with T2DM consumed a warm main meal ≥ five times per week. Among these, women who cooked for themselves less than once a week had a higher risk of diabetes-related deaths (HR 1.86 [95% CI 1.03-3.35], p = 0.039) and stroke (HR 2.47 [95% CI 1.08-5.65], p = 0.033), after adjustment for confounders. For men, infrequent cooking was not related to increased risk for the outcomes investigated. In patients newly diagnosed with T2DM and with a regular intake of warm main meals, infrequent involvement in cooking was associated with an increased risk of diabetes-related death and stroke for women, but not for men. General practitioners should pay special attention to managing diabetes treatment in female patients newly diagnosed with T2DM who report infrequent involvement in cooking.

Hidden Active Galactic Nuclei in Early-type Galaxies

NASA Astrophysics Data System (ADS)

Paggi, Alessandro; Fabbiano, Giuseppina; Civano, Francesca; Pellegrini, Silvia; Elvis, Martin; Kim, Dong-Woo

2016-06-01

We present a stacking analysis of the complete sample of early-type galaxies (ETGs) in the Chandra COSMOS (C-COSMOS) survey, to explore the nature of the X-ray luminosity in the redshift and stellar luminosity ranges 0\\lt z\\lt 1.5 and {10}9\\lt {L}K/{L}⊙ \\lt {10}13. Using established scaling relations, we subtract the contribution of X-ray binary populations to estimate the combined emission of hot ISM and active galactic nuclei (AGNs). To discriminate between the relative importance of these two components, we (1) compare our results with the relation observed in the local universe {L}X,{gas}\\propto {L}K4.5 for hot gaseous halos emission in ETGs, and (2) evaluate the spectral signature of each stacked bin. We find two regimes where the non-stellar X-ray emission is hard, consistent with AGN emission. First, there is evidence of hard, absorbed X-ray emission in stacked bins including relatively high z (˜1.2) ETGs with average high X-ray luminosity ({L}X {- {LMXB}}≳ 6× {10}42 {{erg}} {{{s}}}-1). These luminosities are consistent with the presence of highly absorbed “hidden” AGNs in these ETGs, which are not visible in their optical-IR spectra and spectral energy distributions. Second, confirming the early indication from our C-COSMOS study of X-ray detected ETGs, we find significantly enhanced X-ray luminosity in lower stellar mass ETGs ({L}K≲ {10}11{L}⊙ ), relative to the local {L}X,{gas}\\propto {L}K4.5 relation. The stacked spectra of these ETGs also suggest X-ray emission harder than expected from gaseous hot halos. This emission is consistent with inefficient accretion {10}-5-{10}-4{\\dot{M}}{Edd} onto {M}{BH}˜ {10}6-{10}8 {M}⊙ .

Evaluation of Glycated Hemoglobin (HbA1c) for Diagnosing Type 2 Diabetes and Prediabetes among Palestinian Arab Population

PubMed Central

Kharroubi, Akram T.; Darwish, Hisham M.; Abu Al-Halaweh, Ahmad I.; Khammash, Umaiyeh M.

2014-01-01

The purpose of the study is to compare the potential of HbA1c to diagnose diabetes among Palestinian Arabs compared to fasting plasma glucose (FPG). A cross-sectional sample of 1370 Palestinian men (468) and women (902) without known diabetes and above the age of 30 years were recruited. Whole blood was used to estimate HbA1c and plasma for FPG and total lipid profile. Fasting plasma glucose was used as a reference to diagnose diabetes (≥ 126 mg/dL) and prediabetes (100–125 mg/dL). The area under the receiver operating characteristic curve (AUC) for HbA1c was 81.9% to diagnose diabetes and 63.9% for prediabetes. The agreement between HbA1c and diabetes as diagnosed by FPG was moderate (ĸ  =  0.498) and low with prediabetes (ĸ = 0.142). The optimal cut-off value for HbA1c to diagnose diabetes was ≥ 6.3% (45 mmol/mol). The sensitivity, specificity and the discriminant ability were 65.6% (53.1–76.3%), 94.5% (93.1–95.6%), 80.0% (72.8–87.3%), respectively. However, using cut-off value of ≥ 6.5% (48 mmol/mol) improved specificity. At this cut-off value, the sensitivity, specificity and the discriminant ability were 57.4% (44.9–69.0%), 97.1% (96.0–97.9%) and 77.3% (71.0–83.5%). For diagnosing prediabetes with HbA1c between 5.7–6.4% (39–46 mmol/mol), the sensitivity, specificity and the discriminant ability were 62.7% (57.1–67.9%), 56.3% (53.1–59.4%) and 59.5% (56.3–62.5%), respectively. HbA1c at cut-off value of ≥ 6.5% (48 mmol/mol) by itself diagnosed 5.3% and 48.3% as having diabetes and prediabetes compared to 4.5% and 24.2% using FPG, respectively. Mean HbA1c and FPG increase significantly with increasing body mass index. In conclusion, the ROC curves showed HbA1c could be used for diagnosing diabetes when compared to FPG but not for prediabetes in Palestinians Arabs even though only about 50% of the diabetic subjects were identified by the both HbA1c and FPG. PMID:24505401

Ontogeny of Polycystic Ovary Syndrome and Insulin Resistance In Utero and Early Childhood

PubMed Central

Abbott, David H; Bacha, Fida

2013-01-01

PCOS is a prevalent hyperandrogenic infertility and cardiometabolic disorder that increases a woman’s lifetime risk of type 2 DM. It is heritable and intensely familial. Progress towards a cure has been delayed by absence of an etiology. Evidence is mounting, however, for in utero T excess, together with gestational hyperglycemia, contributing to either early differentiation of PCOS or phenotypic amplification of its genotypes. Abnormal endocrine, ovarian and hyperinsulinemia traits are detectable as early as 2-months of age in daughters of women with PCOS, with adiposity enhancement of hyperinsulinemia during childhood potentially contributing to hyperandrogenism and LH excess by adolescence. These findings encourage increasing clinical focus on early childhood markers for adiposity and hyperinsulinemia accompanying ovarian and adrenal endocrine abnormalities that precede a diagnosable PCOS phenotype. They raise the possibility for lifestyle or therapeutic intervention prior to and during pregnancy or during childhood and adolescence alleviating the manifestations of a familial genetic predisposition to PCOS. PMID:23809624

The sensitivity of harassment to orbit: mass loss from early-type dwarfs in galaxy clusters

NASA Astrophysics Data System (ADS)

Smith, R.; Sánchez-Janssen, R.; Beasley, M. A.; Candlish, G. N.; Gibson, B. K.; Puzia, T. H.; Janz, J.; Knebe, A.; Aguerri, J. A. L.; Lisker, T.; Hensler, G.; Fellhauer, M.; Ferrarese, L.; Yi, S. K.

2015-12-01

We conduct a comprehensive numerical study of the orbital dependence of harassment on early-type dwarfs consisting of 168 different orbits within a realistic, Virgo-like cluster, varying in eccentricity and pericentre distance. We find harassment is only effective at stripping stars or truncating their stellar discs for orbits that enter deep into the cluster core. Comparing to the orbital distribution in cosmological simulations, we find that the majority of the orbits (more than three quarters) result in no stellar mass loss. We also study the effects on the radial profiles of the globular cluster systems of early-type dwarfs. We find these are significantly altered only if harassment is very strong. This suggests that perhaps most early-type dwarfs in clusters such as Virgo have not suffered any tidal stripping of stars or globular clusters due to harassment, as these components are safely embedded deep within their dark matter halo. We demonstrate that this result is actually consistent with an earlier study of harassment of dwarf galaxies, despite the apparent contradiction. Those few dwarf models that do suffer stellar stripping are found out to the virial radius of the cluster at redshift = 0, which mixes them in with less strongly harassed galaxies. However when placed on phase-space diagrams, strongly harassed galaxies are found offset to lower velocities compared to weakly harassed galaxies. This remains true in a cosmological simulation, even when haloes have a wide range of masses and concentrations. Thus phase-space diagrams may be a useful tool for determining the relative likelihood that galaxies have been strongly or weakly harassed.

Targeted next-generation sequencing identifies a homozygous nonsense mutation in ABHD12, the gene underlying PHARC, in a family clinically diagnosed with Usher syndrome type 3

PubMed Central

2012-01-01

Background Usher syndrome (USH) is an autosomal recessive genetically heterogeneous disorder with congenital sensorineural hearing impairment and retinitis pigmentosa (RP). We have identified a consanguineous Lebanese family with two affected members displaying progressive hearing loss, RP and cataracts, therefore clinically diagnosed as USH type 3 (USH3). Our study was aimed at the identification of the causative mutation in this USH3-like family. Methods Candidate loci were identified using genomewide SNP-array-based homozygosity mapping followed by targeted enrichment and next-generation sequencing. Results Using a capture array targeting the three identified homozygosity-by-descent regions on chromosomes 1q43-q44, 20p13-p12.2 and 20p11.23-q12, we identified a homozygous nonsense mutation, p.Arg65X, in ABHD12 segregating with the phenotype. Conclusion Mutations of ABHD12, an enzyme hydrolyzing an endocannabinoid lipid transmitter, cause PHARC (polyneuropathy, hearing loss, ataxia, retinitis pigmentosa, and early-onset cataract). After the identification of the ABHD12 mutation in this family, one patient underwent neurological examination which revealed ataxia, but no polyneuropathy. ABHD12 is not known to be related to the USH protein interactome. The phenotype of our patient represents a variant of PHARC, an entity that should be taken into account as differential diagnosis for USH3. Our study demonstrates the potential of comprehensive genetic analysis for improving the clinical diagnosis. PMID:22938382

Validity of glycated hemoglobin in screening and diagnosing type 2 diabetes mellitus in Chinese subjects.

PubMed

Yu, Yun; Ouyang, Xiao-Jun; Lou, Qing-Lin; Gu, Liu-Bao; Mo, Yong-Zhen; Ko, Gary T; Chow, Chun-Chung; So, Wing-Yee; Ma, Ronald; Kong, Alice; Brown, Nicola; Nan, Jennifer; Chan, Juliana; Bian, Rong-Wen

2012-03-01

The application of glycated hemoglobin (HbA(1c)) for the diagnosis of diabetes is currently under extensive discussion. In this study, we explored the validity of using HbA(1c) as a screening and diagnostic test in Chinese subjects recruited in Nanjing, China. In total, 497 subjects (361 men and 136 women) with fasting plasma glucose (PG) ≥ 5.6 mmol/L were recruited to undergo the oral glucose tolerance test (OGTT) and HbA(1c) test. Plasma lipid, uric acid, and blood pressure were also measured. Using a receiver operating characteristic curve, the optimal cutoff point of HbA(1c) related to diabetes diagnosed by the OGTT was 6.3%, with a sensitivity and specificity of 79.6% and 82.2%, respectively, and the area under the curve was 0.87 (95% confidence interval, 0.83 to 0.92). A HbA(1c) level of 6.5% had a sensitivity and specificity of 62.7% and 93.5%, respectively. When comparing the HbA(1c) ≥ 6.5% or OGTT methods for diagnosing diabetes, the former group had significantly higher HbA(1c) levels and lower levels of fasting and 2-hour PG than the latter group. No significant difference was observed in the other metabolism indexes between the two groups. Our results suggest that HbA(1c) ≥ 6.5% has reasonably good specificity for diagnosing diabetes in Chinese subjects, which is in concordance with the American Diabetes Association recommendations.

Determination of the axial rotation rate using apsidal motion for early-type eclipsing binaries

NASA Astrophysics Data System (ADS)

Khaliullin, Kh. F.; Khaliullina, A. I.

2007-11-01

Because the modern theory of stellar structure and evolution has a sound observational basis, we can consider that the apsidal parameters k2 computed in terms of this theory correctly reflect the radial density distribution in stars of different masses and spectral types. This allows us to address the problem of apsidal motion in close binary systems in a new way. Unlike the traditional approach, in this paper we use the observed apsidal periods Uobs to estimate the angular axial velocities of components, ωr, at fixed model values of k2. We use this approach to analyse the observational data for 28 eclipsing systems with known Uobs and early-type primaries (M >= 1.6 Msolar or Te >= 6000 K). We measure the age of the system in units of the synchronization time, t/tsyn. Our analysis yielded the following results. (i) There is a clear correlation between ωr/ωsyn and t/tsyn: the younger a star, the higher the angular velocity of its axial rotation in units of ωsyn, the angular velocity at pseudo-synchronization. This correlation is more significant and obvious if the synchronization time, tsyn, is computed in terms of the Zahn theory. (ii) This observational fact implies that the synchronization of early-type components in close binary systems continues on the main sequence. The synchronization times for the inner layers of the components (i.e. those that are responsible for apsidal motion) are about 1.6 and 3.1 dex longer than those predicted by the theories of Zahn and Tassoul, respectively. The average initial angular velocities (for the zero-age main sequence) are equal to ω0/ωsyn ~ 2.0. The dependence of the parameter E2 on stellar mass probably needs to be refined in the Zahn theory. (iii) Some components of the eclipsing systems of the sample studied show radially differential axial rotation. This is consistent with the Zahn theory, which predicts that the synchronization starts at the surface, where radiative damping of dynamical tides occurs, and

Neutral Gas Properties of Extremely Isolated Early-type Galaxies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ashley, Trisha; Marcum, Pamela M.; Fanelli, Michael N., E-mail: trisha.l.ashley@nasa.gov, E-mail: pamela.m.marcum@nasa.gov, E-mail: michael.n.fanelli@nasa.gov

We present the results of single-dish atomic hydrogen (H i) observations of six highly isolated early-type galaxies. These objects are a representative subset of galaxies previously studied at optical wavelengths and selected to be separated by at least 2.5 Mpc from companions brighter than M{sub V}  = −16.5 mag. Each galaxy was observed with a single pointing using the NRAO Green Bank Telescope L -band receiver. Five of these systems were strongly detected in H i. These five galaxies exhibit H i profiles with a range of properties: single Gaussian-like peaks, separate double peaks, and double horn-like profiles. The four bluestmore » galaxies ( B − V < 0.54) all contain significant gas with H i masses ranging from 1.1 × 10{sup 8} to 1.4 × 10{sup 9}.« less

Using virtual reality to assess theory of mind subprocesses and error types in early and chronic schizophrenia.

PubMed

Canty, Allana L; Neumann, David L; Shum, David H K

2017-12-01

Individuals with schizophrenia often demonstrate theory of mind (ToM) impairment relative to healthy adults. However, the exact nature of this impairment (first- vs. second-order ToM and cognitive vs. affective ToM) and the extent to which ToM abilities deteriorate with illness chronicity is unclear. Furthermore, little is known about the relationships between clinical symptoms and ToM error types (overmentalising, reduced mentalising and no ToM) in early and chronic schizophrenia. This study examined the nature and types of ToM impairment in individuals with early ( n  = 26) and chronic schizophrenia ( n  = 32) using a novel virtual reality task. Clinical participants and demographically-matched controls were administered the Virtual Assessment of Mentalising Ability, which provides indices of first- and second-order cognitive and affective ToM, and quantifies three different types of mentalising errors (viz., overmentalising, reduced mentalising, and no ToM). Individuals with early schizophrenia performed significantly poorer than healthy controls on first-order affective and second-order cognitive and affective ToM, but significantly higher than individuals with chronic schizophrenia on all ToM subscales. Whereas a lack of mental state concept was associated with negative symptoms, overmentalising was associated with positive symptoms. These findings suggest that ToM abilities selectively deteriorate with illness chronicity and error types are related to these individuals' presenting symptomology. An implication of the findings is that social-cognitive interventions for schizophrenia need to consider the nature, time course and symptomatology of the presenting patient.

Recent Structural Evolution of Early-Type Galaxies: Size Growth from z = 1 to z = 0

NASA Astrophysics Data System (ADS)

van der Wel, Arjen; Holden, Bradford P.; Zirm, Andrew W.; Franx, Marijn; Rettura, Alessandro; Illingworth, Garth D.; Ford, Holland C.

2008-11-01

Strong size and internal density evolution of early-type galaxies between z ~ 2 and the present has been reported by several authors. Here we analyze samples of nearby and distant (z ~ 1) galaxies with dynamically measured masses in order to confirm the previous, model-dependent results and constrain the uncertainties that may play a role. Velocity dispersion (σ) measurements are taken from the literature for 50 morphologically selected 0.8 < z < 1.2 field and cluster early-type galaxies with typical masses Mdyn = 2 × 1011 M⊙. Sizes (Reff) are determined with Advanced Camera for Surveys imaging. We compare the distant sample with a large sample of nearby (0.04 < z < 0.08) early-type galaxies extracted from the Sloan Digital Sky Survey for which we determine sizes, masses, and densities in a consistent manner, using simulations to quantify systematic differences between the size measurements of nearby and distant galaxies. We find a highly significant difference between the σ - Reff distributions of the nearby and distant samples, regardless of sample selection effects. The implied evolution in Reff at fixed mass between z = 1 and the present is a factor of 1.97 +/- 0.15. This is in qualitative agreement with semianalytic models; however, the observed evolution is much faster than the predicted evolution. Our results reinforce and are quantitatively consistent with previous, photometric studies that found size evolution of up to a factor of 5 since z ~ 2. A combination of structural evolution of individual galaxies through the accretion of companions and the continuous formation of early-type galaxies through increasingly gas-poor mergers is one plausible explanation of the observations. Based on observations with the Hubble Space Telescope, obtained at the Space Telescope Science Institute, which is operated by AURA, Inc., under NASA contract NAS5-26555, and observations made with the Spitzer Space Telescope, which is operated by the Jet Propulsion Laboratory

Rigidity in Gender-Typed Behaviors in Early Childhood: A Longitudinal Study of Ethnic Minority Children

ERIC Educational Resources Information Center

Halim, May Ling; Ruble, Diane; Tamis-LeMonda, Catherine; Shrout, Patrick E.

2013-01-01

A key prediction of cognitive theories of gender development concerns developmental trajectories in the relative strength or rigidity of gender typing. To examine these trajectories in early childhood, 229 children (African American, Mexican American, and Dominican American) were followed annually from age 3 to 5 years, and gender-stereotypical…

Aspergillus vertebral osteomyelitis in chronic leukocyte leukemia patient diagnosed by a novel panfungal polymerase chain reaction method.

PubMed

Dayan, Lior; Sprecher, Hannah; Hananni, Amos; Rosenbaum, Hana; Milloul, Victor; Oren, Ilana

2007-01-01

Vertebral osteomyelitis and disciitis caused by Aspergillus spp is a rare event. Early diagnosis and early antifungal therapy are critical in improving the prognosis for these patients. The diagnosis of invasive fungal infections is, in many cases, not straightforward and requires invasive procedures so that histological examination and culture can be performed. Furthermore, current traditional microbiological tests (ie, cultures and stains) lack the sensitivity for diagnosis of invasive aspergillosis. To present a case of vertebral osteomyelitis caused by Aspergillus spp diagnosed using a novel polymerase chain reaction (PCR) assay. Case report. Aspergillus DNA was detected in DNA extracted from the necrotic bone tissue by using a "panfungal" PCR novel method. Treatment with voriconazole was started based on the diagnosis. Using this novel technique enabled us to diagnose accurately an unusual bone pathogen that requires a unique treatment.

Study shows that young adults diagnosed with severe attention deficit hyperactivity disorder as children have more driving risks

DOT National Transportation Integrated Search

1996-07-01

The National Highway Traffic Safety Administration sponsored a study to assess whether Attention Deficit Hyperactivity Disorder (ADHD) diagnosed during childhood would be a risk factor for poorer driving performance during early adulthood. This Traff...

Problem drinking among Flemish students: beverage type, early drinking onset and negative personal & social consequences.

PubMed

De Bruyn, Sara; Wouters, Edwin; Ponnet, Koen; Van Damme, Joris; Maes, Lea; Van Hal, Guido

2018-02-12

Although alcohol is socially accepted in most Western societies, studies are clear about its associated negative consequences, especially among university and college students. Studies on the relationship between alcohol-related consequences and both beverage type and drinking onset, however, are scarce, especially in a European context. The aim of this research was, therefore, twofold: (1) What is the relationship between beverage type and the negative consequences experienced by students? and (2) Are these consequences determined by early drinking onset? We will examine these questions within the context of a wide range of alcohol-related consequences. The analyses are based on data collected by the inter-university project 'Head in the clouds?', measuring alcohol use among students in Flanders (Belgium). In total, a large dataset consisting of information from 19,253 anonymously participating students was available. Negative consequences were measured using a shortened version of the Core Alcohol and Drug Survey (CADS_D). Data were analysed using negative binomial regression. Results vary depending on the type of alcohol-related consequences: Personal negative consequences occur frequently among daily beer drinkers. However, a high rate of social negative consequences was recorded for both daily beer drinkers and daily spirits drinkers. Finally, early drinking onset was significantly associated with both personal and social negative consequences, and this association was especially strong between beer and spirits drinking onset and social negative consequences. Numerous negative consequences, both personal and social, are related to frequent beer and spirits drinking. Our findings indicate a close association between drinking beer and personal negative consequences as well as between drinking beer and/or spirits and social negative consequences. Similarly, early drinking onset has a major influence on the rates of both personal and social negative consequences

Early childhood caries update: A review of causes, diagnoses, and treatments

PubMed Central

Çolak, Hakan; Dülgergil, Çoruh T.; Dalli, Mehmet; Hamidi, Mehmet Mustafa

2013-01-01

Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. Its consequences can affect the immediate and long-term quality of life of the child's family and can have significant social and economic consequences beyond the immediate family as well. ECC can be a particularly virulent form of caries, beginning soon after dental eruption, developing on smooth surfaces, progressing rapidly, and having a lasting detrimental impact on the dentition. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary and permanent dentitions. The relationship between breastfeeding and ECC is likely to be complex and confounded by many biological variables, such as mutans streptococci, enamel hypoplasia, intake of sugars, as well as social variables, such as parental education and socioeconomic status, which may affect oral health. Unlike other infectious diseases, tooth decay is not self-limiting. Decayed teeth require professional treatment to remove infection and restore tooth function. In this review, we give detailed information about ECC, from its diagnosis to management. PMID:23633832

Leadership component of type A behavior predicts physical activity in early midlife.

PubMed

Yang, Xiaolin; Telama, Risto; Hirvensalo, Mirja; Hintsa, Taina; Pulkki-Råback, Laura; Hintsanen, Mirka; Keltikangas-Järvinen, Liisa; Viikari, Jorma S A; Raitakari, Olli T

2012-03-01

Research on the long-term effects of Type A behavior and its components in the prediction of physical activity in adulthood is scarce and there is a lack of prospective data that are able to show such an association. We examined the relations between components of Type A behavior and physical activity from youth to early midlife. The sample included 2,031 participants (43.8% of males) aged 9 to 24 years in 1986 from the Young Finns Study. Type A behavior was measured by the Hunter-Wolf A-B Rating Scale at three phases in 1986, 1989, and 2001. Physical activity was assessed using a short self-report questionnaire at five phases between 1986 and 2007. High Type A leadership was associated with high physical activity in 1986 (r = 0.37, P < 0.01), 1989 (r = 0.36, P < 0.01) and 2001 (r = 0.31, P < 0.01), and youth leadership also predicted high adult physical activity (P < 0.001). After adjustment for age, education, occupation, smoking, body mass index, and baseline physical activity, the association remained significant. There was also a bidirectional association between Type A leadership and physical activity. Persistent physical activity during the adult years was associated with a higher Type A leadership than persistent physical inactivity (Cohen's d = 0.34, P < 0.001), even after controlling for potential confounders. The associations of other components of Type A behavior, i.e., hard-driving, eagerness-energy, and aggression with physical activity were marginal. There is a direct relation between Type A leadership and physical activity at different development phases that maybe bidirectional.

Utility of urinary biomarkers as a diagnostic tool for early diabetic nephropathy in patients with type 2 diabetes mellitus.

PubMed

Vijay, Soorampally; Hamide, Abdoul; Senthilkumar, Gandhipuram Periyasamy; Mehalingam, Vadivelan

2018-04-12

Renal tubulo-interstitial damage has an important role in the pathogenesis of early diabetic nephropathy. Urinary biomarkers can help in the detection of early nephropathy in type 2 diabetic patients. The aim of this study was to estimate the levels of urinary neutrophil gelatinase associated lipocalin (NGAL) and cystatin-C in type 2 diabetic patients with early diabetic nephropathy & to compare them with diabetic patients without nephropathy and to correlate urinary NGAL and cystatin-C levels with microalbuminuria in them. Cross-sectional comparative study. The study was conducted on 126 patients with type 2 diabetes along with 30 control subjects attending the outpatient care department of a tertiary care teaching hospital. There were 3 study groups-diabetic patients with microalbuminuria, diabetic patients without albuminuria and control subjects who were non-diabetic without any renal disease. Details on duration of diabetes and glycemic status were obtained from the patients. Urine examination was done for subjects in all the groups to look for microalbuminuria along with estimation of NGAL and cystatin-C levels. Samples were stored at -20 °C in the deep freezer. Urinary NGAL and cystatin-C levels were significantly elevated in patients with microalbuminuria (228.18 & 3.23 ng/ml) as compared to those without albuminuria (146.12 & 2.61 ng/ml) and in control subjects (26.56 & 0.30 ng/ml). Urinary NGAL and cystatin-C levels showed a linear correlation with microalbuminuria in diabetic patients. Urinary NGAL and cystatin-C levels were increased in type 2 diabetic patients with early diabetic nephropathy as compared to patients without nephropathy. Urine NGAL and cystatin-C levels also showed a positive correlation with microalbuminuria (urine albumin-creatinine ratio) in patients with type 2 diabetes mellitus. Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Detection of protein kinases P38 based on reflectance spectroscopy with n-type porous silicon microcavities for diagnosing hydatidosis hydatid disease

NASA Astrophysics Data System (ADS)

Lv, Xiaoyi; Lv, Guodong; Jia, Zhenhong; Wang, Jiajia; Mo, Jiaqing

2014-11-01

Detection of protein kinases P38 of Echinococcus granulosus and its homologous antibody have great value for early diagnosis and treatment of hydatidosis hydatid disease. In this experiment, n-type mesoporous silicon microcavities have been successfully fabricated without KOH etching or oxidants treatment that reported in other literature. We observed the changes of the reflectivity spectrum before and after the antigen-antibody reaction by n-type mesoporous silicon microcavities. The binding of protein kinases P38 and its homologous antibody causes red shifts in the reflection spectrum of the sensor, and the red shift was proportional to the protein kinases P38 concentration with linear relationship.

Velocardiofacial Syndrome and Early Intervention Providers: Recommendations for Intervention

ERIC Educational Resources Information Center

Boyer, Valerie E.; Fullman, Leah I.; Bruns, Deborah A.

2012-01-01

Velocardiofacial syndrome (VCFS), the most common microdeletion syndrome, is increasingly diagnosed in young children because of advances in diagnostic testing. The result is an increase in the number of young children with VCFS referred for early intervention (EI) services. We describe early development of children with VCFS and strategies to…

People diagnosed with dementia in Sweden: What type of home care services and housing are they granted? A cross-sectional study.

PubMed

Odzakovic, Elzana; Hydén, Lars-Christer; Festin, Karin; Kullberg, Agneta

2018-02-01

This study aims to examine what types of home care services and housing are granted to people with a dementia diagnosis and how these types are associated with socio-demographic factors (sex, age, marital status, native or foreign born, and regional area). A cross-sectional study of all people diagnosed with dementia in three Swedish counties was conducted from the medical records in 2012. Logistic regression analysis was carried out to investigate associations between home care services and housing and socio-demographic variables. In total, 17,405 people had a dementia diagnosis, and the majority were women, aged 80+ years, and unmarried. Some 72% were living in ordinary housing and 28% lived in special housing. Of those who lived in ordinary housing, 50% did not receive any home care service. Not receiving any type of home care services was less common for older people and was also associated with being married and living in rural municipalities. The most common home care services granted were home help and personal care. Special housing was more common for older people, unmarried persons, and those living in rural municipalities. Most people with a dementia diagnosis were living in ordinary housing, and, surprisingly, half of those did not receive any type of home care service. This knowledge is essential for making the living conditions and needs of people living with dementia more visible and to provide good home care services for people with dementia and their families.

Using Nuclear Medicine Imaging Wisely in Diagnosing Infectious Diseases

PubMed Central

Censullo, Andrea

2017-01-01

Abstract In recent years, there has been an increasing emphasis on efficient and accurate diagnostic testing, exemplified by the American Board of Internal Medicine’s “Choosing Wisely” campaign. Nuclear imaging studies can provide early and accurate diagnoses of many infectious disease syndromes, particularly in complex cases where the differential remains broad. This review paper offers clinicians a rational, evidence-based guide to approaching nuclear medicine tests, using an example case of methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia in a patient with multiple potential sources. Fluorodeoxyglucose-positron emission tomography (FDG-PET) with computed tomography (CT) and sulfur colloid imaging with tagged white blood cell (WBC) scanning offer the most promise in facilitating rapid and accurate diagnoses of endovascular graft infections, vertebral osteomyelitis (V-OM), diabetic foot infections, and prosthetic joint infections (PJIs). However, radiologists at different institutions may have varying degrees of expertise with these modalities. Regardless, infectious disease consultants would benefit from knowing what nuclear medicine tests to order when considering patients with complex infectious disease syndromes. PMID:28480283

Rigidity in Gender-Typed Behaviors in Early Childhood: A Longitudinal Study of Ethnic Minority Children

PubMed Central

Ruble, Diane; Tamis-LeMonda, Catherine; Shrout, Patrick E.

2014-01-01

A key prediction of cognitive theories of gender development concerns developmental trajectories in the relative strength or rigidity of gender typing. To examine these trajectories in early childhood, 229 children (African American, Mexican, Dominican) were followed annually from age 3 to 5 and gender-stereotypical appearance, dress-up play, toy play, and sex segregation were examined. High gender-typing was found across ethnic group, and most behaviors increased in rigidity, especially from age 3 to 4. In addressing controversy surrounding the stability and structure of gender-typing it was found that from year to year, most behaviors showed moderately stable individual differences. Behaviors were uncorrelated within age, but showed more concordance in change across time, suggesting that aspects of gender-typing are multidimensional but still show coherence. PMID:23432471

Identifying early indicators in bipolar disorder: a qualitative study.

PubMed

Benti, Liliane; Manicavasagar, Vijaya; Proudfoot, Judy; Parker, Gordon

2014-06-01

The identification of early markers has become a focus for early intervention in bipolar disorder. Using a retrospective, qualitative methodology, the present study compares the early experiences of participants with bipolar disorder to those with unipolar depression up until their first diagnosed episode. The study focuses on differences in early home and school environments as well as putative differences in personality characteristics between the two groups. Finally we a compare and contrast prodromal symptoms in these two populations. Thirty-nine participants, 20 diagnosed with unipolar depression and 19 diagnosed with bipolar disorder, took part in the study. A semi-structured interview was developed to elicit information about participants' experiences prior to their first episode. Participants with bipolar disorder reported disruptive home environments, driven personality features, greater emotion dysregulation and adverse experiences during the school years, whereas participants with depression tended to describe more supportive home environments, and more compliant and introvert personality traits. Retrospective data collection and no corroborative evidence from other family members. No distinction was made between bipolar I and bipolar II disorder nor between melancholic and non-melancholic depression in the sample. Finally the study spanned over a 12-month period which does not allow for the possibility of diagnostic reassignment of some of the bipolar participants to the unipolar condition. These findings indicate that there may be benefits in combining both proximal and distal indicators in identifying a bipolar disorder phenotype which, in turn, may be relevant to the development of early intervention programs for young people with bipolar disorder.

Differences in substance-related risk behavior between dual and triple diagnosed severely mentally ill adults.

PubMed

Hampton, Michelle Decoux; Chafetz, Linda; Portillo, Carmen

2012-02-01

OBJECTIVES: The purpose of this study was to determine if differences exist between adults with dual and triple diagnoses with regard to substance-related risk behaviors. METHODS: This secondary analysis was a cross-sectional study. There were 252 subjects with dual and triple diagnoses recruited from residential crisis programs in San Francisco. Using descriptive and logistic regression analyses, subjects in the two groups were compared with regard to demographic data, types of substances, and routes of administration used in the previous 30 days to determine risk for exposure and/or transmission of HIV/HCV. RESULTS: When compared to the dual diagnosis group, subjects with triple diagnoses were four times more likely to have engaged in IDU (p=.001) and 2.6 times more likely to use amphetamines (p=.05). They also reported using more types of substances over the lifetime (p<.0001). But with regard to other risk behaviors such as alcohol use to intoxication and cocaine/crack use, there were no significant differences. CONCLUSION: Though many substance-related risk behaviors occurred in both groups, adults with triple diagnoses were more likely to engage in IDU, amphetamine use, and to use more types of substances over the lifetime. This information has the potential to inform interventions that might prevent/reduce substance-related risk in this population.

Differences in substance-related risk behavior between dual and triple diagnosed severely mentally ill adults

PubMed Central

Hampton, Michelle DeCoux; Chafetz, Linda; Portillo, Carmen

2011-01-01

Objectives The purpose of this study was to determine if differences exist between adults with dual and triple diagnoses with regard to substance-related risk behaviors. Methods This secondary analysis was a cross-sectional study. There were 252 subjects with dual and triple diagnoses recruited from residential crisis programs in San Francisco. Using descriptive and logistic regression analyses, subjects in the two groups were compared with regard to demographic data, types of substances, and routes of administration used in the previous 30 days to determine risk for exposure and/or transmission of HIV/HCV. Results When compared to the dual diagnosis group, subjects with triple diagnoses were four times more likely to have engaged in IDU (p=.001) and 2.6 times more likely to use amphetamines (p=.05). They also reported using more types of substances over the lifetime (p<.0001). But with regard to other risk behaviors such as alcohol use to intoxication and cocaine/crack use, there were no significant differences. Conclusion Though many substance-related risk behaviors occurred in both groups, adults with triple diagnoses were more likely to engage in IDU, amphetamine use, and to use more types of substances over the lifetime. This information has the potential to inform interventions that might prevent/reduce substance-related risk in this population. PMID:22582086

[A case report of early-onset Alzheimer's disease with multiple psychotic symptoms, finally diagnosed as APPV717I mutation by genetic testing].

PubMed

Ishimaru, Takashi; Ochi, Shinichiro; Matsumoto, Teruhisa; Yoshida, Taku; Abe, Masao; Toyota, Yasutaka; Fukuhara, Ryuji; Tanimukai, Satoshi; Ueno, Shu-ichi

2013-01-01

It is difficult to confirm a diagnosis of early-onset Alzheimer's disease (EOAD) because patients sometimes have non-specific cortical features, such as psychiatric symptoms, executive functional impairment, and pyramidal symptoms, along with typical symptoms, such as recent memory impairment and disorientation. We encountered a patient with multiple psychotic symptoms, finally diagnosed with EOAD on genetic testing. A right-handed sixty-year-old man, whose mother was suspected of having dementia, developed memory impairment at the age of fifty, disorientation at the age of fifty-six, and both visual hallucination and dressing apraxia at the age of fifty-nine. After admission to a psychiatric hospital for treatment, his symptoms disappeared with antipsychotic medication. However, his ADL were declining and so he was referred to our university hospital. He had frontal lobe symptoms, pyramidal signs, and extrapyramidal signs with severe dementia. Neuropsychological examinations were not possible because of sedation. On brain MRI, he showed diffuse atrophy of the cerebral cortex and hippocampus. HMPO-SPECT showed hypoperfusion of cerebral cortices diffusely. We decided to perform genetic testing because he had both family and alcohol abuse histories. He showed EOAD with V717I mutation of the amyloid precursor protein gene. After the discontinuation of antipsychotics, excessive sedation and extrapyramidal signs disappeared. A dose of 10 mg of donepezil was effective to improve motivation and activity, and his mini mental examination score was calculable after recovery. The case supports usefulness of applying genetic testing for Alzheimer's disease to patients with early onset dementia, even when they do not have a family history.

Emotion episodes during psychotherapy sessions among women newly diagnosed with gynecological cancers.

PubMed

Myers Virtue, Shannon; Manne, Sharon L; Darabos, Kathleen; Heckman, Carolyn J; Ozga, Melissa; Kissane, David; Rubin, Stephen; Rosenblum, Norman

2015-09-01

The aim of this study was to describe emotion episodes during early and late psychotherapy sessions among women newly diagnosed with gynecological cancer and to examine whether the total number of emotion episodes during early and later sessions was associated with baseline psychological distress, dispositional emotion expressivity, and patient-rated therapeutic progress. The study utilized data from an ongoing study examining the efficacy of two psychotherapy interventions, a coping and communication intervention and a supportive counseling intervention, for women diagnosed with gynecological cancer. Emotion episode coding was completed for the first and sixth psychotherapy sessions for each patient randomized to receive psychotherapy (N = 173). Patients completed baseline survey measures of psychological distress and dispositional emotional expressivity and post-session ratings of therapeutic progress. The average number of emotion episodes was 7.4 in the first session and 5.2 episodes in the sixth session. In both sessions, the majority of emotion episodes contained only negative emotions and focused on a cancer-related topic. A higher number of emotion episodes in the first session was associated with higher psychological distress reported in the baseline survey (p = 0.02). A higher number of emotion episodes in the sixth session was associated with a higher number of emotion episodes in the first session (p < 0.001) and higher patient-rated progress as rated in the sixth session (p = 0.016). The findings highlight the importance of expressed emotions, particularly negative emotions about cancer-related topics, in therapeutic progress during psychotherapy among women diagnosed with gynecological cancer. Copyright © 2014 John Wiley & Sons, Ltd.

Wireless telemedicine systems for diagnosing sleep disorders with Zigbee star network topology

NASA Astrophysics Data System (ADS)

Oh, Sechang; Kwon, Hyeokjun; Varadan, Vijay K.

2012-10-01

Good sleep is critical for one's overall physical and mental health but more than 50 million Americans have experienced or are suffering from sleep disorders. Nevertheless, 85% of them remain undiagnosed or untreated. They can lead to chronic diseases. Sleep disorders are diagnosed through polysomnography, also known as sleep study, performed in a sleep laboratory overnight. This perturbs his/her daily sleep routine, and consequently, an accurate diagnosis cannot be made. Many companies have been developing home sleep test systems to reduce the cost of sleep studies and provide a more convenience solution to patients. The category of the system varies as type II, type III and type IV according to the type of sleep study. Current systems cannot be easily extended from one type to include a higher type. A patient who has a type III system to diagnose sleep apnea should additionally purchase a type II system which has functions that overlap with a type III system, to evaluate sleep stages. In this paper, we propose a wireless telemedicine system for easy extension of channels using the start network topology of the Zigbee protocol. The HST system consists of two wireless HST devices with a Zigbee module, a wireless HST receiver with both a Zigbee and a Wi-Fi module, and a sever which monitors/saves the physiological signals. One transmitter provides 5 channels for 2x EOG, 2x EEG and EMG to evaluate sleep stages. The other transmitter provides 5 additional channels for ECG, nasal air flow, body position, abdominal/chest efforts and oxygen saturation to diagnose sleep apnea. These two transmitters, acting as routers, and the receiver as a coordinator form a Zigbee star network. The data from each transmitter in the receiver are retransmitted to the monitoring unit through Wi-Fi. By building a star network with Zigbee, channels can be easily extended so that low level systems can be upgraded to higher level systems by simply adding the necessary channels. In addition

HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging.

PubMed

Kattah, Jorge C; Talkad, Arun V; Wang, David Z; Hsieh, Yu-Hsiang; Newman-Toker, David E

2009-11-01

Acute vestibular syndrome (AVS) is often due to vestibular neuritis but can result from vertebrobasilar strokes. Misdiagnosis of posterior fossa infarcts in emergency care settings is frequent. Bedside oculomotor findings may reliably identify stroke in AVS, but prospective studies have been lacking. The authors conducted a prospective, cross-sectional study at an academic hospital. Consecutive patients with AVS (vertigo, nystagmus, nausea/vomiting, head-motion intolerance, unsteady gait) with >or=1 stroke risk factor underwent structured examination, including horizontal head impulse test of vestibulo-ocular reflex function, observation of nystagmus in different gaze positions, and prism cross-cover test of ocular alignment. All underwent neuroimaging and admission (generally <72 hours after symptom onset). Strokes were diagnosed by MRI or CT. Peripheral lesions were diagnosed by normal MRI and clinical follow-up. One hundred one high-risk patients with AVS included 25 peripheral and 76 central lesions (69 ischemic strokes, 4 hemorrhages, 3 other). The presence of normal horizontal head impulse test, direction-changing nystagmus in eccentric gaze, or skew deviation (vertical ocular misalignment) was 100% sensitive and 96% specific for stroke. Skew was present in 17% and associated with brainstem lesions (4% peripheral, 4% pure cerebellar, 30% brainstem involvement; chi(2), P=0.003). Skew correctly predicted lateral pontine stroke in 2 of 3 cases in which an abnormal horizontal head impulse test erroneously suggested peripheral localization. Initial MRI diffusion-weighted imaging was falsely negative in 12% (all <48 hours after symptom onset). Skew predicts brainstem involvement in AVS and can identify stroke when an abnormal horizontal head impulse test falsely suggests a peripheral lesion. A 3-step bedside oculomotor examination (HINTS: Head-Impulse-Nystagmus-Test-of-Skew) appears more sensitive for stroke than early MRI in AVS.

Matrix Analysis of Traditional Chinese Medicine Differential Diagnoses in Gulf War Illness.

PubMed

Taylor-Swanson, Lisa; Chang, Joe; Schnyer, Rosa; Hsu, Kai-Yin; Schmitt, Beth Ann; Conboy, Lisa A

2018-03-08

To qualitatively categorize Traditional Chinese Medicine (TCM) differential diagnoses in a sample of veterans with Gulf War Illness (GWI) pre- and postacupuncture treatment. The authors randomized 104 veterans diagnosed with GWI to a 6-month acupuncture intervention that consisted of either weekly or biweekly individualized acupuncture treatments. TCM differential diagnoses were recorded at baseline and at 6 months. These TCM diagnoses were evaluated using Matrix Analysis to determine co-occurring patterns of excess, deficiency, and channel imbalances. These diagnoses were examined within and between participants to determine patterns of change and to assess stability of TCM diagnoses over time. Frequencies of diagnoses of excess, deficiency, and channel patterns were tabulated. Diagnoses of excess combined with deficiency decreased from 43% at baseline to 39% of the sample at 6 months. Excess+deficiency+channel imbalances decreased from 26% to 17%, while deficiency+channel imbalances decreased from 11% to 4% over the study duration. The authors observed a trend over time of decreased numbers of individuals presenting with all three types of differential diagnosis combinations. This may suggest that fewer people were diagnosed with concurrent excess, deficiency, and channel imbalances and perhaps a lessening in the complexity of their presentation. This is the first published article that organizes and defines TCM differential diagnoses using Matrix Analysis; currently, there are no TCM frameworks for GWI. These findings are preliminary given the sample size and the amount of missing data at 6 months. Characterization of the TCM clinical presentation of veterans suffering from GWI may help us better understand the potential role that East Asian medicine may play in managing veterans with GWI and the design of effective acupuncture treatments based on TCM. The development of a TCM manual for treating GWI is merited.

A prospective observational longitudinal study of new-onset seizures and newly diagnosed epilepsy in dogs.

PubMed

Fredsø, N; Toft, N; Sabers, A; Berendt, M

2017-02-16

Seizures are common in dogs and can be caused by non-epileptic conditions or epilepsy. The clinical course of newly diagnosed epilepsy is sparsely documented. The objective of this study was to prospectively investigate causes for seizures (epileptic and non-epileptic) in a cohort of dogs with new-onset untreated seizures, and for those dogs with newly diagnosed epilepsy to investigate epilepsy type, seizure type and the course of disease over time, including the risk of seizure recurrence. Untreated client-owned dogs experiencing new-onset seizures were prospectively enrolled in a longitudinal observational study including clinical investigations and long-term monitoring at the Copenhagen University Hospital for Companion Animals. A baseline clinical assessment was followed by investigator/owner contact every eight weeks from inclusion to death or end of study. Inclusion of dogs was conducted from November 2010 to September 2012, and the study terminated in June 2014. One hundred and six dogs were included in the study. Seventy-nine dogs (74.5%) were diagnosed with epilepsy: 61 dogs (77.2%) with idiopathic epilepsy, 13 dogs (16.5%) with structural epilepsy and five dogs (6.3%) with suspected structural epilepsy. A non-epileptic cause for seizures was identified in 13 dogs and suspected in 10 dogs. Four dogs in which no cause for seizures was identified experienced only one seizure during the study. In dogs with idiopathic epilepsy 60% had their second epileptic seizure within three months of seizure onset. Twenty-six dogs with idiopathic epilepsy (43%) completed the study without receiving antiepileptic treatment. The natural course of idiopathic epilepsy (uninfluenced by drugs) was illustrated by highly individual and fluctuating seizure patterns, including long periods of remission. Cluster seizures motivated early treatment. In a few dogs with a high seizure frequency owners declined treatment against the investigators advice. Epilepsy is the most likely

The impact of patients’ involvement in cooking on their mortality and morbidity: A 19-year follow-up of patients diagnosed with type 2 diabetes mellitus

PubMed Central

Siersma, Volkert; Køster-Rasmussen, Rasmus; Olivarius, Niels De Fine; Waldorff, Frans Boch

2015-01-01

Abstract Objective. This study explored the impact of involvement in cooking on long-term morbidity and mortality among patients newly diagnosed with type 2 diabetes mellitus (T2DM). Design and subjects. Data are from the population-based study Diabetes Care in General Practice. In baseline questionnaires, 1348 patients newly diagnosed with T2DM gave information on how frequently they consumed a warm main meal and how often they cooked it themselves. The selected patients were followed up for 19 years in the Danish National Patient Registry and the Danish Register of Causes of Death. Main outcome measures. This study analysed the association between involvement in cooking and each of seven pre-specified outcomes was analysed in Cox regression models with stepwise adjustment for possible confounders and mediators. Results. 92% of the patients with T2DM consumed a warm main meal = five times per week. Among these, women who cooked for themselves less than once a week had a higher risk of diabetes-related deaths (HR 1.86 [95% CI 1.03–3.35], p = 0.039) and stroke (HR 2.47 [95% CI 1.08–5.65], p = 0.033), after adjustment for confounders. For men, infrequent cooking was not related to increased risk for the outcomes investigated. Conclusions. In patients newly diagnosed with T2DM and with a regular intake of warm main meals, infrequent involvement in cooking was associated with an increased risk of diabetes-related death and stroke for women, but not for men. General practitioners should pay special attention to managing diabetes treatment in female patients newly diagnosed with T2DM who report infrequent involvement in cooking. PMID:25592166

New radio detections of early-type pre-main-sequence stars

NASA Technical Reports Server (NTRS)

Skinner, Stephen L.; Brown, Alexander; Linsky, Jeffrey L.

1990-01-01

Results of VLA radio continuum observations of 13 early-type pre-main-sequence stars selected from the 1984 catalog of Finkenzeller and Mundt are presented. The stars HD 259431 and MWC 1080 were detected at 3.6 cm, while HD 200775 and TY CrA were detected at both 3.6 and 6 cm. The flux density of HD 200775 has a frequency dependence consistent with the behavior expected for free-free emission originating in a fully ionized wind. However, an observation in A configuration suggests that the source geometry may not be spherically symmetric. In contrast, the spectral index of TY CrA is negative with a flux behavior implying nonthermal emission. The physical mechanism responsible for the nonthermal emission has not yet been identified, although gyrosynchrotron and synchrotron processes cannot be ruled out.

The diagnose of oil palm disease using Naive Bayes Method based on Expert System Technology

NASA Astrophysics Data System (ADS)

Nababan, Marlince; Laia, Yonata; Sitanggang, Delima; Sihombing, Oloan; Indra, Evta; Siregar, Saut; Purba, Windania; Mancur, Roy

2018-04-01

Expert system is dealt with system that used computer-based human intelligence to overcome particular problem which is commonly conducted by an expert. Frequent problem faced by the farmers of oil palm is the difficulty in defining the type of plant disease. As a result, the delay treatment of plant disease brings out the declining of farm products. An application system is needed to deal with the obstacles and diagnosing the type of oil palm plant disease. The researcher designed an intelligence-based application with input-output plan which is able to diagnose the type of oil palm plant disease by applying naive bayes method. Based on the research result by conducting bayes method with recognized symptom, diagnose of oil palm plant disease could be accomplished. The data of symptoms found are leaves turned yellow 0.4, dead leaves 0.4, black and brown color among the veins of leaves 0.5, young and old fruit with whole space 0.4, and decay of bunches is 0.3. The roots are tender in the amount of 0.5, and damage on sheath is 0.3. Through the chosen symptoms as mentioned above, the value of bayes is 80% with the type of disease is rotten bunch.

Stellar haloes in massive early-type galaxies

NASA Astrophysics Data System (ADS)

Buitrago, F.

2017-03-01

The Hubble Ultra Deep Field (HUDF) opens up an unique window to witness galaxy assembly at all cosmic distances. Thanks to its extraordinary depth, it is a privileged tool to beat the cosmological dimming, which affects any extragalactic observations and has a very strong dependence with redshift (1 +z)^4. In particular, massive (M_{stellar}>5 × 10^{10} M_⊙) Early Type Galaxies (ETGs) are the most interesting candidates for these studies, as they must grow in an inside-out fashion developing an extended stellar envelope/halo that accounts for their remarkable size evolution (˜5 times larger in the nearby Universe than at z=2-3). To this end we have analysed the 6 most massive ETGs at z <1 in the HUDF12. Because of the careful data reduction and the exhaustive treatment of the Point Spread Function (PSF), we are able to trace the galaxy surface brightness profiles up to the same levels as in the local Universe but this time at = 0.65 (31 mag arcsec^{-2} in all 8 HST bands, ˜ 29 mag arcsec^{-2} restframe or beyond 25 effective radii). This fact enables us to investigate the galactic outskirts or stellar haloes at a previously unexplored era, characterising their light and mass profiles, colors and for the first time the amount of mass in ongoing mergers.

Colliding winds from early-type stars in binary systems

NASA Technical Reports Server (NTRS)

Stevens, Ian R.; Blondin, John M.; Pollock, A. M. T.

1992-01-01

The dynamics of the wind and shock structure formed by the wind collision in early-type binary systems is examined by means of a 2D hydrodynamics code, which self-consistently accounts for radiative cooling, and represents a significant improvement over previous attempts to model these systems. The X-ray luminosity and spectra of the shock-heated region, accounting for wind attenuation and the influence of different abundances on the resultant level and spectra of X-ray emission are calculated. A variety of dynamical instabilities that are found to dominate the intershock region is examined. These instabilities are found to be particularly important when postshock material is able to cool. These instabilities disrupt the postshock flow and add a time variability of order 10 percent to the X-ray luminosity. The X-ray spectrum of these systems is found to vary with the nuclear abundances of winds. These theoretical models are used to study several massive binary systems, in particular V444 Cyg and HD 193793.

Lower Activation in Frontal Cortex and Posterior Cingulate Cortex Observed during Sex Determination Test in Early-Stage Dementia of the Alzheimer Type.

PubMed

Rajmohan, Ravi; Anderson, Ronald C; Fang, Dan; Meyer, Austin G; Laengvejkal, Pavis; Julayanont, Parunyou; Hannabas, Greg; Linton, Kitten; Culberson, John; Khan, Hafiz; De Toledo, John; Reddy, P Hemachandra; O'Boyle, Michael W

2017-01-01

Face-labeling refers to the ability to classify faces into social categories. This plays a critical role in human interaction as it serves to define concepts of socially acceptable interpersonal behavior. The purpose of the current study was to characterize, what, if any, impairments in face-labeling are detectable in participants with early-stage clinically diagnosed dementia of the Alzheimer type (CDDAT) through the use of the sex determination test (SDT). In the current study, four (1 female, 3 males) CDDAT and nine (4 females, 5 males) age-matched neurotypicals (NT) completed the SDT using chimeric faces while undergoing BOLD fMRI. It was expected that CDDAT participants would have poor verbal fluency, which would correspond to poor performance on the SDT. This could be explained by decreased activation and connectivity patterns within the fusiform face area (FFA) and anterior cingulate cortex (ACC). DTI was also performed to test the association of pathological deterioration of connectivity in the uncinate fasciculus (UF) and verbally-mediated performance. CDDAT showed lower verbal fluency test (VFT) performance, but VFT was not significantly correlated to SDT and no significant difference was seen between CDDAT and NT for SDT performance as half of the CDDAT performed substantially worse than NT while the other half performed similarly. BOLD fMRI of SDT displayed differences in the left superior frontal gyrus and posterior cingulate cortex (PCC), but not the FFA or ACC. Furthermore, although DTI showed deterioration of the right inferior and superior longitudinal fasciculi, as well as the PCC, it did not demonstrate significant deterioration of UF tracts. Taken together, early-stage CDDAT may represent a common emerging point for the loss of face labeling ability.

Radiographic Diagnosis of Pincer-Type Femoroacetabular Impingement: A Systematic Review.

PubMed

Rhee, Chanseok; Le Francois, Tina; Byrd, J W Thomas; Glazebrook, Mark; Wong, Ivan

2017-05-01

Femoroacetabular impingement (FAI) is a well-recognized condition that causes hip pain and can lead to early osteoarthritis if not managed properly. With the increasing awareness and efficacy of operative treatments for pincer-type FAI, there is a need for consensus on the standardized radiographic diagnosis. To perform a systematic review of the evidence regarding imaging modalities and radiographic signs for diagnosing pincer-type FAI. Systematic review; Level of evidence, 4. A literature review was performed in 2016 using the Cochrane, PubMed, and Embase search engines. All articles focusing on a radiographic diagnosis of pincer-type FAI were reviewed. Each of the included 44 articles was assigned the appropriate level of evidence, and the particular radiographic marker and/or type of imaging were also summarized. There were 44 studies included in the final review. Most of the articles were level 4 evidence (26 articles), and there were 12 level 3 and 6 level 2 articles. The crossover sign was the most commonly used radiographic sign (27/44) followed by the lateral center-edge angle (22/44). Anteroposterior (AP) pelvis plain radiographs were the most commonly used imaging modality (33 studies). Poor-quality evidence exists in support of most currently used radiographic markers, including the crossover sign, lateral center-edge angle, posterior wall sign, ischial spine sign, coxa profunda, acetabular protrusion, and acetabular index. There is poor-quality conflicting evidence regarding the use of the herniation pit to diagnose pincer-type FAI. Some novel measurements, such as β-angle, acetabular roof ratio, and acetabular retroversion index, have been proposed, but they also lack support from the literature. No strong evidence exists to support a single best set of current radiographic markers for the diagnosis of pincer-type FAI, largely due to the lack of better quality trials (levels 1 and 2) that compare conventional radiographic findings with the gold

Parental Substance Abuse As an Early Traumatic Event. Preliminary Findings on Neuropsychological and Personality Functioning in Young Drug Addicts Exposed to Drugs Early

PubMed Central

Parolin, Micol; Simonelli, Alessandra; Mapelli, Daniela; Sacco, Marianna; Cristofalo, Patrizia

2016-01-01

Parental substance use is a major risk factor for child development, heightening the risk of drug problems in adolescence and young adulthood, and exposing offspring to several types of traumatic events. First, prenatal drug exposure can be considered a form of trauma itself, with subtle but long-lasting sequelae at the neuro-behavioral level. Second, parents' addiction often entails a childrearing environment characterized by poor parenting skills, disadvantaged contexts and adverse childhood experiences (ACEs), leading to dysfunctional outcomes. Young adults born from/raised by parents with drug problems and diagnosed with a Substance Used Disorder (SUD) themselves might display a particularly severe condition in terms of cognitive deficits and impaired personality function. This preliminary study aims to investigate the role of early exposure to drugs as a traumatic event, capable of affecting the psychological status of young drug addicts. In particular, it intends to examine the neuropsychological functioning and personality profile of young adults with severe SUDs who were exposed to drugs early in their family context. The research involved three groups, each consisting of 15 young adults (aged 18–24): a group of inpatients diagnosed with SUDs and exposed to drugs early, a comparison group of non-exposed inpatients and a group of non-exposed youth without SUDs. A neuropsychological battery (Esame Neuropsicologico Breve-2), an assessment procedure for personality disorders (Shedler-Westen Assessment Procedure-200) and the Symptom CheckList-90-Revised were administered. According to present preliminary results, young drug addicts exposed to drugs during their developmental age were characterized by elevated rates of neuropsychological impairments, especially at the expense of attentive and executive functions (EF); personality disorders were also common but did not differentiate them from non-exposed youth with SUDs. Alternative multi-focused prevention and

Herschel Spectroscopy of Early-type Galaxies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lapham, Ryen Carl; Young, Lisa M.; Crocker, Alison, E-mail: ryen.lapham@student.nmt.edu, E-mail: lyoung@physics.nmt.edu, E-mail: crockera@reed.edu

We present Herschel spectroscopy of atomic lines arising in photodissociation regions as well as ionization regions of nearby early-type galaxies (ETGs), focusing on the volume-limited Atlas3D sample. Our data include the [C ii], [O i], and [N ii] 122 and 205 μ m lines, along with ancillary data including CO and H i maps. We find that ETGs have [C ii]/FIR ratios slightly lower than spiral galaxies in the KINGFISH sample, and several ETGs have unusually large [N ii] 122/[C ii] ratios. The [N ii] 122/[C ii] ratio is correlated with UV colors and there is a strong anti-correlation ofmore » [C ii]/FIR with NUV-K seen in both spirals and ETGs, likely due to a softer radiation field with fewer photons available to ionize carbon and heat the gas. The correlation thus makes a [C ii] deficit in galaxies with redder stellar populations. The high [N ii] 122/[C ii] (and low [C ii]/FIR) line ratios could also be affected by the removal of much of the diffuse, low-density gas, which is consistent with the low H i/H{sub 2} ratios. [C ii] is now being used as a star-formation indicator, and we find that it is just as good for ETGs as in spirals. The [C ii]/CO ratios found are also similar to those found in spiral galaxies. Through the use of the [N ii] 205 μ m line, estimates of the percentage of [C ii] emission arising from ionized gas indicate that a significant portion could arise in ionized regions.« less

An analysis of nursing diagnoses for patients undergoing procedures in a Brazilian interventional radiology suite.

PubMed

Viegas, Liza de Souza; Turrini, Ruth Natalia Teresa; da Silva Bastos Cerullo, Josinete Aparecida

2010-05-01

Innovations in minimally invasive surgery have led to more procedures being performed in the interventional radiology suite. It, therefore, is essential that nurses in radiology departments be competent to care for all types of patients. Use of nursing classification systems can improve care by providing standardized language for documentation. We conducted a project that involved 25 patients undergoing interventional radiology procedures between August and October 2006 in São Paulo, Brazil, to identify the most frequent North American Nursing Diagnosis Association (NANDA) nursing diagnoses used and then compared the NANDA diagnoses to Perioperative Nursing Data Set diagnoses. The most frequent nursing diagnoses in the participants were anxiety, chronic pain, inefficient tissue perfusion-peripheral, deficient knowledge, and risk for falls. These results are similar to diagnoses that have been reported in outpatient centers. The NANDA and Perioperative Nursing Data Set diagnoses were found to be similar. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Endodontic management of maxillary third molar with MB2 (Vertucci type IV) canal configuration diagnosed with Cone Beam Computed Tomography - a case report.

PubMed

Jain, Pradeep; Patni, Pallav; Yogesh, Pant; Anup, Vyas

2017-01-01

The endodontic treatment of maxillary third molar often poses a challenge even to an experienced endodontist because of their most posterior location in the dental arch, aberrant occlusal anatomy, abnormal root canal configuration and eruption patterns. Owing to these anatomical limitations, their extraction remains the treatment of choice for many clinicians. As we know, retaining every functional component of the dental arch is of prime importance in contemporary dental practice. This clinical case report aims to discuss the endodontic treatment of maxillary third molar with MB2 root canal separated throughout the length and exit at two separate apical foramina (Vertucci type IV) diagnosed with Cone Beam Computed Tomography (CBCT)..

A twin study of early-childhood asthma in Puerto Ricans.

PubMed

Bunyavanich, Supinda; Silberg, Judy L; Lasky-Su, Jessica; Gillespie, Nathan A; Lange, Nancy E; Canino, Glorisa; Celedón, Juan C

2013-01-01

The relative contributions of genetics and environment to asthma in Hispanics or to asthma in children younger than 3 years are not well understood. To examine the relative contributions of genetics and environment to early-childhood asthma by performing a longitudinal twin study of asthma in Puerto Rican children ≤ 3 years old. 678 twin infants from the Puerto Rico Neo-Natal Twin Registry were assessed for asthma at age 1 year, with follow-up data obtained for 624 twins at age 3 years. Zygosity was determined by DNA microsatellite profiling. Structural equation modeling was performed for three phenotypes at ages 1 and 3 years: physician-diagnosed asthma, asthma medication use in the past year, and ≥ 1 hospitalization for asthma in the past year. Models were additionally adjusted for early-life environmental tobacco smoke exposure, sex, and age. The prevalences of physician-diagnosed asthma, asthma medication use, and hospitalization for asthma were 11.6%, 10.8%, 4.9% at age 1 year, and 34.1%, 40.1%, and 8.5% at 3 years, respectively. Shared environmental effects contributed to the majority of variance in susceptibility to physician-diagnosed asthma and asthma medication use in the first year of life (84%-86%), while genetic effects drove variance in all phenotypes (45%-65%) at age 3 years. Early-life environmental tobacco smoke, sex, and age contributed to variance in susceptibility. Our longitudinal study in Puerto Rican twins demonstrates a changing contribution of shared environmental effects to liability for physician-diagnosed asthma and asthma medication use between ages 1 and 3 years. Early-life environmental tobacco smoke reduction could markedly reduce asthma morbidity in young Puerto Rican children.

Early Adversity, Psychopathology, and Latent Class Profiles of Global Physical Health From Preschool Through Early Adolescence.

PubMed

Whalen, Diana J; Belden, Andy C; Tillman, Rebecca; Barch, Deanna M; Luby, Joan L

The purpose of the present report was to describe the longitudinal trajectories of physical health beginning during preschool and continuing into early adolescence; explore whether these trajectories were predicted by psychosocial adversity, family income-to-needs ratio, and psychiatric disorders occurring during the preschool period; and determine whether psychiatric disorders mediated these relations. Participants included 296 children participating in a longitudinal study of early-onset psychopathology spanning 10 years. Semistructured clinical interviews were conducted with caregivers to determine children's psychiatric diagnoses between ages 3 and 6 years. Caregivers also completed annual assessments of their child's physical health problems (ages 3-13) and reported on the family's income and indicators of psychosocial adversity. Growth mixture modeling revealed 2 trajectories of physical health problems: a stable, low group (n = 199) and a high, increasing group (n = 57) indicating linear increases in physical health problems from ages 3 to 13. Preschool psychiatric diagnoses (Estimate [Est] = 0.05, p < .001), family income-to-needs ratio (Est = -0.01, p = .012), and psychosocial adversity (Est = 0.02, p = .015) predicted membership in the high, increasing trajectory of physical health problems. Early-onset psychopathology mediated relations between psychosocial adversity and physical health problems (αβ = 0.31, p = .050) and between income-to-needs ratio and physical health problems (αβ = -0.29, p < .021). These findings indicate the importance of early indicators of risk: low income-to-needs ratios, high psychosocial adversity, and psychiatric disorders occurring during the preschool period for contributing to increasing physical health problems from preschool through early adolescence. Early-onset psychiatric disorders also mediated relations between psychosocial adversity, income-to-needs ratio, and physical health problems.

Drug usage patterns and treatment costs in newly-diagnosed type 2 diabetes mellitus cases, 2007 vs 2012: findings from a large US healthcare claims database analysis.

PubMed

Weng, W; Liang, Y; Kimball, E S; Hobbs, T; Kong, S; Sakurada, B; Bouchard, J

2016-07-01

Objective To explore trends in demographics, comorbidities, anti-diabetic drug usage, and healthcare utilization costs in patients with newly-diagnosed type 2 diabetes mellitus (T2DM) using a large US claims database. Methods For the years 2007 and 2012, Truven Health Marketscan Research Databases were used to identify adults with newly-diagnosed T2DM and continuous 12-month enrollment with prescription benefits. Variables examined included patient demographics, comorbidities, inpatient utilization patterns, healthcare costs (inpatient and outpatient), drug costs, and diabetes drug claim patterns. Results Despite an increase in the overall database population between 2007-2012, the incidence of newly-diagnosed T2DM decreased from 1.1% (2007) to 0.65% (2012). Hyperlipidemia and hypertension were the most common comorbidities and increased in prevalence from 2007 to 2012. In 2007, 48.3% of newly-diagnosed T2DM patients had no claims for diabetes medications, compared with 36.2% of patients in 2012. The use of a single oral anti-diabetic drug (OAD) was the most common diabetes medication-related claim (46.2% of patients in 2007; 56.7% of patients in 2012). Among OAD monotherapy users, metformin was the most commonly used and increased from 2007 (74.7% of OAD monotherapy users) to 2012 (90.8%). Decreases were observed for sulfonylureas (14.1% to 6.2%) and thiazolidinediones (7.3% to 0.6%). Insulin, predominantly basal insulin, was used by 3.9% of patients in 2007 and 5.3% of patients in 2012. Mean total annual healthcare costs increased from $13,744 in 2007 to $15,175 in 2012, driven largely by outpatient services, although costs in all individual categories of healthcare services (inpatient and outpatient) increased. Conversely, total drug costs per patient were lower in 2012 compared with 2007. Conclusions Despite a drop in the rate of newly-diagnosed T2DM from 2007 to 2012 in the US, increased total medical costs and comorbidities per individual patient suggest that

Cognitive assessments for the early diagnosis of dementia after stroke

PubMed Central

Al-Qazzaz, Noor Kamal; Ali, Sawal Hamid; Ahmad, Siti Anom; Islam, Shabiul

2014-01-01

The early detection of poststroke dementia (PSD) is important for medical practitioners to customize patient treatment programs based on cognitive consequences and disease severity progression. The aim is to diagnose and detect brain degenerative disorders as early as possible to help stroke survivors obtain early treatment benefits before significant mental impairment occurs. Neuropsychological assessments are widely used to assess cognitive decline following a stroke diagnosis. This study reviews the function of the available neuropsychological assessments in the early detection of PSD, particularly vascular dementia (VaD). The review starts from cognitive impairment and dementia prevalence, followed by PSD types and the cognitive spectrum. Finally, the most usable neuropsychological assessments to detect VaD were identified. This study was performed through a PubMed and ScienceDirect database search spanning the last 10 years with the following keywords: “post-stroke”; “dementia”; “neuro-psychological”; and “assessments”. This study focuses on assessing VaD patients on the basis of their stroke risk factors and cognitive function within the first 3 months after stroke onset. The search strategy yielded 535 articles. After application of inclusion and exclusion criteria, only five articles were considered. A manual search was performed and yielded 14 articles. Twelve articles were included in the study design and seven articles were associated with early dementia detection. This review may provide a means to identify the role of neuropsychological assessments as early PSD detection tests. PMID:25246795

Early effectiveness of endoscopic posterior urethra primary alignment.

PubMed

Kim, Fernando J; Pompeo, Alexandre; Sehrt, David; Molina, Wilson R; Mariano da Costa, Renato M; Juliano, Cesar; Moore, Ernest E; Stahel, Philip F

2013-08-01

Posterior urethra primary realignment (PUPR) after complete transection may decrease the gap between the ends of the transected urethra, tamponade the retropubic bleeding, and optimize urinary drainage without the need of suprapubic catheter facilitating concurrent pelvic orthopedic and trauma procedures. Historically, the distorted anatomy after pelvic trauma has been a major surgical challenge. The purpose of the study was to assess the relationship of the severity of the pelvic fracture to the success of endoscopic and immediate PUPR following complete posterior urethral disruption using the Young-Burgess classification system. A review of our Level I trauma center database for patients diagnosed with pelvic fracture and complete posterior urethral disruption from January 2005 to April 2012 was performed. Pelvic fracture severity was categorized according to the Young-Burgees classification system. Management consisted of suprapubic catheter insertion at diagnosis followed by early urethral realignment when the patient was clinically stable. Failure of realignment was defined as inability to achieve urethral continuity with Foley catheterization. Clinical follow-up consisted of radiologic, pressure studies and cystoscopic evaluation. A total of 481 patients with pelvic trauma from our trauma registry were screened initially, and 18 (3.7%) were diagnosed with a complete posterior urethral disruption. A total of 15 primary realignments (83.3%) were performed all within 5 days of trauma. The success rate of early realignment was 100%. There was no correlation between the type of pelvic ring fracture and the success of PUPR. Postoperatively, 8 patients (53.3%) developed urethral strictures, 3 patients (20.0%) developed incontinence, and 7 patients (46.7%) reported erectile dysfunction after the trauma. The mean follow-up of these patients was 31.8 months. Endoscopic PUPR may be an effective option for the treatment of complete posterior urethral disruption and

Transient ischaemic attack clinic: an evaluation of diagnoses and clinical decision making.

PubMed

Lee, Will; Frayne, Judith

2015-04-01

The diagnosis of transient ischaemic attack (TIA) is based largely on the patient's symptom recall and clinical judgement. This decision-making process is highly subjective and the inter-observer reliability of TIA diagnosis is at best moderate, even among neurologists. The aim of this study is to examine the presenting features and final diagnoses of referrals to a TIA clinic and to evaluate characteristics that favoured the diagnosis of TIA over other TIA "mimics". Consecutive new referrals to a tertiary metropolitan hospital TIA clinic over a 9month period were examined. Characteristics between TIA and non-TIA diagnoses were compared and analysed. Eighty-two patients were recruited. Eighteen (22%) were given a final diagnosis of TIA or stroke. Major alternative diagnoses included migraine (n=17, 21%), presyncope/syncope (n=13, 16%) and anxiety (n=7, 9%). Four (5%) patients had unclassifiable symptoms with no clear final diagnosis. Mean age was 67±a standard deviation of 17years and patients diagnosed with TIA/stroke were on average older than those with non-TIA diagnoses (77±10 versus 64±17years, p=0.003). A diagnosis of TIA/stroke was favoured in the presence of moderate to severe weakness (p=0.032), dysphasia (p=0.037) or dysarthria (p=0.005). Unclassifiable symptoms (for example, palpitations, confusion, headache) were reported in 27 patients (33%) and their presence favoured non-TIA diagnoses (p=0.0003). TIA constituted a minority of the referrals to our clinic. Accurate clinical diagnosis of TIA facilitates early stroke prevention and avoids unnecessary investigations and prescriptions. Attempts to improve diagnostic accuracy of TIA should target improving the education and awareness of frontline medical practitioners. Copyright © 2014 Elsevier Ltd. All rights reserved.

Patient-level predictors of achieving early glycaemic control in Type 2 diabetes mellitus: a population-based study.

PubMed

Svensson, E; Baggesen, L M; Thomsen, R W; Lyngaa, T; Pedersen, L; Nørrelund, H; Buhl, E S; Haase, C L; Johnsen, S P

2016-11-01

To identify individual predictors of early glycaemic control in people with Type 2 diabetes mellitus after initiation of first glucose-lowering drug treatment in everyday clinical practice. Using medical registries, we identified a population-based cohort of people with a first-time glucose-lowering drug prescription in Northern Denmark in the period 2000-2012. We used Poisson regression analysis to examine patient-level predictors of success in reaching early glycaemic control [HbA 1c target of < 53 mmol/mol (7%)] < 6 months after treatment start. Among the 38 418 people (median age 63 years), 27 545 (72%) achieved early glycaemic control. The strongest predictor of achieving early control was pre-treatment HbA 1c level; compared with a pre-treatment HbA 1c level of ≤ 58 mmol/mol (7.5%), the adjusted relative risks of attaining early control were 0.63 (95% CI 0.61-0.64) for baseline HbA 1c levels of > 58 and ≤ 75 mmol/mol (> 7.5 and ≤ 9%), and 0.58 (95% CI 0.57-0.59) for a baseline HbA 1c level of > 9% (> 75 mmol/mol). All other examined predictors were only weakly associated with the chance of achieving early control. After adjustment, the only characteristics that remained independently associated with early control (in addition to high baseline HbA 1c ) were being widowed (adjusted relative risk 0.95; 95% CI 0.93-0.97) and having a high Charlson comorbidity index score (score ≥ 3; adjusted relative risk 0.94; 95% CI 0.90-0.97). In a real-world clinical setting, people with Type 2 diabetes mellitus initiating glucose-lowering medication had a similar likelihood of achieving glycaemic control, regardless of sex, age, comorbidities and other individual factors; the only strong and potentially modifiable predictor was HbA 1c before therapy start. © 2016 Diabetes UK.

Macular telangiectasia type 2 (MacTel) in a 34-year-old patient

PubMed Central

Nicolai, Heleen; Wirix, Mieke; Spielberg, Leigh; Leys, Anita

2014-01-01

We report macular telangiectasia type 2 (MacTel) in a 34-year-old man, the youngest patient so far published with MacTel type 2. The patient presented with metamorphopsia and impaired reading ability. Diagnosis was based on bilateral abnormal macular autofluorescence, perifoveal telangiectasia with fluorescein angiographic hyperfluorescence without cystoid oedema, a small foveal avascular zone, asymmetric configuration of the foveal pit, disruptions in the inner segment/outer segment layer and hyper-reflective haze and spots in the outer nuclear layer. Although MacTel usually manifests with a slowly progressive decrease in visual acuity in the fifth to seventh decades of life, younger patients may occasionally be diagnosed with the disease. Awareness of subtle signs of the condition is essential for early diagnosis. PMID:25249218

Smoking is associated with increased hepatic lipase activity, insulin resistance, dyslipidaemia and early atherosclerosis in Type 2 diabetes.

PubMed

Kong, C; Nimmo, L; Elatrozy, T; Anyaoku, V; Hughes, C; Robinson, S; Richmond, W; Elkeles, R S

2001-06-01

We have studied the relationships between hepatic lipase activity, smoking, dyslipidaemia insulin resistance, and early atherosclerosis in 67 Type 2 diabetic subjects, 47 non-smokers and 20 smokers. Insulin resistance was measured using an insulin modified frequently sampled intravenous glucose tolerance test. Early atherosclerosis was assessed using high-resolution ultrasound to measure carotid intima media thickness (IMT) and an arterial ultrasonic score (AUS). Smokers had higher serum cholesterol and triglyceride, lower HDL and HDL2 cholesterol as well as increased hepatic lipase activity. They were also more insulin resistant than non-smokers. Smokers also had higher patient AUS scores. On multiple regression analysis, hepatic lipase activity emerged as the most significant variable affecting patient AUS. We suggest that smoking accentuates the dyslipidaemia of Type 2 diabetic subjects and this is associated with increased hepatic lipase activity. This may be one mechanism whereby smoking further increases the risk of cardiovascular disease in Type 2 diabetes.

Effect of the Large Scale Environment on the Internal Dynamics of Early-Type Galaxies

NASA Astrophysics Data System (ADS)

Maubon, G.; Prugniel, Ph.

We have studied the population-density relation in very sparse environments, from poor clusters to isolated galaxies, and we find that early-type galaxies with a young stellar population are preferably found in the lowest density environments. We show a marginal indication that this effect is due to an enhancement of the stellar formation independent of the morphological segregation, but we failed to find any effect from the internal dynamics.