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Sample records for osnove medi titana

  1. MediMax Elektronik-Marktkette

    NASA Astrophysics Data System (ADS)

    Die Elektronikkette MediMax setzt auf Server Based Computing mit Windows Server 2003® und Thin Clients. Mit über 100 Filialen ist MediMax die erfolgreiche Fachmarktlinie der ElectronicPartner-Verbundgruppe in Deutschland. Die Zugehörigkeit zum Mutterverbund garantiert den Franchisenehmern der Elektronikkette eine schnelle Warenversorgung und günstige Einkaufskonditionen. Über 50.000 Artikel zahlreicher namhafter Markenhersteller und unterschiedlicher Preisklassen sind ständig abrufbar. Darüber hinaus profitieren die Filialen von einer zentralen Organisation und Betreuung ihrer IT. Von Düsseldorf aus administriert ein internes Supportteam die Arbeitsplätze aller Standorte und stellt außerdem die Warenwirtschaftslösung zur Verfügung. Dank der Umstellung auf eine moderne Server Based Computing-Umgebung sind Wartung und Support künftig so effizient wie nie zuvor.

  2. Targeting CD73 in the tumor microenvironment with MEDI9447.

    PubMed

    Hay, Carl M; Sult, Erin; Huang, Qihui; Mulgrew, Kathy; Fuhrmann, Stacy R; McGlinchey, Kelly A; Hammond, Scott A; Rothstein, Raymond; Rios-Doria, Jonathan; Poon, Edmund; Holoweckyj, Nick; Durham, Nicholas M; Leow, Ching Ching; Diedrich, Gundo; Damschroder, Melissa; Herbst, Ronald; Hollingsworth, Robert E; Sachsenmeier, Kris F

    2016-08-01

    MEDI9447 is a human monoclonal antibody that is specific for the ectoenzyme CD73 and currently undergoing Phase I clinical trials. Here we show that MEDI9447 is a potent inhibitor of CD73 ectonucleotidase activity, with wide ranging immune regulatory consequences. MEDI9447 results in relief from adenosine monophosphate (AMP)-mediated lymphocyte suppression in vitro and inhibition of mouse syngeneic tumor growth in vivo. In contrast with other cancer immunotherapy agents such as checkpoint inhibitors or T-cell agonists, MEDI9447 drives changes in both myeloid and lymphoid infiltrating leukocyte populations within the tumor microenvironment of mouse models. Changes include significant alterations in a number of tumor micro-environmental subpopulations including increases in CD8(+) effector cells and activated macrophages. Furthermore, these changes correlate directly with responder and non-responder subpopulations within animal studies using syngeneic tumors. Combination data showing additive activity between MEDI9447 and anti-PD-1 antibodies using human cells in vitro and mouse tumor models further demonstrate the potential value of relieving adenosine-mediated immunosuppression. Based on these data, a Phase I study to test the safety, tolerability, and clinical activity of MEDI9447 in cancer patients was initiated (NCT02503774). PMID:27622077

  3. Targeting CD73 in the tumor microenvironment with MEDI9447

    PubMed Central

    Hay, Carl M.; Sult, Erin; Huang, Qihui; Mulgrew, Kathy; Fuhrmann, Stacy R.; McGlinchey, Kelly A.; Hammond, Scott A.; Rothstein, Raymond; Rios-Doria, Jonathan; Poon, Edmund; Holoweckyj, Nick; Durham, Nicholas M.; Leow, Ching Ching; Diedrich, Gundo; Damschroder, Melissa; Herbst, Ronald; Hollingsworth, Robert E.; Sachsenmeier, Kris F.

    2016-01-01

    ABSTRACT MEDI9447 is a human monoclonal antibody that is specific for the ectoenzyme CD73 and currently undergoing Phase I clinical trials. Here we show that MEDI9447 is a potent inhibitor of CD73 ectonucleotidase activity, with wide ranging immune regulatory consequences. MEDI9447 results in relief from adenosine monophosphate (AMP)-mediated lymphocyte suppression in vitro and inhibition of mouse syngeneic tumor growth in vivo. In contrast with other cancer immunotherapy agents such as checkpoint inhibitors or T-cell agonists, MEDI9447 drives changes in both myeloid and lymphoid infiltrating leukocyte populations within the tumor microenvironment of mouse models. Changes include significant alterations in a number of tumor micro-environmental subpopulations including increases in CD8+ effector cells and activated macrophages. Furthermore, these changes correlate directly with responder and non-responder subpopulations within animal studies using syngeneic tumors. Combination data showing additive activity between MEDI9447 and anti-PD-1 antibodies using human cells in vitro and mouse tumor models further demonstrate the potential value of relieving adenosine-mediated immunosuppression. Based on these data, a Phase I study to test the safety, tolerability, and clinical activity of MEDI9447 in cancer patients was initiated (NCT02503774). PMID:27622077

  4. Targeting CD73 in the tumor microenvironment with MEDI9447

    PubMed Central

    Hay, Carl M.; Sult, Erin; Huang, Qihui; Mulgrew, Kathy; Fuhrmann, Stacy R.; McGlinchey, Kelly A.; Hammond, Scott A.; Rothstein, Raymond; Rios-Doria, Jonathan; Poon, Edmund; Holoweckyj, Nick; Durham, Nicholas M.; Leow, Ching Ching; Diedrich, Gundo; Damschroder, Melissa; Herbst, Ronald; Hollingsworth, Robert E.; Sachsenmeier, Kris F.

    2016-01-01

    ABSTRACT MEDI9447 is a human monoclonal antibody that is specific for the ectoenzyme CD73 and currently undergoing Phase I clinical trials. Here we show that MEDI9447 is a potent inhibitor of CD73 ectonucleotidase activity, with wide ranging immune regulatory consequences. MEDI9447 results in relief from adenosine monophosphate (AMP)-mediated lymphocyte suppression in vitro and inhibition of mouse syngeneic tumor growth in vivo. In contrast with other cancer immunotherapy agents such as checkpoint inhibitors or T-cell agonists, MEDI9447 drives changes in both myeloid and lymphoid infiltrating leukocyte populations within the tumor microenvironment of mouse models. Changes include significant alterations in a number of tumor micro-environmental subpopulations including increases in CD8+ effector cells and activated macrophages. Furthermore, these changes correlate directly with responder and non-responder subpopulations within animal studies using syngeneic tumors. Combination data showing additive activity between MEDI9447 and anti-PD-1 antibodies using human cells in vitro and mouse tumor models further demonstrate the potential value of relieving adenosine-mediated immunosuppression. Based on these data, a Phase I study to test the safety, tolerability, and clinical activity of MEDI9447 in cancer patients was initiated (NCT02503774).

  5. Medi-Cal selective contracting creates inequities, limits access.

    PubMed

    Parks, M C

    1991-01-01

    SPCP rate reductions, intended to encourage cost-effectiveness and efficiency, simply slash desperately needed funds. The reduced rates paid to Los Angeles county hospitals caused an estimated $130 million loss of Medi-Cal funds in the first four years of the contracting program alone.

  6. MediDial cards: a quick win for service improvement

    PubMed Central

    Davies, Mike; Panchal, Sonia

    2014-01-01

    One of the key roles of a junior doctor is co-ordinating the care of their patients and communicating with different departments or specialties within the hospital. To do this, junior doctors often spend a lot of time on a daily basis contacting the hospital switchboard in order to locate a required bleep/extension/fax number, or trying to navigate an intranet based directory which can be difficult to use. We aimed to improve this task for junior doctors as a pilot project for engaging junior doctors in service improvement. Our multi-disciplinary team, led by junior doctors and with the support of the Trust, produced and implemented lanyard (MediDial) cards containing common and relevant (fax, bleep, and extension) numbers for use by junior doctors. Through the introduction of our MediDial cards we not only reduced the frequency junior doctors needed to contact the switchboard on a daily basis, but also the length of time spent waiting to speak to an operator. The MediDial cards were also found to be time saving and more useful than the previous intranet based database. Since the introduction of the MediDial cards, the project has been rolled out across the Trust and presented at Grand Rounds as an example of junior doctor led service improvement, aiming to encourage trainees to engage with quality improvement projects. PMID:26734285

  7. PD-L1 blockade for cancer treatment: MEDI4736.

    PubMed

    Ibrahim, Ramy; Stewart, Ross; Shalabi, Aiman

    2015-06-01

    MEDI4736 is a human immunoglobulin (Ig) G1к monoclonal antibody that blocks programmed cell death ligand-1 (PD-L1) binding to its receptors, allowing T cells to recognize and kill tumor cells. Key attributes include high affinity and selectivity for PD-L1, sustained drug exposure for up to 1 year of dosing, and engineering of the antibody to prevent antibody-dependent cell-mediated cytotoxicity. No immunogenicity impacting on the pharmacokinetics/pharmacodynamics of MEDI4736 has been reported at the 10 mg/kg every 2 weeks dose selected for further clinical development. The current safety profile and encouraging early anti-tumor activity of MEDI4736 support further clinical assessment. A broad development program for MEDI4736, both as monotherapy and in combination, is underway across a range of tumor types. This includes a large, multicenter, phase I, dose-escalation/expansion study in solid tumors (with a smaller corresponding study in Japanese patients), a phase I study in myelodysplastic syndrome, and a phase II study in advanced colorectal cancer. In addition, multiple phase I combination studies are ongoing with different agents, including those targeting MEK/BRAF in melanoma, epidermal growth factor receptor, programmed cell death-1, cytotoxic T-lymphocyte antigen-4, OX40, chemokine (C-C motif) receptor 4, and indoleamine 2,3-dioxygenase. Development is most advanced in non-small cell lung cancer, with a program currently comprising four pivotal studies and three phase I combination studies. A pivotal program for MEDI4736 in head and neck cancer began in late 2014. PMID:25965366

  8. PicSafe Medi: a clinical photography app review.

    PubMed

    Lo, Michelle Chin I; Brinkworth, Simon; Knights, Christina; Mackie, Ian

    2015-01-01

    Medical photographs are used in many clinical settings; however, there are significant risks associated with using the camera feature on mobile devices, namely, breaches of security. PicSafe Medi is an app that allows healthcare professionals to take clinical photographs using smart devices whilst addressing the concerns of patient confidentiality. We review the app to assess its functionality in a UK clinical setting, taking into account UK guidelines such as those offered by the General Medical Council, UK legislation, the Institute of Medical Illustrators and the Department of Health. PMID:26828558

  9. PicSafe Medi: a clinical photography app review.

    PubMed

    Lo, Michelle Chin I; Brinkworth, Simon; Knights, Christina; Mackie, Ian

    2015-01-01

    Medical photographs are used in many clinical settings; however, there are significant risks associated with using the camera feature on mobile devices, namely, breaches of security. PicSafe Medi is an app that allows healthcare professionals to take clinical photographs using smart devices whilst addressing the concerns of patient confidentiality. We review the app to assess its functionality in a UK clinical setting, taking into account UK guidelines such as those offered by the General Medical Council, UK legislation, the Institute of Medical Illustrators and the Department of Health.

  10. Pharmacological profile of MEDI-551, a novel anti-CD19 antibody, in human CD19 transgenic mice.

    PubMed

    Gallagher, Sandra; Turman, Sean; Yusuf, Isharat; Akhgar, Ahmad; Wu, Yuling; Roskos, Lorin K; Herbst, Ronald; Wang, Yue

    2016-07-01

    B cell depletion therapy is beneficial for patients with B cell malignancies and autoimmune diseases. CD19, a transmembrane protein, is expressed on a vast majority of normal and neoplastic B cells, making it a suitable target for monoclonal antibody (MAb) mediated immunotherapy. We have developed MEDI-551, an affinity optimized and afucosylated IgG1 MAb targeting human CD19 for B cell depletion. MEDI-551 is currently under investigation in multiple clinical trials. Because MEDI-551 does not cross react with rodent and non-human primate CD19, the pharmacological characteristics of the MAb were evaluated in human CD19 transgenic mice (hCD19 Tg). Here we show that MEDI-551 potently depletes tissue and circulating B cells in hCD19 Tg mice and is more efficacious than the anti-CD19 MAb with intact fucose. The length of B cell depletion depends on MEDI-551 dose; and, B cell recovery in the circulation follows stepwise phenotypic maturation. Furthermore, intravenous (IV) and subcutaneous (SC) administration of MEDI-551 results in comparable efficacy. Lastly, the combination of MEDI-551 with the anti-CD20 MAb, rituximab, further prolongs the duration of B cell depletion. In summary, the pharmacological profile of MEDI-551 presented in hCD19 Tg mice supports further testing of MEDI-551 in clinical trials involving B cell malignancies and autoimmune diseases. PMID:27163209

  11. MediAgent: a WWW-based scalable and self-learning medical search engine.

    PubMed Central

    Tay, J.; Ke, S.; Lun, K. C.

    1998-01-01

    Searching for medical information on the Internet can be tedious and frustrating due to the number of irrelevant entries returned from generic search engines. We have developed MediAgent, a scalable search engine that aims to deliver a web-based medical search solution which is focused, exhaustive and able to keep improving its databases. The software package can run off a single low-end system and be scaled into a client-server, distributed computing architecture for high-end needs. This scalable architecture boosts MediAgent's handling capacity to tens of millions of web pages. In addition to large volume handling, MediAgent is designed to be manageable. All subsystems are not only highly configurable, but also support remote, interactive management and monitoring by the system administrator. PMID:9929289

  12. Identification and Characterization of MEDI4736, an Antagonistic Anti-PD-L1 Monoclonal Antibody.

    PubMed

    Stewart, Ross; Morrow, Michelle; Hammond, Scott A; Mulgrew, Kathy; Marcus, Danielle; Poon, Edmund; Watkins, Amanda; Mullins, Stefanie; Chodorge, Matthieu; Andrews, John; Bannister, David; Dick, Emily; Crawford, Nicola; Parmentier, Julie; Alimzhanov, Marat; Babcook, John S; Foltz, Ian N; Buchanan, Andrew; Bedian, Vahe; Wilkinson, Robert W; McCourt, Matthew

    2015-09-01

    Programmed cell-death 1 ligand 1 (PD-L1) is a member of the B7/CD28 family of proteins that control T-cell activation. Many tumors can upregulate expression of PD-L1, inhibiting antitumor T-cell responses and avoiding immune surveillance and elimination. We have identified and characterized MEDI4736, a human IgG1 monoclonal antibody that binds with high affinity and specificity to PD-L1 and is uniquely engineered to prevent antibody-dependent cell-mediated cytotoxicity. In vitro assays demonstrate that MEDI4736 is a potent antagonist of PD-L1 function, blocking interaction with PD-1 and CD80 to overcome inhibition of primary human T-cell activation. In vivo MEDI4736 significantly inhibits the growth of human tumors in a novel xenograft model containing coimplanted human T cells. This activity is entirely dependent on the presence of transplanted T cells, supporting the immunological mechanism of action for MEDI4736. To further determine the utility of PD-L1 blockade, an anti-mouse PD-L1 antibody was investigated in immunocompetent mice. Here, anti-mouse PD-L1 significantly improved survival of mice implanted with CT26 colorectal cancer cells. The antitumor activity of anti-PD-L1 was enhanced by combination with oxaliplatin, which resulted in increased release of HMGB1 within CT26 tumors. Taken together, our results demonstrate that inhibition of PD-L1 function can have potent antitumor activity when used as monotherapy or in combination in preclinical models, and suggest it may be a promising therapeutic approach for the treatment of cancer. MEDI4736 is currently in several clinical trials both alone and in combination with other agents, including anti-CTLA-4, anti-PD-1, and inhibitors of IDO, MEK, BRAF, and EGFR.

  13. Dai Nippon Printing Co., Ltd Medi·Ca CC for Enumeration of Coliform Bacteria.

    PubMed

    Saito, Fumihiko; Shimizu, Mai; Suzuki, Takeo; Hamada, Chie; Iwase, Tatsuhiko; Okochi, Norihiko; Yamazaki, Mamoru; Kyotani, Hitoshi

    2015-01-01

    A ready-made dry medium method for coliform count, the Medi·Ca CC method, was compared to the Violet Red Bile Agar method (Bacteriological Analytical Manual, Chapter 4, Enumeration of Escherichia coli and the Coliform Bacteria, Section G) for nine raw foods from four food categories: raw ground pork, raw lamb, raw ground chicken, raw tuna fillet, raw salmon fillet, raw shrimp, fresh peeled banana, fresh cut pineapple, and fresh cut apple. The 95% confidence interval for the mean difference between the two methods at each contamination level for seven matrixes from all four categories fell within the range of -0.50 to 0.50, and no statistical difference was observed at all three contamination levels for four matrixes from three categories. These results demonstrated that the Medi·Ca CC method is a reasonable alternative to the reference method for raw meat, raw poultry, raw fish, and fresh fruits.

  14. IL-6 Inhibition With MEDI5117 Decreases The Fraction of Head and Neck Cancer Stem Cells and Prevents Tumor Recurrence.

    PubMed

    Finkel, Kelsey A; Warner, Kristy A; Kerk, Samuel; Bradford, Carol R; McLean, Scott A; Prince, Mark E; Zhong, Haihong; Hurt, Elaine M; Hollingsworth, Robert E; Wicha, Max S; Tice, David A; Nör, Jacques E

    2016-05-01

    Head and neck squamous cell carcinomas (HNSCC) exhibit a small population of uniquely tumorigenic cancer stem cells (CSC) endowed with self-renewal and multipotency. We have recently shown that IL-6 enhances the survival and tumorigenic potential of head and neck cancer stem cells (i.e. ALDH(high)CD44(high) cells). Here, we characterized the effect of therapeutic inhibition of IL-6 with a novel humanized anti-IL-6 antibody (MEDI5117) using three low-passage patient-derived xenograft (PDX) models of HNSCC. We observed that single agent MEDI5117 inhibited the growth of PDX-SCC-M1 tumors (P < .05). This PDX model was generated from a previously untreated HNSCC. In contrast, MEDI5117 was not effective at reducing overall tumor volume for PDX models representing resistant disease (PDX-SCC-M0, PDX-SCC-M11). Low dose MEDI5117 (3 mg/kg) consistently decreased the fraction of cancer stem cells in PDX models of HNSCC when compared to IgG-treated controls, as follows: PDX-SCC-M0 (P < .001), PDX-SCC-M1 (P < .001), PDX-SCC-M11 (P = .04). Interestingly, high dose MEDI5117 (30 mg/kg) decreased the CSC fraction in the PDX-SCC-M11 model (P = .002), but not in PDX-SCC-M0 and PDX-SCC-M1. MEDI5117 mediated a dose-dependent decrease in the number of orospheres generated by ALDH(high)CD44(high) cells cultured in ultra-low attachment plates (P < .05), supporting an inhibitory effect on head and neck cancer stem cells. Notably, single agent MEDI5117 reduced the overall recurrence rate of PDX-SCC-M0, a PDX generated from the local recurrence of human HNSCC. Collectively, these data demonstrate that therapeutic inhibition of IL-6 with low-dose MEDI5117 decreases the fraction of cancer stem cells, and that adjuvant MEDI5117 inhibits recurrence in preclinical models of HNSCC.

  15. Morphology enabled dipole inversion (MEDI) from a single-angle acquisition: comparison with COSMOS in human brain imaging.

    PubMed

    Liu, Tian; Liu, Jing; de Rochefort, Ludovic; Spincemaille, Pascal; Khalidov, Ildar; Ledoux, James Robert; Wang, Yi

    2011-09-01

    Magnetic susceptibility varies among brain structures and provides insights into the chemical and molecular composition of brain tissues. However, the determination of an arbitrary susceptibility distribution from the measured MR signal phase is a challenging, ill-conditioned inverse problem. Although a previous method named calculation of susceptibility through multiple orientation sampling (COSMOS) has solved this inverse problem both theoretically and experimentally using multiple angle acquisitions, it is often impractical to carry out on human subjects. Recently, the feasibility of calculating the brain susceptibility distribution from a single-angle acquisition was demonstrated using morphology enabled dipole inversion (MEDI). In this study, we further improved the original MEDI method by sparsifying the edges in the quantitative susceptibility map that do not have a corresponding edge in the magnitude image. Quantitative susceptibility maps generated by the improved MEDI were compared qualitatively and quantitatively with those generated by calculation of susceptibility through multiple orientation sampling. The results show a high degree of agreement between MEDI and calculation of susceptibility through multiple orientation sampling, and the practicality of MEDI allows many potential clinical applications.

  16. Rapid Assessment with Qualitative Telephone Interviews: Lessons from an Evaluation of California's Healthy Families Program & Medi-Cal for Children

    ERIC Educational Resources Information Center

    Sobo, Elisa J.; Simmes, Diana R.; Landsverk, John A.; Kurtin, Paul S.

    2003-01-01

    California's Healthy Families/Medi-Cal for Children (HF/MCC) program provides low- and no-cost health insurance to low-income children. In December 1999 and January 2000, 72 community-based organizations (CBOs) were contracted by California's Department of Health Services (DHS) to supply culturally appropriate HF/MCC outreach and enrollment…

  17. Financial Performance and Participation in Medicaid and Medi-Cal Managed Care

    PubMed Central

    McCue, Michael J.; McCall, Nelda; Hurley, Robert E.; Wyttenbach, Mindy; White, Michelle

    2001-01-01

    This article assesses the participation and the financial performance of licensed health maintenance organizations (HMOs) in the Medicaid market. The study found that participation by Medicaid Dominant plans has more than doubled from 11 percent in 1992 to 23 percent in 1998 while Medicaid membership in Commercial Dominant plans declined from 71 percent in 1994 to 51 percent in 1998. Both participating and non-participating plans incurred operating losses in 1998. Medi-Cal participating plans had higher operating margins than Medicaid participating plans throughout the United States. Interviews with key informants express concern about competence in program management, rate adequacy, decline in Medicaid enrollment, and turbulence forces of managed care market on Medicaid programs. PMID:12500339

  18. MediHandTrace ®: a tool for measuring and understanding hand hygiene adherence.

    PubMed

    Boudjema, S; Dufour, J C; Aladro, A S; Desquerres, I; Brouqui, P

    2014-01-01

    The proper implementation of hand hygiene at key moments during patient care is the most important means of preventing healthcare-associated infection. Although there are many programmes aimed at enhancing hand hygiene, the compliance of healthcare workers (HCWs) remains incredibly low. One limiting factor is the lack of standardized measures and reports of hand hygiene opportunities. Direct observational audits have reported the weaknesses in this field. We report here a radiofrequency identification-based real-time automated continuous recording system (MediHandTrace(®)) that permits the tracking of hand hygiene opportunities and the disinfection compliance of HCWs that we evaluated against video recordings as being accurate (99.02%), sensitive (95.65%) and specific (100%). The system can also provide information that is useful to understand HCW non-compliance and will allow the evaluation of future intervention studies. PMID:24261513

  19. Análise da medição do raio solar em ultravioleta

    NASA Astrophysics Data System (ADS)

    Saraiva, A. C. V.; Giménez de Castro, C. G.; Costa, J. E. R.; Selhorst, C. L.; Simões, P. J. A.

    2003-08-01

    A medição acurada do raio solar em qualquer banda do espectro eletromagnético é de relevância na formulação e calibração de modelos da estrutura e atmosfera solar. Esses modelos atribuem emissão do contínuo do Sol calmo em microondas à mesma região da linha Ha do Hell. Apresentamos a medição do raio solar em UV com imagens do EIT (Extreme Ultraviolet Image Telescope) entre 1996 e 2002, no comprimento de onda 30,9 nm (Ha do Hell), que se forma na região de transição/cromosfera solar. A técnica utilizada para o cálculo do raio UV foi baseada na transformada Wavelet B3spline. Fizemos um banco de dados com 1 imagem por dia durante o período citado. Obtivemos como resultado o raio médio da ordem de 975.61" e uma diminuição do mesmo para o período citado variando em média -0,45" /ano. Comparamos estes dados com os valores obtidos pelo ROI (Radio Observatório de Itapetinga) em 22/48 GHz e Nobeyama Radio Heliograph em 17 GHz mostrando que os raios médios são muito próximos o que indica que a região de formação nessas freqüências é a mesma conforme os modelos. Comparamos os resultados também com outros índices de atividade solar.

  20. Dai nippon printing co., ltd, Medi-Ca AC for enumeration of aerobic bacteria. Performance tested method 041302.

    PubMed

    Okochi, Norihiko; Yamazaki, Mamoru; Kiso, Shoichi; Kinoshita, Mai; Okita, Yurie; Kazama, Keisuke; Saito, Rui

    2014-01-01

    A ready-made dry medium method for aerobic count, the MediCa AC method, was compared to the AOAC Official Method 966.23, Microbiological Methods, for seven different heat-processed meat matrixes: cooked roast beef, Chinese barbecued pork (barbecued pork seasoned with honey-based sauce), bacon, cooked ham, frankfurter (made from beef and pork), and boiled and cooked pork sausage. The 95% confidence interval for the mean difference between the two methods at each contamination level for each matrix fell within the range of -0.50 to 0.50, and no statistical difference was observed at all three contamination levels for five matrixes. These results demonstrate that the Medi-Ca AC method is a reasonable alternative to the AOAC 966.23 method for cooked meat products.

  1. MediSim: A Prototype VR System for Training Medical First Responders

    SciTech Connect

    Stansfield, S.; Shawver, D.; Sobel, A.

    1997-12-31

    This paper presents a prototype virtual reality (VR) system for training medical first responders. The initial application is to battlefield medicine and focuses on the training of medical corpsmen and other front-line personnel who might be called upon to provide emergency triage on the battlefield. The system is built upon Sandia`s multi-user, distributed VR platform and provides an interactive, immersive simulation capability. The user is represented by an Avatar and is able to manipulate his virtual instruments and carry out medical procedures. A dynamic casualty simulation provides realistic cues to the patient`s condition (e.g. changing blood pressure and pulse) and responds to the actions of the trainee (e.g. a change in the color of a patient`s skin may result from a check of the capillary refill rate). The current casualty simulation is of an injury resulting in a tension pneumothorax. This casualty model was developed by the University of Pennsylvania and integrated into the Sandia MediSim system.

  2. The CEA/CD3-Bispecific Antibody MEDI-565 (MT111) Binds a Nonlinear Epitope in the Full-Length but Not a Short Splice Variant of CEA

    PubMed Central

    Huang, Jiaqi; Brohawn, Philip; Morehouse, Chris; Lekstrom, Kristen; Baeuerle, Patrick A.; Wu, Herren; Yao, Yihong; Coats, Steven R.; Dall’Acqua, William; Damschroder, Melissa; Hammond, Scott A.

    2012-01-01

    MEDI-565 (also known as MT111) is a bispecific T-cell engager (BiTE®) antibody in development for the treatment of patients with cancers expressing carcinoembryonic antigen (CEA). MEDI-565 binds CEA on cancer cells and CD3 on T cells to induce T-cell mediated killing of cancer cells. To understand the molecular basis of human CEA recognition by MEDI-565 and how polymorphisms and spliced forms of CEA may affect MEDI-565 activity, we mapped the epitope of MEDI-565 on CEA using mutagenesis and homology modeling approaches. We found that MEDI-565 recognized a conformational epitope in the A2 domain comprised of amino acids 326–349 and 388–410, with critical residues F326, T328, N333, V388, G389, P390, E392, I408, and N410. Two non-synonymous single-nucleotide polymorphisms (SNPs) (rs10407503, rs7249230) were identified in the epitope region, but they are found at low homozygosity rates. Searching the National Center for Biotechnology Information GenBank® database, we further identified a single, previously uncharacterized mRNA splice variant of CEA that lacks a portion of the N-terminal domain, the A1 and B1 domains, and a large portion of the A2 domain. Real-time quantitative polymerase chain reaction analysis of multiple cancers showed widespread expression of full-length CEA in these tumors, with less frequent but concordant expression of the CEA splice variant. Because the epitope was largely absent from the CEA splice variant, MEDI-565 did not bind or mediate T-cell killing of cells solely expressing this form of CEA. In addition, the splice variant did not interfere with MEDI-565 binding or activity when co-expressed with full-length CEA. Thus MEDI-565 may broadly target CEA-positive tumors without regard for expression of the short splice variant of CEA. Together our data suggest that MEDI-565 activity will neither be impacted by SNPs nor by a splice variant of CEA. PMID:22574157

  3. Validation of the MediByte® type 3 portable monitor compared with polysomnography for screening of obstructive sleep apnea

    PubMed Central

    Driver, Helen S; Pereira, Effie J; Bjerring, Kathryn; Toop, Fern; Stewart, Steven C; Munt, Peter W; Fitzpatrick, Michael F

    2011-01-01

    BACKGROUND: Portable monitors are increasingly being used as a diagnostic screening tool for obstructive sleep apnea (OSA), and in-laboratory validation of these devices with polysomnography (PSG) is required. OBJECTIVE: To assess the reliability of the MediByte (Braebon Medical Corporation, Canada) type 3 screening device compared with overnight PSG. METHODS: To cover a range of OSA severity, a consecutive series of patients wore the screening device while simultaneously undergoing PSG. Data acquired from the screener and PSG were blinded and scored separately. The number of apneas and hypopneas per hour were calculated using recording time (respiratory disturbance index [RDI]) for the MediByte device, and sleep time (apnea-hypopnea index [AHI]) for PSG. RESULTS: Data from 73 patients with a mean age of 53 years and body mass index of 32.2 kg/m2 showed high measurement association between the RDI and AHI, with a Pearson correlation of 0.92, accounting for 85% of the variance. Based on Bland-Altman measurement agreement, the mean difference between the RDI and AHI (−5.9±11.2 events/h) indicated screener under-reporting. For an AHI of greater than 15 events/h, the sensitivity and specificity of the screener was 80% and 97%, respectively; for an AHI of greater than 30 events/h, the positive predictive value was 100%, while the negative predictive value was 88%. CONCLUSION: The MediByte device accurately identified patients without OSA and had a high sensitivity for moderate-to-severe OSA. PMID:21766076

  4. The detection of single electrons using a Micromegas gas amplification and a MediPix2 CMOS pixel readout

    NASA Astrophysics Data System (ADS)

    Fornaini, A.; Campbell, M.; Chefdeville, M.; Colas, P.; Colijn, A. P.; van der Graaf, H.; Giomataris, Y.; Heijne, E. H. M.; Kluit, P.; Llopart, X.; Schmitz, J.; Timmermans, J.; Visschers, J. L.

    2005-07-01

    By placing a Micromegas gas gain grid on top of a CMOS pixel readout circuit (MediPix2), we developed a device which acts as a pixel-segmented direct anode in gas-filled detectors. With a He/Isobutane 80/20 mixture (capable of achieving gas gain factors up to 20×103) and employing a drift length of 15 mm, signals from radioactive sources and cosmic radiation were measured. Single primary electrons originating from the passage of cosmic muons through the gas volume were detected with an efficiency higher than 90%.

  5. Detection of single electrons by means of a Micromegas-covered MediPix2 pixel CMOS readout circuit

    NASA Astrophysics Data System (ADS)

    Campbell, M.; Chefdeville, M.; Colas, P.; Colijn, A. P.; Fornaini, A.; Giomataris, Y.; van der Graaf, H.; Heijne, E. H. M.; Kluit, P.; Llopart, X.; Schmitz, J.; Timmermans, J.; Visschers, J. L.

    2005-03-01

    A small drift chamber was read out by means of a MediPix2 readout chip as a direct anode. A Micromegas foil was placed 50 μm above the chip, and electron multiplication occurred in the gap. With a He/isobutane 80/20 mixture, gas multiplication factors up to tens of thousands were achieved, resulting in an efficiency for detecting single electrons of better than 90%. We recorded many frames containing 2D images with tracks from cosmic muons. Along these tracks, electron clusters were observed, as well as δ-rays.

  6. Non-fluoroscopic catheter visualization using MediGuide™ technology: experience from the first 600 procedures.

    PubMed

    Sommer, P; Richter, S; Hindricks, G; Rolf, S

    2014-09-01

    A novel cardiovascular navigation system known as MediGuide™ (MG) which allows non-fluoroscopic catheter tracking over a background of pre-recorded cine loops was recently introduced. This system allows significant reduction of fluoroscopy exposure which is one of the potentially harmful aspects of today's electrophysiological procedures such as ablations or device implantations. We provide a summary of recently published studies related to this new technological platform and describe our experience from the first 600 MG procedures at our institution.After reviewing the currently available publications in the field of MG-supported EP procedures, we describe the workflows for (1) ablation of supraventricular tachycardia (SVT), atrial fibrillation (AF), and ventricular tachycardia using MG-enabled diagnostic and ablation catheters, as well as (2) implant of cardiac resynchronization therapy (CRT) devices using sensor-equipped delivery tools including sheaths, sub-selectors, and guidewires.As shown in several studies [5-9], MG procedures resulted in similar efficacy as conventional cases but with a significant reduction in fluoroscopy time and dose. In particular, for SVT ablations, the median fluoroscopy time using the MG technology was 0.5 ± 1.4 min compared to 10.2 ± 9.6 min in conventional fluoroscopic settings. Similar reductions were demonstrated for AF ablation procedures from 25 min in conventional settings with electroanatomical mapping systems and live x-ray to 4.6 min with the addition of the MG technology. Recently, it was demonstrated that the application of MG for CRT device implants could successfully result in a median fluoroscopy time of 2.6 min for LV lead deployment.In summary, the first measurable clinical impact of the MG technology on a daily clinical routine is the reduction of fluoroscopy time and radiation exposure for various EP indications. These beneficial effects were achieved without negative consequences on procedural

  7. Implication of respiratory syncytial virus (RSV) F transgene sequence heterogeneity observed in Phase 1 evaluation of MEDI-534, a live attenuated parainfluenza type 3 vectored RSV vaccine.

    PubMed

    Yang, Chin-Fen; Wang, C Kathy; Malkin, Elissa; Schickli, Jeanne H; Shambaugh, Cindy; Zuo, Fengrong; Galinski, Mark S; Dubovsky, Filip; Tang, Roderick S

    2013-06-10

    MEDI-534 is the first live vectored RSV vaccine candidate to be evaluated in seronegative children. It consists of the bovine parainfluenza virus type 3 (PIV3) genome with substituted human PIV3 F and HN glycoproteins engineered to express RSV F protein. A Phase 1 study of 49 healthy RSV and PIV3 seronegative children 6 to <24 months of age demonstrated an acceptable safety profile at the following doses: 10(4), 10(5) and 10(6)TCID50. After 3 doses of MEDI-534 at 10(6)TCID50, administered at 0, 2 and 4 month intervals, 100% of subjects seroresponded to PIV3, whereas only 50% seroresponded to RSV. To investigate the discordance in seroresponse rates, the RSV F transgene and its flanking non-coding nucleotides were sequenced from shed virus recovered from the nasal washes of 24 MEDI-534-vaccinated children. Eleven out of 24 samples contained no nucleotide changes in the analyzed region. The other 13 samples contained mixtures of variant subpopulations. Fifty-five percent exhibited changes in the transcription termination poly A gene sequences of the upstream bPIV3N gene while 21% had variant subpopulations in the RSV F open reading frame that resulted in pre-mature stop codons. Both types of changes are expected to reduce RSV F expression. Evaluation of the administered vaccine by dual immunofluorescence staining showed ~2.5% variants with low or no RSV F expression while single nucleotide primer extension detected ~1% variation at nucleotide 2045 that resulted in a pre-mature translational termination at codon 85. An association between shedding of variants and lower RSV F serological response was observed but it was not possible to establish a definitive clinical significance due to the small number of subjects in this study.

  8. Evaluation of assay interference and interpretation of CXCR4 receptor occupancy results in a preclinical study with MEDI3185, a fully human antibody to CXCR4

    PubMed Central

    Chavez, Carlos; Henderson, Simon; Vainshtein, Inna; Standifer, Nathan; DelNagro, Christopher; Mehrzai, Freshta; Schneider, Amy; Roskos, Lorin; Liang, Meina

    2015-01-01

    Background Receptor occupancy (RO) assays provide a means to measure the direct interaction of therapeutics with their cell surface targets. Free receptor assays quantify cell‐surface receptors not bound by a therapeutic while total receptor assays quantify the amount of target on the cell surface. Methods We developed both a flow cytometry‐based free RO assay to detect free surface CXCR4, and a total surface CXCR4 assay. In an effort to evaluate potential displacement interference, we performed in vitro experiments to compare on‐cell affinity with the IC50 values from in vitro and in vivo from the free CXCR4 assay. We determined free and total surface CXCR4 on circulating blood cells in cynomolgus monkeys dosed with MEDI3185, a fully human monoclonal antibody to CXCR4. Results We devised an approach to evaluate displacement interference during assay development and showed that our free assay demonstrated little to no displacement interference. After dosing cynomolgus monkeys with MEDI3185, we observed dose‐dependence in the magnitude and duration of receptor occupancy and found CXCR4 to increase on lymphocytes, monocytes, and granulocytes. In a multiple dose study, we observed time points where surface CXCR4 appeared fully occupied but MEDI3185 was not detectable in serum. These paradoxical results represented a type of assay interference, and by comparing pharmacokinetic, ADA and total CXCR4 results, the most likely reason for the free CXCR4 results was the emergence of neutralizing anti‐drug antibodies (ADA). The total CXCR4 assay was unaffected by ADA and provided a reliable marker of target modulation in both in vivo studies. © 2015 The Authors Cytometry Part B: Clinical Cytometry Published byWiley Periodicals, Inc. PMID:26384735

  9. Staphylococcus aureus Alpha-Toxin Is Conserved among Diverse Hospital Respiratory Isolates Collected from a Global Surveillance Study and Is Neutralized by Monoclonal Antibody MEDI4893.

    PubMed

    Tabor, David E; Yu, Li; Mok, Hoyin; Tkaczyk, Christine; Sellman, Bret R; Wu, Yuling; Oganesyan, Vaheh; Slidel, Tim; Jafri, Hasan; McCarthy, Michael; Bradford, Patricia; Esser, Mark T

    2016-09-01

    Staphylococcus aureus infections lead to an array of illnesses ranging from mild skin infections to serious diseases, such endocarditis, osteomyelitis, and pneumonia. Alpha-toxin (Hla) is a pore-forming toxin, encoded by the hla gene, that is thought to play a key role in S. aureus pathogenesis. A monoclonal antibody targeting Hla, MEDI4893, is in clinical development for the prevention of S. aureus ventilator-associated pneumonia (VAP). The presence of the hla gene and Hla protein in 994 respiratory isolates collected from patients in 34 countries in Asia, Europe, the United States, Latin America, the Middle East, Africa, and Australia was determined. Hla levels were correlated with the geographic location, age of the subject, and length of stay in the hospital. hla gene sequence analysis was performed, and mutations were mapped to the Hla crystal structure. S. aureus supernatants containing Hla variants were tested for susceptibility or resistance to MEDI4893. The hla gene was present and Hla was expressed in 99.0% and 83.2% of the isolates, respectively, regardless of geographic region, hospital locale, or age of the subject. More methicillin-susceptible than methicillin-resistant isolates expressed Hla (86.9% versus 78.8%; P = 0.0007), and S. aureus isolates from pediatric patients expressed the largest amounts of Hla. Fifty-seven different Hla subtypes were identified, and 91% of the isolates encoded an Hla subtype that was neutralized by MED4893. This study demonstrates that Hla is conserved in diverse S. aureus isolates from around the world and is an attractive target for prophylactic monoclonal antibody (MAb) or vaccine development.

  10. Staphylococcus aureus Alpha-Toxin Is Conserved among Diverse Hospital Respiratory Isolates Collected from a Global Surveillance Study and Is Neutralized by Monoclonal Antibody MEDI4893

    PubMed Central

    Yu, Li; Mok, Hoyin; Tkaczyk, Christine; Sellman, Bret R.; Wu, Yuling; Oganesyan, Vaheh; Slidel, Tim; Jafri, Hasan; McCarthy, Michael; Bradford, Patricia; Esser, Mark T.

    2016-01-01

    Staphylococcus aureus infections lead to an array of illnesses ranging from mild skin infections to serious diseases, such endocarditis, osteomyelitis, and pneumonia. Alpha-toxin (Hla) is a pore-forming toxin, encoded by the hla gene, that is thought to play a key role in S. aureus pathogenesis. A monoclonal antibody targeting Hla, MEDI4893, is in clinical development for the prevention of S. aureus ventilator-associated pneumonia (VAP). The presence of the hla gene and Hla protein in 994 respiratory isolates collected from patients in 34 countries in Asia, Europe, the United States, Latin America, the Middle East, Africa, and Australia was determined. Hla levels were correlated with the geographic location, age of the subject, and length of stay in the hospital. hla gene sequence analysis was performed, and mutations were mapped to the Hla crystal structure. S. aureus supernatants containing Hla variants were tested for susceptibility or resistance to MEDI4893. The hla gene was present and Hla was expressed in 99.0% and 83.2% of the isolates, respectively, regardless of geographic region, hospital locale, or age of the subject. More methicillin-susceptible than methicillin-resistant isolates expressed Hla (86.9% versus 78.8%; P = 0.0007), and S. aureus isolates from pediatric patients expressed the largest amounts of Hla. Fifty-seven different Hla subtypes were identified, and 91% of the isolates encoded an Hla subtype that was neutralized by MED4893. This study demonstrates that Hla is conserved in diverse S. aureus isolates from around the world and is an attractive target for prophylactic monoclonal antibody (MAb) or vaccine development. PMID:27324766

  11. Medi-Port Pilot Randomized Controlled Trial

    ClinicalTrials.gov

    2016-10-13

    Actively Undergoing Cancer Treatment; 4-9 Years of Age; At Least 1 Month From Diagnosis; Able to Speak and Understand English; Presenting to Clinic for at Least a 2nd Subcutaneous Port Needle Insertion

  12. CDA Templates - Utilizing the MediCUBE.

    PubMed

    Burwitz, Martin; Benedict, Martin; Schlieter, Hannes

    2016-01-01

    The specification and customization of clinical document types are tasks that need a strong collaboration between domain experts and IT specialists. However, these collaborators are often faced with difficulties due to different interpretation of domain knowledge. Therefore, an adequate method for sharing domain knowledge about documents is necessary. Even though there are some tools that help to define medical document types, there is a lack of approaches that focus on the understandability of the specification for the domain experts. This paper proposes a modeling approach based on the Clinical Document Architecture to address this gap. PMID:27577429

  13. Advanced Networks in Dental Rich Online MEDiA (ANDROMEDA)

    NASA Astrophysics Data System (ADS)

    Elson, Bruce; Reynolds, Patricia; Amini, Ardavan; Burke, Ezra; Chapman, Craig

    There is growing demand for dental education and training not only in terms of knowledge but also skills. This demand is driven by continuing professional development requirements in the more developed economies, personnel shortages and skills differences across the European Union (EU) accession states and more generally in the developing world. There is an excellent opportunity for the EU to meet this demand by developing an innovative online flexible learning platform (FLP). Current clinical online systems are restricted to the delivery of general, knowledge-based training with no easy method of personalization or delivery of skill-based training. The PHANTOM project, headed by Kings College London is developing haptic-based virtual reality training systems for clinical dental training. ANDROMEDA seeks to build on this and establish a Flexible Learning Platform that can integrate the haptic and sensor based training with rich media knowledge transfer, whilst using sophisticated technologies such as including service-orientated architecture (SOA), Semantic Web technologies, knowledge-based engineering, business intelligence (BI) and virtual worlds for personalization.

  14. Improving interMediAte Risk management. MARK study

    PubMed Central

    2011-01-01

    Background Cardiovascular risk functions fail to identify more than 50% of patients who develop cardiovascular disease. This is especially evident in the intermediate-risk patients in which clinical management becomes difficult. Our purpose is to analyze if ankle-brachial index (ABI), measures of arterial stiffness, postprandial glucose, glycosylated hemoglobin, self-measured blood pressure and presence of comorbidity are independently associated to incidence of vascular events and whether they can improve the predictive capacity of current risk equations in the intermediate-risk population. Methods/Design This project involves 3 groups belonging to REDIAPP (RETICS RD06/0018) from 3 Spanish regions. We will recruit a multicenter cohort of 2688 patients at intermediate risk (coronary risk between 5 and 15% or vascular death risk between 3-5% over 10 years) and no history of atherosclerotic disease, selected at random. We will record socio-demographic data, information on diet, physical activity, comorbidity and intermittent claudication. We will measure ABI, pulse wave velocity and cardio ankle vascular index at rest and after a light intensity exercise. Blood pressure and anthropometric data will be also recorded. We will also quantify lipids, glucose and glycosylated hemoglobin in a fasting blood sample and postprandial capillary glucose. Eighteen months after the recruitment, patients will be followed up to determine the incidence of vascular events (later follow-ups are planned at 5 and 10 years). We will analyze whether the new proposed risk factors contribute to improve the risk functions based on classic risk factors. Discussion Primary prevention of cardiovascular diseases is a priority in public health policy of developed and developing countries. The fundamental strategy consists in identifying people in a high risk situation in which preventive measures are effective and efficient. Improvement of these predictions in our country will have an immediate, clinical and welfare impact and a short term public health effect. Trial Registration Clinical Trials.gov Identifier: NCT01428934 PMID:21992621

  15. Chocolate in History: Food, Medicine, Medi-Food

    PubMed Central

    Lippi, Donatella

    2013-01-01

    Throughout history, chocolate has been used to treat a wide variety of ailments, and in recent years, multiple studies have found that chocolate can have positive health effects, providing evidence to a centuries-long established use; this acknowledgement, however, did not have a straight course, having been involved in religious, medical and cultural controversies. Christian Europe, in fact, feared the exhilarating effects of new drinks, such as chocolate, coffee and tea. Therefore, these beverages would have been banished, had not doctors and scientists explained that they were good for the body. The scientific debate, which reached its peak in Florence in the 18th century, regarded the therapeutic effectiveness of the various chocolate components: it was necessary to know their properties first, in order to prepare the best cacao concoction for every patient. When Dietetics separated from Medicine, however, chocolate acquired the role of vehicle for easing the administration of bitter medicines, being associated to different health problems. The recent rediscovery of the beneficial use of cacao and chocolate focuses upon its value as supplemental nutrition. Building a bridge to the past may be helpful to detect the areas where the potential health benefits of chocolate are likely to be further explored. PMID:23673608

  16. MEDI4736 (Durvalumab) in Patients With Brain Metastasis From Epithelial-derived Tumors

    ClinicalTrials.gov

    2016-09-12

    Non-Small Cell Lung Cancer; Nonsmall Cell Lung Cancer; Breast Cancer; Cancer of Breast; Cancer of the Breast; Gastroesophageal Cancer; Pancreatic Cancer; Cancer of the Pancreas; Colorectal Cancer; Colorectal Carcinoma; Renal Cancer; Kidney Cancer; Cancer of the Kidney; Cancer of Kidney; Ovarian Cancer; Ovary Cancer; Cancer of the Ovary; Cancer of Ovary

  17. Successful Aging among Elders Living in the Mani Continental Region vs. Insular Areas of the Mediterranean: the MEDIS Study.

    PubMed

    Mariolis, Anargiros; Foscolou, Alexandra; Tyrovolas, Stefanos; Piscopo, Suzanne; Valacchi, Giuseppe; Tsakountakis, Nikos; Zeimbekis, Akis; Bountziouka, Vassiliki; Gotsis, Efthimios; Metallinos, George; Tyrovola, Dimitra; Tur, Josep-Antoni; Matalas, Antonia-Leda; Lionis, Christos; Polychronopoulos, Evangelos; Panagiotakos, Demosthenes

    2016-05-01

    To evaluate the role of geography i.e., continental vs. insular Mediterranean, on successful aging among older inhabitants. During 2005-2014, 2693 elderly (aged 65 to 100 years) individuals from 21 Mediterranean islands in Greece, Italy and Spain as well as Cyprus, Malta, and the rural region of Mani (southeast continental region of Greece keeping old-time traditions), were voluntarily recruited. Successful aging was evaluated using a validated index composed of 10 health-related socio-lifestyle and clinical characteristics. After accounting for age, sex, body mass index (BMI), physical activity, smoking habits, MedDietScore and access to health care services, the older inhabitants of islands were found to have a higher level of the successful aging index when compared to their counterparts in Mani (Beta=0.174, p<0.001); moreover, islanders exhibited slightly more years of "good" health (68.7 vs 68.4 years for Mani residents (p=0.99)). However, compared to the residents of Mani, islanders had 1.64 times higher odds (95%CI, 1.08-2.48) for having hypertension, 2.4-times higher odds (95%CI, 1.34-4.21) for having diabetes and 1.52 times higher odds (95%CI, 0.97-2.38) for having hypercholesterolemia. Engaging in physical activities and healthy dietary habits were the major determinants of healthy aging, among islanders as compared to their counterparts of continental Mani region. Elder residents of the continental Mani area enjoyed a better health status, whereas elder islanders had a higher level of successful aging; a finding which could be attributed to differences in lifestyle among elders. PMID:27330843

  18. Successful Aging among Elders Living in the Mani Continental Region vs. Insular Areas of the Mediterranean: the MEDIS Study

    PubMed Central

    Mariolis, Anargiros; Foscolou, Alexandra; Tyrovolas, Stefanos; Piscopo, Suzanne; Valacchi, Giuseppe; Tsakountakis, Nikos; Zeimbekis, Akis; Bountziouka, Vassiliki; Gotsis, Efthimios; Metallinos, George; Tyrovola, Dimitra; Tur, Josep-Antoni; Matalas, Antonia-Leda; Lionis, Christos; Polychronopoulos, Evangelos; Panagiotakos, Demosthenes

    2016-01-01

    To evaluate the role of geography i.e., continental vs. insular Mediterranean, on successful aging among older inhabitants. During 2005-2014, 2693 elderly (aged 65 to 100 years) individuals from 21 Mediterranean islands in Greece, Italy and Spain as well as Cyprus, Malta, and the rural region of Mani (southeast continental region of Greece keeping old-time traditions), were voluntarily recruited. Successful aging was evaluated using a validated index composed of 10 health-related socio-lifestyle and clinical characteristics. After accounting for age, sex, body mass index (BMI), physical activity, smoking habits, MedDietScore and access to health care services, the older inhabitants of islands were found to have a higher level of the successful aging index when compared to their counterparts in Mani (Beta=0.174, p<0.001); moreover, islanders exhibited slightly more years of “good” health (68.7 vs 68.4 years for Mani residents (p=0.99)). However, compared to the residents of Mani, islanders had 1.64 times higher odds (95%CI, 1.08-2.48) for having hypertension, 2.4-times higher odds (95%CI, 1.34-4.21) for having diabetes and 1.52 times higher odds (95%CI, 0.97-2.38) for having hypercholesterolemia. Engaging in physical activities and healthy dietary habits were the major determinants of healthy aging, among islanders as compared to their counterparts of continental Mani region. Elder residents of the continental Mani area enjoyed a better health status, whereas elder islanders had a higher level of successful aging; a finding which could be attributed to differences in lifestyle among elders. PMID:27330843

  19. 78 FR 6167 - Order of Suspension of Trading; In the Matter of Medis Technologies Ltd., Modern Medical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-29

    ...., Tamir Biotechnology, Inc., and Techmedia Advertising, Inc., January 25, 2013. It appears to the... concerning the securities of Tamir Biotechnology, Inc. because it has not filed any periodic reports...

  20. Successful Aging among Elders Living in the Mani Continental Region vs. Insular Areas of the Mediterranean: the MEDIS Study.

    PubMed

    Mariolis, Anargiros; Foscolou, Alexandra; Tyrovolas, Stefanos; Piscopo, Suzanne; Valacchi, Giuseppe; Tsakountakis, Nikos; Zeimbekis, Akis; Bountziouka, Vassiliki; Gotsis, Efthimios; Metallinos, George; Tyrovola, Dimitra; Tur, Josep-Antoni; Matalas, Antonia-Leda; Lionis, Christos; Polychronopoulos, Evangelos; Panagiotakos, Demosthenes

    2016-05-01

    To evaluate the role of geography i.e., continental vs. insular Mediterranean, on successful aging among older inhabitants. During 2005-2014, 2693 elderly (aged 65 to 100 years) individuals from 21 Mediterranean islands in Greece, Italy and Spain as well as Cyprus, Malta, and the rural region of Mani (southeast continental region of Greece keeping old-time traditions), were voluntarily recruited. Successful aging was evaluated using a validated index composed of 10 health-related socio-lifestyle and clinical characteristics. After accounting for age, sex, body mass index (BMI), physical activity, smoking habits, MedDietScore and access to health care services, the older inhabitants of islands were found to have a higher level of the successful aging index when compared to their counterparts in Mani (Beta=0.174, p<0.001); moreover, islanders exhibited slightly more years of "good" health (68.7 vs 68.4 years for Mani residents (p=0.99)). However, compared to the residents of Mani, islanders had 1.64 times higher odds (95%CI, 1.08-2.48) for having hypertension, 2.4-times higher odds (95%CI, 1.34-4.21) for having diabetes and 1.52 times higher odds (95%CI, 0.97-2.38) for having hypercholesterolemia. Engaging in physical activities and healthy dietary habits were the major determinants of healthy aging, among islanders as compared to their counterparts of continental Mani region. Elder residents of the continental Mani area enjoyed a better health status, whereas elder islanders had a higher level of successful aging; a finding which could be attributed to differences in lifestyle among elders.

  1. Anti-ICOS Monoclonal Antibody MEDI-570 in Treating Patients With Relapsed or Refractory Peripheral T-cell Lymphoma Follicular Variant or Angioimmunoblastic T-cell Lymphoma

    ClinicalTrials.gov

    2016-09-08

    Follicular Variant Peripheral T-Cell Lymphoma; Recurrent Angioimmunoblastic T-cell Lymphoma; Recurrent Mature T- and NK-Cell Non-Hodgkin Lymphoma; Refractory Angioimmunoblastic T-cell Lymphoma; Refractory Mature T-Cell and NK-Cell Non-Hodgkin Lymphoma

  2. A Phase III Study of Durvalumab (MEDI4736) With or Without Tremelimumab for Previously Treated Patients With Advanced NSCLC: Rationale and Protocol Design of the ARCTIC Study.

    PubMed

    Planchard, David; Yokoi, Takashi; McCleod, Michael J; Fischer, Jürgen R; Kim, Young-Chul; Ballas, Marc; Shi, Kelvin; Soria, Jean-Charles

    2016-05-01

    Anti-programmed cell death-1 and anti-programmed cell death ligand-1 (PD-L1) monotherapies have shown promising clinical activity in advanced, refractory non-small-cell lung cancer (NSCLC), but antitumor activity appears to be greater in patients with PD-L1(+) tumors compared with patients harboring PD-L1(-) tumors. Combining the anti-PD-L1 antibody durvalumab and the anti-cytotoxic T-lymphocyte antigen 4 antibody tremelimumab offers the potential for antitumor activity in patients with advanced NSCLC, regardless of PD-L1 tumor status. ARCTIC (NCT02352948) is a global, phase III, randomized, open-label multicenter study in patients with advanced NSCLC assessing the safety and clinical activity of durvalumab versus standard of care (SoC; erlotinib, gemcitabine, or vinorelbine) in patients with PD-L1(+) tumors (≥25% of tumor cells with membrane staining using VENTANA PD-L1 [SP263] CDx Assay) (Sub-study A) and the combination of durvalumab + tremelimumab or either agent as monotherapy versus SoC in patients with PD-L1(-) tumors (Sub-study B). Eligible patients are those with locally advanced or metastatic NSCLC (Stage IIIB/IV), without epidermal growth factor receptor tyrosine kinase activating mutations or anaplastic lymphoma kinase rearrangements, who have received at least 2 prior systemic regimens, including 1 platinum-based chemotherapy regimen. Co-primary endpoints are progression-free survival and overall survival. Secondary endpoints include the proportion of patients alive at 12 months, objective response rate, duration of response, progression-free survival at 6 and 12 months, safety and tolerability, pharmacokinetics, immunogenicity, and quality of life. The exploratory endpoints will assess potential biomarkers of treatment response. Recruitment started in January 2015 and is ongoing. PMID:27265743

  3. A Phase III Study of Durvalumab (MEDI4736) With or Without Tremelimumab for Previously Treated Patients With Advanced NSCLC: Rationale and Protocol Design of the ARCTIC Study.

    PubMed

    Planchard, David; Yokoi, Takashi; McCleod, Michael J; Fischer, Jürgen R; Kim, Young-Chul; Ballas, Marc; Shi, Kelvin; Soria, Jean-Charles

    2016-05-01

    Anti-programmed cell death-1 and anti-programmed cell death ligand-1 (PD-L1) monotherapies have shown promising clinical activity in advanced, refractory non-small-cell lung cancer (NSCLC), but antitumor activity appears to be greater in patients with PD-L1(+) tumors compared with patients harboring PD-L1(-) tumors. Combining the anti-PD-L1 antibody durvalumab and the anti-cytotoxic T-lymphocyte antigen 4 antibody tremelimumab offers the potential for antitumor activity in patients with advanced NSCLC, regardless of PD-L1 tumor status. ARCTIC (NCT02352948) is a global, phase III, randomized, open-label multicenter study in patients with advanced NSCLC assessing the safety and clinical activity of durvalumab versus standard of care (SoC; erlotinib, gemcitabine, or vinorelbine) in patients with PD-L1(+) tumors (≥25% of tumor cells with membrane staining using VENTANA PD-L1 [SP263] CDx Assay) (Sub-study A) and the combination of durvalumab + tremelimumab or either agent as monotherapy versus SoC in patients with PD-L1(-) tumors (Sub-study B). Eligible patients are those with locally advanced or metastatic NSCLC (Stage IIIB/IV), without epidermal growth factor receptor tyrosine kinase activating mutations or anaplastic lymphoma kinase rearrangements, who have received at least 2 prior systemic regimens, including 1 platinum-based chemotherapy regimen. Co-primary endpoints are progression-free survival and overall survival. Secondary endpoints include the proportion of patients alive at 12 months, objective response rate, duration of response, progression-free survival at 6 and 12 months, safety and tolerability, pharmacokinetics, immunogenicity, and quality of life. The exploratory endpoints will assess potential biomarkers of treatment response. Recruitment started in January 2015 and is ongoing.

  4. Promethium-147 capacitor.

    PubMed

    Kavetskiy, A; Yakubova, G; Lin, Q; Chan, D; Yousaf, S M; Bower, K; Robertson, J D; Garnov, A; Meier, D

    2009-06-01

    Beta particle surface fluxes for tritium, Ni-63, Pm-147, and Sr-90 sources were calculated in this work. High current density was experimentally achieved from Pm-147 oxide in silica-titana glass. A 96 GBq (2.6 Ci) Pm-147 4pi-source with flux efficiency greater than 50% was used for constructing a direct charge capacitor with a polyimide coated collector and vacuum as electrical insulation. The capacitor connected to high resistance (TOmega) loads produced up to 35 kV. Overall conversion efficiency was over 10% (on optimal load).

  5. The SAATELLITE and EVADE Clinical Studies Within the COMBACTE Consortium: A Public-Private Collaborative Effort in Designing and Performing Clinical Trials for Novel Antibacterial Drugs to Prevent Nosocomial Pneumonia.

    PubMed

    François, Bruno; Chastre, Jean; Eggiman, Philippe; Laterre, Pierre-François; Torres, Antoni; Sanchez, Miguel; Esser, Mark T; Bishop, Brian; Bonten, Marc; Goosens, Herman; Jafri, Hasan S

    2016-08-15

    The Innovative Medicines Initiative-funded COMBACTE consortium fosters academic-industry partnership in pioneering studies to combat serious bacterial infections. We describe how this partnership is advancing the development of 2 monoclonal antibodies, MEDI4893 and MEDI3902, for the prevention of nosocomial pneumonia. PMID:27481953

  6. The SAATELLITE and EVADE Clinical Studies Within the COMBACTE Consortium: A Public-Private Collaborative Effort in Designing and Performing Clinical Trials for Novel Antibacterial Drugs to Prevent Nosocomial Pneumonia.

    PubMed

    François, Bruno; Chastre, Jean; Eggiman, Philippe; Laterre, Pierre-François; Torres, Antoni; Sanchez, Miguel; Esser, Mark T; Bishop, Brian; Bonten, Marc; Goosens, Herman; Jafri, Hasan S

    2016-08-15

    The Innovative Medicines Initiative-funded COMBACTE consortium fosters academic-industry partnership in pioneering studies to combat serious bacterial infections. We describe how this partnership is advancing the development of 2 monoclonal antibodies, MEDI4893 and MEDI3902, for the prevention of nosocomial pneumonia.

  7. Development and evaluation of an ensemble resource linking medications to their indications

    PubMed Central

    Wei, Wei-Qi; Cronin, Robert M; Xu, Hua; Lasko, Thomas A; Bastarache, Lisa; Denny, Joshua C

    2013-01-01

    Objective To create a computable MEDication Indication resource (MEDI) to support primary and secondary use of electronic medical records (EMRs). Materials and methods We processed four public medication resources, RxNorm, Side Effect Resource (SIDER) 2, MedlinePlus, and Wikipedia, to create MEDI. We applied natural language processing and ontology relationships to extract indications for prescribable, single-ingredient medication concepts and all ingredient concepts as defined by RxNorm. Indications were coded as Unified Medical Language System (UMLS) concepts and International Classification of Diseases, 9th edition (ICD9) codes. A total of 689 extracted indications were randomly selected for manual review for accuracy using dual-physician review. We identified a subset of medication–indication pairs that optimizes recall while maintaining high precision. Results MEDI contains 3112 medications and 63 343 medication–indication pairs. Wikipedia was the largest resource, with 2608 medications and 34 911 pairs. For each resource, estimated precision and recall, respectively, were 94% and 20% for RxNorm, 75% and 33% for MedlinePlus, 67% and 31% for SIDER 2, and 56% and 51% for Wikipedia. The MEDI high-precision subset (MEDI-HPS) includes indications found within either RxNorm or at least two of the three other resources. MEDI-HPS contains 13 304 unique indication pairs regarding 2136 medications. The mean±SD number of indications for each medication in MEDI-HPS is 6.22±6.09. The estimated precision of MEDI-HPS is 92%. Conclusions MEDI is a publicly available, computable resource that links medications with their indications as represented by concepts and billing codes. MEDI may benefit clinical EMR applications and reuse of EMR data for research. PMID:23576672

  8. In-Situ Missions for the Exploration of Titan's Lakes

    NASA Technical Reports Server (NTRS)

    Elliott, John O.; Waite, J. Hunter

    2011-01-01

    The lakes of Titan represent an increasingly tantalizing target for future exploration. As Cassini continues to reveal more details the lakes appear to offer a particularly rich reservoir of knowledge that could provide insights to Titan's formation and evolution, as well as an ideal location to explore Titan's potential for pre-biotic chemistry. A recent study of Titan Lake Probe missions was undertaken as one of several dozen studies commissioned by the National Research Council (NRC) Planetary Decadal Survey to explore the technical readiness, feasibility and affordability of scientifically promising mission scenarios. This in-depth study focused on an in-situ examination of a hydrocarbon lake on the Saturnian moon Titan--a target that presents unique scientific opportunities as well as several unique engineering challenges (e.g., submersion systems and cryogenic sampling) to enable those measurements. Per direction from the NRC Planetary Decadal Survey Satellites Panel, and after an initial trade-space examination, study architectures focused on three possible New Frontiers-class missions and a more ambitious Flagship-class lander intended as the in-situ portion of a larger collaborative mission. Detailed point designs were developed to explore these four potential mission options, including consideration of flight system and mission designs, as well as operations on and under the lake's surface and scenarios for data return. In this paper we present an overview of the science objectives of the missions, the mission architecture and surface.

  9. Relationship Of Mediterranean Diet And Caloric Intake To Phenoconversion In Huntington Disease

    PubMed Central

    Marder, Karen; Gu, Yian; Eberly, Shirley; Tanner, Caroline M.; Scarmeas, Nikolaos; Oakes, David; Shoulson, Ira

    2014-01-01

    Importance Adherence to Mediterranean-type diet (MeDi) may delay onset of Alzheimer's and Parkinson's disease. Whether adherence to MeDi affects time to phenoconversion in Huntington’s Disease (HD), a highly penetrant, single gene disorder, is unknown. Objective To determine if MeDi modifies the time to clinical onset of HD ('phenoconversion') in premanifest carriers participating in Prospective Huntington At Risk Observational Study (PHAROS), and to examine the effects of BMI and caloric intake on time to phenoconversion. Design A prospective cohort study. Setting 41 Huntington Study Group sites in the US and Canada. Participants 1001 participants were enrolled in PHAROS between July 1999 and January 2004, and were followed every 9 months until 2010. A total of 211 participants aged 26–57 with an expanded CAG repeat (≥37) were included in the current study. Exposure A semi-quantitative food frequency questionnaire (FFQ) was administered 33 months after baseline. We calculated daily gram intake for dairy, meat, fruit, vegetables, legumes, cereals, fish, monounsaturated and saturated fatty-acids, and alcohol, and constructed MeDi scores (0–9); higher scores indicate higher adherence. Demographics, medical history, BMI, and Unified Huntington's Disease Rating Scale (UHDRS) were collected. Main Outcome Measure Cox proportional hazards models to determine the association of MeDi and phenoconversion. Results Age, caloric intake, gender, education, and UHDRS motor scores did not differ among MeDi tertiles (0–3, 4–5, 6–9). The highest BMI was associated with lowest adherence to MeDi. 31 participants phenoconverted. In a model adjusted for age, CAG, and caloric intake, MeDi was not associated with phenoconversion (p for trend=0.14 for tertile of MeDi, and p=0.22 for continuous MeDi). When individual diet components of MeDi were analyzed, higher dairy consumption (hazard ratio 2.36; 1.0–5.57; p=0.051) and higher caloric intake (p=0.035) were associated with

  10. Central venous catheters - ports

    MedlinePlus

    Central venous catheter - subcutaneous; Port-a-Cath; InfusaPort; PasPort; Subclavian port; Medi - port; Central venous line - port ... Catheters are used when you need medical treatment over a long period of time. For example, you ...

  11. Safety and Immunogenicity of a Live Attenuated RSV Vaccine in Healthy RSV-Seronegative Children 5 to 24 Months of Age

    PubMed Central

    Malkin, Elissa; Yogev, Ram; Abughali, Nazha; Sliman, Joseph; Wang, C. Kathy; Zuo, Fengrong; Yang, Chin-Fen; Eickhoff, Mark; Esser, Mark T.; Tang, Roderick S.; Dubovsky, Filip

    2013-01-01

    Despite substantial morbidity associated with respiratory syncytial virus (RSV) infection, there is no licensed vaccine. MEDI-559 is a live attenuated intranasal vaccine candidate being developed for prevention of lower respiratory illness due to RSV in young children. This randomized, placebo-controlled study evaluated safety of MEDI-559 in healthy, RSV-seronegative children. MEDI-559 or placebo was administered on 3 occasions, 2 months apart. Primary safety was based on solicited symptoms (SSs) and adverse events (AEs) collected for 28 days after each dose. Nasal wash samples were collected 3 times after each dose (days 7-10, 12-18, 28-34) and at sick visits. Serum was collected for measuring antibody immune responses to RSV prior to first vaccination and 28 days post final dose. Long-term safety was monitored for 365 days from first dose. SSs were mild and frequent (MEDI-559 84%; placebo 91%); most common SSs were runny/stuffy nose, cough, and irritability/fussiness. AEs occurred in 67% MEDI-559 and 57% placebo recipients: most common AE was upper respiratory tract infection (MEDI-559 35%; placebo 23%). Higher incidence of medically attended lower respiratory illness within 28 days after dosing occurred in the MEDI-559 arm compared to placebo (none associated with vaccine virus shedding). There was no evidence of enhanced RSV disease. Vaccine virus was detected only in MEDI-559 recipients; shedding occurred in 56%subjects, primarily post dose 1. A functional immune response was observed in 59% and 9% MEDI-559 and placebo recipients, respectively, by an RSV microneutralization assay. Vaccine take, assessed by proportion that shed vaccine-type virus or had a seroresponse against RSV, was seen in 95% MEDI-559 subjects. MEDI-559 is therefore biologically active and immunogenic in this seronegative pediatric population. Although the frequency of SSs and AEs was not considered clinically significant, the increase in medically attended lower respiratory illnesses in

  12. Adherence to a Mediterranean diet in Morocco and its correlates: cross-sectional analysis of a sample of the adult Moroccan population

    PubMed Central

    2012-01-01

    Background Dietary habits in Morocco are changing and the causes are not well understood. This study aimed to analyse socio-demographic factors associated with adherence to the Mediterranean diet (MeDi) in a national random sample of the adult Moroccan population. Methods The data collected in this cross-sectional survey included socio-demographic factors and a food frequency questionnaire. MeDi adherence was assessed in 2214 individuals with complete dietary data. MeDi adherence was measured according to a simplified MeDi score based on the weekly frequency of intake of eight food groups (vegetables, legumes, fruits, cereal or potatoes, fish, red meat, dairy products and olive oil) with the use of the sex specific medians of the sample as cut-offs. A value of 0 or 1 was assigned to consumption of each component according to its presumed detrimental or beneficial effect on health. Logistic regression was used to estimate the association between MeDi adherence (low score 1-4 vs. high 5-8) and other factors. Results Mean age of the sample was 41.4 (standard deviation 15.3) years, 45.4% were men and 29.9% had a low MeDi adherence. Married subjects (adjusted odds ratio ORa=0.68, 95% CI 0.55-0.84) were less likely to have a low MeDi adherence compared to single, divorced or widowed persons. Persons from rural areas (ORa=1.46, 95% CI: 1.02-2.08), were more often low MeDi adherents compared to those from urban areas. Obese persons (ORa=1.56, 95% CI: 1.16-2.11) were more prone to low MeDi adherence than normal weight individuals. Conclusion MeDi is far from being a universal pattern in the Moroccan population. Intervention strategies should be implemented in target groups to maintain the traditional MeDi pattern considered as the original diet in Morocco. PMID:22578133

  13. Potential benefits of adherence to the Mediterranean diet on cognitive health.

    PubMed

    Féart, Catherine; Samieri, Cecilia; Allès, Benjamin; Barberger-Gateau, Pascale

    2013-02-01

    The purpose of this review was to update available knowledge on the relationship between adherence to the Mediterranean diet (MeDi) and cognitive decline, risk of dementia or Alzheimer's Disease (AD), and to analyse the reasons for some inconsistent results across studies. The traditional MeDi has been recognised by the United Nations Educational Scientific and Cultural Organisation as an Intangible Cultural Heritage of Humanity. This dietary pattern is characterised by a high consumption of plant foods (i.e. vegetables, fruits, legumes and cereals), a high intake of olive oil as the main source of fat, a moderate intake of fish, low-to-moderate intake of dairy products and low consumption of meat and poultry, with wine consumed in low-to-moderate amounts during meals. Beyond the well-known association between higher adherence to the MeDi and lower risk of mortality, in particular from CVD and cancer, new data from large epidemiological studies suggest a relationship between MeDi adherence and cognitive decline or risk of dementia. However, some inconsistent results have been found as well, even in Mediterranean countries. In this review, we analyse the reasons likely to explain these discrepancies, and propose that most of these differences are due to variations in the methodology used to assess MeDi adherence. We also discuss the possibility of residual confounding by lifestyle, that is, greater adherents to the MeDi also have a healthier lifestyle in general, which can favourably affect cognition. In conclusion, large-scale studies in various populations with common methodology are required before considering the MeDi as an optimal dietary strategy to prevent cognitive decline or dementia.

  14. Structure and Function Analysis of an Antibody Recognizing All Influenza A Subtypes.

    PubMed

    Kallewaard, Nicole L; Corti, Davide; Collins, Patrick J; Neu, Ursula; McAuliffe, Josephine M; Benjamin, Ebony; Wachter-Rosati, Leslie; Palmer-Hill, Frances J; Yuan, Andy Q; Walker, Philip A; Vorlaender, Matthias K; Bianchi, Siro; Guarino, Barbara; De Marco, Anna; Vanzetta, Fabrizia; Agatic, Gloria; Foglierini, Mathilde; Pinna, Debora; Fernandez-Rodriguez, Blanca; Fruehwirth, Alexander; Silacci, Chiara; Ogrodowicz, Roksana W; Martin, Stephen R; Sallusto, Federica; Suzich, JoAnn A; Lanzavecchia, Antonio; Zhu, Qing; Gamblin, Steven J; Skehel, John J

    2016-07-28

    Influenza virus remains a threat because of its ability to evade vaccine-induced immune responses due to antigenic drift. Here, we describe the isolation, evolution, and structure of a broad-spectrum human monoclonal antibody (mAb), MEDI8852, effectively reacting with all influenza A hemagglutinin (HA) subtypes. MEDI8852 uses the heavy-chain VH6-1 gene and has higher potency and breadth when compared to other anti-stem antibodies. MEDI8852 is effective in mice and ferrets with a therapeutic window superior to that of oseltamivir. Crystallographic analysis of Fab alone or in complex with H5 or H7 HA proteins reveals that MEDI8852 binds through a coordinated movement of CDRs to a highly conserved epitope encompassing a hydrophobic groove in the fusion domain and a large portion of the fusion peptide, distinguishing it from other structurally characterized cross-reactive antibodies. The unprecedented breadth and potency of neutralization by MEDI8852 support its development as immunotherapy for influenza virus-infected humans.

  15. Mediterranean Diet and Risk of Dementia.

    PubMed

    Safouris, Apostolos; Tsivgoulis, Georgios; Sergentanis, Theodoros N; Psaltopoulou, Theodora

    2015-01-01

    Dementia is a major global health challenge, as its burden on society will increase with population aging. Given the lack of effective pharmaceutical treatment for common types of dementia including Alzheimer's disease and vascular dementia, research interest in lifestyle modifications that could prevent, postpone the clinical syndrome or decelerate progression of dementia is growing. Among the various dietary patterns that were tested for their effects on cognition, the traditional Mediterranean diet (MeDi) has shown promising results. This review aims to summarize the epidemiological evidence on the effects of MeDi on the prevention of dementia, presenting data from cross-sectional as well as longitudinal observational studies conducted both in Mediterranean and non-Mediterranean countries. These findings have been also reproduced in the context of one recent randomized-controlled clinical trial. Postulated mechanisms of action that may account for the potential protective effect of MeDi on cognitive impairment will be briefly discussed. Despite the fact that the link between MeDi and cognitive decline has been only explored for less than a decade, data on efficacy is rapidly increasing and allows optimism that MeDi could emerge as an alternative prophylactic treatment for dementia.

  16. Structure and Function Analysis of an Antibody Recognizing All Influenza A Subtypes.

    PubMed

    Kallewaard, Nicole L; Corti, Davide; Collins, Patrick J; Neu, Ursula; McAuliffe, Josephine M; Benjamin, Ebony; Wachter-Rosati, Leslie; Palmer-Hill, Frances J; Yuan, Andy Q; Walker, Philip A; Vorlaender, Matthias K; Bianchi, Siro; Guarino, Barbara; De Marco, Anna; Vanzetta, Fabrizia; Agatic, Gloria; Foglierini, Mathilde; Pinna, Debora; Fernandez-Rodriguez, Blanca; Fruehwirth, Alexander; Silacci, Chiara; Ogrodowicz, Roksana W; Martin, Stephen R; Sallusto, Federica; Suzich, JoAnn A; Lanzavecchia, Antonio; Zhu, Qing; Gamblin, Steven J; Skehel, John J

    2016-07-28

    Influenza virus remains a threat because of its ability to evade vaccine-induced immune responses due to antigenic drift. Here, we describe the isolation, evolution, and structure of a broad-spectrum human monoclonal antibody (mAb), MEDI8852, effectively reacting with all influenza A hemagglutinin (HA) subtypes. MEDI8852 uses the heavy-chain VH6-1 gene and has higher potency and breadth when compared to other anti-stem antibodies. MEDI8852 is effective in mice and ferrets with a therapeutic window superior to that of oseltamivir. Crystallographic analysis of Fab alone or in complex with H5 or H7 HA proteins reveals that MEDI8852 binds through a coordinated movement of CDRs to a highly conserved epitope encompassing a hydrophobic groove in the fusion domain and a large portion of the fusion peptide, distinguishing it from other structurally characterized cross-reactive antibodies. The unprecedented breadth and potency of neutralization by MEDI8852 support its development as immunotherapy for influenza virus-infected humans. PMID:27453466

  17. Enrolling in Medicaid through the National School Lunch Program: outcome of a pilot project in California schools.

    PubMed

    Cousineau, Michael R; Wada, Eriko O; Hogan, Laura

    2007-01-01

    California has several health insurance programs for children. However, the system for enrolling into these programs is complex and difficult to manage for many families. Express Lane Eligibility is designed to streamline the Medicaid (called Medi-Cal in California) enrollment process by linking it to the National School Lunch Program. If a child is eligible for free lunch and the parents consent, the program provides two months of presumptive eligibility for Medi-Cal and a simplified application process for continuation in Medi-Cal. For those who are ineligible, it provides a referral to other programs. An evaluation of Express Lane shows that while many children were presumptively enrolled, nearly half of the applicants were already enrolled in Medi-Cal. Many Express Enrolled children failed to complete the full Medi-Cal enrollment process. Few were referred to the State Children's Health Insurance Program or county programs. Express Lane is less useful as a broad screening strategy, but can be one of many tools that communities use to enroll children in health insurance. PMID:17639647

  18. A Novel IL6 Antibody Sensitizes Multiple Tumor Types to Chemotherapy Including Trastuzumab-Resistant Tumors.

    PubMed

    Zhong, Haihong; Davis, April; Ouzounova, Maria; Carrasco, Rosa A; Chen, Cui; Breen, Shannon; Chang, Yong S; Huang, Jiaqi; Liu, Zheng; Yao, Yihong; Hurt, Elaine; Moisan, Jacques; Fung, Michael; Tice, David A; Clouthier, Shawn G; Xiao, Zhan; Wicha, Max S; Korkaya, Hasan; Hollingsworth, Robert E

    2016-01-15

    Elevated levels of the proinflammatory cytokine IL6 are associated with poor survival outcomes in many cancers. Antibodies targeting IL6 and its receptor have been developed for chronic inflammatory disease, but they have not yet been shown to clearly benefit cancer patients, possibly due to antibody potency or the settings in which they have been tested. In this study, we describe the development of a novel high-affinity anti-IL6 antibody, MEDI5117, which features an extended half-life and potent inhibitory effects on IL6 biologic activity. MEDI5117 inhibited IL6-mediated activation of STAT3, suppressing the growth of several tumor types driven by IL6 autocrine signaling. In the same models, MEDI5117 displayed superior preclinical activity relative to a previously developed anti-IL6 antibody. Consistent with roles for IL6 in promoting tumor angiogenesis, we found that MEDI5117 inhibited the growth of endothelial cells, which can produce IL6 and support tumorigenesis. Notably, in tumor xenograft assays in mice, we documented the ability of MEDI5117 to enhance the antitumor activities of chemotherapy or gefitinib in combination treatment regimens. MEDI5117 also displayed robust activity on its own against trastuzumab-resistant HER2(+) tumor cells by targeting the CD44(+)CD24(-) cancer stem cell population. Collectively, our findings extend the evidence of important pleiotropic roles of IL6 in tumorigenesis and drug resistance, and offer a preclinical proof of concept for the use of IL6 antibodies in combination regimens to heighten therapeutic responses and overcome drug resistance.

  19. Physical Activity, Mediterranean Diet and Biomarkers-Assessed Risk of Alzheimer’s: A Multi-Modality Brain Imaging Study

    PubMed Central

    Matthews, Dawn C.; Davies, Michelle; Murray, John; Williams, Schantel; Tsui, Wai H.; Li, Yi; Andrews, Randolph D.; Lukic, Ana; McHugh, Pauline; Vallabhajosula, Shankar; de Leon, Mony J.; Mosconi, Lisa

    2014-01-01

    Increased physical activity and higher adherence to a Mediterranean-type diet (MeDi) have been independently associated with reduced risk of Alzheimer’s disease (AD). Their association has not been investigated with the use of biomarkers. This study examines whether, among cognitively normal (NL) individuals, those who are less physically active and show lower MeDi adherence have brain biomarker abnormalities consistent with AD. Methods Forty-five NL individuals (age 54 ± 11, 71% women) with complete leisure time physical activity (LTA), dietary information, and cross-sectional 3D T1-weigthed MRI, 11C-Pittsburgh Compound B (PiB) and 18F-fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) scans were examined. Voxel-wise multivariate partial least square (PLS) regression was used to examine the effects of LTA, MeDi and their interaction on brain biomarkers. Age, gender, ethnicity, education, caloric intake, BMI, family history of AD, Apolipoprotein E (APOE) genotype, presence of hypertension and insulin resistance were examined as confounds. Subjects were dichotomized into more and less physically active (LTA+ vs. LTA−; n = 21 vs. 24), and into higher vs. lower MeDi adherence groups (n = 18 vs. 27) using published scoring methods. Spatial patterns of brain biomarkers that represented the optimal association between the images and the groups were generated for all modalities using voxel-wise multivariate Partial Least Squares (PLS) regression. Results Groups were comparable for clinical and neuropsychological measures. Independent effects of LTA and MeDi factors were observed in AD-vulnerable brain regions for all modalities (p < 0.001). Increased AD-burden (in particular higher Aβ load and lower glucose metabolism) were observed in LTA− compared to LTA+ subjects, and in MeDi− as compared to MeDi+ subjects. A gradient effect was observed for all modalities so that LTA−/MeDi− subjects had the highest and LTA+/MeDi+ subjects had the lowest AD

  20. Asthma remission in a patient with rheumatoid arthritis while on antiangiogenesis therapy during a rheumatoid arthritis trial demonstrated by forced oscillation and spirometry.

    PubMed

    Saadeh, Charles; Saadeh, Constantine

    2007-05-01

    Asthma is a chronic inflammatory condition. An integral part of the inflammation is angiogenesis (neovascularization). This report describes a patient with rheumatoid arthritis (RA) and moderately severe asthma despite maintenance on inhaled corticosteroids (ics) and intermittent systemic steroids (ss). While enrolled in a clinical trial for RA employing MEDI-522 (Vitaxin), her asthma symptoms remitted substantially, with significant improvement in spirometry and airflow resistance measured by forced oscillation. The patient was able to discontinue ics and required no ss while taking MEDI-522. After termination of the clinical trial, the patient's asthma symptoms again increased and required reinstitution of ics for control. PMID:17530526

  1. Apparent Motion of the Sun, Shadows of Objects and Measurement of Time in the View of Seventh Grade Students of Middle School. (Breton Title: Movimento Aparente do Sol, Sombras dos Objetos e Medição do Tempo na Visão de Alunos do Sétimo Ano do Ensino Fundamental.) Movimiento Aparente del Sol, Sombras de los Objetos y Medición del Tiempo en la Visión de Estudiantes del Séptimo Grado del Ciclo Pirmario

    NASA Astrophysics Data System (ADS)

    Iria Machado, Daniel

    2013-07-01

    The apparent motion of the Sun on the celestial sphere and the behavior of the shadows of objects over time are observable phenomena in everyday life. However, students often do not have a proper understanding of such occurrences, and can even display misconceptions about them. Therefore, we performed a research in order to know students' notions about these subjects and to evaluate the contribution to their understanding brought about by an activity performed with an interactive sundial in an informal learning environment. We investigated the ideas of 43 students from the seventh grade of middle school by applying a test with open questions before and after an activity with an analemmatic sundial, conducted by a monitor. A significant proportion of students were initially unaware of most of the phenomena treated. The intervention performed helped the students to assimilate new concepts, providing the contact with new phenomena and to a lesser degree, the development of explanations about them, indicating an educational potential of this action. However, the contribution to the understanding of some of the ideas explored was small, pointing to the need to make additional observations, studies and discussions. O movimento aparente do Sol na esfera celeste e o comportamento das sombras dos objetos com o passar do tempo são fenômenos observáveis no dia a dia. No entanto, muitas vezes os estudantes não possuem uma compreensão adequada de tais ocorrências, podendo inclusive exibir concepções alternativas a seu respeito. Por isso, efetuou-se uma pesquisa com o intuito de conhecer as noções dos alunos sobre esses temas e avaliar a contribuição para seu entendimento propiciada por uma atividade feita com um relógio de Sol interativo, em um ambiente de ensino informal. Foram investigadas as ideias de 43 alunos do sétimo ano do Ensino Fundamental mediante a aplicação de um teste com questões abertas antes e depois de uma atividade com um relógio de Sol analemático, conduzida por um monitor. Uma proporção significativa de estudantes desconhecia inicialmente a maioria dos fenômenos tratados. A intervenção realizada colaborou para uma parte dos alunos assimilar novos conceitos, propiciando o contato com novos fenômenos e, em menor grau, a elaboração de explicações a respeito destes, indicando um potencial educativo dessa ação. Porém, a contribuição para o entendimento de algumas das ideias exploradas foi pequena, apontando para a necessidade de se fazer observações, estudos e discussões complementares. El movimiento aparente del Sol en la esfera celeste y el comportamiento de las sombras de los objetos a lo largo del tiempo son fenómenos observables en la vida cotidiana. Sin embargo, los estudiantes a menudo no tienen una adecuada comprensión de dichos problemas, e incluso pueden mostrar conceptos erróneos acerca de ellos. Por lo tanto, se realizó una investigación a fin de conocer las nociones de los estudiantes acerca de estas cuestiones y evaluar la contribución a su comprensión proporcionada por una actividad realizada con un reloj de Sol interactivo, en un entorno informal de aprendizaje. Se investigaron las ideas de 43 estudiantes del séptimo grado del ciclo primario mediante la aplicación de un test con preguntas abiertas antes y después de una actividad con un reloj de Sol analemático, dirigida por un monitor. Una proporción significativa de los estudiantes inicialmente desconocía la mayoría de los fenómenos tratados. La intervención realizada contribuyó para que los estudiantes asimilasen nuevos conceptos, proporcionando el contacto con nuevos fenómenos y, en menor medida, desarrollasen explicaciones acerca de estos, lo que indica un potencial educativo de esta acción. Sin embargo, la contribución a la comprensión de algunas de las ideas exploradas fue pequeña, lo que apunta a la necesidad de hacer observaciones, estudios y debates adicionales.

  2. Service engineering for grid services in medicine and life science.

    PubMed

    Weisbecker, Anette; Falkner, Jürgen

    2009-01-01

    Clearly defined services with appropriate business models are necessary in order to exploit the benefit of grid computing for industrial and academic users in medicine and life sciences. In the project Services@MediGRID the service engineering approach is used to develop those clearly defined grid services and to provide sustainable business models for their usage.

  3. Low levels of energy expenditure in childhood cancer survivors: Implications for obesity prevention

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Childhood cancer survivors are at an increased risk of obesity but causes for this elevated risk are uncertain. We evaluated total energy expenditure in childhood cancer survivors using the doubly labeled water method in a cross-sectional study of 17 survivors of pediatric leukemia or lymphoma (medi...

  4. Extraction and HPLC- UV Analysis of C60, C70, and [6,6]-phenyl C61-butyric acid methyl ester in Synthetic and Natural Waters

    EPA Science Inventory

    Studies have shown that C60 fullerene can form stable colloidal suspensions in water that result in C60 aqueous concentrations many orders of magnitude above C60's aqueous solubility; however, quantitative methods for the analysis of C60 and other fullerenes in environmental medi...

  5. Environmental conditions and reproductive health outcomes

    EPA Science Inventory

    Environmental exposures range across multiple domains to affect human health. In an effort to learn how environmental factors combine to contribute to health outcomes we constructed a multiple environmental domain index (MEDI) for use in health research. We used principal compone...

  6. 76 FR 27652 - Center for Scientific Review; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-12

    ... Scientific Review Special Emphasis Panel, Member Conflict: CMIP-MEDI-BMIT (A & B) Medical Imaging... Imaging Technologies. Date: June 1, 2011. Time: 11 a.m. to 3 p.m. Agenda: To review and evaluate grant...: Interdisciplinary Molecular Sciences and Training Integrated Review Group, Enabling Bioanalytical and...

  7. Growth of Piscirickettsia salmonis on Enriched Blood Agar

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Piscirickettsia salmonis is the etiologic agent of piscirickettsiosis, an economically significant disease of fish. Isolation of P. salmonis by culturing on fish cell lines has been the standard technique since the initial isolation of the organism. The ability to grow P. salmonis on artificial medi...

  8. Discovery of chemicals that mediate mosquito host-seeking behavior

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Since 1942, the United States Department of Agriculture (USDA) has developed repellents and insecticides for the U.S. military. A small thrust of this research program has been focused on discovery of attractants for use as lures in commercial traps designed to attract and capture arthropods of medi...

  9. Utilization of high resolution computed tomography to visualize the three dimensional structure and function of plant vasculature

    Technology Transfer Automated Retrieval System (TEKTRAN)

    High resolution x-ray computed tomography (HRCT) is a non-destructive diagnostic imaging technique with sub-micron resolution capability that is now being used to evaluate the structure and function of plant xylem network in three dimensions (3D). HRCT imaging is based on the same principles as medi...

  10. Injury among Stimulant-Treated Youth with ADHD

    ERIC Educational Resources Information Center

    Marcus, Steven C.; Wan, George J.; Zhang, Huabin F.; Olfson, Mark

    2008-01-01

    Objective: To assess risk factors for injury among children and adolescents treated with stimulants for ADHD. Method: An analysis was performed of pharmacy and service claims data from 2000-2003 California Medicaid (Medi-Cal) focusing on children and adolescents ages 6 to 17 years who initiated stimulant therapy for ADHD. Bivariate and…

  11. Youth Emancipating from Foster Care in California: Findings Using Linked Administrative Data.

    ERIC Educational Resources Information Center

    Needell, Barbara; Cuccaro-Alamin, Stephanie; Brookhart, Alan; Jackman, William; Shlonsky, Aron

    This study examined characteristics of youth emancipated from child welfare (ECW) and probation (EPR) supervised foster care; receipt of mental health services for emancipating youth; births to emancipating females; deaths of youth who emancipated from foster care; receipt of Medi-Cal due to AFDC/TANF, SSI/disability, or medical indigence after…

  12. Systematics of the genus Streptomyces: will a phylogeny based on 16S ribosomal RNA genes yield taxonomic resolution or confusion?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Species of the bacterial genus Streptomyces are a predominant component of the microbial population of soil throughout the world, where they are thought to contribute to the degradation of complex organic materials and facilitate nutrient recycling. Streptomyces species produce a wide array of medi...

  13. Ozone Induces a Proinflammatory Response in Primary Human Bronchial Epithelial Cells Through Mitogen-Activated Protein Kinase Activation Without Nuclear Factor-kB Activation

    EPA Science Inventory

    Ground-level ozone (O3) is a ubiquitous environmental air pollutant that is a potent inducer of airway inflammation and has been linked with both respiratory and cardiovascular morbidity and mortality. Some studies using transformed or immortalized cells have attributed O3-medi...

  14. 75 FR 31797 - Center for Scientific Review; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-04

    ... Review Special Emphasis Panel; Bioengineering Research Partnerships and Imaging Member Conflicts. Date... Special Emphasis Panel; Fellowships: Brain Disorders and Related Neuroscience. Date: June 24-25, 2010... . Name of Committee: Center for Scientific Review Special Emphasis Panel; BMIT/CMIP/MEDI...

  15. The effect of moderate alcohol consumption on biomarkers of inflammation and hemostatic factors in postmenopausal women

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Inflammation and hemostasis contribute to the etiology of cardiovascular disease. We previously demonstrated that moderate alcohol consumption (1-2 drinks/day) may decrease risk for cardiovascular disease due to an improved the lipid profile. In addition to these beneficial changes, the alcohol medi...

  16. [Development of telepathology systems between different types of terminals based on the standard for image collaboration command protocol].

    PubMed

    Tofukuji, Ikuo; Nakagawa, Shuji; Suzuki, Akitoshi; Saito, Makoto; Hara, Shigeji; Tsuchihashi, Yasunari; Shiraishi, Taizo; Ooshiro, Mariko; Sawai, Takashi; Kaihara, Shigekoto

    2003-01-01

    In Japan telepathology systems have been developed in medical or pathological environment such as a shortage and an uneven distribution of pathologists. More than 100 telepathology terminals are working mainly for intraoperative quick diagnosis. They cannot communicate with different types each other. In March 2000 the Medical Information System Development Center(MEDIS-DC) successfully demonstrated the interconnection between different types of telepathology terminals based on the Standard for Image Collaboration Command Protocol (SICCP). Nikon, NTTdata and Olympus had joined the development. In February 2002 MEDIS-DC examined these systems for pathological consultations in the fields of Okinawa-Kyoto, Kyoto-Mie and Mie-Okinawa. These successful examinations let us know that telepathology systems need new observation methodologies for telecytology and teleconsultation in addition to the flow for intraoperative quick diagnosis, new GUI guidelines for telepathology terminal design and, education and support for users of their smooth operation. Outcomes of MEDIS-DC activities encourageed us to challenge the next generation telepathology. We found some new trends in telepathology or pathology informatics such as virtual slide technologies and the internet applications in US and Europe. In order to keep Japanese priority, MEDIS-DC telepathology comittee has started investigations to construct a strategy for development of Japanese next generation telepathology.

  17. First report of bacterial blight of crucifers caused by Pseudomonas cannabina pv. alisalensis in Minnesota on arugula (Eruca vesicaria subsp. sativa)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In 2011, bacterial blight of arugula (Eruca vesicaria subsp. sativa; cv. Roquette) was observed in organically grown plants under overhead irrigation near Delano, MN. Approximately 80 to 100% of each planting was affected. Blue-green fluorescent pseudomonads were isolated consistently on King’s Medi...

  18. Multiple environmental contexts and preterm birth risks

    EPA Science Inventory

    Human health is affected by simultaneous exposure to numerous stressors and amenities, but research often focuses on single exposure models. To address this, a United States county-level Multiple Environmental Domain Index (MEDI) was constructed with data representing five envir...

  19. RF-Medisys: a radio frequency identification-based electronic medical record system for improving medical information accessibility and services at point of care.

    PubMed

    Ting, Jacky S L; Tsang, Albert H C; Ip, Andrew W H; Ho, George T S

    2011-01-01

    This paper presents an innovative electronic medical records (EMR) system, RF-MediSys, which can perform medical information sharing and retrieval effectively and which is accessible via a 'smart' medical card. With such a system, medical diagnoses and treatment decisions can be significantly improved when compared with the conventional practice of using paper medical records systems. Furthermore, the entire healthcare delivery process, from registration to the dispensing or administration of medicines, can be visualised holistically to facilitate performance review. To examine the feasibility of implementing RF-MediSys and to determine its usefulness to users of the system, a survey was conducted within a multi-disciplinary medical service organisation that operates a network of medical clinics and paramedical service centres throughout Hong Kong Island, the Kowloon Peninsula and the New Territories. Questionnaires were distributed to 300 system users, including nurses, physicians and patients, to collect feedback on the operation and performance of RF-MediSys in comparison with conventional paper-based medical record systems. The response rate to the survey was 67%. Results showed a medium to high level of user satisfaction with the radiofrequency identification (RFID)-based EMR system. In particular, respondents provided high ratings on both 'user-friendliness' and 'system performance'. Findings of the survey highlight the potential of RF-MediSys as a tool to enhance quality of medical services and patient safety. PMID:21430306

  20. Was it really only a scant few years ago that Silicon Valley was booming, dot-coms were the next big things and Nortel shares were trading at more than $100?

    PubMed

    Menzies, David

    2003-01-01

    Alas, there's nothing like a pinch of reality to pop an overinflated hype bubble. Yet not all software vendors that have fallen on hard times in recent years have succumbed to bankruptcy. In fact, Canadian software firms--MediSolution and Ormed--are proof that turnarounds are possible.

  1. Nutraceutical properties of Mediterranean diet and cognitive decline: possible underlying mechanisms.

    PubMed

    Frisardi, Vincenza; Panza, Francesco; Seripa, Davide; Imbimbo, Bruno P; Vendemiale, Gianluigi; Pilotto, Alberto; Solfrizzi, Vincenzo

    2010-01-01

    Recent prospective studies provided evidence that higher adherence to a Mediterranean-type diet could be associated with slower cognitive decline, reduced risk of progression from mild cognitive impairment to Alzheimer's disease (AD), reduced risk of AD, and decreased mortality in AD patients. Furthermore, the Mediterranean diet (MeDi) combines several foods, micro- and macronutrients already separately proposed as potential protective factors against dementia and predementia syndromes. At present, epidemiological evidence suggests a possible association between fish consumption, monounsaturated fatty acids, and polyunsaturated fatty acids (PUFA) (particularly, n-3 PUFA), and reduced risk of cognitive decline and dementia. Light to moderate alcohol use may be associated with a reduced risk of incident dementia and AD, while for vascular dementia, cognitive decline, and predementia syndromes, the current evidence is only suggestive of a protective effect. Finally, the limited epidemiological evidence available on fruit and vegetable consumption and cognition generally support a protective role of these macronutrients against cognitive decline, dementia, and AD. We reviewed evidence on the possible mechanisms underlying the suggested protective role of MeDi against age-related changes in cognitive function, predementia syndromes, and dementia, examining the possible role of macronutrients and food nutrients of the MeDi and their nutraceutical properties in modulating the risk of cognitive decline. Although vascular variables are likely to be in the causal pathway between MeDi and dementia syndromes and should be considered as possible mediators, other nonvascular biological mechanisms (i.e., metabolic, oxidative, and inflammatory) may be invoked to explain the complex epidemiological association between MeDi and cognitive decline.

  2. Using an Architecture-Centric Model-Driven Approach for Developing Service-Oriented Solutions: A Case Study

    NASA Astrophysics Data System (ADS)

    López-Sanz, Marcos; Acuña, César J.; de Castro, Valeria; Marcos, Esperanza; Cuesta, Carlos E.

    As services continue achieving more importance in the development of software solutions for the Internet, software developers and researchers turn their attention to strategies based on the SOC (Service-Oriented Computing) paradigm. One of these development approaches is SOD-M specifically designed for building service-oriented solutions. In this article we present the results of redesigning a real-world Web-based Information System, called MEDiWIS, using SOD-M. The main goal of the redesigned MEDiWIS system is to support the storage and management of digital medical images and related information by presenting its functionalities as software services. We analyze in detail the main challenges we have found using an ACMDA (Architecture-Centric Model-Driven Architecture) approach to achieve this goal.

  3. Components of a Mediterranean diet and their impact on cognitive functions in aging

    PubMed Central

    Huhn, Sebastian; Kharabian Masouleh, Shahrzad; Stumvoll, Michael; Villringer, Arno; Witte, A. Veronica

    2015-01-01

    Background: Adhering to the Mediterranean diet (MeDi) is known to be beneficial with regard to many age-associated diseases including cardiovascular diseases and type 2 diabetes. Recent studies also suggest an impact on cognition and brain structure, and increasing effort is made to track effects down to single nutrients. Aims: We aimed to review whether two MeDi components, i.e., long-chain omega-3 fatty acids (LC-n3-FA) derived from sea-fish, and plant polyphenols including resveratrol (RSV), exert positive effects on brain health in aging. Content: We summarized health benefits associated with the MeDi and evaluated available studies on the effect of (1) fish-consumption and LC-n3-FA supplementation as well as (2) diet-derived or supplementary polyphenols such as RSV, on cognitive performance and brain structure in animal models and human studies. Also, we discussed possible underlying mechanisms. Conclusion: A majority of available studies suggest that consumption of LC-n3-FA with fish or fishoil-supplements exerts positive effects on brain health and cognition in older humans. However, more large-scale randomized controlled trials are needed to draw definite recommendations. Considering polyphenols and RSV, only few controlled studies are available to date, yet the evidence based on animal research and first interventional human trials is promising and warrants further investigation. In addition, the concept of food synergy within the MeDi encourages future trials that evaluate the impact of comprehensive lifestyle patterns to help maintaining cognitive functions into old age. PMID:26217224

  4. Interpreting hypernymic propositions in an online medical encyclopedia.

    PubMed

    Fiszman, Marcelo; Rindflesch, Thomas C; Kilicoglu, Halil

    2003-01-01

    Interpretation of semantic propositions from bio-medical texts documents would provide valuable support to natural language processing (NLP) applications. We are developing a methodology to interpret a kind of semantic proposition, the hypernymic proposition, in MEDLINE abstracts. In this paper, we expanded the system to identify these structures in a different discourse domain: the Medical Encyclopedia from the National Library of Medi-cine's MEDLINEplus Website.

  5. A great honor and a huge challenge for China: You-you TU getting the Nobel Prize in Physiology or Medicine.

    PubMed

    Yuan, Da; Yang, Xue; Guo, Jun-Chao

    2016-05-01

    Public excitement over the award of the 2015 Nobel Prize in Physiology or Medicine to the Chinese medical scientist You-you TU for the discovery of a herbal anti-malarial, may mislead the Chinese people into believing that traditional Chinese herbal medi-cine can be used to cure all disease without any ad-verse effects. The aim of this paper is to explain the advantages and disadvantages of herbal traditional Chinese medicine (TCM) objectively. PMID:27143269

  6. Enhanced Photoluminescence Properties of Carbon Dots by Doping with Europium.

    PubMed

    Chen, Yuan; Xu, Jiafu; Liu, Bitao; Li, Jiyun; Fang, Xiaomei; Xiong, Liqiong; Peng, Lingling; Han, Tao; Tu, Mingjing

    2016-04-01

    Europium (Eu) doped carbon dots (CDs) were synthesized via a rapid and simple microwave medi- ated method using polyethylene glycol (PEG) as a precursor, and characterized in detail. The results were that these as-prepared CDs showed a uniform and small particle size, and exhibit good pho- tostability and high photoluminescence quantum yields. Additionally, it also found that the doped Eu would change the fluorescence properties, which indicates potential applications in the field of biolabeling. PMID:27451699

  7. Targeting Alpha Toxin and ClfA with a Multimechanistic Monoclonal-Antibody-Based Approach for Prophylaxis of Serious Staphylococcus aureus Disease

    PubMed Central

    Tkaczyk, C.; Hamilton, M. M.; Sadowska, A.; Shi, Y.; Chang, C.S.; Chowdhury, P.; Buonapane, R.; Xiao, X.; Warrener, P.; Mediavilla, J.; Kreiswirth, B.; Suzich, J.; Stover, C. K.

    2016-01-01

    ABSTRACT Staphylococcus aureus produces numerous virulence factors, each contributing different mechanisms to bacterial pathogenesis in a spectrum of diseases. Alpha toxin (AT), a cytolytic pore-forming toxin, plays a key role in skin and soft tissue infections and pneumonia, and a human anti-AT monoclonal antibody (MAb), MEDI4893*, has been shown to reduce disease severity in dermonecrosis and pneumonia infection models. However, interstrain diversity and the complex pathogenesis of S. aureus bloodstream infections suggests that MEDI4893* alone may not provide adequate protection against S. aureus sepsis. Clumping factor A (ClfA), a fibrinogen binding protein, is an important virulence factor facilitating S. aureus bloodstream infections. Herein, we report on the identification of a high-affinity anti-ClfA MAb, 11H10, that inhibits ClfA binding to fibrinogen, prevents bacterial agglutination in human plasma, and promotes opsonophagocytic bacterial killing (OPK). 11H10 prophylaxis reduced disease severity in a mouse bacteremia model and was dependent on Fc effector function and OPK. Additionally, prophylaxis with 11H10 in combination with MEDI4893* provided enhanced strain coverage in this model and increased survival compared to that obtained with the individual MAbs. The MAb combination also reduced disease severity in murine dermonecrosis and pneumonia models, with activity similar to that of MEDI4893* alone. These results indicate that an MAb combination targeting multiple virulence factors provides benefit over a single MAb neutralizing one virulence mechanism by providing improved efficacy, broader strain coverage, and protection against multiple infection pathologies. PMID:27353753

  8. A great honor and a huge challenge for China: You-you TU getting the Nobel Prize in Physiology or Medicine.

    PubMed

    Yuan, Da; Yang, Xue; Guo, Jun-Chao

    2016-05-01

    Public excitement over the award of the 2015 Nobel Prize in Physiology or Medicine to the Chinese medical scientist You-you TU for the discovery of a herbal anti-malarial, may mislead the Chinese people into believing that traditional Chinese herbal medi-cine can be used to cure all disease without any ad-verse effects. The aim of this paper is to explain the advantages and disadvantages of herbal traditional Chinese medicine (TCM) objectively.

  9. Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients

    PubMed Central

    McClellan, Sean R.

    2013-01-01

    Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P < .05). However, the increase was insufficient to significantly reduce language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663

  10. Anti-alpha-toxin monoclonal antibody and antibiotic combination therapy improves disease outcome and accelerates healing in a Staphylococcus aureus dermonecrosis model.

    PubMed

    Hilliard, Jamese J; Datta, Vivekananda; Tkaczyk, Christine; Hamilton, Melissa; Sadowska, Agnieszka; Jones-Nelson, Omari; O'Day, Terrence; Weiss, William J; Szarka, Szabolcs; Nguyen, Vien; Prokai, Laszlo; Suzich, JoAnn; Stover, C Kendall; Sellman, Bret R

    2015-01-01

    Alpha-toxin (AT) is a major virulence determinant in Staphylococcus aureus skin and soft tissue infection models. We previously demonstrated that prophylactic administration of 2A3, an AT-neutralizing monoclonal antibody (MAb), prevents S. aureus disease in a mouse dermonecrosis model by neutralizing AT-mediated tissue necrosis and immune evasion. In the present study, MEDI4893*, an affinity-optimized version of 2A3, was characterized for therapeutic activity in the dermonecrosis model as a single agent and in combination with two frontline antibiotics, vancomycin and linezolid. MEDI4893* postinfection therapy was found to exhibit a therapeutic treatment window similar to that for linezolid but longer than that for vancomycin. Additionally, when combined with either vancomycin or linezolid, MEDI4893* resulted in reduced tissue damage, increased neutrophil and macrophage infiltration and abscess formation, and accelerated healing relative to those with the antibiotic monotherapies. These data suggest that AT neutralization with a potent MAb holds promise for both prophylaxis and adjunctive therapy with antibiotics and may be a valuable addition to currently available options for the treatment of S. aureus skin and soft tissue infections.

  11. Crystallization and preliminary X-ray diffraction analysis of the complex between a human anti-alpha toxin antibody fragment and alpha toxin

    PubMed Central

    Oganesyan, Vaheh; Barnes, Arnita; Tkaczyk, Christine; Ferguson, Andrew; Wu, Herren; Dall’Acqua, William F.

    2013-01-01

    Staphylococcus aureus alpha toxin (AT) has been crystallized in complex with the Fab fragment of a human antibody (MEDI4893). This constitutes the first reported crystals of AT bound to an antibody. The monoclinic crystals belonged to space group P21, with unit-cell parameters a = 85.52, b = 148.50, c = 93.82 Å, β = 99.82°. The diffraction of the crystals extended to 2.56 Å resolution. The asymmetric unit contained two MEDI4893 Fab–AT complexes. This corresponds to a crystal volume per protein weight (V M) of 2.3 Å3 Da−1 and a solvent content of 47%. The three-dimensional structure of this complex will contribute to an understanding of the molecular basis of the interaction of MEDI4893 with AT. It will also shed light on the mechanism of action of this antibody, the current evaluation of which in the field of S. aureus-mediated diseases makes it a particularly interesting case study. Finally, this study will provide the three-dimensional structure of AT in a monomeric state for the first time. PMID:23519809

  12. Anti-alpha-toxin monoclonal antibody and antibiotic combination therapy improves disease outcome and accelerates healing in a Staphylococcus aureus dermonecrosis model.

    PubMed

    Hilliard, Jamese J; Datta, Vivekananda; Tkaczyk, Christine; Hamilton, Melissa; Sadowska, Agnieszka; Jones-Nelson, Omari; O'Day, Terrence; Weiss, William J; Szarka, Szabolcs; Nguyen, Vien; Prokai, Laszlo; Suzich, JoAnn; Stover, C Kendall; Sellman, Bret R

    2015-01-01

    Alpha-toxin (AT) is a major virulence determinant in Staphylococcus aureus skin and soft tissue infection models. We previously demonstrated that prophylactic administration of 2A3, an AT-neutralizing monoclonal antibody (MAb), prevents S. aureus disease in a mouse dermonecrosis model by neutralizing AT-mediated tissue necrosis and immune evasion. In the present study, MEDI4893*, an affinity-optimized version of 2A3, was characterized for therapeutic activity in the dermonecrosis model as a single agent and in combination with two frontline antibiotics, vancomycin and linezolid. MEDI4893* postinfection therapy was found to exhibit a therapeutic treatment window similar to that for linezolid but longer than that for vancomycin. Additionally, when combined with either vancomycin or linezolid, MEDI4893* resulted in reduced tissue damage, increased neutrophil and macrophage infiltration and abscess formation, and accelerated healing relative to those with the antibiotic monotherapies. These data suggest that AT neutralization with a potent MAb holds promise for both prophylaxis and adjunctive therapy with antibiotics and may be a valuable addition to currently available options for the treatment of S. aureus skin and soft tissue infections. PMID:25348518

  13. Anti-Alpha-Toxin Monoclonal Antibody and Antibiotic Combination Therapy Improves Disease Outcome and Accelerates Healing in a Staphylococcus aureus Dermonecrosis Model

    PubMed Central

    Hilliard, Jamese J.; Datta, Vivekananda; Tkaczyk, Christine; Hamilton, Melissa; Sadowska, Agnieszka; Jones-Nelson, Omari; O'Day, Terrence; Weiss, William J.; Szarka, Szabolcs; Nguyen, Vien; Prokai, Laszlo; Suzich, JoAnn; Stover, C. Kendall

    2014-01-01

    Alpha-toxin (AT) is a major virulence determinant in Staphylococcus aureus skin and soft tissue infection models. We previously demonstrated that prophylactic administration of 2A3, an AT-neutralizing monoclonal antibody (MAb), prevents S. aureus disease in a mouse dermonecrosis model by neutralizing AT-mediated tissue necrosis and immune evasion. In the present study, MEDI4893*, an affinity-optimized version of 2A3, was characterized for therapeutic activity in the dermonecrosis model as a single agent and in combination with two frontline antibiotics, vancomycin and linezolid. MEDI4893* postinfection therapy was found to exhibit a therapeutic treatment window similar to that for linezolid but longer than that for vancomycin. Additionally, when combined with either vancomycin or linezolid, MEDI4893* resulted in reduced tissue damage, increased neutrophil and macrophage infiltration and abscess formation, and accelerated healing relative to those with the antibiotic monotherapies. These data suggest that AT neutralization with a potent MAb holds promise for both prophylaxis and adjunctive therapy with antibiotics and may be a valuable addition to currently available options for the treatment of S. aureus skin and soft tissue infections. PMID:25348518

  14. LONG-TERM STABILITY OF THE LOCAL GROUND CONTROL NETWORK AT THE CO-LOCATION SITE OF MEDICINA

    NASA Astrophysics Data System (ADS)

    Abbondanza, C.; Sarti, P.; Legrand, J.

    2009-12-01

    ITRF combinations rely on the availability of accurate tie vectors linking reference points of space geodetic techniques. Co-located instruments are assumed to move consistently and no local relative motion is taken into account. Instabilities may degrade the quality of the co-location itself and perturb the result of ITRF combinations. This work aims to determine the stability of the local ground control network at Medicina (Italy) with independent surveying methods. The observatory hosts a co-location between a VLBI telescope and two GPS antennas, MEDI and MSEL. It is located in the Po Plain where thick layers of clays are the prevalent soil characteristics. Hence, provision of long term stability of geodetic monuments is a challenge and monitoring their stability is an issue. MEDI and the VLBI station regularly contribute to the determination of ITRF, while MSEL is part of the EUREF network. A set of five tie vectors observations linking the VLBI and MEDI reference points was acquired between 2001 and 2007. It is our main tool for performing local deformation analysis. Additionally, the GPS time series of MEDI and MSEL were used to cross check and confirm the local instability detected by terrestrial methods. To achieve a rigorous and reliable investigation of the local stability, multi-epoch terrestrial observations were homogeneously processed according to common parameterizations in a consistent reference frame. Similarly, continuous GPS observations from MEDI and MSEL were analysed according to the new EPN reprocessing strategy in order to monitor the short baseline between MEDI and MSEL; to spotlight any change in its length. Both approaches confirm differential motions at the site which can be related to monument instabilities originated by the particularly unfavourable local geological setting and the inapt design of the monuments foundation. The monuments move non homogeneously at rates reaching up to 1.6 mm/year, this value being comparable to intra

  15. Mediterranean diet and other lifestyle factors in relation to 20-year all-cause mortality: a cohort study in an Italian population.

    PubMed

    Prinelli, Federica; Yannakoulia, Mary; Anastasiou, Costas A; Adorni, Fulvio; Di Santo, Simona G; Musicco, Massimo; Scarmeas, Nikolaos; Correa Leite, Maria L

    2015-03-28

    The aim of the present analysis was to evaluate the association of the Mediterranean diet (MeDi), smoking habits and physical activity with all-cause mortality in an Italian population during a 20-year follow-up study. A total of 1693 subjects aged 40-74 who enrolled in the study in 1991-5 were asked about dietary and other lifestyle information at baseline. Adherence to the MeDi was evaluated by the Mediterranean dietary score (MedDietScore). A healthy lifestyle score was computed by assigning 1 point each for a medium or high adherence to the MedDietScore, non-smoking and physical activity. Cox models were used to assess the associations between lifestyle factors and healthy lifestyle scores and all-cause mortality, adjusting for potential confounders. The final sample included 974 subjects with complete data and without chronic disease at baseline. During a median of 17·4 years of follow-up, 193 people died. Subjects with high adherence to the MedDietScore (hazard ratio (HR) 0·62, 95 % CI 0·43, 0·89)), non-smokers (HR 0·71, 95 % CI 0·51, 0·98) and physically active subjects (HR 0·55, 95 % CI 0·36, 0·82) were at low risk of death. Each point increase in the MedDietScore was associated with a significant 5 % reduction of death risk. Subjects with 1, 2 or 3 healthy lifestyle behaviours had a significantly 39, 56, and 73 % reduced risk of death, respectively. A high adherence to MeDi, non-smoking and physical activity were strongly associated with a reduced risk of all-cause mortality in healthy subjects after long-term follow-up. This reduction was even stronger when the healthy lifestyle behaviours were combined. PMID:25746109

  16. Effect of insurance coverage on the relationship between asthma hospitalizations and exposure to air pollution.

    PubMed Central

    Nauenberg, E; Basu, K

    1999-01-01

    OBJECTIVE: Based on the assumption that people without health insurance have limited access to the primary care services needed to prevent unnecessary hospitalizations for asthma, the authors hypothesized that insurance is a factor in the strength of the association between hospital admissions for asthma and exposure to air pollution. They tested this hypothesis with 1991-1994 data from central Los Angeles. METHODS: The authors analyzed the effect of insurance status on the association between asthma-related hospital admissions and exposure to atmospheric particulates (PM10) and ozone (O3) using hospital discharge and air quality data for 1991-1994 for central Los Angeles. They used regression techniques with weighted moving averages (simulating distributed lag structures) to measure the effects of exposure on overall hospital admissions, admissions of uninsured patients, admissions for which MediCal (California Medicaid) was the primary payer, and admissions for which the primary payer was another government or private health insurance program. RESULTS: No associations were found between asthma admissions and O3 exposure. An estimated increase from 1991 to 1994 of 50 micrograms per cubic meter in PM10 concentrations averaged over eight days was associated with an increase of 21.0% in the number of asthma admissions. An even stronger increase--27.4%--was noted among MediCal asthma admissions. CONCLUSIONS: The authors conclude that low family income, as indicated by MediCal coverage, is a better predictor of asthma exacerbations associated with air pollution than lack of insurance and, by implication, a better predictor of insufficient access to primary care. PMID:10199716

  17. Mediterranean diet and other lifestyle factors in relation to 20-year all-cause mortality: a cohort study in an Italian population.

    PubMed

    Prinelli, Federica; Yannakoulia, Mary; Anastasiou, Costas A; Adorni, Fulvio; Di Santo, Simona G; Musicco, Massimo; Scarmeas, Nikolaos; Correa Leite, Maria L

    2015-03-28

    The aim of the present analysis was to evaluate the association of the Mediterranean diet (MeDi), smoking habits and physical activity with all-cause mortality in an Italian population during a 20-year follow-up study. A total of 1693 subjects aged 40-74 who enrolled in the study in 1991-5 were asked about dietary and other lifestyle information at baseline. Adherence to the MeDi was evaluated by the Mediterranean dietary score (MedDietScore). A healthy lifestyle score was computed by assigning 1 point each for a medium or high adherence to the MedDietScore, non-smoking and physical activity. Cox models were used to assess the associations between lifestyle factors and healthy lifestyle scores and all-cause mortality, adjusting for potential confounders. The final sample included 974 subjects with complete data and without chronic disease at baseline. During a median of 17·4 years of follow-up, 193 people died. Subjects with high adherence to the MedDietScore (hazard ratio (HR) 0·62, 95 % CI 0·43, 0·89)), non-smokers (HR 0·71, 95 % CI 0·51, 0·98) and physically active subjects (HR 0·55, 95 % CI 0·36, 0·82) were at low risk of death. Each point increase in the MedDietScore was associated with a significant 5 % reduction of death risk. Subjects with 1, 2 or 3 healthy lifestyle behaviours had a significantly 39, 56, and 73 % reduced risk of death, respectively. A high adherence to MeDi, non-smoking and physical activity were strongly associated with a reduced risk of all-cause mortality in healthy subjects after long-term follow-up. This reduction was even stronger when the healthy lifestyle behaviours were combined.

  18. Medicaid and the Mainstream: Reassessment in the Context of the Taxpayer Revolt

    PubMed Central

    Myers, Beverlee A.; Leighton, Rigby

    1980-01-01

    California's Medicaid program—Medi-Cal—attempted to implement the ideal of mainstream medical care for the poor by giving program beneficiaries a “credit card” for use in the private health care marketplace. This exposed the program to the perverse economic incentives of the fee-for-service, costplus health care system, and contributed to a high rate of increase in program costs. Attempts to control costs have been equally perverse, resulting in low payment rates, the second-guessing of physician professional judgments, the probing of medical and fiscal records, and the use of computerized surveillance systems. Attempts to shift to the use of more efficient delivery systems have had small success. Attempts to attain cost containment through restructuring the Medi-Cal program have been rejected in the name of the mainstream ideal. Costs have continued to escalate, with annual increases as high as 20 percent in some years. Medi-Cal now costs $4 billion per year, the largest single program in California state government. The taxpayer revolt in California is creating a fiscal crisis that will force rethinking of the premises of publicly funded health care for the poor, and a restructuring of strategies for reaching that objective. In the short run, it appears that the issue may not be whether the indigent will have access to mainstream medical care, but whether they will have access to any medical care. In the longer run, the crisis should represent an opportunity for building a system of health care that can serve the financially disadvantaged at a cost tolerable to our society. PMID:6996334

  19. Creating virtual humans for simulation-based training and planning

    SciTech Connect

    Stansfield, S.; Sobel, A.

    1998-05-12

    Sandia National Laboratories has developed a distributed, high fidelity simulation system for training and planning small team Operations. The system provides an immersive environment populated by virtual objects and humans capable of displaying complex behaviors. The work has focused on developing the behaviors required to carry out complex tasks and decision making under stress. Central to this work are techniques for creating behaviors for virtual humans and for dynamically assigning behaviors to CGF to allow scenarios without fixed outcomes. Two prototype systems have been developed that illustrate these capabilities: MediSim, a trainer for battlefield medics and VRaptor, a system for planning, rehearsing and training assault operations.

  20. Patterns of Antibacterial Use and Impact of Age, Race-Ethnicity, and Geographic Region on Antibacterial Use in an Outpatient Medicaid Cohort

    PubMed Central

    Gahbauer, Alice M.; Gonzales, Marco L.; Guglielmo, B. Joseph

    2014-01-01

    STUDY OBJECTIVES To describe patterns of outpatient antibacterial use among California Medicaid (Medi-Cal) fee-for-service system beneficiaries, and to investigate the influence of demographic factors—age, race-ethnicity, state county, and population density—on those patterns. DESIGN Retrospective analysis of administrative claims data. DATA SOURCE Medi-Cal fee-for-service system claims database. PATIENTS All outpatient Medi-Cal fee-for-service system beneficiaries enrolled between 2006 and 2011 who had at least one systemic antibacterial claim. MEASUREMENTS AND MAIN RESULTS Rates of antibacterial prescribing and the proportion of broad-spectrum antibacterial use were measured over the study period and among age, racial-ethnic and geographic (county) groups. Of the 10,018,066 systemic antibacterial claims selected for analysis, antibacterial prescribing rates decreased from 542 claims/1000 beneficiaries in 2006 to 461 claims/1000 beneficiaries in 2011 (r = –0.971, p = 0.0012; τ-b = –1.00, p = 0.009). Among age groups, children had the highest rate of use (605 claims/1000 beneficiaries, χ2 (2) = 320,000, p < 0.001); among racial-ethnic groups, Alaskan Natives and Native Americans had the highest rate of use (1086/1000 beneficiaries, χ2 (5) = 197,000, p < 0.001). Broad-spectrum antibacterial prescribing increased from 28.1% (95% confidence interval [CI] 28.1–28.2%) to 32.7% (95% CI 32.6–32.8%) over the study period. Senior age groups and Caucasians received the highest proportions of broad-spectrum agents (53.4% [95% CI 52.5–54.3%] and 36.6% [95% CI 36.6–36.7%], respectively). Population density was inversely related to both overall antibacterial use (ρ = –0.432, p = 0.0018) and broad-spectrum antibacterial prescribing (ρ = –0.359, p < 0.001). The rate of prescribing decreased over the study period for all antibacterial classes with the exception of macrolides and sulfonamides. Amoxicillin was the most frequently prescribed agent. CONCLUSION

  1. Aeromedical Disposition and Waiver Consideration for ISS Crewmembers

    NASA Technical Reports Server (NTRS)

    Taddeo, Terrance

    2012-01-01

    Aeromedical certification of astronauts and cosmonauts traveling to the International Space Station is a multi?-tiered process that involv es standards agreed to by the partner agencies, and participation by the individual agency aeromedical boards and a multilateral space medi cine board. Medical standards are updated continually by a multilater al working group. The boards operate by consensus and strive to achie ve effective decision making through experience, medical judgment, medical evidence and risk modeling. The aim of the certification process is to minimize the risk to the ISS program of loss of mission object ives due to human health issues.

  2. [Evaluation of efficacy of selected antiseptics for hands disinfection before surgical procedures].

    PubMed

    Leksowski, K; Jasiński, A; Marszałek, A

    2001-08-01

    The most important in surgical hands washing and disinfections is long-term and effective reduction of bacteria number. The aim of this study was to compare the efficiency of some antiseptic fluids used for surgical hands disinfection's (AHD 2000, Biotensid, Manopronto and Medi-Scrub PVP Iodine). 62 doctors and surgical nurses were examined. The material for the bacteriological examination was collected before and after hands disinfection's. The bacterial flora reduction have been presented as a percent and a logarithmic reduction ratio. All estimated antiseptic fluids were very potent and provided prolonged efficiency when the operation team complied with orders of hands washing.

  3. Developing e-Business Capabilities to Bridge the Knowledge Divide in Mediterranean Countries

    NASA Astrophysics Data System (ADS)

    Secundo, Giustina; Elia, Gianluca; Margherita, Alessandro; Passiante, Giuseppina

    This paper presents the results achieved in terms of e-business capabilities developed in an International Master framed within an Euro-Medi-terranean cooperation. In particular, an e-Business Design Laboratory is here described which has been set up for designing and implementing innovative solutions to bring digital and organizational innovation in traditional and new industries. The most significant highlights of the last two editions of the Master are also reported in terms of the human, social and structural capital being generated.

  4. Simulated casualties and medics for emergency training.

    PubMed

    Chi, D M; Kokkevis, E; Ogunyemi, O; Bindiganavale, R; Hollick, M J; Clarke, J R; Webber, B L; Badler, N I

    1997-01-01

    The MediSim system extends virtual environment technology to allow medical personnel to interact with and train on simulated casualties. The casualty model employs a three-dimensional animated human body that displays appropriate physical and behavioral responses to injury and/or treatment. Medical corpsmen behaviors were developed to allow the actions of simulated medical personnel to conform to both military practice and medical protocols during patient assessment and stabilization. A trainee may initiate medic actions through a mouse and menu interface; a VR interface has also been created by Stansfield's research group at Sandia National Labs. PMID:10168943

  5. An assessment of PKI and networked electronic patient record system: lessons learned from real patient data exchange at the platform of OCHIS (Osaka Community Healthcare Information System).

    PubMed

    Takeda, Hiroshi; Matsumura, Yasushi; Kuwata, Shigeki; Nakano, Hirohiko; Shanmai, Ji; Qiyan, Zhang; Yufen, Chen; Kusuoka, Hideo; Matsuoka, Masaki

    2004-03-31

    To enhance medical cooperation between the hospitals and clinics around Osaka local area, the healthcare network system, named Osaka Community Healthcare Information System (OCHIS), was established with support of a supplementary budget from the Japanese government in fiscal year 2002. Although the system has been based on healthcare public key infrastructure (PKI), there remain security issues to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority in contract with the Japanese Medical Information Systems Organization (MEDIS) in 2003. This paper describes the experimental design and the results of the study concerning message security.

  6. [Measuring Instruments of the Quality of Life Pediatric Palliative Care].

    PubMed

    Araújo, Joana; Dourado, Marília; Ferreira, Pedro Lopes

    2015-01-01

    Introdução: Os cuidados paliativos estão intimamente ligados ao conceito de qualidade de vida. Neste trabalho, focaremos a nossa atenção na necessidade de avaliar a qualidade de vida em cuidados paliativos pediátricos oncológicos.Objetivo: Descrever/comparar os instrumentos de medição da qualidade de vida em cuidados paliativos pediátricos oncológicos. Material e Métodos: Pesquisa da bibliográfica dos vários instrumentos de medição da qualidade de vida das crianças em cuidados paliativos, em inglês e português, entre 2000 e 2013, nas bases de dados reconhecidas para este efeito. Resultados: Encontraram-se quinze instrumentos de medição: 10 genéricos e cinco específicos. Identificou-se, para cada instrumento de medição, país de origem, faixa etária para que se encontra direcionado, modalidade de preenchimento, número de dimensões avaliadas, descrição das dimensões, número de perguntas, propriedades psicométricas e validação para português. Discussão: Verifica-se que tem havido uma crescente preocupação em medir a qualidade de vida em idade pediátrica e que a maioria dos instrumentos de medição foi desenhada, nos Estados Unidos, após 1994, coincidindo temporalmente com a definição de qualidade de vida da Organização Mundial de Saúde. Relativamente à faixa etária, a maioria dos instrumentos foi desenvolvida para crianças com idade igual ou superior a oito anos não existindo nenhum para ser respondido apenas pela criança. Podemos verificar que a maioria dos instrumentos de medição, sobretudo os mais atuais, procuram envolver a criança na avaliação da sua própria qualidadede vida relacionada com a saúde através do autopreenchimento (n = 10). Porém, há ainda uma dependência substancial dos pais para a medição da qualidade de vida relacionada com a saúde dos seus filhos, apesar dos estudos que demonstram diferenças na perceção de qualidade de vida relacionada com a saúde entre a criança e os pais

  7. An integrated readout system for drift chambers: the application of monolithic CMOS pixel sensors as segmented direct anode

    NASA Astrophysics Data System (ADS)

    Campbell, M.; Heijne, E. H. M.; Llopart, X.; Chefdeville, M.; Colas, P.; Giomataris, Y.; Colijn, A. P.; Fornaini, A.; van der Graaf, H.; Kluit, P.; Timmermans, J.; Visschers, J. L.; Schmitz, J.

    2006-01-01

    A small TPC has been read out by means of a MediPix2 readout chip as direct anode. A Micromegas foil was placed 50 μm above the chip, and electron multiplication occurred in the gap. With a He/Isobutane 80/20 mixture, gas multiplication factors up to tens of thousands were achieved, resulting in an efficiency for detecting single electrons of better than 90%. We recorded many frames containing 2D images with tracks from cosmic muons. Along these tracks, electron clusters were observed, as well as δ-rays.

  8. A panchromatic view of the evolution of Supermassive Black Holes

    NASA Astrophysics Data System (ADS)

    Lusso, E.; Brusa, M.; Comastri, A.; Vignali, C.; Gilli, R.

    2008-10-01

    Verranno presentati i risultati preliminari di uno studio sistematico delle distribuzioni di energia spettrale (SED) di un campione statisticamente significativo di alcune centinaia di AGN (sia di tipo 1 che di tipo 2) selezionati dalla survey XMM-COSMOS. La vasta mole di dati disponibili sull'intero spettro elettromagnetico permette di calcolare le SED medie per diversi intervalli di redshift e luminosita'. Una stima affidabile della SED e' di fondamentale importanza per il calcolo della luminosita' bolometrica e quindi per lo studio della fisica dei processi di accrescimento su SMBH, per la loro evoluzione con il tempo cosmico.

  9. Inhibition of CD73 AMP hydrolysis by a therapeutic antibody with a dual, non-competitive mechanism of action.

    PubMed

    Geoghegan, James C; Diedrich, Gundo; Lu, Xiaojun; Rosenthal, Kim; Sachsenmeier, Kris F; Wu, Herren; Dall'Acqua, William F; Damschroder, Melissa M

    2016-01-01

    CD73 (ecto-5'-nucleotidase) has recently been established as a promising immuno-oncology target. Given its role in activating purinergic signaling pathways to elicit immune suppression, antagonizing CD73 (i.e., releasing the brake) offers a complimentary pathway to inducing anti-tumor immune responses. Here, we describe the mechanistic activity of a new clinical therapeutic, MEDI9447, a human monoclonal antibody that non-competitively inhibits CD73 activity. Epitope mapping, structural, and mechanistic studies revealed that MEDI9447 antagonizes CD73 through dual mechanisms of inter-CD73 dimer crosslinking and/or steric blocking that prevent CD73 from adopting a catalytically active conformation. To our knowledge, this is the first report of an antibody that inhibits an enzyme's function through 2 distinct modes of action. These results provide a finely mapped epitope that can be targeted for selective, potent, and non-competitive inhibition of CD73, as well as establish a strategy for inhibiting enzymes that function in both membrane-bound and soluble states.

  10. Dietary Factors and Cognitive Decline

    PubMed Central

    Smith, P.J.; Blumenthal, J.A.

    2015-01-01

    Cognitive decline is an increasingly important public health problem, with more than 100 million adults worldwide projected to develop dementia by 2050. Accordingly, there has been an increased interest in preventive strategies that diminish this risk. It has been recognized that lifestyle factors including dietary patterns, may be important in the prevention of cognitive decline and dementia in later life. Several dietary components have been examined, including antioxidants, fatty acids, and B vitamins. In addition, whole dietary eating plans, including the Mediterranean diet (MeDi), and the Dietary Approaches to Stop Hypertension (DASH) diet, with and without weight loss, have become areas of increasing interest. Although prospective epidemiological studies have observed that antioxidants, fatty acids, and B vitamins are associated with better cognitive functioning, randomized clinical trials have generally failed to confirm the value of any specific dietary component in improving neurocognition. Several randomized trials have examined the impact of changing ‘whole’ diets on cognitive outcomes. The MeDi and DASH diets offer promising preliminary results, but data are limited and more research in this area is needed. PMID:26900574

  11. Health and Oral Health Care Needs and Health Care-Seeking Behavior Among Homeless Injection Drug Users in San Francisco

    PubMed Central

    Wenger, Lynn; Lorvick, Jennifer; Shiboski, Caroline; Kral, Alex H.

    2010-01-01

    Few existing studies have examined health and oral health needs and treatment-seeking behavior among the homeless and injection drug users (IDUs). This paper describes the prevalence and correlates of health and oral health care needs and treatment-seeking behaviors in homeless IDUs recruited in San Francisco, California, from 2003 to 2005 (N = 340). We examined sociodemographic characteristics, drug use patterns, HIV status via oral fluid testing, physical health using the Short Form 12 Physical Component Score, self-reported needs for physical and oral health care, and the self-reported frequency of seeking medical and oral health care. The sample had a lower health status as compared to the general population and reported a frequent need for physical and oral health care. In bivariate analysis, being in methadone treatment was associated with care-seeking behavior. In addition, being enrolled in Medi-Cal, California’s state Medicaid program, was associated with greater odds of seeking physical and oral health care. Methamphetamine use was not associated with higher odds of needing oral health care as compared to people who reported using other illicit drugs. Homeless IDUs in San Francisco have a large burden of unmet health and oral health needs. Recent cuts in Medi-Cal’s adult dental coverage may result in a greater burden of oral health care which will need to be provided by emergency departments and neighborhood dental clinics. PMID:20945108

  12. Inhibition of CD73 AMP hydrolysis by a therapeutic antibody with a dual, non-competitive mechanism of action

    PubMed Central

    Geoghegan, James C.; Diedrich, Gundo; Lu, Xiaojun; Rosenthal, Kim; Sachsenmeier, Kris F.; Wu, Herren; Dall'Acqua, William F.; Damschroder, Melissa M.

    2016-01-01

    ABSTRACT CD73 (ecto-5′-nucleotidase) has recently been established as a promising immuno-oncology target. Given its role in activating purinergic signaling pathways to elicit immune suppression, antagonizing CD73 (i.e., releasing the brake) offers a complimentary pathway to inducing anti-tumor immune responses. Here, we describe the mechanistic activity of a new clinical therapeutic, MEDI9447, a human monoclonal antibody that non-competitively inhibits CD73 activity. Epitope mapping, structural, and mechanistic studies revealed that MEDI9447 antagonizes CD73 through dual mechanisms of inter-CD73 dimer crosslinking and/or steric blocking that prevent CD73 from adopting a catalytically active conformation. To our knowledge, this is the first report of an antibody that inhibits an enzyme's function through 2 distinct modes of action. These results provide a finely mapped epitope that can be targeted for selective, potent, and non-competitive inhibition of CD73, as well as establish a strategy for inhibiting enzymes that function in both membrane-bound and soluble states. PMID:26854859

  13. Growth of Accountable Care Organizations in California: Number, Characteristics, and State Regulation.

    PubMed

    Fulton, Brent D; Pegany, Vishaal; Keolanui, Beth; Scheffler, Richard M

    2015-08-01

    Accountable care organizations (ACOs) result in physician organizations' and hospitals' receiving risk-based payments tied to costs, health care quality, and patient outcomes. This article (1) describes California ACOs within Medicare, the commercial market, and Medi-Cal and the safety net; (2) discusses how ACOs are regulated by the California Department of Managed Health Care and the California Department of Insurance; and (3) analyzes the increase of ACOs in California using data from Cattaneo and Stroud. While ACOs in California are well established within Medicare and the commercial market, they are still emerging within Medi-Cal and the safety net. Notwithstanding, the state has not enacted a law or issued a regulation specific to ACOs; they are regulated under existing statutes and regulations. From August 2012 to February 2014, the number of lives covered by ACOs increased from 514,100 to 915,285, representing 2.4 percent of California's population, including 10.6 percent of California's Medicare fee-for-service beneficiaries and 2.3 percent of California's commercially insured lives. By emphasizing health care quality and patient outcomes, ACOs have the potential to build and improve on California's delegated model. If recent trends continue, ACOs will have a greater influence on health care delivery and financial risk sharing in California.

  14. Medical instrument data exchange.

    PubMed

    Gumudavelli, Suman; McKneely, Paul K; Thongpithoonrat, Pongnarin; Gurkan, D; Chapman, Frank M

    2008-01-01

    Advances in medical devices and health care has been phenomenal during the recent years. Although medical device manufacturers have been improving their instruments, network connection of these instruments still rely on proprietary technologies. Even if the interface has been provided by the manufacturer (e.g., RS-232, USB, or Ethernet coupled with a proprietary API), there is no widely-accepted uniform data model to access data of various bedside instruments. There is a need for a common standard which allows for internetworking with the medical devices from different manufacturers. ISO/IEEE 11073 (X73) is a standard attempting to unify the interfaces of all medical devices. X73 defines a client access mechanism that would be implemented into the communication controllers (residing between an instrument and the network) in order to access/network patient data. On the other hand, MediCAN technology suite has been demonstrated with various medical instruments to achieve interfacing and networking with a similar goal in its open standardization approach. However, it provides a more generic definition for medical data to achieve flexibility for networking and client access mechanisms. In this paper, a comparison between the data model of X73 and MediCAN will be presented to encourage interoperability demonstrations of medical instruments. PMID:19163033

  15. Inhibition of CD73 AMP hydrolysis by a therapeutic antibody with a dual, non-competitive mechanism of action.

    PubMed

    Geoghegan, James C; Diedrich, Gundo; Lu, Xiaojun; Rosenthal, Kim; Sachsenmeier, Kris F; Wu, Herren; Dall'Acqua, William F; Damschroder, Melissa M

    2016-01-01

    CD73 (ecto-5'-nucleotidase) has recently been established as a promising immuno-oncology target. Given its role in activating purinergic signaling pathways to elicit immune suppression, antagonizing CD73 (i.e., releasing the brake) offers a complimentary pathway to inducing anti-tumor immune responses. Here, we describe the mechanistic activity of a new clinical therapeutic, MEDI9447, a human monoclonal antibody that non-competitively inhibits CD73 activity. Epitope mapping, structural, and mechanistic studies revealed that MEDI9447 antagonizes CD73 through dual mechanisms of inter-CD73 dimer crosslinking and/or steric blocking that prevent CD73 from adopting a catalytically active conformation. To our knowledge, this is the first report of an antibody that inhibits an enzyme's function through 2 distinct modes of action. These results provide a finely mapped epitope that can be targeted for selective, potent, and non-competitive inhibition of CD73, as well as establish a strategy for inhibiting enzymes that function in both membrane-bound and soluble states. PMID:26854859

  16. Improving video processing performance using temporal reasoning

    NASA Astrophysics Data System (ADS)

    Ahmed, Mohamed; Karmouch, Ahmed

    1999-10-01

    In this paper, we present a system, called MediABS, for extracting key frames in a video segment. First we will describe the overall architecture of the system and we will show how our system can handle multiple video formats with a single video-processing module. Then we will present a new algorithm, based on color histograms. The algorithm exploits the temporal characteristic of the visual information and provides techniques for avoiding false cuts and eliminating the possibility of missing true cuts. A discussion, along with some results, will be provided to show the merits of our algorithm compared to existing related algorithms. Finally we will discuss the performance (in terms of processing time and accuracy) obtained by our system in extracting the key frames from a video segment. This work is part of the Mobile Agents Alliance project involving University of Ottawa, National Research Council (NRC) and Mitel Corporation.

  17. Management of incontinence-associated dermatitis with a skin barrier protectant.

    PubMed

    Southgate, Geraldine; Bradbury, Sarah

    The skin performs many important protective functions, one of which is to act as a barrier to moisture, irritants and bacteria. Good management of patients' skin is a fundamental part of nursing care to prevent development of complex and distressing problems, such as pressure ulceration and incontinence-associated dermatitis (IAD). IAD is skin breakdown related to faecal and/or urinary incontinence, which requires adoption of a structured skin care regimen, including regular skin inspection, cleansing and the use of skin barrier protectants, to proactively protect the skin from irritant bodily fluids. Six case studies using Medi Derma-S skin barrier protectants on patients with IAD highlighted the potential for improved clinical outcomes on skin either vulnerable or compromised due to the effects of incontinence. Positive observations were noted with regard to improvement in skin condition, pain and discomfort, promotion of independence and prevention of deterioration of concurrent pressure damage. PMID:27172503

  18. Management of incontinence-associated dermatitis with a skin barrier protectant.

    PubMed

    Southgate, Geraldine; Bradbury, Sarah

    The skin performs many important protective functions, one of which is to act as a barrier to moisture, irritants and bacteria. Good management of patients' skin is a fundamental part of nursing care to prevent development of complex and distressing problems, such as pressure ulceration and incontinence-associated dermatitis (IAD). IAD is skin breakdown related to faecal and/or urinary incontinence, which requires adoption of a structured skin care regimen, including regular skin inspection, cleansing and the use of skin barrier protectants, to proactively protect the skin from irritant bodily fluids. Six case studies using Medi Derma-S skin barrier protectants on patients with IAD highlighted the potential for improved clinical outcomes on skin either vulnerable or compromised due to the effects of incontinence. Positive observations were noted with regard to improvement in skin condition, pain and discomfort, promotion of independence and prevention of deterioration of concurrent pressure damage.

  19. [Method of traditional Chinese medicine formula design based on 3D-database pharmacophore search and patent retrieval].

    PubMed

    He, Yu-su; Sun, Zhi-yi; Zhang, Yan-ling

    2014-11-01

    By using the pharmacophore model of mineralocorticoid receptor antagonists as a starting point, the experiment stud- ies the method of traditional Chinese medicine formula design for anti-hypertensive. Pharmacophore models were generated by 3D-QSAR pharmacophore (Hypogen) program of the DS3.5, based on the training set composed of 33 mineralocorticoid receptor antagonists. The best pharmacophore model consisted of two Hydrogen-bond acceptors, three Hydrophobic and four excluded volumes. Its correlation coefficient of training set and test set, N, and CAI value were 0.9534, 0.6748, 2.878, and 1.119. According to the database screening, 1700 active compounds from 86 source plant were obtained. Because of lacking of available anti-hypertensive medi cation strategy in traditional theory, this article takes advantage of patent retrieval in world traditional medicine patent database, in order to design drug formula. Finally, two formulae was obtained for antihypertensive. PMID:25850277

  20. Women & smoking: becoming part of the solution.

    PubMed

    Suárez, Nery

    2011-10-01

    El hecho de que tantas enfermedades, ya sean graves o leves, estén relacionadas con el tabaquismo es una de las conclusiones más asombrosas de la investigación médica de este siglo; si bien es posible que no sea tan sorprendente como el hecho de que tantas personas lo hayan ignorado. —Sir Richard Doll, 1912–2005 Las empresas transnacionales del tabaco minimizan los peligros de fumar en poderosas campañas de publicidad desplegadas alrededor del mundo, al mismo tiempo que los organismos internacionales e instituciones sanitarias se esfuerzan por contrarrestar estos mensajes mediáticos con presupuestos ínfimos: una asimetría asombrosa que pone en peligro la salud de millones de personas.

  1. Davis signs return-to-work plan, three other bills.

    PubMed

    1999-10-29

    California Governor Gray Davis recently signed several pieces of legislation related to HIV and AIDS. A.B. 155 allows Medi-Cal recipients to return to work and maintain their benefits as long as they meet the Federal Medicaid definition of disability and pay monthly coverage premiums. Another bill protects local governments from prosecution if they distribute syringes in a needle-exchange program authorized by a declaration of emergency. Newly signed legislation also includes a ban on the disclosure of HIV-related medical records by insurers in workers compensation claims unless occupational exposure to HIV is involved. A fourth bill authorizes research on the safety and efficacy of marijuana when treating certain medical conditions. The 3-year research program, to be run by the University of California, gives top priority to patients with AIDS, cancer, seizures, or glaucoma.

  2. Risk factors associated with children lost to care in a state early childhood intervention program.

    PubMed

    Giannoni, Peggy P; Kass, Philip H

    2010-01-01

    A retrospective cohort study was conducted to identify risk factors associated with children lost to care, and their families, compared to those not lost to care within the California Early Start Program. The cohort included data on 8987 children enrolled in the Early Start Program in 1998. This cohort consisted of 2443 children lost to care, 6363 children not lost to care, and 187 children that were lost to follow-up due to death or moving outside the state of California. Premature birth was the only medical risk factor in this study related to an increased risk of loss. Family risk factors exert a significant effect on loss to care. Risk factors that are predictive of loss to care include mother's age and educational level, Medi-Cal ineligibility, and lack of transportation. By identifying and examining risk factors for loss to care, interventions may be strengthened to promote continued family participation in early intervention services.

  3. Davis signs return-to-work plan, three other bills.

    PubMed

    1999-10-29

    California Governor Gray Davis recently signed several pieces of legislation related to HIV and AIDS. A.B. 155 allows Medi-Cal recipients to return to work and maintain their benefits as long as they meet the Federal Medicaid definition of disability and pay monthly coverage premiums. Another bill protects local governments from prosecution if they distribute syringes in a needle-exchange program authorized by a declaration of emergency. Newly signed legislation also includes a ban on the disclosure of HIV-related medical records by insurers in workers compensation claims unless occupational exposure to HIV is involved. A fourth bill authorizes research on the safety and efficacy of marijuana when treating certain medical conditions. The 3-year research program, to be run by the University of California, gives top priority to patients with AIDS, cancer, seizures, or glaucoma. PMID:11367063

  4. Developments towards the LHCb VELO upgrade

    NASA Astrophysics Data System (ADS)

    Cid Vidal, Xabier

    2016-09-01

    The Vertex Locator (VELO) is a silicon strip detector surrounding the interaction region of the LHCb experiment. The upgrade of the VELO is planned to be installed in 2019-2020, and the current detector will be replaced by a hybrid pixel system equipped with electronics capable of reading out at a rate of 40 MHz. The new detector is designed to withstand the radiation dose expected at an integrated luminosity of 50 fb-1. The detector will be composed of silicon pixel sensors, read out by the VeloPix ASIC that is being developed based on the TimePix/MediPix family. The prototype sensors for the VELO upgrade are being irradiated in five different facilities and the post-irradiation performance is being measured with testbeams, and in the lab. These proceedings present the VELO upgrade and briefly discuss the results of the sensor testing campaign.

  5. Sources of information in drug advertisements: evidence from the drug indexing journal of Bangladesh.

    PubMed

    Islam, Mohammad Saidul; Farah, Sharmin Shams

    2008-01-01

    Drug advertisements often lack scientific evidence to support their claims. This descriptive study was conducted to measure the sources of information in drug advertisements in Bangladesh. Advertisements containing at least one medical or pharmaceutical claim were extracted from a convenience sample of the second issue of MediMedia Index of Medical Specialities (MIMS) Bangladesh in 2006. Descriptive statistical analyses including frequency distribution and percentage were performed for data analysis. Of the total 112 advertisements about 82 per cent did not provide any references in support of their claims. Only 17.9 per cent did; of which 65 per cent of the references included journal articles, which was followed by "data on file" in 25 per cent of cases. Superlative claims were commonly used without any scientific evidence. The study reported that medical or pharmaceutical claims made in the drug advertisements in MIMS Bangladesh are mostly not supported by scientific evidence. PMID:18754240

  6. [Implementing population-based integrated care for a region: a work-in-progress report on the project "Gesundes Kinzigtal"].

    PubMed

    Hildebrandt, Helmut; Schmitt, Gwendolyn; Roth, Monika; Stunder, Brigitte

    2011-01-01

    The regional integrated care model "Gesundes Kinzigtal" pursues the idea of integrated health care with special focus on increasing the health gain of the served population. Physicians (general practitioners) and psychotherapists, physiotherapists, hospitals, nursing services, non-profit associations, fitness centers, and health insurance companies work closely together with a regional management company and its programs on prevention and care coordination and enhancement. The 10 year-project is run by a company that was founded by the physician network "MQNK" and "OptiMedis AG", a corporation with public health background specialising in integrated health care. The aim of this project is to enhance prevention and quality of health care for a whole region in a sustainable way, and to decrease costs of care. The article describes the special funding model of the project, the engagement of patients, and the different health and prevention programmes. The programmes and projects are developed, implemented, and evaluated by multidisciplinary teams.

  7. Society of Nuclear Medicine--57th annual meeting.

    PubMed

    Searle, Ben

    2010-08-01

    The 57th Annual Meeting of the Society of Nuclear Medicine, held in Salt Lake City, UT, USA, included topics covering new developments in imaging agents and radiopharmaceutical therapies in the field of nuclear medicine. This conference report highlights selected presentations related to imaging of the brain, the prediction of heart disease, and the detection and treatment of various cancers. Investigational drugs discussed include TF-2 plus [68Ga]IMP-288 and TF-2 plus [111In]IMP-288 (both Immunomedics Inc), [11C]PBR-170 (Royal Prince Alfred Hospital/Australian Nuclear Science & Technology Organization), [11C]LY-2795050 (Eli Lilly & Co), yttrium (90Y) clivatuzumab tetraxetan (Garden State Cancer Center/Immunomedics Inc), [18F]LMI-1195 (Lantheus Medical Imaging Inc), fluciclovine (18F) (GE Healthcare/Nihon Medi-Physics Co Ltd), [99mTc]MIP-1340 and [99mTc]MIP-1407 (both Molecular Insight Pharmaceuticals Inc).

  8. Mediterranean diet in predementia and dementia syndromes.

    PubMed

    Solfrizzi, V; Frisardi, V; Seripa, D; Logroscino, G; Imbimbo, B P; D'Onofrio, G; Addante, F; Sancarlo, D; Cascavilla, L; Pilotto, A; Panza, F

    2011-08-01

    There is a critical need to potentially individualize new strategies able to prevent and to slow down the progression of predementia and dementia syndromes. Only recently higher adherence to a Mediterranean-type diet was associated with decreased cognitive decline although the Mediterranean diet (MeDi) combines several foods, micro- and macronutrients already separately proposed as potential protective factors against dementia and predementia syndromes. In fact, elevated saturated fatty acids could have negative effects on age-related cognitive decline and mild cognitive impairment (MCI). Furthermore, at present, epidemiological evidence suggested a possible association among fish consumption, monounsaturated fatty acids and polyunsaturated fatty acids (PUFA) (particularly, n-3 PUFA) and reduced risk of cognitive decline and dementia. Light to moderate alcohol use may be associated with a reduced risk of incident dementia and Alzheimer's disease (AD), while for vascular dementia, cognitive decline, and predementia syndromes the current evidence is only suggestive of a protective effect. Finally, the limited epidemiological evidence available on fruit and vegetable consumption and cognition generally supported a protective role of these macronutrients against cognitive decline, dementia, and AD. Moreover, recent prospective studies provided evidence that higher adherence to a Mediterranean-type diet could be associated with slower cognitive decline, reduced risk of progression from MCI to AD, reduced risk of AD, and decreased all-causes mortality in AD patients. These findings suggested that adherence to the MeDi may affect not only the risk for AD, but also for predementia syndromes and their progression to overt dementia. Nonetheless, at present, no definitive dietary recommendations are possible. However, high levels of consumption of fats from fish, vegetable oils, non-starchy vegetables, low glycemic fruits, and diet low in foods with added sugars and with

  9. Factors associated with the initiation of alpha-interferon treatment in Medicaid patients diagnosed with hepatitis C.

    PubMed

    Markowitz, J S; Gutterman, E M; Hodes, D; Klaskala, W

    2005-03-01

    We aimed to determine rates of treatment with alpha-interferon medication in patients diagnosed with hepatitis C virus (HCV), to ascertain the prevalence of selected conditions that could influence initiation of interferon treatment, and to examine the association between the presence of these conditions and interferon treatment. A nested case-control design was used in California Medicaid (Medi-Cal) claims data covering the period from 1 January 1996 to 30 June 2002. Interferon-treated cases and non-treated controls were selected in a 1 : 2 ratio that matched the length of the observation period and year of index HCV diagnosis. Predictor variables examined in bivariate and multivariate analyses included demographics, substance abuse and dependence, psychotropic drug use, selected chronic conditions and medical utilization. The proportion of eligible subjects diagnosed with HCV and treated with interferon ranged from 10.7 to 13.9%. There were 529 treated cases that met the eligibility criteria and 1058 non-treated HCV patients selected as controls. Multivariate factors that increased the likelihood of treatment were a liver biopsy, a diagnosis of mild liver disease, a diagnosis of psoriasis, antidepressant use and classification of race/ethnicity as 'other'. A decreased likelihood of treatment was linked to age > or =65 years, a diagnosis of kidney disease, one to four emergency visits and five or more emergency visits. The proportion of patients receiving interferon treatment in the Medi-Cal-insured population was low compared with published rates in HCV patients in other general medical settings. The diverse factors linked to initiation of HCV therapy raise compelling questions for further research.

  10. Performance analysis of a proposed tightly-coupled medical instrument network based on CAN protocol.

    PubMed

    Mujumdar, Shantanu; Thongpithoonrat, Pongnarin; Gurkan, D; McKneely, Paul K; Chapman, Frank M; Merchant, Fatima

    2010-01-01

    Advances in medical devices and health care has been phenomenal during the recent years. Although medical device manufacturers have been improving their instruments, network connection of these instruments still rely on proprietary technologies. Even if the interface has been provided by the manufacturer (e.g., RS-232, USB, or Ethernet coupled with a proprietary API), there is no widely-accepted uniform data model to access data of various bedside instruments. There is a need for a common standard which allows for internetworking with the medical devices from different manufacturers. ISO/IEEE 11073 (X73) is a standard attempting to unify the interfaces of all medical devices. X73 defines a client access mechanism that would be implemented into the communication controllers (residing between an instrument and the network) in order to access/network patient data. On the other hand, MediCAN™ technology suite has been demonstrated with various medical instruments to achieve interfacing and networking with a similar goal in its open standardization approach. However, it provides a more generic definition for medical data to achieve flexibility for networking and client access mechanisms. The instruments are in turn becoming more sophisticated; however, the operation of an instrument is still expected to be locally done by authorized medical personnel. Unfortunately, each medical instrument has its unique proprietary API (application programming interface - if any) to provide automated and electronic access to monitoring data. Integration of these APIs requires an agreement with the manufacturers towards realization of interoperable health care networking. As long as the interoperability of instruments with a network is not possible, ubiquitous access to patient status is limited only to manual entry based systems. This paper demonstrates an attempt to realize an interoperable medical instrument interface for networking using MediCAN technology suite as an open

  11. Percutaneous ultrasound-guided treatment of shoulder tendon calcifications: Clinical and radiological follow-up at 6 months().

    PubMed

    De Conti, G; Marchioro, U; Dorigo, A; Boscolo, N; Vio, S; Trevisan, M; Meneghini, A; Baldo, V; Angelini, F

    2010-12-01

    Sommario INTRODUZIONE: La tendinopatia calcifica di spalla è una condizione relativamente frequente caratterizzata, quando sintomatica, da dolore cronico e da fasi di dolore acuto molto intenso. MATERIALI E METODI: Da ottobre 2006 a marzo 2008 abbiamo trattato 126 spalle di 125 pazienti consecutivi. Tutti hanno eseguito Rx ed ecografia prima del trattamento ed il test di Constant prima del trattamento e a 6 mesi di distanza. 55 pazienti su 123 (42%) sono stati trattati due o più volte con infiltrazione intrabursale di corticosteroide. Tre pazienti hanno rifiutato altri trattamenti dopo il primo. Sono stati quindi raccolti i dati complessivamente di 123 spalle. È stata eseguita RM di controllo a sei mesi. RISULTATI: Incremento del Constant Score dopo la procedura in tutti i pazienti trattati una sola volta ed in quasi tutti i pazienti trattati due volte; i pazienti sono stati divisi in due classi, rispettivamente trattati una o due (o più) volte. In ciascuna delle due classi c’è stato un significativo incremento (p < 0,0001)delle medie dei Cs pre e post trattamento; nella classe dei pazienti trattati due volte significatività statistica (p < 0,0001) tra le medie dei Cs rispettivamente prima del trattamento iniziale e dopo il primo trattamento, e tra la media Cs di quest’ultimo e quella dopo 6 mesi dal primo trattamento. Il Cs dopo il trattamento è significativamente diverso nei pazienti con impingement (p < 0,001). CONCLUSION: Incremento del Cs, in più del 95% dei pazienti. Non lesioni tendinee ai controlli ecografici/RM. L’impingement è risultato un fattore di rischio per il risultato finale.

  12. Impact of Compliance with a Sepsis Resuscitation Bundle in a Portuguese Emergency Department.

    PubMed

    Carvas, Joao Miguel; Canelas, Cátia; Montanha, Gustavo; Silva, Carlos; Esteves, Francisco

    2016-02-01

    Introdução: A sépsis severa e o choque sético são entidades clínicas frequentes com elevada morbi-mortalidade que superam os da doença cardíaca coronária ou do acidente vascular cerebral. A realidade da sépsis tratada no hospital fora das unidades de cuidados intensivos é amplamente desconhecida. Pretende-se neste trabalho estimar o cumprimento da bundle das 6-horas da Surviving Sepsis Campaign num serviço de urgência português e os resultados clínicos dos doentes. Material e Métodos: Estudo retrospetivo, observacional de coorte com 178 pacientes com sépsis severa/choque sético internados na unidade de cuidados intensivos e intermédios entre 1 de Janeiro de 2012 e 31 de Dezembro de 2012. Resultados: Durante o período estudado foi diagnosticado choque sético em 100 pacientes (56,2%) e sépsis severa em 78 pacientes (43,8%). O cumprimento com a bundle foi: (1) 62,9% para a medição de lactatos; (2) 62,9% para a colheita hemoculturas antes da antibioterapia; (3) 41,6% para a administração de antibióticos nas primeiras 3 horas; (4) 76,4% para a administração de fluidos; (5) 25% para a administração de vasopressores; (6) 37% for medição da pressão venosa central; (7) 39% para a medição da saturação venosa central de oxigénio. O cumprimento de todas as medidas foi observado em 22% dos pacientes. A medida 'colheita hemoculturas antes da antibioterapia' esteve significativamente associada a um menor risco de mortalidade na unidade de cuidados intensivos e aos 28 dias. Também se verificou uma tendência para uma correlação inversa entre cumprimento crescente da bundle e a mortalidade na unidade de cuidados intensivos e aos 28 dias. Discussão: A baixa adesão à bundle das 6-horas da Surviving Sepsis Campaign é um resultado que replica o de estudos internacionais semelhantes. A explicação para este fenómeno é complexa mas pode incluir a falta de monitorização da qualidade dos cuidados no serviço de urgência. Conclusões: O

  13. Physico-Chemical Research on the Sounding Rocket Maser 13

    NASA Astrophysics Data System (ADS)

    Lockowandt, Christian; Kemi, Stig; Abrahamsson, Mattias; Florin, Gunnar

    MASER is a sounding rocket platform for short-duration microgravity experiments, providing the scientific community with an excellent microgravity tool. The MASER programme has been running by SSC from 1987 and has up to 2012 provided twelve successful flights for microgravity missions with 6-7 minutes of microgravity, the g-level is normally below 1x10-5 g. The MASER 13 is planned to be launched in spring 2015 from Esrange Space Center in Northern Sweden. The rocket will carry four ESA financed experiment modules. The MASER 13 vehicle will be propelled by the 2-stage solid fuel VSB-30 rocket motor, which provided the 390 kg payload with an apogee of 260 km and 6 and a half minutes of microgravity. Swedish Space Corporation carries out the MASER missions for ESA and the program is also available for other customers. The payload comprise four different experiment modules of which three could be defined as physic-chemical research; XRMON-SOL, CDIC-3, MEDI. It also comprises the Maser Service Module and the recovery system. The Service Module provided real-time 5 Mbps down-link of compressed experiment digital video data from the on-board cameras, as well as high-speed housekeeping telemetry data. XRMON-SOL In this experiment the influence of gravity on the formation of an equiaxed microstructure will be investigated. Special attention will be put on the aspect of nucleation, segregation and impingement. The experiment scope is to melt and solidify an AlCu-alloy sample in microgravity. The solidification will be performed in an isothermal environment. The solidification process will be monitored and recorded with X-ray image during the whole flight, images will also be down-linked to ground for real-time monitoring and possible interaction. CDIC-3 The goal is to study in migrogravity the spatio-temporal dynamics of a chemical front travelling in a thin solution layer open to the air and specifically the respective role of Marangoni and density-related hydrodynamic

  14. Diet and Alzheimer's disease risk factors or prevention: the current evidence.

    PubMed

    Solfrizzi, Vincenzo; Panza, Francesco; Frisardi, Vincenza; Seripa, Davide; Logroscino, Giancarlo; Imbimbo, Bruno P; Pilotto, Alberto

    2011-05-01

    Preventing or postponing the onset of Alzheimer's disease (AD) and delaying or slowing its progression would lead to a consequent improvement of health status and quality of life in older age. Elevated saturated fatty acids could have negative effects on age-related cognitive decline and mild cognitive impairment (MCI). Furthermore, at present, epidemiological evidence suggests a possible association between fish consumption, monounsaturated fatty acids and polyunsaturated fatty acids (PUFA; in particular, n-3 PUFA) and a reduced risk of cognitive decline and dementia. Poorer cognitive function and an increased risk of vascular dementia (VaD) were found to be associated with a lower consumption of milk or dairy products. However, the consumption of whole-fat dairy products may be associated with cognitive decline in the elderly. Light-to-moderate alcohol use may be associated with a reduced risk of incident dementia and AD, while for VaD, cognitive decline and predementia syndromes, the current evidence is only suggestive of a protective effect. The limited epidemiological evidence available on fruit and vegetable consumption and cognition generally supports a protective role of these macronutrients against cognitive decline, dementia and AD. Only recently, higher adherence to a Mediterranean-type diet was associated with decreased cognitive decline, although the Mediterranean diet (MeDi) combines several foods, micro- and macro-nutrients already separately proposed as potential protective factors against dementia and predementia syndromes. In fact, recent prospective studies provided evidence that higher adherence to a Mediterranean-type diet could be associated with slower cognitive decline, reduced risk of progression from MCI to AD, reduced risk of AD and a decreased all-cause mortality in AD patients. These findings suggested that adherence to the MeDi may affect not only the risk of AD, but also of predementia syndromes and their progression to overt dementia

  15. Characterization of alpha-toxin hla gene variants, alpha-toxin expression levels, and levels of antibody to alpha-toxin in hemodialysis and postsurgical patients with Staphylococcus aureus bacteremia.

    PubMed

    Sharma-Kuinkel, Batu K; Wu, Yuling; Tabor, David E; Mok, Hoyin; Sellman, Bret R; Jenkins, Amy; Yu, Li; Jafri, Hasan S; Rude, Thomas H; Ruffin, Felicia; Schell, Wiley A; Park, Lawrence P; Yan, Qin; Thaden, Joshua T; Messina, Julia A; Fowler, Vance G; Esser, Mark T

    2015-01-01

    Alpha-toxin is a major Staphylococcus aureus virulence factor. This study evaluated potential relationships between in vitro alpha-toxin expression of S. aureus bloodstream isolates, anti-alpha-toxin antibody in serum of patients with S. aureus bacteremia (SAB), and clinical outcomes in 100 hemodialysis and 100 postsurgical SAB patients. Isolates underwent spa typing and hla sequencing. Serum anti-alpha-toxin IgG and neutralizing antibody levels were measured by using an enzyme-linked immunosorbent assay and a red blood cell (RBC)-based hemolysis neutralization assay. Neutralization of alpha-toxin by an anti-alpha-toxin monoclonal antibody (MAb MEDI4893) was tested in an RBC-based lysis assay. Most isolates encoded hla (197/200; 98.5%) and expressed alpha-toxin (173/200; 86.5%). In vitro alpha-toxin levels were inversely associated with survival (cure, 2.19 μg/ml, versus failure, 1.09 μg/ml; P < 0.01). Both neutralizing (hemodialysis, 1.26 IU/ml, versus postsurgical, 0.95; P < 0.05) and IgG (hemodialysis, 1.94 IU/ml, versus postsurgical, 1.27; P < 0.05) antibody levels were higher in the hemodialysis population. Antibody levels were also significantly higher in patients infected with alpha-toxin-expressing S. aureus isolates (P < 0.05). Levels of both neutralizing antibodies and IgG were similar among patients who were cured and those not cured (failures). Sequence analysis of hla revealed 12 distinct hla genotypes, and all genotypic variants were susceptible to a neutralizing monoclonal antibody in clinical development (MEDI4893). These data demonstrate that alpha-toxin is highly conserved in clinical S. aureus isolates. Higher in vitro alpha-toxin levels were associated with a positive clinical outcome. Although patients infected with alpha-toxin-producing S. aureus exhibited higher anti-alpha-toxin antibody levels, these levels were not associated with a better clinical outcome in this study.

  16. Characterization of Alpha-Toxin hla Gene Variants, Alpha-Toxin Expression Levels, and Levels of Antibody to Alpha-Toxin in Hemodialysis and Postsurgical Patients with Staphylococcus aureus Bacteremia

    PubMed Central

    Wu, Yuling; Tabor, David E.; Mok, Hoyin; Sellman, Bret R.; Jenkins, Amy; Yu, Li; Jafri, Hasan S.; Rude, Thomas H.; Ruffin, Felicia; Schell, Wiley A.; Park, Lawrence P.; Yan, Qin; Thaden, Joshua T.; Messina, Julia A.; Esser, Mark T.

    2014-01-01

    Alpha-toxin is a major Staphylococcus aureus virulence factor. This study evaluated potential relationships between in vitro alpha-toxin expression of S. aureus bloodstream isolates, anti-alpha-toxin antibody in serum of patients with S. aureus bacteremia (SAB), and clinical outcomes in 100 hemodialysis and 100 postsurgical SAB patients. Isolates underwent spa typing and hla sequencing. Serum anti-alpha-toxin IgG and neutralizing antibody levels were measured by using an enzyme-linked immunosorbent assay and a red blood cell (RBC)-based hemolysis neutralization assay. Neutralization of alpha-toxin by an anti-alpha-toxin monoclonal antibody (MAb MEDI4893) was tested in an RBC-based lysis assay. Most isolates encoded hla (197/200; 98.5%) and expressed alpha-toxin (173/200; 86.5%). In vitro alpha-toxin levels were inversely associated with survival (cure, 2.19 μg/ml, versus failure, 1.09 μg/ml; P < 0.01). Both neutralizing (hemodialysis, 1.26 IU/ml, versus postsurgical, 0.95; P < 0.05) and IgG (hemodialysis, 1.94 IU/ml, versus postsurgical, 1.27; P < 0.05) antibody levels were higher in the hemodialysis population. Antibody levels were also significantly higher in patients infected with alpha-toxin-expressing S. aureus isolates (P < 0.05). Levels of both neutralizing antibodies and IgG were similar among patients who were cured and those not cured (failures). Sequence analysis of hla revealed 12 distinct hla genotypes, and all genotypic variants were susceptible to a neutralizing monoclonal antibody in clinical development (MEDI4893). These data demonstrate that alpha-toxin is highly conserved in clinical S. aureus isolates. Higher in vitro alpha-toxin levels were associated with a positive clinical outcome. Although patients infected with alpha-toxin-producing S. aureus exhibited higher anti-alpha-toxin antibody levels, these levels were not associated with a better clinical outcome in this study. PMID:25392350

  17. The Association between a Mediterranean-Style Diet and Kidney Function in the Northern Manhattan Study Cohort

    PubMed Central

    Moon, Yeseon P.; Scarmeas, Nikolaos; Gu, Yian; Gardener, Hannah; Cheung, Ken; Wright, Clinton B.; Sacco, Ralph L.; Nickolas, Thomas L.; Elkind, Mitchell S.V.

    2014-01-01

    Background and objectives Various dietary strategies have been investigated to slow kidney function decline. However, it is unknown whether a Mediterranean diet, which has been associated with improved cardiovascular risk, is associated with change in kidney function. Design, setting, participants, & measurements This study used the Northern Manhattan Study, a prospective, multiethnic, observational cohort of participants who were stroke free at baseline. Data were collected between 1993 and 2008. Serum creatinine measurements were taken a mean 6.9 years apart. A baseline dietary questionnaire was extrapolated into a previously used 9-point scoring system (MeDi). The primary outcome was incident eGFR<60 ml/min per 1.73 m2using the Modification of Diet in Renal Disease formula. A secondary outcome was the upper quartile of annualized eGFR decline (≥2.5 ml/min per 1.73 m2 per year). Conditional logistic regression models adjusted for demographics and baseline vascular risk factors. Results Mean baseline age was 64 years, with 59% women and 65% Hispanics (N=900); mean baseline eGFR was 83.1 ml/min per 1.73 m2. Incident eGFR<60 ml/min per 1.73 m2 developed in 14% . In adjusted models, every 1-point increase in the MeDi score, indicating increasing adherence to a Mediterranean diet, was associated with decreased odds of incident eGFR<60 ml/min per 1.73 m2 (odds ratio, 0.83; 95% confidence interval, 0.71 to 0.96) and decreased odds of being in the upper quartile of eGFR decline (odds ratio, 0.88; 95% confidence interval, 0.79 to 0.98). Conclusions A Mediterranean diet was associated with a reduced incidence of eGFR<60 ml/min per 1.73 m2 and upper quartile of eGFR decline in a multiethnic cohort. PMID:25359387

  18. Diet and Alzheimer's disease risk factors or prevention: the current evidence.

    PubMed

    Solfrizzi, Vincenzo; Panza, Francesco; Frisardi, Vincenza; Seripa, Davide; Logroscino, Giancarlo; Imbimbo, Bruno P; Pilotto, Alberto

    2011-05-01

    Preventing or postponing the onset of Alzheimer's disease (AD) and delaying or slowing its progression would lead to a consequent improvement of health status and quality of life in older age. Elevated saturated fatty acids could have negative effects on age-related cognitive decline and mild cognitive impairment (MCI). Furthermore, at present, epidemiological evidence suggests a possible association between fish consumption, monounsaturated fatty acids and polyunsaturated fatty acids (PUFA; in particular, n-3 PUFA) and a reduced risk of cognitive decline and dementia. Poorer cognitive function and an increased risk of vascular dementia (VaD) were found to be associated with a lower consumption of milk or dairy products. However, the consumption of whole-fat dairy products may be associated with cognitive decline in the elderly. Light-to-moderate alcohol use may be associated with a reduced risk of incident dementia and AD, while for VaD, cognitive decline and predementia syndromes, the current evidence is only suggestive of a protective effect. The limited epidemiological evidence available on fruit and vegetable consumption and cognition generally supports a protective role of these macronutrients against cognitive decline, dementia and AD. Only recently, higher adherence to a Mediterranean-type diet was associated with decreased cognitive decline, although the Mediterranean diet (MeDi) combines several foods, micro- and macro-nutrients already separately proposed as potential protective factors against dementia and predementia syndromes. In fact, recent prospective studies provided evidence that higher adherence to a Mediterranean-type diet could be associated with slower cognitive decline, reduced risk of progression from MCI to AD, reduced risk of AD and a decreased all-cause mortality in AD patients. These findings suggested that adherence to the MeDi may affect not only the risk of AD, but also of predementia syndromes and their progression to overt dementia

  19. Depression: Evolutionary New Neural Circuitries Are Still Adjusting for Cognition.

    PubMed

    Graczynska, Agata; Stefano, George B

    2015-01-01

    Depression can be both normal and abnormal, and the balance of its expression determines the behavioral outcome/diagnosis. It is a complex pathophysiology based on a heterogeneous syndrome whose etiology is diverse as well. Within the context of a central nervous system, the nervous system blueprint can be found in single cells (sensory, motor, and integrative processes). These consolidated functions provide for novel coping strategies for survival. The maintenance and evolvement of this system into a central nervous system is based on conserving these functions, including chemical messengers and functionality in having specific cells medi-ate these primordial functions. Additionally, this neural coping strategy provides advantages for DNA. Thus, with different neural cells at work, pathways/networks would evolve, producing more complex behaviors and become a very critical phenomenon for future advances. This evolvement has taken over 1 billion years to de-velop. In so doing, as with any new programming (e.g., cognition), errors will occur. Given the widespread qual-ities of depression, it is surmised that this abnormality, and other psychiatric disorders, may emerge due to in-herent neural weaknesses related to cognition being a recent evolutionary development.

  20. Benefits planning--what you must know: interview with Daniel Fortuno, AIDS Benefits Counselors. Interview by John S. James.

    PubMed

    Fortuno, D

    1996-09-20

    Daniel Fortuno, a counselor with AIDS Benefits Counselors (ABC), summarizes key insurance and benefits information for persons living with AIDS (PWAs), particularly those who reside in California. Fortuno explains the managed care concept and basic health insurance terms, such as pre-existing conditions, health maintenance organizations (HMOs), preferred provider organizations (PPOs), contestability, and the Consolidated Omnibus Budget Reconciliation Act (COBRA). Fortuno explains a California law that became effective in July 1993 that greatly restricts the ability of health insurance companies to refuse insurance due to preexisting conditions to small groups of persons. This law, AB 1672, makes health insurance available to the sick with little overall rises in prices. Federal insurance laws and regulations that impact PWAs and HIV-positive individuals are outlined. In the interview, Fortuno also discusses Medicaid/Medi-Cal (California's Medicaid), Social Security programs, State disability, and the AIDS Drug Assistance Program. Fortuno offers suggestions for obtaining good private insurance and evaluates the pros and cons of HMOs, PPOs, and indemnity insurance.

  1. No change in complication rate using spring-loaded gun compared to traditional percutaneous renal allograft biopsy techniques.

    PubMed

    Kovalik, E C; Schwab, S J; Gunnells, J C; Bowie, D; Smith, S R

    1996-06-01

    The previous methods to biopsy renal allografts at our institution involved the use of the Franklin-Silverman or Tru-Cut needles. Unfortunately they had a significant rate of post biopsy bleeding secondary to deep penetration when excess force was used to penetrate a tough transplant capsule. Although spring loaded biopsy devices have been widely used for native kidney biopsies over the past three years, the complication rate for renal allograft biopsies has not been sufficiently evaluated. We describe our experience using a disposable spring loaded biopsy device on transplanted renal grafts. Fifty-four biopsies were performed with the device, all under ultrasound guidance. The ASAP automatic biopsy system by Medi-tech was used comprising of a spring loaded gun with a 15 cm long 15 GA needle echogenic tip and 17 mm specimen notch. All patients were ultrasounded immediately post biopsy to look for hematomas. Compared to 55 previous biopsies performed using Tru-Cut needles, we conclude that the ASAP automated biopsy system proved equally effective in obtaining adequate tissue for diagnosis with fewer post-biopsy hematomas compared to traditional biopsy methods.

  2. Linear dimensions and volumes of human lungs

    SciTech Connect

    Hickman, David P.

    2012-03-30

    TOTAL LUNG Capacity is defined as “the inspiratory capacity plus the functional residual capacity; the volume of air contained in the lungs at the end of a maximal inspiration; also equals vital capacity plus residual volume” (from MediLexicon.com). Within the Results and Discussion section of their April 2012 Health Physics paper, Kramer et al. briefly noted that the lungs of their experimental subjects were “not fully inflated.” By definition and failure to obtain maximal inspiration, Kramer et. al. did not measure Total Lung Capacity (TLC). The TLC equation generated from this work will tend to underestimate TLC and does not improve or update total lung capacity data provided by ICRP and others. Likewise, the five linear measurements performed by Kramer et. al. are only representative of the conditions of the measurement (i.e., not at-rest volume, but not fully inflated either). While there was significant work performed and the data are interesting, the data does not represent a maximal situation, a minimal situation, or an at-rest situation. Moreover, while interesting, the linear data generated by this study is limited by the conditions of the experiment and may not be fully comparative with other lung or inspiratory parameters, measures, or physical dimensions.

  3. Reduction mammoplasty using oxidized regenerated cellulose as a filler in breast conservation surgery.

    PubMed

    Franceschini, Gianluca; Sanchez, Alejandro Martin; Visconti, Giuseppe; Di Leone, Alba; D'Archi, Sabatino; Mulè, Antonino; Santoro, Angela; Salgarello, Marzia; Masetti, Riccardo

    La chirurgia oncoplastica della mammella ha suscitato grande interesse negli ultimi anni ed è progressivamente divenuta una componente integrante ed essenziale del trattamento chirurgico conservativo dei tumori del seno. Le tecniche di chirurgia oncoplastica combinano i migliori principi della chirurgia oncologica con in migliori principi della chirurgia plastica con lo scopo di ottenere margini indenni da malattia ed al tempo stesso ottimizzare i risultati estetici. In particolare le tecniche di mastoplastica riduttiva sono state applicate in pazienti con seni medio-grandi e ptosici per ottimizzare i risultati oncologici ed estetici. Grazie a queste procedure il trattamento conservativo della mammella è stato esteso ad includere un gruppo di pazienti che altrimenti avrebbero richiesto una mastectomia associata a complessi interventi di ricostruzione mammaria. Tuttavia anche con l’applicazione delle tecniche di mastoplastica riduttiva gli esiti cosmetici possono risultare insoddisfacenti, in particolar modo in pazienti con seni medi che richiedono ampie resezioni parenchimali per tumori di voluminose dimensioni, localizzati nei quadranti supero-interni o inferiori. Recentemente è stato quindi proposto l’utilizzo della cellulosa ossidata rigenerata come biomateriale ricostruttivo per ottimizzare i risultati estetici nella chirurgia oncoplastica. Lo scopo di questo articolo è quello di descrivere il modello standard di una innovativa tecnica oncoplastica con cellulosa ossidata rigenerata che abbiamo denominato “QUORC” (QUadrantectomy with Oxidized Regenerated Cellulose) grazie alla quale sembra possibile migliorare i risultati estetici e ridurre al minimo le possibile complicanze post-operatorie, come infezioni ed ematomi, nella chirurgia oncoplastica con tecnica di mastoplastica riduttiva.

  4. One-stop shopping: efforts to integrate physical and behavioral health care in five California community health centers.

    PubMed

    Pourat, Nadereh; Hadler, Max W; Dixon, Brittany; Brindis, Claire

    2015-01-01

    More than 70 percent of behavioral health conditions are first diagnosed in the primary care setting. Yet physical and behavioral health care are typically provided separately, compelling many vulnerable patients to navigate the complexities of two separate systems of care. This policy brief examines five community health centers (CHCs) in California that have taken preliminary steps toward creating "one-stop shopping" for both physical and behavioral health care. The steps taken to increase integration by the CHCs include employing behavioral health providers, using a single electronic health record that includes both physical and behavioral health data, transforming the physical space, and developing mechanisms for effective transition of patients between providers. The findings emphasize the importance of changes to Medi-Cal reimbursement policies to promote same-day visits, as well as the importance of cultural changes to integrate behavioral health. They also highlight the need for comprehensive tools to assess and promote integration and to identify solutions for the most challenging activities required to achieve full integration.

  5. [Research progress of drugs commonly used to anti-rheumatoid arthritis].

    PubMed

    Chi, Li-Qun; Zhou, Bin; Gao, Wen-Yuan; Liu, Zhen

    2014-08-01

    Rheumatoid arthritis (RA) is a kind of chronic, progressive, multiple, invasive autoimmune disease with two chief cclinical manifestations arthrosynovitis and ex-arthrosis, easy to occur in middle-aged women, also occur in children and the elderly, is characterized by progressive and break out repeatedly. RA pathogenesis is complex, there is no special treatment, used in treatment of R drug varied, new drugs and new therapies also emerge in endlessly, main including non-steroidal anti-inflammatory drugs (NSAIDs), slow action anti-rheumatism medicine (SAARDs), glucocorticoids (GCs), biological agent, traditional Chinese medicine and traditional Chinese medicine preparations, domestic market for rheumatoid main drug treatment are NSAIDs, SAARDs, GCs, traditional Chinese medicine and traditional Chinese medicine preparations. Traditional Chinese medicine and traditional Chinese medi- cine preparations for the treatment of RA have its unique advantages, show the characteristics of overall adjustment, multi-level and multiple targets, and also can alleviate and against side effects of western medicine. In recent years, more and more get people's atten- tion. This paper reviewed the research progress and treatment features of commonly used therapeutic agents for the treatment of RA in recent years, which provides reference and basis for future medicine anti-RA.

  6. Medicaid beneficiaries in california reported less positive experiences when assigned to a managed care plan.

    PubMed

    McDonnell, Diana D; Graham, Carrie L

    2015-03-01

    In 2011 California began transitioning approximately 340,000 seniors and people with disabilities from Medicaid fee-for-service (FFS) to Medicaid managed care plans. When beneficiaries did not actively choose a managed care plan, the state assigned them to one using an algorithm based on their previous FFS primary and specialty care use. When no clear link could be established, beneficiaries were assigned by default to a managed care plan based on weighted randomization. In this article we report the results of a telephone survey of 1,521 seniors and people with disabilities enrolled in Medi-Cal (California Medicaid) and who were recently transitioned to a managed care plan. We found that 48 percent chose their own plan, 11 percent were assigned to a plan by algorithm, and 41 percent were assigned to a plan by default. People in the latter two categories reported being similarly less positive about their experiences compared to beneficiaries who actively chose a plan. Many states in addition to California are implementing mandatory transitions of Medicaid-only beneficiaries to managed care plans. Our results highlight the importance of encouraging beneficiaries to actively choose their health plan; when beneficiaries do not choose, states should employ robust intelligent assignment algorithms.

  7. The construction of a public key infrastructure for healthcare information networks in Japan.

    PubMed

    Sakamoto, N

    2001-01-01

    The digital signature is a key technology in the forthcoming Internet society for electronic healthcare as well as for electronic commerce. Efficient exchanges of authorized information with a digital signature in healthcare information networks require a construction of a public key infrastructure (PKI). In order to introduce a PKI to healthcare information networks in Japan, we proposed a development of a user authentication system based on a PKI for user management, user authentication and privilege management of healthcare information systems. In this paper, we describe the design of the user authentication system and its implementation. The user authentication system provides a certification authority service and a privilege management service while it is comprised of a user authentication client and user authentication serves. It is designed on a basis of an X.509 PKI and is implemented with using OpenSSL and OpenLDAP. It was incorporated into the financial information management system for the national university hospitals and has been successfully working for about one year. The hospitals plan to use it as a user authentication method for their whole healthcare information systems. One implementation of the system is free to the national university hospitals with permission of the Japanese Ministry of Education, Culture, Sports, Science and Technology. Another implementation is open to the other healthcare institutes by support of the Medical Information System Development Center (MEDIS-DC). We are moving forward to a nation-wide construction of a PKI for healthcare information networks based on it. PMID:11604934

  8. The physician data query (PDQ) cancer information system.

    PubMed

    Hubbard, S M

    1987-01-01

    PDQ is an online database that provides information about the prognosis and treatment of all major types of cancer. It represents a major effort by the NCI to communicate advances in cancer treatment using computer technology, and serves as a major component of the Institute's program to reduce cancer mortality nationwide. PDQ utilizes a modern large-scale computer to provide processing speed, a general purpose database management system to provide retrieval and display functions, and commercial telecommunication networks to provide online access to up-to-date information on cancer treatment. A series of user-friendly menus allow searching, browsing, and displaying without having to learn a specialized search language. PDQ is accessible through the National Library of Medicine's computer system via a computer terminal or personal computer and is available to the medical community at over 6,000 medical libraries and centers and through individual access codes. PDQ is also available as an online database under a special license agreement with NCI through two medical information systems produced by commercial database vendors: BRS/Saunders' COLLEAGUE Mead Data Central's MEDIS, and Telmed, a Swiss database.

  9. IL-6 inhibitors for treatment of rheumatoid arthritis: past, present, and future.

    PubMed

    Kim, Go Woon; Lee, Na Ra; Pi, Ryo Han; Lim, Yee Seul; Lee, Yu Mi; Lee, Jong Min; Jeong, Hye Seung; Chung, Sung Hyun

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by polyarthritis. Numerous agents with varying mechanisms are used in the treatment of RA, including non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, and some biological agents. Studies to uncover the cause of RA have recently ended up scrutinizing the importance of pro-inflammatory cytokine such as tumor necrosis factor α (TNF-α) and interleukin (IL)-6 in the pathogenesis of RA. TNF-α inhibitors are increasingly used to treat RA patients who are non-responsive to conventional anti-arthritis drugs. Despite its effectiveness in a large patient population, up to two thirds of RA patients are found to be partially responsive to anti-TNF therapy. Therefore, agents targeting IL-6 such as tocilizumab (TCZ) attracted significant attention as a promising agent in RA treatment. In this article, we review the mechanism of anti-IL-6 in the treatment of RA, provide the key efficacy and safety data from clinical trials of approved anti-IL-6, TCZ, as well as six candidate IL-6 blockers including sarilumab, ALX-0061, sirukumab, MEDI5117, clazakizumab, and olokizumab, and their future perspectives in the treatment of RA.

  10. The construction of a public key infrastructure for healthcare information networks in Japan.

    PubMed

    Sakamoto, N

    2001-01-01

    The digital signature is a key technology in the forthcoming Internet society for electronic healthcare as well as for electronic commerce. Efficient exchanges of authorized information with a digital signature in healthcare information networks require a construction of a public key infrastructure (PKI). In order to introduce a PKI to healthcare information networks in Japan, we proposed a development of a user authentication system based on a PKI for user management, user authentication and privilege management of healthcare information systems. In this paper, we describe the design of the user authentication system and its implementation. The user authentication system provides a certification authority service and a privilege management service while it is comprised of a user authentication client and user authentication serves. It is designed on a basis of an X.509 PKI and is implemented with using OpenSSL and OpenLDAP. It was incorporated into the financial information management system for the national university hospitals and has been successfully working for about one year. The hospitals plan to use it as a user authentication method for their whole healthcare information systems. One implementation of the system is free to the national university hospitals with permission of the Japanese Ministry of Education, Culture, Sports, Science and Technology. Another implementation is open to the other healthcare institutes by support of the Medical Information System Development Center (MEDIS-DC). We are moving forward to a nation-wide construction of a PKI for healthcare information networks based on it.

  11. Protective Effect of Selenium-Based Medicines on Toxicity of Three Common Organophosphorus Compounds in Human Erythrocytes In Vitro

    PubMed Central

    Mostafalou, Sara; Navaei-Nigjeh, Mona; Baeeri, Maryam; Mohammadirad, Azadeh; Abdollahi, Mohammad

    2016-01-01

    Objective Organophosphorus (OP) compounds are used to control pests, however they can reach the food chain and enter the human body causing serious health problems by means of acetylcholinesterase (AChE) inhibition and oxidative stress (OS). Among the OPs, chlorpyrifos (CHP), malathion (MAL), and diazinon (DIA) are commonly used for commercial extermination purposes, in addition to veterinary practices, domestic, agricul- ture and public health applications. Two new recently registered medicines that contain selenium and other antioxidants, IMOD and angipars (ANG), have shown beneficial ef- fects for OS related disorders. This study examines the effect of selenium-based medi- cines on toxicity of three common OP compounds in erythrocytes. Materials and Methods In the present experimental study, we determined the ef- ficacy of IMOD and ANG on OS induced by three mentioned OP pesticides in human erythrocytes in vitro. After dose-response studies, AChE, lipid peroxidation (LPO), total antioxidant power (TAP) and total thiol molecules (TTM) were measured in eryth- rocytes after exposure to OPs alone and in combined treatment with IMOD or ANG. Results AChE activity, TAP and TTM reduced in erythrocytes exposed to CHP, MAL and DIA while they were restored in the presence of ANG and IMOD. ANG and IMOD reduced the OPs-induced elevation of LPO. Conclusion The present study shows the positive effects of IMOD and ANG in re- duction of OS and restoration of AChE inhibition induced by CHP, MAL and DIA in erythrocytes in vitro. PMID:26862533

  12. California settles lawsuit by AIDS Healthcare Foundation.

    PubMed

    1999-04-01

    The California Department of Health Services agreed to settle a lawsuit alleging it withheld funding from the AIDS Healthcare Foundation (AHF) in retaliation for AHF's advocacy on behalf of its clients. The public protest arose when the department attempted to cite one of the AHF hospices for not having a licensed nursing home administrator, which would have blocked Medi-Cal payments for patient care. For the type of facility being cited, having a nursing home administrator is not a requirement under State regulations. AHF charged the state with engaging in a pattern of discrimination, in violation of the Americans with Disabilities Act, the Federal Rehabilitation Act, and California's Unruh Civil Rights Act. A U.S. District judge granted summary judgment to the state on all claims except one transferring AHF's oversight responsibility to a county without AHF facilities. The transfer was viewed as having been aimed at AHF lobbying efforts and as an attempt to silence the foundation. The settlement returned AHF monitoring to Los Angeles County and dropped its claim that the two hospices had to hire a licensed nursing home administrator.

  13. The first synthesis of chem-prep varistor LAC (lightning arrestor connector) granules

    SciTech Connect

    Tuttle, B.A.; Voigt, J.A.; Andrews, L.A.

    1988-03-01

    ZnO variestor granules are the active medis for many lightning arrestor connectors (LACs). The 150 to 200 micron diameter granules provide a controlled electrical breakdown in the 400 micron gap between the electrically conductive pin and web of the connector. Tradiationally, the varistor granules are made from commercially available, reagent grade, mixed oxide powders that range in particle size from 1 to 20 microns. For the first time, we have synthesized varistor granules from chemically prepared powders developed at Sandia. These chem-prep varistor powders are more homogeneous and much finer than the mixed oxide powders; the mean particle size of the chem-prep powders is approximately 0.06 microns. LAC granules were formed from chemically prepared powders by traditional ceramic processing techniques. Although the chem-prep granules were not as spherical as the mixed oxide granules, the chem-prep granules did meet present LAC component requirements for fast-rise breakdown voltage and insulation resistance. The insulation resistance of chem-prep granules for a 200 volt pin-to-web voltage was 100 times less than for mixed oxide granules; however, both types of granules had similar insulation resistance for a 250 volt pin-to-web voltage.

  14. Use of postpartum care: predictors and barriers.

    PubMed

    DiBari, Jessica N; Yu, Stella M; Chao, Shin M; Lu, Michael C

    2014-01-01

    This study aimed to identify actual and perceived barriers to postpartum care among a probability sample of women who gave birth in Los Angeles County, California in 2007. Survey data from the 2007 Los Angeles Mommy and Baby (LAMB) study (N = 4,075) were used to identify predictors and barriers to postpartum care use. The LAMB study was a cross-sectional, population-based study that examined maternal and child health outcomes during the preconception, prenatal, and postpartum periods. Multivariable analyses identified low income, being separated/divorced and never married, trying hard to get pregnant or trying to prevent pregnancy, Medi-Cal insurance holders, and lack of prenatal care to be risk factors of postpartum care nonuse, while Hispanic ethnicity was protective. The most commonly reported barriers to postpartum care use were feeling fine, being too busy with the baby, having other things going on, and a lack of need. Findings from this study can inform the development of interventions targeting subgroups at risk for not obtaining postpartum care. Community education and improved access to care can further increase the acceptability of postpartum visits and contribute to improvements in women's health. Postpartum care can serve as a gateway to engage underserved populations in the continuum of women's health care. PMID:24693433

  15. Thorny issues confront California lawmakers in 1998.

    PubMed

    1997-10-31

    When the California Legislature reconvenes in January 1998 it will consider bills that were not resolved during the 1997 session. Senate Bill 705 makes it a felony for a person to intentionally infect another person with HIV through sexual activity. The current version of S.B. 705 only punishes those who intend to expose others to HIV through unprotected anal or vaginal intercourse. Senate Bill 885 would waive California's ban on nonprescription use of syringes and create a government-sanctioned needle exchange pilot program in Los Angeles, San Francisco, Long Beach, and San Jose through January 2000. It is unlikely that Governor Wilson will approve this bill. Senate Bill 1110 requires school districts to notify parents or guardians before pupils receive HIV prevention or human sexuality instruction. Senate Bill 535 establishes a $1 million State research program at the University of California to determine the efficacy of the medical use of marijuana for AIDS wasting syndrome, glaucoma, and cancer. Assembly Bill 1055 would require all contractors operating Medi-Cal managed care plans to provide all HIV medications that have been approved by the U.S. Food and Drug Administration.

  16. Development and Validation of a Standardized Tool for Prioritization of Information Sources

    PubMed Central

    Akwar, Holy; Kloeze, Harold; Mukhi, Shamir

    2016-01-01

    Purpose: To validate the utility and effectiveness of a standardized tool for prioritization of information sources for early detection of diseases. Methods: The tool was developed with input from diverse public health experts garnered through survey. Ten raters used the tool to evaluate ten information sources and reliability among raters was computed. The Proc mixed procedure with random effect statement and SAS Macros were used to compute multiple raters’ Fleiss Kappa agreement and Kendall's Coefficient of Concordance. Results: Ten disparate information sources evaluated obtained the following composite scores: ProMed 91%; WAHID 90%; Eurosurv 87%; MediSys 85%; SciDaily 84%; EurekAl 83%; CSHB 78%; GermTrax 75%; Google 74%; and CBC 70%. A Fleiss Kappa agreement of 50.7% was obtained for ten information sources and 72.5% for a sub-set of five sources rated, which is substantial agreement validating the utility and effectiveness of the tool. Conclusion: This study validated the utility and effectiveness of a standardized criteria tool developed to prioritize information sources. The new tool was used to identify five information sources suited for use by the KIWI system in the CEZD-IIR project to improve surveillance of infectious diseases. The tool can be generalized to situations when prioritization of numerous information sources is necessary. PMID:27752297

  17. Placebo-controlled study in neuromyelitis optica—Ethical and design considerations

    PubMed Central

    Cree, Bruce AC; Bennett, Jeffrey L; Sheehan, Mark; Cohen, Jeffrey; Hartung, Hans-Peter; Aktas, Orhan; Kim, Ho Jin; Paul, Friedemann; Pittock, Sean; Weinshenker, Brian; Wingerchuk, Dean; Fujihara, Kazuo; Cutter, Gary; Patra, Kaushik; Flor, Armando; Barron, Gerard; Madani, Soraya; Ratchford, John N; Katz, Eliezer

    2015-01-01

    Background: To date, no treatment for neuromyelitis optica (NMO) has been granted regulatory approval, and no controlled clinical studies have been reported. Objective: To design a placebo-controlled study in NMO that appropriately balances patient safety and clinical–scientific integrity. Methods: We assessed the “standard of care” for NMO to establish the ethical framework for a placebo-controlled trial. We implemented measures that balance the need for scientific robustness while mitigating the risks associated with a placebo-controlled study. The medical or scientific community, patient organizations, and regulatory authorities were engaged early in discussions on this placebo-controlled study, and their input contributed to the final study design. Results: The N-MOmentum study (NCT02200770) is a clinical trial that randomizes NMO patients to receive MEDI-551, a monoclonal antibody that depletes CD19+ B-cells, or placebo. The study design has received regulatory, ethical, clinical, and patient approval in over 100 clinical sites in more than 20 countries worldwide. Conclusion: The approach we took in the design of the N-MOmentum trial might serve as a roadmap for other rare severe diseases when there is no proven therapy and no established clinical development path. PMID:26666258

  18. Linear dimensions and volumes of human lungs

    DOE PAGES

    Hickman, David P.

    2012-03-30

    TOTAL LUNG Capacity is defined as “the inspiratory capacity plus the functional residual capacity; the volume of air contained in the lungs at the end of a maximal inspiration; also equals vital capacity plus residual volume” (from MediLexicon.com). Within the Results and Discussion section of their April 2012 Health Physics paper, Kramer et al. briefly noted that the lungs of their experimental subjects were “not fully inflated.” By definition and failure to obtain maximal inspiration, Kramer et. al. did not measure Total Lung Capacity (TLC). The TLC equation generated from this work will tend to underestimate TLC and does notmore » improve or update total lung capacity data provided by ICRP and others. Likewise, the five linear measurements performed by Kramer et. al. are only representative of the conditions of the measurement (i.e., not at-rest volume, but not fully inflated either). While there was significant work performed and the data are interesting, the data does not represent a maximal situation, a minimal situation, or an at-rest situation. Moreover, while interesting, the linear data generated by this study is limited by the conditions of the experiment and may not be fully comparative with other lung or inspiratory parameters, measures, or physical dimensions.« less

  19. Informing public policy toward binational health insurance: Empirical evidence from California

    PubMed Central

    Fulton, Brent D; Galárraga, Omar; Dow, William H

    2015-01-01

    Objective To estimate reimbursement rate differences between Mexico and US based physicians reimbursed by a binational health insurance (BHI) plan and US payers, respectively; and show the relationship between plan benefit designs and health care utilization in Mexico. Materials and methods Data include 33 841 and 53 909 HMO enrollees in California from Sistemas Médicos Nacionales (SIMNSA) and Salud con Health Net, respectively. We use descriptive statistical methods. Results SIMNSA’s physician reimbursement rates averaged 50.7% (95% CI: 34.5%–67.0%) of Medi-Cal’s, 28.3% (95% CI: 19.6%–37.0%) of Medicare’s, and 22% of US private plans’. Each year, 99.4% of SIMNSA enrollees but only 0.1% of Salud con Health Net enrollees obtained care in Mexico. Conclusion SIMNSA only covers emergency and urgent care in the US, while Salud con Health Net covers comprehensive care with higher patient cost sharing than in Mexico. To realize potential savings, plans need strong incentives to increase utilization in Mexico. PMID:25153186

  20. A new inventory for middle east dust source points.

    PubMed

    Moridnejad, Ali; Karimi, Neamat; Ariya, Parisa A

    2015-09-01

    We use the Moderate Resolution Imaging Spectroradiometer (MODIS) sensor on both Terra and Aqua satellites to present new high-resolution mapping of major atmospheric dust source points in the Middle East region on the basis of the improved version of the recently developed Middle East Dust Index (MEDI) applied to 70 dust storms, which occurred during the period between 2001 and 2012. Results indicate that 247 different source points have participated in dust storm generation in the Middle East region in which Iraq and Syria are the highest efficient sites for dust storm generation in this region, respectively. Using extracted indices for Deep Blue algorithm, identified dust sources were classified into three levels of intensity. The frequency of occurrence approach, the relationship between high atmospheric dust content and its number of occurrences, is also used to identify sensitive source points. High-intensity dust storms are mainly located west of Iraq and the border of Iraq and Syria. We will discuss the implications of our results in understanding the global dust cycle. PMID:26297415

  1. US veterinary support to standardization of food and water safety and animal care and use within NATO.

    PubMed

    Burke, Ronald L; Mann, Kelly A; Richards, Steven; Stevenson, Timothy H

    2013-01-01

    NATO requires all standardization agreements and Al-lied Medical Publications to be reviewed at least once every 3 years to ensure they reflect current technologies and national military policies and procedures. This is particularly applicable with regard to veterinary medi-cine and food and water safety where advances in scientific knowledge and practices may result in documents quickly becoming obsolete. Such is the case with the 8 standardization agreements for which the FWSVS has responsibility; all are currently undergoing major revisions. With each revision, national representatives, including US veterinary and preventive medicine personnel, must review the documents to ensure there are no significant issues which would prevent ratification and implementation. This improves standardization and enhances interoperability between NATO partners to minimize duplication. This is accomplished by leveraging other national military capabilities, while maintaining confidence that the food, water, and veterinary support provided to their Warriors, support personnel, and animals in the field is safe and high in quality. Adherence to such standards is a major factor in maintaining the operational readiness of all alliance armed forces. PMID:23277450

  2. Prior Sexual Trauma and Adjustment Following the Virginia Tech Campus Shootings: Examination of the Mediating Role of Schemas.

    PubMed

    Littleton, Heather L; Grills-Taquechel, Amie E; Axsom, Danny; Bye, Kimberly; Buck, Katherine S

    2012-11-01

    A sizable body of research supports trauma's cumulative nature. However, few studies have evaluated potential mechanisms through which the experience of multiple traumas leads to elevated distress. The current study sought to evaluate differences between sexual trauma victims and women who had not experienced sexual trauma in their adjustment following a mass trauma (college women exposed to the 2007 Virginia Tech campus shooting). In addition, the study examined whether maladaptive schema change (lower self-worth and less belief in benevolence) and social support mediated the relationship between experiencing multiple traumas (sexual trauma and the campus shooting) and distress. The sample consisted of 215 college women who were assessed preshooting as well as two months and one year following the campus shooting. Women who had experienced sexual trauma (either contact sexual abuse or sexual assault) were compared to those who had not on their one-year postshooting PTSD and depressive symptoms. Results supported that sexual trauma victims reported significantly more depressive symptoms and shooting-related PTSD as well as less belief in benevolence and lower family support. Family support and benevolence beliefs at the two month postshooting assessment were significant medi-ators of the association between sexual trauma history and depression and PTSD. Implications of the findings for future research evaluating the cumulative impact of multiple traumatic experiences are discussed. PMID:23795237

  3. New secure communication-layer standard for medical image management (ISCL)

    NASA Astrophysics Data System (ADS)

    Kita, Kouichi; Nohara, Takashi; Hosoba, Minoru; Yachida, Masuyoshi; Yamaguchi, Masahiro; Ohyama, Nagaaki

    1999-07-01

    This paper introduces a summary of the standard draft of ISCL 1.00 which will be published by MEDIS-DC officially. ISCL is abbreviation of Integrated Secure Communication Layer Protocols for Secure Medical Image Management Systems. ISCL is a security layer which manages security function between presentation layer and TCP/IP layer. ISCL mechanism depends on basic function of a smart IC card and symmetric secret key mechanism. A symmetry key for each session is made by internal authentication function of a smart IC card with a random number. ISCL has three functions which assure authentication, confidently and integrity. Entity authentication process is done through 3 path 4 way method using functions of internal authentication and external authentication of a smart iC card. Confidentially algorithm and MAC algorithm for integrity are able to be selected. ISCL protocols are communicating through Message Block which consists of Message Header and Message Data. ISCL protocols are evaluating by applying to regional collaboration system for image diagnosis, and On-line Secure Electronic Storage system for medical images. These projects are supported by Medical Information System Development Center. These project shows ISCL is useful to keep security.

  4. Older adults challenged financially when adult children move home.

    PubMed

    Wallace, Steven P; Padilla-Frausto, D Imelda

    2014-02-01

    This policy brief looks at the financial burdens imposed on older Californians when adult children return home, often due to a crisis not of their own making, to live with their parents. The findings show that on average in California, the amount of money that older adults need in order to maintain a minimally decent standard of living while supporting one adult child in their home increases their expenses by a minimum of 50 percent. Low-income older adults are usually on fixed incomes, so helping an adult child can provide the child with a critical safety net but at the cost of the parents' own financial well-being. Policy approaches to assisting this vulnerable population of older adults include implementing reforms to increase Supplemental Security Income (SSI), improving the availability of affordable housing, assuring that all eligible nonelderly adults obtain health insurance through health care reform's expansion of Medi-Cal and subsidies, and increasing food assistance through SNAP and senior meal programs. PMID:24804354

  5. Data safety and drug safety in Germany: a closing gap?

    PubMed

    Rathmann, W

    2001-12-01

    Pharmacoepidemiology and drug utilization research are more and more involved in a fundamental conflict with data privacy regulations in Germany. In an attempt to close this gap, a working group of German data protection commissioners and representatives from epidemiologic research societies published guidelines on epidemiology and data protection, which are briefly reviewed. There are several data sources for drug utilization research and pharmacoepidemiology in Germany (national health surveys, routine data from hospitals, general practitioners, or statutory health insurance companies) allowing descriptive and analytic epidemiologic studies. Furthermore, since 1980 a random sample of all prescriptions of patients from statutory health insurances (GKV-Arzneimittelindex) is analysed to produce an annual report on prescription drug use. More intensive use of health insurance data for evaluation of medical care including drug prescriptions is in discussion. The MediPlus (IMS HEALTH) database on 400 general and internal medicine practices provides an example to close the gap between the current demand for drug safety studies and data privacy issues. Finally, large provider systems with enormous data storage and data flow are emerging. Therefore, a further development of policies to guarantee ethically correct use of personally identifiable health data in the changing health care environment is urgently required.

  6. [Hypolipidemic and antihypertensive therapy in diabetic patients in the Czech Republic: notes on the VZP (General Health Insurance Company) Data].

    PubMed

    Šnejdrlová, Michaela; Češka, Richard; Janíčková-Žďárská, Denisa; Honěk, Petr; Dušek, Pavel; Pavlík, Tomáš; Kvapil, Milan

    2015-11-01

    Diabetes mellitus and in particular type 2 diabetes mellitus is one of the most important risk factors of cardiovascular disease. To influence cardiovascular risk there is enormous important not only positive influence of glycemia, but also the treatment of diabetic dyslipidemia and hypertension. The present work provides an analysis of lipid-lowering and antihypertensive therapy for all diabetics registered with General Health Insurance Company in the period 2010-2013. In this time 866,570 patients with diabetes mellitus registered with General Health Insurance Company were treated, the majority of them were diabetics independent on insulin. Approximately half of the patients were observed by dialectologists and half of them by the doctors of other specialization. Out of antihypertensive medi-cation, patients were most often treated by drugs that affect the renin-angiotensin system, as well as beta-blockers and diuretics. Prescription of the lipid-lowering therapy, especially prescription of statins, in accordance with the guidelines, is increasing, but remains insufficient (at 2013 43.6% diabetics treated by dialectologists and 51.3% diabetics treated by GP´s didn´t have lipid lowering therapy). Inadequate use of combination lipid-lowering therapy was recorded too, still represented mainly by combination of statin and fibrate, but in coming years we expect (based on the positive results of the subanalysis IMPROVE-IT study), an increase of combination therapy statin and ezetimibe.

  7. The LHCb VELO upgrade

    NASA Astrophysics Data System (ADS)

    Dosil Suárez, Álvaro

    2016-07-01

    The upgrade of the LHCb experiment, planned for 2019, will transform the experiment to a trigger-less system reading out the full detector at 40 MHz event rate. All data reduction algorithms will be executed in a high-level software farm. The upgraded detector will run at luminosities of 2×1033 cm-2 s-1 and probe physics beyond the Standard Model in the heavy flavour sector with unprecedented precision. The Vertex Locator (VELO) is the silicon vertex detector surrounding the interaction region. The current detector will be replaced with a hybrid pixel system equipped with electronics capable of reading out at 40 MHz. The detector comprises silicon pixel sensors with 55×55 μm2 pitch, read out by the VeloPix ASIC, based on the TimePix/MediPix family. The hottest region will have pixel hit rates of 900 Mhits/s yielding a total data rate more than 3 Tbit/s for the upgraded VELO. The detector modules are located in a separate vacuum, separated from the beam vacuum by a thin custom made foil. The detector halves are retracted when the beams are injected and closed at stable beams, positioning the first sensitive pixel at 5.1 mm from the beams. The material budget will be minimised by the use of evaporative CO2 coolant circulating in microchannels within 400 μm thick silicon substrates.

  8. The health of U.S. hired farm workers.

    PubMed

    Villarejo, Don

    2003-01-01

    Despite a recent surge in knowledge about U.S. hired farm workers, little is known about the health of this population. No national data are available on the size of the population, mortality or morbidity data, or on chronic health indicators. Demographic data show that these workers are mostly Mexican immigrant or migrant males, and nearly two thirds live in poverty. At least half of all current hired farm workers are undocumented. Fewer than one in five have health insurance, either through their employer or through government programs. However, programs targeting women farm workers, such as WIC or, in California, emergency MediCal, are more effective in helping them obtain needed services. The federal Migrant Health Program serves about 13% of the total of workers plus dependent family members. This paper reviews what is known in the following topical areas: (a) mortality and morbidity; (b) access to health care services; (c) control of infectious diseases; (d) maternal and child care; (e) occupational health; (f) violence; and (g) chronic health indicators. It is suggested that future research incorporate a minimal physical examination of all patients or subjects in order to establish baseline information for the population. Such information will be helpful in targeting interventions and measuring their effectiveness. PMID:12359914

  9. An overview of triple infection with hepatitis B, C and D viruses.

    PubMed

    Riaz, Mehwish; Idrees, Muhamad; Kanwal, Hifza; Kabir, Firoz

    2011-01-01

    Viral hepatitis is one of the major health problems worldwide, particularly in South East Asian countries including Pakistan where hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are highly endemic. Hepatitis delta virus (HDV) is also not uncommon world-wide. HCV, HBV, and HDV share parallel routes of transmission due to which dual or triple viral infection can occur in a proportion of patients at the same time. HBV and HCV are important factors in the development of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). In addition to LC and HCC, chronic HDV infection also plays an important role in liver damage with oncogenic potential.The current article reviews the available literature about the epidemiology, pathogenesis, transmission, symptoms, diagnosis, replication, disease outcome, treatment and preventive measures of triple hepatitis infection by using key words; epidemiology of triple infection, risk factors, awareness status, treatment and replication cycle in PubMed, PakMediNet, Directory of Open Access Journals (DOAJ) and Google Scholar. Total data from 74 different studies published from 1983 to 2010 on triple hepatitis infections were reviewed and included in this study. The present article briefly describes triple infection with HCV, HBV and HDV. PMID:21791115

  10. Intrasite motions and monument instabilities at Medicina ITRF co-location site

    NASA Astrophysics Data System (ADS)

    Sarti, Pierguido; Abbondanza, Claudio; Legrand, Juliette; Bruyninx, Carine; Vittuari, Luca; Ray, Jim

    2013-03-01

    We process the total-station surveys performed at the ITRF co-location site Medicina (Northern Italy) over the decade (2001-2010) with the purpose of determining the extent of local intrasite motions and relating them to local geophysical processes, the geological setting and the design of the ground pillars. In addition, continuous observations acquired by two co-located GPS stations (MEDI and MSEL separated by ≈27 m) are analysed and their relative motion is cross-checked with the total-station results. The local ground control network extends over a small area (<100 × 100 m) but the results demonstrate significant anisotropic deformations with rates up to 1.6 mm a-1, primarily horizontal, a value comparable to intraplate tectonic deformations. The results derived from GPS and total-station observations are consistent and point to the presence of horizontal intrasite motions over very short distances possibly associated with varying environmental conditions in a very unfavourable local geological setting and unsuitable monument design, these latter being crucial aspects of the realization and maintenance of global permanent geodetic networks and the global terrestrial reference frame.

  11. Structural and membrane modifying properties of suzukacillin, a peptide antibiotic related to alamethicin. Part A. Sequence and conformation.

    PubMed

    Jung, G; König, W A; Leibfritz, D; Ooka, T; Janko, K; Boheim, G

    1976-04-16

    The primary structure and conformation of the polypeptide antibiotic suzukacillin A are investigated. Suzukacillin A is isolated from the Trichoderma viride strain 1037 and exhibits membrane modifying and lysing properties similar to those of alamethicin. A combined gas chromatographic mass spectrometric analysis of the trifluoroacetylated peptide methyl esters of partial hydrolysates revealed a tentative sequence of 23 residues including 10 2-methylalanines and one phenylalaninol, which shows many fragments known from alamethicin: Ac-Aib-Pro-Val-Aib-Val-Ala-Aib-Ala-Aib-Aib-Gln-Aib-Leu-Aib-Gly-Leu-Aib-Pro-Val-Aib-Aib-Glu(Pheol)-Gln-OH. All chiral amino acids and phenylalainol have L-configuration. Ultraviolet and infrared spectroscopy, circular dichroism in various solvents and in particular 13C nuclear magnetic resonance have been used for a comparative study of suzukacillin with alamethicin. Suzukacillin has a partially alpha-helical structure and the helix content increases largely from polar to lipophilic solvents. Suzukacillin aggregates more strongly than alamethicin in aqueous medis due to a longer alpha-helical part and higher number of aliphatic residues. A part of the alpha-helix is exceptionally stabilized due to 2-methylalanine residues shielding the peptide bonds from interactions with polar solvents. In lipophilic solvents and lecithin vesicles particularly large temperature induced reductions of the high alpha-helix content are found for alamethicin. Suzukacillin shows similar temperature coefficients in lipophilic media, however, in contrast to alamethicin a more linear change in intensity of the Cotton effects is observed. PMID:1260057

  12. The role of the insulin-like growth factor signaling pathway in non-small cell lung cancer and other solid tumors.

    PubMed

    Scagliotti, Giorgio V; Novello, Silvia

    2012-06-01

    The type 1 insulin-like growth factor receptor (IGF-1R) and its downstream signaling components have become increasingly recognized as having a driving role in the development of malignancy, and consequently IGF-1R has become a potential target for cancer therapy. Several inhibitors of IGF-1R are in clinical development for the treatment of solid tumors, including non-small cell lung cancer (NSCLC). These IGF-1R-targeted agents include monoclonal antibodies such as cixutumumab (IMC-A12), AMG-479, AVE1642, BIIB022, dalotuzumab (MK-0646), and robatumumab (Sch717454), the ligand neutralizing antibody Medi-573, and the small molecule inhibitors BMS-754807, linsitinib (OSI-906), XL228, and AXL1717. Two phase III trials of the anti-IGF-1R monoclonal antibody, figitumumab (CP-751,871), were discontinued in 2010 as it was considered unlikely either trial would meet their primary endpoints. In light of disappointing clinical data with figitumumab and other targeted agents, it is likely that the use of molecular markers will become important in predicting response to treatment. This review outlines the role of IGF-1R signaling in solid tumors with a particular focus on NSCLC, and provides an overview of clinical data.

  13. Flexible DAQ card for detector systems utilizing the CoaXPress communication standard

    NASA Astrophysics Data System (ADS)

    Neue, G.; Hejtmánek, M.; Marčišovský, M.; Voleš, P.

    2015-04-01

    This work concerns the design and construction of a flexible FPGA based data acquisition system aimed for particle detectors. The interface card as presented was designed for large area detectors with millions of individual readout channels. Flexibility was achieved by partitioning the design into multiple PCBs, creating a set of modular blocks, allowing the creation of a wide variety of configurations by simply stacking functional PCBs together. This way the user can easily toggle the polarity of the high voltage bias supply or switch the downstream interface from CoaXPress to PCIe or stream directly HDMI. We addressed the issues of data throughput, data buffering, bias voltage generation, trigger timing and fine tuning of the whole readout chain enabling a smooth data transmission. On the current prototype, we have wire-bonded a MediPix2 MXR quad and connected it to a XILINX FPGA. For the downstream interface, we implemented the CoaXPress communication protocol, which enables us to stream data at 3.125 Gbps to a standard PC.

  14. One-step endosonography-guided drainage of a pancreatic pseudocyst: a new technique of stent delivery through the echo endoscope.

    PubMed

    Vilmann, P; Hancke, S; Pless, T; Schell-Hincke, J D; Henriksen, F W

    1998-10-01

    We report here the first case of a one-step endosonography(EUS)-guided pseudocyst drainage. A prototype large channel curved array echo endoscope (Pentax FG-38 UX) and a prototype delivery system for placement of an endoprosthesis was used for the procedure. The delivery system (GIP MedicinTechnik GmbH/Medi-Globe Corporation) consists of a handle part with a piston, a metal ring sheath, a plastic catheter with a diathermy needle and a double pigtail endoprosthesis (8.5 Fr). When mounted on the endoscope the endoprosthesis can be advanced out of the distal end of the endoscope. The introduction of the stent as well as the stent release can be monitored entirely by ultrasound. The procedure was tested in a 76-year-old woman with a pseudocyst measuring 60 mm in diameter located in the tail of the pancreas. The procedure was well tolerated by the patient, and there were no procedural complications. The advantage of a large channel echo endoscope and our new prototype delivery system is that the endoprosthesis can be inserted in to a pancreatic cyst guided exclusively by EUS without exchange of endoscopes, catheters or guide wires. Further studies are warranted. PMID:9865567

  15. Modern use of smartphone applications in the perioperative management in microsurgical breast reconstruction

    PubMed Central

    Rozen, Warren Matthew; Marsh, Daniel; Chow, Whitney T.H.; Vickers, Tobias; Khan, Lubna; Miller, George S.; Hunter-Smith, David J.; Ramakrishnan, Venkat V.

    2016-01-01

    Background Advances in mobile telecommunication, improved mobile internet and affordability have led to a significant increase in smartphone use within medicine. The capability of instant messaging, photography, videography, word processing, drawing and internet access allow significant potential in this small portable device. Smartphone use within medicine has grown tremendously worldwide given its affordability, improved internet and capabilities. Methods We have searched for apps specifically helpful in the perioperative care of microsurgical breast reconstructive patients. Results The useful apps have been subdivided: (I) communication apps—multimedia messaging, WhatsApp, PicSafeMedi: allow efficient communication via text, picture and video messages leading to earlier assessment and definitive management of free flaps; (II) storage apps—Notability, Elogbook: electronic storage of patient notes and logbooks of case which can be shared with others if required; (III) educational apps—FlapApp, Touch Surgery, PubMed on tap: step by step guides to surgical procedures to aid learning and medical journal database; (IV) flap monitoring app—SilpaRamanitor: free flap monitoring app based on photographic analysis for earlier detection of compromised flaps. Conclusions There has been remarkable growth in smartphones use among surgeons. Apps are being developed for every conceivable use. The future will be in wearable smart devices that allow continuous monitoring with the potential to instigate change should deviations from the norm occur. The smart watch is the start of this digital revolution. PMID:27047783

  16. Innovative technique for large septal perforation repair and radiological evaluation.

    PubMed

    Mocella, S; Muia, F; Giacomini, P G; Bertossi, D; Residori, E; Sgroi, S

    2013-06-01

    La perforazione del setto nasale ha cause molteplici: traumatiche, iatrogene, infettive, degenerative, da abuso di vasocostrittori, da uso di cocaina e di recente anche da chemioterapici antineoplastici. Le perforazioni sono altresì classificate in funzione delle dimensioni e della tipologia del deficit cartilagineo o osteocartilagineo e della sede anteriore, mediana e posteriore. Molteplici tecniche di riparazione chirurgica del danno sono state proposte nel tempo e vengono riassunte nel presente lavoro per tipologia di approccio; i risultati conseguiti, sono soddisfacenti per le perforazioni di piccole e medie dimensioni, ma nelle grandi perforazioni non garantiscono sempre la permanente obliterazione del difetto. Spesso si rende necessario l'utilizzo di tessuti prelevati all'interno delle fosse nasali come i turbinati o il prelievo di cartilagine da altre sedi donatrici come l'orecchio o la costa; le varie tecniche vengono illustrate alla luce della più recente letteratura. Gli Autori hanno valutato i pazienti osservati negli ultimi 8 anni e i risultati chirurgici conseguiti in particolare considerando, gli approcci chirurgici effettuati in approccio aperto o chiuso, endoscopico ed i materiali impiegati. Gli autori propongono tra le varie tecniche impiegate in questa serie di pazienti, una tecnica innovativa utilizzabile con successo in molti dei casi considerati di perforazione settale iatrogena che prevede l'utilizzo del gibbo osteocartilagineo quale sede donatrice, nonché la rinosettoplastica riduttiva quale scelta mirata per ottenere agevolmente lembi di scorrimento mucopericondrale e talora produrre anche un miglioramento estetico morfologico.

  17. Indian Society for Apheresis and apheresis tourism in India--is there a future?

    PubMed

    Srivastava, R

    2006-04-01

    Apheresis has now become an internationally popular mode of treatment for multiple immune complex disorders. However, the treatment remains quite expensive in Western Europe and the US. Apheresis tourism is a part of medical tourism or medical tourism specially related to therapeutic apheresis (TA) treatment in a foreign country on a cost effective basis. In the last couple of years, 'Medical Tourism' has become an upcoming and growing enterprise in India. The Indian Society for Apheresis (ISA) has taken a plunge at the opportune time and is trying to promote apheresis tourism in India. ISA is a member of various international apheresis organizations globally including the World Apheresis Association (WAA), the International Society for Apheresis (ISFA), the International Society for Artificial Organs (ISAO) and an associate of other national apheresis societies. The Indian Society for Apheresis (ISA) and the Ludhiana MediCiti (LMC) at Ludhiana Punjab are taking a big step in this direction. The therapeutic apheresis (TA) center at LMC is being set up as a Therapeutic Apheresis Institute and Research Center of excellence. The potential future impacts on the apheresis scenario are summarized.

  18. How to successfully incorporate antiaging and wellness into your practice: things you should know.

    PubMed

    Pontius, Allison T; Smith, Pamela W

    2010-02-01

    Antiaging medicine is the fastest growing medical specialty. It would behoove plastic surgeons to give serious consideration to extending their practices to incorporate antiaging medicine given the similarities in their patient populations, office settings, and fee-for-service practices. It is important to find a practitioner board-certified in antiaging and regenerative medicine that has done a 2-year fellowship in the specialty. Additionally, you must structure your business relationship appropriate to your needs and your practice. There are several options for the arrangement, including (1) having the antiaging physician use your office on your operative days or days off, (2) incorporating the antiaging physician as a part of your practice on a full-time or part-time basis, or (3) renting office space for the antiaging practice in your medi-spa, wellness center, or medical building. These are just some of the more common arrangements all with the ultimate goal of delineating your practice from others in your area, being a forerunner in the future of cutting-edge medical care and offering your patients the full array of aesthetic and health services.

  19. [Treatment of malignant pleural effusion by percutaneous catheter drainage and chemical pleurodesis].

    PubMed

    Chella, A; Ribechini, A; Dini, P; Adamo, C; Mussi, A; Angeletti, C A

    1994-11-01

    From June 1989 to December 1991, 93 patients affected by malignant pleural effusion (MPE) were treated as out patients using a ultrasound (US) guided catheter drainage (10F Percuflex pig-tail catheter-Medi-tech@(PTC) and chemical pleurodesis. The PTC was positioned when the MPE had been diagnosed by X-ray and all the patients had undergone some thoracentesis (mean 3.2, range 2-6). We started a chemical pleurodesis when the MPE was inferior to 100cc/day injecting Epidoxorubicin (EDX 30 mg/mq) in the pleural space on alternate day for three administrations, and then, a lyophilized Corynebacterium Parvum (Wellcome strain CN 6134) (CBP 14 mg) on alternate day for two administrations. The complete response rate of this treatment was 90% (86 pt) with a mean treatment period of 32.9 days (range 12-62). Complete response was assessed as total resolution of pleural effusion. Side effects were short-term hyperpyrexia in 65 cases (69.8%) and pleurodynia in 15 cases (15.7%). Three patients (3.1%) were complicated by a pleural infection which was resolved in 1 case and became chronic in 2. These findings indicate that this technique is an adequate treatment for the control of MPE inducing a clinical and quality-life improvement. PMID:7708227

  20. Il ruolo svolto dall’attività lavorativa sull’ipertensione arteriosa

    PubMed Central

    Barbini, N.; Gorini, G.; Ferrucci, L.; Biggeri, A.

    2009-01-01

    RIASSUNTO Introduzione I parametri di pressione arteriosa, sistolica (PAS) o diastolica (PAD) hanno costituito I’oggetto di numerosi studi, alcuni dei quali stabiliscono un’associazione tra I’aumnto di tali parametri e la mortalità, in particolare alle età medie. I fattori di rischio di ipertensione più frequentemente studiati sono il consumo di alcol, il fumo e I’origine etnica in riferimento sia alle differenze genetiche che nella condotta alimentare, mentre i fattori di origine professionale sono stati presi in considerazione più raramente e in maniera poco approfondita, inoltre sono state riferite notevoli differenze nelle pressioni arteriose medie di individui che svolgono professioni diverse. Sembra infatti che i “colletti blu” siano più a rischio dei “colletti bianchi”. Obiettivi Il nostro scopo è valutare se determinati rischi o vincoli connessi con l’attività professionale o determinati stili di vita rappresentano un fattore di rischio per l’ipertensione arteriosa in considerazioni dell’aumentare dell’età. Elementi specifici che rendano conto di questa relazione non sono stati ancora completamente chiariti e soprattutto i dati sulla popolazione italiana sono molto limitati. Metodi La metodologia di ricerca utilizzata è stata quella dell’indagine francese ESTEV (Derriennic, Touranchet, Volkoff) - VISAT (Marquie, Janson), studio epidemiologico longitudinale su oltre 23000 lavoratori attivata in Francia nel 1990 al fine di indagare gli effetti a lungo termine delle condizioni di lavoro, riferite all’intera vita professionale, sia sull’invecchiamento sia sulla salute dei lavoratori. Analoga indagine è stata avviata in Italia, nel 2000, in 6 Regioni, prendendo in esame i lavoratori dipendenti di diversi settori produttivi appartenenti a 5 coorti di età: da 32 a 52 anni con intervallo di 5 anni. Le rilevazioni sono state effettuate dai medici del lavoro di azienda attraverso 3 questionari: 1. sulle condizioni

  1. Respiratory syncytial virus modified by deletions of the NS2 gene and amino acid S1313 of the L polymerase protein is a temperature-sensitive, live-attenuated vaccine candidate that is phenotypically stable at physiological temperature.

    PubMed

    Luongo, Cindy; Winter, Christine C; Collins, Peter L; Buchholz, Ursula J

    2013-02-01

    Human respiratory syncytial virus (RSV) is the leading viral cause of lower respiratory tract disease in infants and children worldwide. In previous work to develop point mutations in RSV with improved genetic stability, we observed that an attenuating mutation at amino acid position 1321 in the L polymerase protein was subject to deattenuation by a spontaneous second-site compensatory mutation at position 1313 (C. Luongo, C. C. Winter, P. L. Collins, and U. J. Buchholz, J. Virol. 86:10792-10804, 2012). In the present study, we found that deletion of position 1313 (Δ1313), irrespective of the presence of an attenuating mutation at position 1321, provided a new attenuating mutation. RSV bearing Δ1313 replicated in cell culture as efficiently as wild-type virus at 32°C, was restricted for replication at 37°C, and was restricted 50-fold and 150-fold in the upper and lower respiratory tracts, respectively, of mice. We combined the Δ1313 deletion with the previously described, attenuating NS2 gene deletion (ΔNS2) to produce the recombinant live-attenuated RSV vaccine candidate ΔNS2/Δ1313. During in vitro stress tests involving serial passage at incrementally increasing temperatures, a second-site compensatory mutation was detected in close proximity of Δ1313, namely, I1314T. This site was genetically and phenotypically stabilized by an I1314L substitution. Combination of I1314L with ΔNS2/Δ1313 yielded a virus, ΔNS2/Δ1313/1314L, with genetic stability at physiological temperature. This stabilized vaccine candidate was moderately temperature sensitive and had a level of restriction in chimpanzees comparable to that of MEDI-559, a promising RSV vaccine candidate that presently is in clinical trials but lacks stabilized attenuating mutations. The level of attenuation and genetic stability identify ΔNS2/Δ1313/1314L as a promising candidate for evaluation in pediatric phase I studies.

  2. Electromagnetic Reciprocity.

    SciTech Connect

    Aldridge, David F.

    2014-11-01

    A reciprocity theorem is an explicit mathematical relationship between two different wavefields that can exist within the same space - time configuration. Reciprocity theorems provi de the theoretical underpinning for mod ern full waveform inversion solutions, and also suggest practical strategies for speed ing up large - scale numerical modeling of geophysical datasets . In the present work, several previously - developed electromagnetic r eciprocity theorems are generalized to accommodate a broader range of medi um, source , and receiver types. Reciprocity relations enabling the interchange of various types of point sources and point receivers within a three - dimensional electromagnetic model are derived. Two numerical modeling algorithms in current use are successfully tested for adherence to reciprocity. Finally, the reciprocity theorem forms the point of departure for a lengthy derivation of electromagnetic Frechet derivatives. These mathe matical objects quantify the sensitivity of geophysical electromagnetic data to variatio ns in medium parameters, and thus constitute indispensable tools for solution of the full waveform inverse problem. ACKNOWLEDGEMENTS Sandia National Labor atories is a multi - program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the US Department of Energy's National Nuclear Security Administration under contract DE - AC04 - 94AL85000. Signif icant portions of the work reported herein were conducted under a Cooperative Research and Development Agreement (CRADA) between Sandia National Laboratories (SNL) and CARBO Ceramics Incorporated. The author acknowledges Mr. Chad Cannan and Mr. Terry Pa lisch of CARBO Ceramics, and Ms. Amy Halloran, manager of SNL's Geophysics and Atmospheric Sciences Department, for their interest in and encouragement of this work. Special thanks are due to Dr . Lewis C. Bartel ( recently retired from Sandia National Labo ratories and now a

  3. The role of the Pharmaceuticals and Medical Devices Agency and healthcare professionals in post-marketing safety.

    PubMed

    Mori, Kazuhiko; Watanabe, Meguru; Horiuchi, Naoya; Tamura, Atsushi; Kutsumi, Hiromu

    2014-04-01

    The development of drugs and medical devices is necessary for medical progress; however, safety measures need to be put in place to protect the health of the population. In order to ensure the safety of drugs and medical devices, it is important to determine measures for appropriate management of risks at any time during the development phase, the regulatory review and the post-marketing phase. Adverse events detected in clinical trials are limited due to the restricted numbers of patients enrolled in the trials. Therefore, it is almost impossible to predict rare serious adverse events during the post-marketing phase. The revised Pharmaceutical Affairs Act was established in Japan in November 20, 2013. The new act focuses on increased safety of drugs and medical devices. The Pharmaceuticals and Medical Devices Agency (PMDA) is the regulatory authority in Japan that promotes safety measures from the development phase through to the post-marketing phase. In the post-marketing phase, the PMDA collects information from the medical product companies and healthcare professionals, as well as instructing and advising them with regard to post-marketing safety measures for each drug and medical device. Since Japan has a national health insurance system, a new drug or a medical device is available throughout the country when the drug price or medical fee is listed in the National Health Insurance price list. Healthcare professionals in medical institutions must learn about the drugs and medical devices they handle, and should make an effort to maintain patient safety. The PMDA medi-navi is a very useful electronic mail delivery service that provides critical information for protecting patients from health hazards caused by adverse events. The 'risk management plan' is also important as it contains important information about safety profile and post-marketing measures of a new drug. PMID:26183623

  4. REG4 Is Highly Expressed in Mucinous Ovarian Cancer: A Potential Novel Serum Biomarker.

    PubMed

    Lehtinen, Laura; Vesterkvist, Pia; Roering, Pia; Korpela, Taina; Hattara, Liisa; Kaipio, Katja; Mpindi, John-Patrick; Hynninen, Johanna; Auranen, Annika; Davidson, Ben; Haglund, Caj; Iljin, Kristiina; Grenman, Seija; Siitari, Harri; Carpen, Olli

    2016-01-01

    Preoperative diagnostics of ovarian neoplasms rely on ultrasound imaging and the serum biomarkers CA125 and HE4. However, these markers may be elevated in non-neoplastic conditions and may fail to identify most non-serous epithelial cancer subtypes. The objective of this study was to identify histotype-specific serum biomarkers for mucinous ovarian cancer. The candidate genes with mucinous histotype specific expression profile were identified from publicly available gene-expression databases and further in silico data mining was performed utilizing the MediSapiens database. Candidate biomarker validation was done using qRT-PCR, western blotting and immunohistochemical staining of tumor tissue microarrays. The expression level of the candidate gene in serum was compared to the serum CA125 and HE4 levels in a patient cohort of prospectively collected advanced ovarian cancer. Database searches identified REG4 as a potential biomarker with specificity for the mucinous ovarian cancer subtype. The specific expression within epithelial ovarian tumors was further confirmed by mRNA analysis. Immunohistochemical staining of ovarian tumor tissue arrays showed distinctive cytoplasmic expression pattern only in mucinous carcinomas and suggested differential expression between benign and malignant mucinous neoplasms. Finally, an ELISA based serum biomarker assay demonstrated increased expression only in patients with mucinous ovarian cancer. This study identifies REG4 as a potential serum biomarker for histotype-specific detection of mucinous ovarian cancer and suggests serum REG4 measurement as a non-invasive diagnostic tool for postoperative follow-up of patients with mucinous ovarian cancer. PMID:26981633

  5. A comprehensive operating room information system using the Kinect sensors and RFID.

    PubMed

    Nouei, Mahyar Taghizadeh; Kamyad, Ali Vahidian; Soroush, Ahmad Reza; Ghazalbash, Somayeh

    2015-04-01

    Occasionally, surgeons do need various types of information to be available rapidly, efficiently and safely during surgical procedures. Meanwhile, they need to free up hands throughout the surgery to necessarily access the mouse to control any application in the sterility mode. In addition, they are required to record audio as well as video files, and enter and save some data. This is an attempt to develop a comprehensive operating room information system called "Medinav" to tackle all mentioned issues. An integrated and comprehensive operating room information system is introduced to be compatible with Health Level 7 (HL7) and digital imaging and communications in medicine (DICOM). DICOM is a standard for handling, storing, printing, and transmitting information in medical imaging. Besides, a natural user interface (NUI) is designed specifically for operating rooms where touch-less interactions with finger and hand tracking are in use. Further, the system could both record procedural data automatically, and view acquired information from multiple perspectives graphically. A prototype system is tested in a live operating room environment at an Iranian teaching hospital. There are also contextual interviews and usability satisfaction questionnaires conducted with the "MediNav" system to investigate how useful the proposed system could be. The results reveal that integration of these systems into a complete solution is the key to not only stream up data and workflow but maximize surgical team usefulness as well. It is now possible to comprehensively collect and visualize medical information, and access a management tool with a touch-less NUI in a rather quick, practical, and harmless manner.

  6. Scenarios of Future Water use on Mediterranean Islands based on an Integrated Assessment of Water Management

    NASA Astrophysics Data System (ADS)

    Lange, M. A.

    2006-12-01

    The availability of water in sufficient quantities and adequate quality presents considerable problems on Mediterranean islands. Because of their isolation and thus the impossibility to draw on more distant or more divers aquifers, they rely entirely on precipitation as natural replenishing mechanism. Recent observations indicate decreasing precipitation, increasing evaporation and steadily growing demand for water on the islands. Future climate change will exacerbate this problem, thus increasing the already pertinent vulnerability to droughts. Responsible planning of water management strategies requires scenarios of future supply and demand through an integrated assessment including climate scenarios based on regional climate modeling as well as scenarios on changes in societal and economical determinants of water demand. Constructing such strategies necessitates a thorough understanding about the interdependencies and feedbacks between physical/hydrological and socio-economic determinants of water balances on an island. This has to be based on a solid understanding of past and present developments of these drivers. In the framework of the EU-funded MEDIS project (Towards sustainable water use on Mediterranean Islands: addressing conflicting demands and varying hydrological, social and economic conditions, EVK1-CT-2001-00092), detailed investigations on present vulnerabilities and adaptation strategies to droughts have been carried out on Mallorca, Corsica, Sicily, Crete and Cyprus. This was based on an interdisciplinary study design including hydrological, geophysical, agricultural-, social and political sciences investigations. A central element of the study has been the close interaction with stakeholders on the islands and their contribution to strategy formulation. An important result has been a specification of vulnerability components including: a physical/environmental-, an economical/regulatory- and a social/institutional/political component. Their

  7. [Nursing students' satisfaction and perception of their first clinical placement: observational study].

    PubMed

    Comparcini, Dania; Simonetti, Valentina; Tomietto, Marco; Galli, Francesco; Fiorani, Catia; Di Labio, Luisa; Cicolini, Giancarlo

    2014-01-01

    Background. Gli ambienti di apprendimento clinico sono definiti come una rete di fattori interagenti nel contesto, in grado di influenzare gli esiti dell’apprendimento degli studenti. La soddisfazione degli studenti è considerata un indicatore del raggiungimento degli esiti dell’apprendimento ed è determinante a partire dalla prima esperienza di tirocinio. Scopo. Analizzare l’esperienza di apprendimento clinico degli studenti infermieri del primo anno di corso dopo il primo tirocinio clinico ed identificare i principali determinanti della soddisfazione degli studenti. Metodo. Lo studio osservazionale è stato realizzato in cinque sedi universitarie italiane del Corso di Laurea in Infermieristica. 420 studenti hanno compilato la versione italiana della “Clinical Learning Environment, Supervision and plus Nurse Teacher (CLES+T) scale” al termine del primo tirocinio clinico. Risultati. I punteggi medi assegnati alle dimensioni della scala variano da 4.02 (clima di apprendimento) a 3.30 (relazione di tutorato). La maggior parte degli studenti è soddisfatto della propria esperienza di tirocinio (75.6%), ma sono emerse differenze in relazione alle diverse sedi di tirocinio clinico. Discussione. I principali determinanti della soddisfazione sono lo stile di leadership del coordinatore infermieristico e l’integrazione teoria-pratica nella relazione fra tutor clinico, universitario e studente. Conclusioni. I risultati dello studio contribuiscono alla comprensione della prima esperienza di tirocinio degli studenti. Tuttavia, sono necessarie ulteriori ricerche per determinare le variabili organizzative specifiche e i modelli tutoriali in grado di aumentare la soddisfazione degli studenti, per sviluppare strategie formative basate sull’integrazione tra tutor universitari e guide di tirocinio.

  8. Performance of QuantiFERON TB Gold test in detecting latent tuberculosis infection in brain-dead organ donors in Iran: a brief report.

    PubMed

    Tabarsi, Payam; Yousefzadeh, Amir; Najafizadeh, Katayoun; Droudinia, Atousa; Bayati, Rouzbeh; Marjani, Majid; Shafaghi, Shadi; Farokhzad, Banafsheh; Javanmard, Pedram; Velayati, Ali Akbar

    2014-11-01

    With regard to the significant morbidity and mortality due to tuberculosis in lung transplant recipients, the identification of brain-dead organ donors with latent tuberculosis by use of the QuantiFERON TB Gold (QFT-G) test may be of help to reduce the risk of TB reactivation and mortality in lung recipients. This study was conducted in the National Research Institute of Tuber-culosis and Lung Diseases (NRITLD) in Iran, from January to March 2013. A total of 38 conse-cutive brain-dead donors, not currently infected with active tuberculosis, were recruited. The medi-cal records of all the study enrollees were reviewed. A whole-blood IFN- release assay (IGRA) in reaction to early secreted antigenic target 6 (ESAT-6), culture filtrate protein 10 (CFP-10), and TB7.7 antigens, was performed and the released Interferon- was measured via enzyme-linked immunosorbent assay (ELISA). The data was analyzed with QFT-G software which was provided by the company. The demographic, characteristics and other variables were entered into SPSS version 11.5. The QFT-G test results of three donors (7.9%) turned out to be positive, negative for 24 donors (63.1%), and indeterminate for 11 cases (28.9%). Our study revealed the potential advantages of QFT-G in lowering the incidence of donor-derived post-transplant tuberculosis among lung recipients. However, a high rate of indeterminate results restricted the performance of QFT-G in this study.

  9. A comprehensive operating room information system using the Kinect sensors and RFID.

    PubMed

    Nouei, Mahyar Taghizadeh; Kamyad, Ali Vahidian; Soroush, Ahmad Reza; Ghazalbash, Somayeh

    2015-04-01

    Occasionally, surgeons do need various types of information to be available rapidly, efficiently and safely during surgical procedures. Meanwhile, they need to free up hands throughout the surgery to necessarily access the mouse to control any application in the sterility mode. In addition, they are required to record audio as well as video files, and enter and save some data. This is an attempt to develop a comprehensive operating room information system called "Medinav" to tackle all mentioned issues. An integrated and comprehensive operating room information system is introduced to be compatible with Health Level 7 (HL7) and digital imaging and communications in medicine (DICOM). DICOM is a standard for handling, storing, printing, and transmitting information in medical imaging. Besides, a natural user interface (NUI) is designed specifically for operating rooms where touch-less interactions with finger and hand tracking are in use. Further, the system could both record procedural data automatically, and view acquired information from multiple perspectives graphically. A prototype system is tested in a live operating room environment at an Iranian teaching hospital. There are also contextual interviews and usability satisfaction questionnaires conducted with the "MediNav" system to investigate how useful the proposed system could be. The results reveal that integration of these systems into a complete solution is the key to not only stream up data and workflow but maximize surgical team usefulness as well. It is now possible to comprehensively collect and visualize medical information, and access a management tool with a touch-less NUI in a rather quick, practical, and harmless manner. PMID:25017016

  10. Feasibility of coblation versus laser resection in recurrent nasal polyps

    NASA Astrophysics Data System (ADS)

    Ilgner, Justus; Schramm, Karsten; Duwel, Philip; Donner, Andreas; Westhofen, Martin

    2005-04-01

    Introduction: Chronic sinusitis with nasal polyps is one of the commonest diseases of the upper airways, with a recurrence rate of about 15%. Minimally-invasive endoscopic laser procedures have been established to reduce the need for conventional revision surgery whenever medical follow-up fails. However, laser surgery requires special considerations for surgical, safety and economic aspects. This study evaluates the feasibility of coblation versus laser resection for recurrent nasal polyps. Material and methods: 6 nasal polyps were harvested each from the ostiomeatal complex of patients undergoing microscopic endonasal surgery for chronic sinusitis. 3 were dissected using a Neodymium:YAG laser system (Dornier MediLas 5060N) set at 10, 20 and 30w in cw mode with a 600μm bare fiber in contact mode with negative feedback power control, while further 3 polyps were dissected using a Coblation system (ArthroCare® Coblator® I) with a 30° angled and a 0° straight probe with 2.4 mm outer diameter. The specimens were examined histologically for carbonization and coagulation as well as unaltered tissue. Results: Laser resection resulted in a carbonization zone of 30μm in depth plus a coagulation zone of about 100μm, depending on the water content and type of tissue. While the carbonization zone was smaller with coblation, coagulation zones were comparable, leaving ample amount of unaltered tissue available for further diagnosis. Conclusion: Both resection techniques are generally feasible to be used in day case surgery for recurrent polyps. While the coblation system required no special safety requirements, accessibility of the sinuses was limited by the rigidity of applicators that are available.

  11. Molecular and clinical rationale for therapeutic targeting of interleukin-5 and its receptor.

    PubMed

    Molfino, N A; Gossage, D; Kolbeck, R; Parker, J M; Geba, G P

    2012-05-01

    Interleukin-5 is a Th2 homodimeric cytokine involved in the differentiation, maturation, migration, development, survival, trafficking and effector function of blood and local tissue eosinophils, in addition to basophils and mast cells. The IL-5 receptor (IL-5R) consists of an IL-5-specific α subunit that interacts in conformationally dynamic ways with the receptor's βc subunit, an aggregate of domains it shares with binding sites of IL-3 and granulocyte-macrophage colony-stimulating factor. IL-5 and IL-5R drive allergic and inflammatory immune responses characterizing numerous diseases, such as asthma, atopic dermatitis, chronic obstructive pulmonary disease, eosinophilic gastrointestinal diseases, hyper-eosinophilic syndrome, Churg-Strauss syndrome and eosinophilic nasal polyposis. Although corticosteroid therapy is the primary treatment for these diseases, a substantial number of patients exhibit incomplete responses and suffer side-effects. Two monoclonal antibodies have been designed to neutralize IL-5 (mepolizumab and reslizumab). Both antibodies have demonstrated the ability to reduce blood and tissue eosinophil counts. One additional monoclonal antibody, benralizumab (MEDI-563), has been developed to target IL-5R and attenuate eosinophilia through antibody-dependent cellular cytotoxicity. All three monoclonal antibodies are being clinically evaluated. Antisense oligonucleotide technology targeting the common βc IL-5R subunit is also being used therapeutically to inhibit IL-5-mediated effects (TPI ASM8). Small interfering RNA technology has also been used therapeutically to inhibit the expression of IL-5 in animal models. This review summarizes the structural interactions between IL-5 and IL-5R and the functional consequences of such interactions, and describes the pre-clinical and clinical evidence supporting IL-5R as a therapeutic target.

  12. Mycobactericidal activity of selected disinfectants using a quantitative suspension test.

    PubMed

    Griffiths, P A; Babb, J R; Fraise, A P

    1999-02-01

    In this study, a quantitative suspension test carried out under both clean and dirty conditions was used to assess the activity of various instrument and environmental disinfectants against the type strain NCTC 946 and an endoscope washer disinfector isolate of Mycobacterium chelonae, Mycobacterium fortuitum NCTC 10,394, Mycobacterium tuberculosis H37 Rv NCTC 7416 and a clinical isolate of Mycobacterium avium-intracellulare (MAI). The disinfectants tested were; a chlorine releasing agent, sodium dichloroisocyanurate (NaDCC) at 1000 ppm and 10,000 ppm av Cl; chlorine dioxide at 1100 ppm av ClO2 (Tristel, MediChem International Limited); 70% industrial methylated spirits (IMS); 2% alkaline glutaraldehyde (Asep, Galan); 10% succinedialdehyde and formaldehyde mixture (Gigasept, Schulke & Mayr); 0.35% peracetic acid (NuCidex, Johnson & Johnson); and a peroxygen compound at 1% and 3% (Virkon, Antec International). Results showed that the clinical isolate of MAI was much more resistant than M. tuberculosis to all the disinfectants, while the type strains of M. chelonae and M. fortuitum were far more sensitive. The washer disinfector isolate of M. chelonae was extremely resistant to 2% alkaline activated glutaraldehyde and appeared to be slightly more resistant than the type strain to Nu-Cidex, Gigasept, Virkon and the lower concentration of NaDCC. This study has shown peracetic acid (Nu-Cidex), chlorine dioxide (Tristel), alcohol (IMS) and high concentrations of a chlorine releasing agent (NaDCC) are rapidly mycobactericidal. Glutaraldehyde, although effective, is a slow mycobactericide. Gigasept and Virkon are poor mycobactericidal agents and are not therefore recommended for instruments or spillage if mycobacteria are likely to be present. PMID:10063473

  13. Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

    PubMed Central

    H., Hildebrandt; C., Hermann; R., Knittel; M., Richter-Reichhelm; A., Siegel; W., Witzenrath

    2010-01-01

    Introduction Integrated care solutions need supportive financial incentives. In this paper, we describe the financial architecture and operative details of the integrated pilot Gesundes Kinzigtal. Description of integrated care case Located in Southwest Germany, Gesundes Kinzigtal is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH) in cooperation with the physicians' network in the region (MQNK), a German health care management company with a background in medical sociology and health economics (OptiMedis AG) and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg). Discussion and (preliminary) conclusion The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a substantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organization of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether—and to what extent—cost reduction may be attributed to a real population health gain. PMID:20689772

  14. The role of the Pharmaceuticals and Medical Devices Agency and healthcare professionals in post-marketing safety.

    PubMed

    Mori, Kazuhiko; Watanabe, Meguru; Horiuchi, Naoya; Tamura, Atsushi; Kutsumi, Hiromu

    2014-04-01

    The development of drugs and medical devices is necessary for medical progress; however, safety measures need to be put in place to protect the health of the population. In order to ensure the safety of drugs and medical devices, it is important to determine measures for appropriate management of risks at any time during the development phase, the regulatory review and the post-marketing phase. Adverse events detected in clinical trials are limited due to the restricted numbers of patients enrolled in the trials. Therefore, it is almost impossible to predict rare serious adverse events during the post-marketing phase. The revised Pharmaceutical Affairs Act was established in Japan in November 20, 2013. The new act focuses on increased safety of drugs and medical devices. The Pharmaceuticals and Medical Devices Agency (PMDA) is the regulatory authority in Japan that promotes safety measures from the development phase through to the post-marketing phase. In the post-marketing phase, the PMDA collects information from the medical product companies and healthcare professionals, as well as instructing and advising them with regard to post-marketing safety measures for each drug and medical device. Since Japan has a national health insurance system, a new drug or a medical device is available throughout the country when the drug price or medical fee is listed in the National Health Insurance price list. Healthcare professionals in medical institutions must learn about the drugs and medical devices they handle, and should make an effort to maintain patient safety. The PMDA medi-navi is a very useful electronic mail delivery service that provides critical information for protecting patients from health hazards caused by adverse events. The 'risk management plan' is also important as it contains important information about safety profile and post-marketing measures of a new drug.

  15. Reproducibility of Quantitative Susceptibility Mapping in the Brain at Two Field Strengths From Two Vendors

    PubMed Central

    Deh, Kofi; Nguyen, Thanh D.; Eskreis-Winkler, Sarah; Prince, Martin R.; Spincemaille, Pascal; Gauthier, Susan; Kovanlikaya, Ilhami; Zhang, Yan; Wang, Yi

    2015-01-01

    Purpose To assess the reproducibility of brain quantitative susceptibility mapping (QSM) in healthy subjects and in patients with multiple sclerosis (MS) on 1.5 and 3T scanners from two vendors. Materials and Methods Ten healthy volunteers and 10 patients were scanned twice on a 3T scanner from one vendor. The healthy volunteers were also scanned on a 1.5T scanner from the same vendor and on a 3T scanner from a second vendor. Similar imaging parameters were used for all scans. QSM images were reconstructed using a recently developed nonlinear morphology-enabled dipole inversion (MEDI) algorithm with L1 regularization. Region-of-interest (ROI) measurements were obtained for 20 major brain structures. Reproducibility was evaluated with voxel-wise and ROI-based Bland–Altman plots and linear correlation analysis. Results ROI-based QSM measurements showed excellent correlation between all repeated scans (correlation coefficient R ≥ 0.97), with a mean difference of less than 1.24 ppb (healthy subjects) and 4.15 ppb (patients), and 95% limits of agreements of within −25.5 to 25.0 ppb (healthy subjects) and −35.8 to 27.6 ppb (patients). Voxel-based QSM measurements had a good correlation (0.64 ≤ R ≤ 0.88) and limits of agreements of −60 to 60 ppb or less. Conclusion Brain QSM measurements have good interscanner and same-scanner reproducibility for healthy and MS subjects, respectively, on the systems evaluated in this study. PMID:25960320

  16. [An unusual bodily injury].

    PubMed

    Kernbach-Wighton, Gerhard; Hess, Cornelius; Madea, Burkhard

    2016-01-01

    In most cases, bodily harm results from the use of sharp objects or blunt force. This paper deals with a 42-year-old pharmacist who was known to the police and the courts because of several previous convictions for bodily injury. The man had visited a pub just before it closed and was therefore not served any drinks. He got angry about this and returned to his pharmacy (within walking distance) to fetch three disposable syringes which he filled with phosphoric acid (85%). Through the open pub window, he splattered the acid from the syringes on two guests and the host, who were hit on the upper part of their bodies and the arms. All the victims developed dermal alterations such as focal erythema and small blisters (pemphigus-like efflorescences, as already described by Weyrich). At first, the pharmacist denied the use of phosphoric acid and claimed to have used a mixture of urine and water. Examinations of spots on the still unwashed clothes revealed very low pH-values (ca. 2.0; pH-Indicator-Stripes, Merck; Medi-Test, Machery & Nagel). Tests for substances typical of urine produced completely negative results. However, very high phosphate concentrations were found on the spots in question. Thus, the probability that the pharmacist had used phosphoric acid to commit the offence was very high. The pharmacist was sentenced to one year and two months' imprisonment for dangerous bodily harm according to Section 224 German Criminal Code. In accordance with the law, phosphoric acid was classified as "poison", for which application on the skin is sufficient. PMID:27386625

  17. Breast Reconstruction with Enhanced Stromal Vascular Fraction Fat Grafting: What Is the Best Method?

    PubMed Central

    Scioli, Maria Giovanna; Orlandi, Augusto; Cervelli, Valerio

    2015-01-01

    Background: Actually, there are 2 main methods to obtain stromal vascular fraction (SVF): enzymatic digestion and mechanical filtration; however, the available systems report heterogeneous and sometimes not univocal results. The aim of this study is to evaluate different procedures for SVF isolation and compare their clinical efficacy in the treatment of soft-tissue defects in plastic and reconstructive surgery. The authors evaluated Celution and Medikhan, enzymatic systems, and Fatstem and Mystem system, mechanical separation systems. Methods: Fifty patients affected by breast soft-tissue defects were treated in the Plastic and Reconstructive Surgery Department of Tor Vergata University of Rome. Four groups of 10 patients were managed with enhanced SVF fat grafts using cells obtained by Celution (Cytori Therapeutics, Inc., San Diego, Calif.), Medikhan (Medi-Khan Inc., West Hollywood, Calif.), Fatstem (Fatstem CORIOS Soc. Coop, San Giuliano Milanese, Italy), and Mystem (Mystem evo Bi-Medica, Treviolo, Italy) systems. A control group of 10 patients was treated with only centrifuged fat according to Coleman’s technique. Results: In enhanced SVF–treated patients treated with cells obtained by Celution system, we observed a 63% ± 6.2% maintenance of contour restoring after 1 year, compared with 39% ± 4.4% of control group. In patients treated with SVF obtained by Medikhan system, we observed a 39% ± 3.5% maintenance, whereas enhanced SVF with Fatstem and Mystem systems gave a 52% ± 4.6% and 43% ± 3.8% maintenance of contour restoring, respectively. SVF cell counting indicated that Celution and Fatstem were the most efficient systems to obtain SVF cells. Conclusions: Celution and Fatstem were the 2 best automatic systems to obtain SVF and to improve maintenance of fat volume and prevent the reabsorption. PMID:26180707

  18. [Comparison of detection sensitivity in rapid-diagnosis influenza virus kits].

    PubMed

    Tokuno, Osamu; Fujiwara, Miki; Nakajoh, Yoshimi; Yamanouchi, Sumika; Adachi, Masayo; Ikeda, Akiko; Kitayama, Shigeo; Takahashi, Toshio; Kase, Tetsuo; Kinoshita, Shouhiro; Kumagai, Shunichi

    2009-09-01

    Rapid-diagnosis kits able to detect influenza A and B virus by immunochromatography developed by different manufacturers, while useful in early diagnosis, may vary widely in detection sensitivity. We compared sensitivity results for eight virus-detection kits in current use--Quick Chaser FluA, B (Mizuho Medy), Espline Influenza A & B-N (Fujirebio), Capilia Flu A + B (Nippon Beckton Dickinson & Alfesa Pharma), Poctem Influenza A/B (Otsuka Pharma & Sysmex), BD Flu Examan (Nippon Beckton Dickinson), Quick Ex-Flu "Seiken" (Denka Seiken), Quick Vue Rapid SP Influ (DP Pharma Biomedical), and Rapid Testa FLU stick (Daiichi Pure Chemicals)--against influenza virus stocks, contained five vaccination strains (one A/H1N1, two A/H3N2, and two B) and six clinical strains (two A/H1N1, two A/H3N2, and two B). Minimum detection concentrations giving immunologically positive signals in serial dilution and RNA copies in positive dilution in real-time reverse transcriptase-polymerase chain reaction (RT-PCR) were assayed for all kits and virus stock combinations. RNA log10 copy numbers/mL in dilutions within detection limits yielded 5.68-7.02, 6.37-7,17, and 6.5-8.13 for A/H1N1, A/H3N2, and B. Statistically significant differences in sensitivity were observed between some kit combinations. Detection sensitivity tended to be relatively higher for influenza A than B virus. This is assumed due to different principles in kit methods, such as monoclonal antibodies, specimen-extraction conditions, and other unknown factors.

  19. REG4 Is Highly Expressed in Mucinous Ovarian Cancer: A Potential Novel Serum Biomarker.

    PubMed

    Lehtinen, Laura; Vesterkvist, Pia; Roering, Pia; Korpela, Taina; Hattara, Liisa; Kaipio, Katja; Mpindi, John-Patrick; Hynninen, Johanna; Auranen, Annika; Davidson, Ben; Haglund, Caj; Iljin, Kristiina; Grenman, Seija; Siitari, Harri; Carpen, Olli

    2016-01-01

    Preoperative diagnostics of ovarian neoplasms rely on ultrasound imaging and the serum biomarkers CA125 and HE4. However, these markers may be elevated in non-neoplastic conditions and may fail to identify most non-serous epithelial cancer subtypes. The objective of this study was to identify histotype-specific serum biomarkers for mucinous ovarian cancer. The candidate genes with mucinous histotype specific expression profile were identified from publicly available gene-expression databases and further in silico data mining was performed utilizing the MediSapiens database. Candidate biomarker validation was done using qRT-PCR, western blotting and immunohistochemical staining of tumor tissue microarrays. The expression level of the candidate gene in serum was compared to the serum CA125 and HE4 levels in a patient cohort of prospectively collected advanced ovarian cancer. Database searches identified REG4 as a potential biomarker with specificity for the mucinous ovarian cancer subtype. The specific expression within epithelial ovarian tumors was further confirmed by mRNA analysis. Immunohistochemical staining of ovarian tumor tissue arrays showed distinctive cytoplasmic expression pattern only in mucinous carcinomas and suggested differential expression between benign and malignant mucinous neoplasms. Finally, an ELISA based serum biomarker assay demonstrated increased expression only in patients with mucinous ovarian cancer. This study identifies REG4 as a potential serum biomarker for histotype-specific detection of mucinous ovarian cancer and suggests serum REG4 measurement as a non-invasive diagnostic tool for postoperative follow-up of patients with mucinous ovarian cancer.

  20. Hepatitis B virus in Pakistan: a systematic review of prevalence, risk factors, awareness status and genotypes.

    PubMed

    Ali, Muhammad; Idrees, Muhammad; Ali, Liaqat; Hussain, Abrar; Ur Rehman, Irshad; Saleem, Sana; Afzal, Samia; Butt, Sadia

    2011-01-01

    In Pakistan, there are estimated 7-9 million carriers of hepatitis B virus (HBV) with a carrier rate of 3-5%. This article reviews the available literature about the prevalence, risk factors, awareness status and genotypes of the HBV in Pakistan by using key words; HBV prevalence, risk factors, awareness status and genotypes in Pakistani population in PubMed, PakMediNet, Directory of Open Access Journals (DOAJ) and Google Scholar. One hundred and six different studies published from 1998 to 2010 were included in this study. Weighted mean and standard deviation were determined for each population group. The percentage of hepatitis B virus infection in general population was 4.3318% ± 1.644%, healthy blood donors (3.93% ± 1.58%), military recruits (4.276% ± 1.646%), healthcare persons (3.25% ± 1.202%), pregnant women (5.872% ± 4.984), prisoners (5.75% ± 0.212%), surgical patients (7.397% ± 2.012%), patients with cirrhosis (28.87% ± 11.90%), patients with HCC (22% ± 2.645%), patients with hepatitis (15.896% ± 14.824%), patients with liver diseases (27.54% ± 6.385%), multiple transfused patients (6.223% ± 2.121%), opthalmic patients (3.89% ± 1.004%) and users of injectable drugs (14.95% ± 10.536%). Genotype D (63.71%) is the most prevalent genotype in Pakistani population. Mass vaccination and awareness programs should be initiated on urgent basis especially in populations with HBV infection rates of more than 5%. PMID:21375760

  1. Latex allergy: a health care problem of epidemic proportions.

    PubMed

    Agarwal, Sanjay; Gawkrodger, David J

    2002-01-01

    Latex allergy is one of the major health concerns of the decade. The induction of latex allergy commonly occurs after exposure of skin or mucous membrane to natural rubber latex. It is usually a type I, immediate hypersensitivity reaction mediated by IgE which can range from mild skin erythema to anaphylaxis and death. To manage latex allergy appropriately, prompt and correct diagnosis is essential. This depends primarily on clinical history, latex specific IgE RAST (in vitro) and skin prick test (in vivo). It affects people who are frequently exposed to products made of natural rubber latex, such as, health care workers, workers in the rubber industry and those who have had multiple surgical operations. The prevalence in the general population was estimated at 0.7% in a population study in France, but this can be higher in health care workers (up to 17%) and in patients with spina bifida to almost 65%. Prevention strategies should therefore target at risk population, rather than the population as a whole. At present this primarily involves providing non-powdered latex gloves in hospitals and primary health care centres. However, once latex allergy has been established, the situation becomes more complicated. Health care workers either have to be moved to a latex free environment or in extreme circumstances may have to give up their occupation. For patients undergoing operations most hospitals have adopted a latex free protocol. It is important that this is understood and followed by every member of the staff. Those who have had serious adverse reactions should wear Medi-Alert bracelets and in exceptional circumstances may need to keep epinephrine injections on their person. Future strategies focus on the reduction of allergens during latex manufacture, development of suitable non latex gloves and immunotherapy including desensitisation of latex allergic individuals and development of candidate vaccine. PMID:12095872

  2. Comparing a Combination of Validated Questionnaires and Level III Portable Monitor with Polysomnography to Diagnose and Exclude Sleep Apnea

    PubMed Central

    Pereira, Effie J.; Driver, Helen S.; Stewart, Steven C.; Fitzpatrick, Michael F.

    2013-01-01

    Study Objectives: Questionnaires have been validated as screening tools in adult populations at risk for obstructive sleep apnea (OSA). Portable monitors (PM) have gained acceptance for confirmation of OSA in some patients with a high pretest probability of the disorder. We evaluated the combined diagnostic utility of 3 validated questionnaires and a Level III PM in the diagnosis and exclusion of OSA, as compared with in-laboratory polysomnography (PSG) derived apnea hypopnea index (AHI). Methods: Consecutive patients referred to the Sleep Disorders Clinic completed 3 testing components: (1) 3 questionnaires (Berlin, STOP-Bang, and Sleep Apnea Clinical Score [SACS]); (2) Level III at-home PM (MediByte) study; and (3) Level I in-laboratory PSG. The utility of individual questionnaires, the Level III device alone, and the combination of questionnaires and the Level III device were compared with the PSG. Results: One hundred twenty-eight patients participated in the study (84M, 44F), mean ± SD age 50 ± 12.3years, BMI 31 ± 6.6 kg/m2. At a PSG threshold AHI = 10, the PM derived respiratory disturbance index (RDI) had a sensitivity and specificity of 79% and 86%, respectively. The sensitivity and specificity for the other screening tools were: Berlin 88%, 25%; STOP-Bang 90%, 25%; SACS 33%, 75%. The sensitivity and specificity at a PSG AHI = 15 were: PM 77%, 95%; Berlin 91%, 28%; STOP-Bang 93%, 28%; SACS 35%, 78%. Conclusions: Questionnaires alone, possibly given a reliance on sleepiness as a symptom, cannot reliably rule out the presence of OSA. Objective physiological measurement is critical for the diagnosis and exclusion of OSA. Citation: Pereira EJ; Driver HS; Stewart SC; Fitzpatrick MF. Comparing a combination of validated questionnaires and level III portable monitor with polysomnography to diagnose and exclude sleep apnea. J Clin Sleep Med 2013;9(12):1259-1266. PMID:24340287

  3. [FAMILY EATING HABITS AND PERCEPTION OF RISK IN EATING DISORDERS].

    PubMed

    Rodríguez Lazo, María; Hernández Camacho, Juan Diego; Bolaños Ríos, Patricia; Ruiz-Prieto, Inmaculada; Jáuregui Lobera, Ignacio

    2015-10-01

    Introducción: los aspectos relacionados con la comida, la figura, el peso y el ejercicio físico, transmitidos de padres a hijos, y los factores socioculturales de índole mediática, como las redes sociales, pueden influir en el desarrollo de Trastornos de la Conducta Alimentaria (TCA). Objetivos: analizar la influencia de la alimentación familiar y la percepción de esta sobre la influencia de las redes sociales en el inicio y mantenimiento del TCA. Método: 30 padres de pacientes con TCA participaron voluntariamente en este estudio cumplimentando una serie de cuestionarios, y recogiéndose su peso y talla. Resultados: se observa una subestimación del peso en casos de sobrepeso (33,33%) y obesidad (25%), ya que ni siquiera se plantean realizar una dieta futura (91,67% y 25%, respectivamente) (2 = 11,31; p < 0,01). Destaca un exceso en el consumo de carnes, snacks y dulces. Durante el fin de semana hay un incremento en el consumo de kcal y azúcar (p < 0,01) y colesterol (p < 0,05), disminuyendo la ingesta de fibra, Fe, Zn y Mg (p < 0,01). Asimismo, se consume menos agua y pan, aumentando el picoteo (p < 0,01) y la frecuencia de aparición de un único plato (p < 0,05). Discusión y conclusiones: los hábitos alimentarios de estos familiares mejoran gracias a la educación nutricional incluida en el tratamiento. Los familiares no perciben adecuadamente el riesgo de las redes sociales en sus hijos, pudiendo contribuir al mantenimiento y a futuras recaídas del TCA.

  4. Transcrestal sinus lift and implant placement using the sinus balloon technique

    PubMed Central

    Galán-Gil, Sónnica; Carrillo-García, Celia; Peñarrocha-Diago, David; Peñarrocha-Diago, Miguel

    2012-01-01

    Objective: A description is made of transcrestal sinus lift using the sinus balloon technique, evaluating the bone height achieved and implant success one year after prosthetic loading. Material and method: Between January and July 2007, transcrestal sinus lift using the sinus balloon technique for dental implant placement was carried out in 6 patients. A panoramic X-ray study and maxillary computed tomography scan were carried out before the operation, in order to discard possible sinus pathology. During the intervention, the integrity of the sinus membrane was evaluated using a Medi Pack Pal endoscope (Farol Store and Co., Tuttlingen, Germany), and the intraoperative complications were analyzed. The dental implants were placed in the same surgical step in the presence of 3 mm or more of residual bone. Following the operation, panoramic X-rays were used to assess the bone height gained. One year after prosthetic loading, the implant success rate was determined based on the criteria of Buser. Results: One patient was excluded due to Schneider’s membrane perforation as confirmed by endoscopy. Trans-crestal sinus lift was carried out in 5 males with a mean age of 41.6 years (range 27-51), without antecedents of sinus disease. There were no intraoperative complications. In four patients the implants were placed simultaneous to sinus lift, while in another case implant placement was postponed due to insufficient remaining bone height. The mean gain in height after the operation was 8.7 mm. One year after prosthetic loading, the implant success rate was 100%. Conclusions: Transcrestal sinus lift using the sinus balloon technique is a minimally invasive procedure. In 5 patients the bone height gained proved sufficient to allow implant placement even in the presence of 3 mm of residual bone. Key words: Sinus lift, balloon, sinus complications. PMID:22157670

  5. Assessment of pulmonary functions in obese adolescent boys

    PubMed Central

    Paralikar, Swapnil J.; Kathrotia, Rajesh G.; Pathak, Narendra R.; Jani, Madhusudan B.

    2012-01-01

    Background: Obesity is rapidly escalating in India in all age groups. School-based data indicate a prevalence rate between 5.6% and 24% in children and adolescents. Adolescent obesity is associated with a greater long-term risk of hypertension and type 2 diabetes mellitus in adulthood. However, studies investigating pulmonary functions in obese adolescents are few. The present study assesses pulmonary functions in obese adolescent boys from a school in Baroda city, Gujarat. Aims: (i) To assess the dynamic lung functions in obese adolescent boys. (ii) To determine the predominant lung function impairment associated with obesity in adolescence. Materials and Methods: Dynamic lung functions were measured in 30 obese adolescent boys and an equal number of age-matched controls using MEDI:SPIRO software (Maestros Mediline Systems Ltd., Navi Mumbai, India). Results: Forced expiratory volume in the 1st second (FEV1)/forced vital capacity (FVC) and maximum voluntary ventilation (MVV) were significantly decreased in the obese group (P < 0.001). Pulmonary functions in the study population correlated negatively with various indices of obesity, viz. weight, body mass index (BMI), waist circumference, hip circumference, and waist-to-hip ratio. The strongest negative correlation was between BMI and FEV1/FVC (P < 0.001) and between BMI, MVV, and Forced Expiratory Flow (FEF25–75%) (P < 0.001). Waist-to-hip ratio in the study population correlated negatively with MVV (P < 0.01), but not with FEV1/FVC. Conclusions: Lung function impairment, particularly decreased MVV and reduced FEV1/FVC ratio, is associated with obesity in adolescence. In addition, pulmonary functions deteriorate with increasing obesity in adolescence and correlate negatively with various indices of obesity, viz. weight, BMI, waist circumference, hip circumference, and waist-to-hip ratio. This study reveals another health hazard associated with obesity and highlights the need to aggressively reduce weight at a

  6. Gateways to clinical trials.

    PubMed

    Moral, M A; Tomillero, A

    2008-03-01

    Gateways to Clinical Trials are a guide to the most recent clinical trials in current literature and congresses. The data in the following tables has been retrieved from the Clinical Trials Knowledge Area of Prous Science Integrity, the drug discovery and development portal, http://integrity.prous.com. This issue focuses on the following selection of drugs: 131-I-Chlorotoxin, 423557; Abatacept, Ad.Egr.TNF.11D, Adalimumab, AE-941, Ambrisentan, AMR-001, Anacetrapib, Anakinra, Aripiprazole, Atazanavir sulfate; BAY-639044, Bazedoxifene acetate, Belimumab, Bevacizumab, Bortezomib, Botulinum toxin type B, Brivaracetam, Bucindolol hydrochloride; Carfilzomib, Carisbamate, CCX-282, CD20Bi, Ceftobiprole, Certolizumab pegol, CF-101, Cinacalcet hydrochloride, Cypher; Darifenacin hydrobromide, Degarelix acetate, Denosumab, Desvenlafaxine succinate, Dexlansoprazole, Dexverapamil, Drotrecogin alfa (activated), Duloxetine hydrochloride, Dutasteride; Efalizumab, EPs-7630, Escitalopram oxalate, Etoricoxib; Fluticasone furoate, Fondaparinux sodium, Fospropofol disodium; Hexadecyloxypropyl-cidofovir, HIV gp120/NefTat/AS02A, HPV-6/11/16/18; INCB-18424, Incyclinide, Inhalable human insulin, Insulin detemir; KNS-760704, KW-0761; Lacosamide, Lenalidomide, Levetiracetam, Licofelone, Lidocaine/prilocaine; mAb 216, MEDI-528, Men ACWY, Meningococcal C-CRM197 vaccine, Methylnaltrexone bromide; Nemifitide ditriflutate, Nicotine conjugate vaccine, Nilotinib hydrochloride monohydrate; Octaparin; Parathyroid hormone (human recombinant), Pegaptanib octasodium, Pitrakinra, Prasterone, Pregabalin; Ranelic acid distrontium salt, Rasagiline mesilate, Retigabine, Rimonabant, RTS,S/AS02D; Sarcosine, Sitaxentan sodium, Solifenacin succinate, Sunitinib malate; Taranabant, Taxus, Teduglutide, Teriparatide, Ticagrelor, Travoprost, TRU-015; USlipristal acetate, Urocortin 2; Vardenafil hydrochloride hydrate; YM-155, Yttrium 90 (90Y) ibritumomab tiuxetan; Zanolimumab, Zoledronic acid monohydrate, Zotarolimus

  7. REG4 Is Highly Expressed in Mucinous Ovarian Cancer: A Potential Novel Serum Biomarker

    PubMed Central

    Lehtinen, Laura; Vesterkvist, Pia; Roering, Pia; Korpela, Taina; Hattara, Liisa; Kaipio, Katja; Mpindi, John-Patrick; Hynninen, Johanna; Auranen, Annika; Davidson, Ben; Haglund, Caj; Iljin, Kristiina; Grenman, Seija; Siitari, Harri; Carpen, Olli

    2016-01-01

    Preoperative diagnostics of ovarian neoplasms rely on ultrasound imaging and the serum biomarkers CA125 and HE4. However, these markers may be elevated in non-neoplastic conditions and may fail to identify most non-serous epithelial cancer subtypes. The objective of this study was to identify histotype-specific serum biomarkers for mucinous ovarian cancer. The candidate genes with mucinous histotype specific expression profile were identified from publicly available gene-expression databases and further in silico data mining was performed utilizing the MediSapiens database. Candidate biomarker validation was done using qRT-PCR, western blotting and immunohistochemical staining of tumor tissue microarrays. The expression level of the candidate gene in serum was compared to the serum CA125 and HE4 levels in a patient cohort of prospectively collected advanced ovarian cancer. Database searches identified REG4 as a potential biomarker with specificity for the mucinous ovarian cancer subtype. The specific expression within epithelial ovarian tumors was further confirmed by mRNA analysis. Immunohistochemical staining of ovarian tumor tissue arrays showed distinctive cytoplasmic expression pattern only in mucinous carcinomas and suggested differential expression between benign and malignant mucinous neoplasms. Finally, an ELISA based serum biomarker assay demonstrated increased expression only in patients with mucinous ovarian cancer. This study identifies REG4 as a potential serum biomarker for histotype-specific detection of mucinous ovarian cancer and suggests serum REG4 measurement as a non-invasive diagnostic tool for postoperative follow-up of patients with mucinous ovarian cancer. PMID:26981633

  8. [Scintigraphy of pulmonary ventilation with 99mTc-DTPA radio-aerosol. I. Semiotics of the static images].

    PubMed

    Maini, C L; Bonetti, M G; Giordano, A; Pistelli, R; Antonelli Incalzi, R; Vecchioli, A; Galli, G

    1986-04-01

    Papers on deposition pattern analyses of radio-aerosol lung scans are few and not easy to interpret as there is a general lack of technical standardization and the number of patients studied is not large. Moreover these reports have been generally obtained with non-hydrosoluble radioaerosols. In the present study 43 patients underwent conventional pulmonary function testing and lung scanning using small droplet (equal or less than 2 microns) polydisperse 99mTc-DTPA radioaerosol produced with the "Settling Bag System"--Medi 400 (Sorin). The scans were analysed by two methods: a semiquantitative method proposed by Taplin (SQT); an original simpler semiquantitative method (SQM). Correlations of SQT and SQM with FEV1 and MEF75 resulted highly significant (p less than 0,001). SQM proved to be superior to SQT as far as reproducibility is concerned. The following conclusions can be drawn: small particle 99mTc-DTPA aerosol can be easily and cheaply produced by a commercial device; such a radioaerosol is well suited for the evaluation of small and large airways patency, as reflected by MEF75 and FEV1 respectively, with a diagnostic yield comparable to non-hydrosoluble radioaerosols; the original semiquantitative description of the deposition patterns proposed and validated in this study is quite easy to implement and it yields a high correlation with pulmonary function tests; moreover such an approach does not require digital data processing; the sensitivity of 99mTc-DTPA for the diagnosis of bronchial obstruction is very high and superior to routine pulmonary function tests; in addition the ventilation scan allows the topographical localization of the obstructions themselves.

  9. The Effect of Traditional Cupping on Pain and Mechanical Thresholds in Patients with Chronic Nonspecific Neck Pain: A Randomised Controlled Pilot Study

    PubMed Central

    Lauche, Romy; Cramer, Holger; Hohmann, Claudia; Choi, Kyung-Eun; Rampp, Thomas; Saha, Felix Joyonto; Musial, Frauke; Langhorst, Jost; Dobos, Gustav

    2012-01-01

    Introduction. Cupping has been used since antiquity in the treatment of pain conditions. In this pilot study, we investigated the effect of traditional cupping therapy on chronic nonspecific neck pain (CNP) and mechanical sensory thresholds. Methods. Fifty CNP patients were randomly assigned to treatment (TG, n = 25) or waiting list control group (WL, n = 25). TG received a single cupping treatment. Pain at rest (PR), pain related to movement (PM), quality of life (SF-36), Neck Disability Index (NDI), mechanical detection (MDT), vibration detection (MDT), and pressure pain thresholds (PPT) were measured before and three days after a single cupping treatment. Patients also kept a pain and medication diary (PaDi, MeDi) during the study. Results. Baseline characteristics were similar in the two groups. After cupping TG reported significantly less pain (PR: −17.9 mm VAS, 95%CI −29.2 to −6.6; PM: −19.7, 95%CI −32.2 to −7.2; PaDi: −1.5 points on NRS, 95%CI −2.5 to −0.4; all P < 0.05) and higher quality of life than WL (SF-36, Physical Functioning: 7.5, 95%CI 1.4 to 13.5; Bodily Pain: 14.9, 95%CI 4.4 to 25.4; Physical Component Score: 5.0, 95%CI 1.4 to 8.5; all P < 0.05). No significant effect was found for NDI, MDT, or VDT, but TG showed significantly higher PPT at pain-areas than WL (in lg(kPa); pain-maximum: 0.088, 95%CI 0.029 to 0.148, pain-adjacent: 0.118, 95%CI 0.038 to 0.199; both P < 0.01). Conclusion. A single application of traditional cupping might be an effective treatment for improving pain, quality of life, and hyperalgesia in CNP. PMID:22203873

  10. A review of accessibility of administrative healthcare databases in the Asia-Pacific region

    PubMed Central

    Milea, Dominique; Azmi, Soraya; Reginald, Praveen; Verpillat, Patrice; Francois, Clement

    2015-01-01

    Objective We describe and compare the availability and accessibility of administrative healthcare databases (AHDB) in several Asia-Pacific countries: Australia, Japan, South Korea, Taiwan, Singapore, China, Thailand, and Malaysia. Methods The study included hospital records, reimbursement databases, prescription databases, and data linkages. Databases were first identified through PubMed, Google Scholar, and the ISPOR database register. Database custodians were contacted. Six criteria were used to assess the databases and provided the basis for a tool to categorise databases into seven levels ranging from least accessible (Level 1) to most accessible (Level 7). We also categorised overall data accessibility for each country as high, medium, or low based on accessibility of databases as well as the number of academic articles published using the databases. Results Fifty-four administrative databases were identified. Only a limited number of databases allowed access to raw data and were at Level 7 [Medical Data Vision EBM Provider, Japan Medical Data Centre (JMDC) Claims database and Nihon-Chouzai Pharmacy Claims database in Japan, and Medicare, Pharmaceutical Benefits Scheme (PBS), Centre for Health Record Linkage (CHeReL), HealthLinQ, Victorian Data Linkages (VDL), SA-NT DataLink in Australia]. At Levels 3–6 were several databases from Japan [Hamamatsu Medical University Database, Medi-Trend, Nihon University School of Medicine Clinical Data Warehouse (NUSM)], Australia [Western Australia Data Linkage (WADL)], Taiwan [National Health Insurance Research Database (NHIRD)], South Korea [Health Insurance Review and Assessment Service (HIRA)], and Malaysia [United Nations University (UNU)-Casemix]. Countries were categorised as having a high level of data accessibility (Australia, Taiwan, and Japan), medium level of accessibility (South Korea), or a low level of accessibility (Thailand, China, Malaysia, and Singapore). In some countries, data may be available but

  11. [To Protect Corneal Transparency against Diseases].

    PubMed

    Usui, Tomohiko

    2016-03-01

    template single strand DNA in vitro. Thus, CRISPR-Cas9 medi-ated HDR could be a future radical treatment for TGFBI-related corneal dystrophy. PMID:27164760

  12. [Adherence to the Mediterranean diet and its relation to nutritional status in older people].

    PubMed

    Zaragoza Martí, Ana; Ferrer Cascales, Rosario; Cabañero Martínez, María José; Hurtado Sánchez, Jose Antonio; Laguna Pérez, Ana

    2015-04-01

    Introducción: la Dieta Mediterránea (DM) como modelo de dieta de calidad se asocia con una reducción de la mortalidad y con una mejora en la calidad de vida en personas mayores. Objetivo: evaluar la relación entre el estado nutricional y los estilos de vida con el grado de adherencia a la DM en personas mayores Métodos: Muestra compuesta por 60 sujetos que acudían a la consulta de enfermería de un cetro de salud de Alicante con un Índice de Masa Corporal mayor a 24.9. Se utilizó el cuestionario de frecuencia de consumo de alimentos MEDIS-FFQ, el cuestionario de adherencia a la Dieta Mediterránea PREDIMED y la valoración antropométrica. Resultados: El 83.3% de la población presentó sobrepeso frente a un 16.7% de obesidad, sin diferencias significativas entre sexos. El porcentaje de grasa corporal fue del 40.3% en las mujeres y 29.5% en los hombres (p=0.001). El 65.2% de la mujeres presentó riesgo cardiovascular frente al 81.8% de los hombres (p=0.001). Se observó bajo cumplimento de las recomendaciones alimentarias en los cereales integrales, fruta y frutos secos. Los sujetos con baja adherencia a la DM presentaron mayores índices de obesidad (OR= 1.46; IC 95%, 0.89-2.40), un mayor consumo de tabaco (OR= 1.65; IC 95%, 1.05-2.60) y de alcohol (OR=1.53; IC 95%, 0.91-2.55), un mayor índice cintura-cadera (OR= 2.57; IC 95%, 1.3-4.9) y mayor porcentaje de grasa corporal (OR= 5.3; IC 95%, 1.02-6.48). Conclusión: Los sujetos con una buena adherencia a la (DM) presentaron un menor índice cintura-cadera y un menor porcentaje de grasa corporal.

  13. In vitro and in vivo characterization of 64Cu-labeled Abegrin, a humanized monoclonal antibody against integrin alpha v beta 3.

    PubMed

    Cai, Weibo; Wu, Yun; Chen, Kai; Cao, Qizhen; Tice, David A; Chen, Xiaoyuan

    2006-10-01

    Abegrin (MEDI-522 or Vitaxin), a humanized monoclonal antibody against human integrin alpha(v)beta(3), is in clinical trials for cancer therapy. In vivo imaging using Abegrin-based probes is needed for better treatment monitoring and dose optimization. Here, we conjugated Abegrin with macrocyclic chelating agent 1,4,7,10-tetra-azacylododecane N,N',N'',N'''-tetraacetic (DOTA) at five different DOTA/Abegrin ratios. The conjugates were labeled with (64)Cu (half-life = 12.7 hours) and tested in three human (U87MG, MDA-MB-435, and PC-3) and one mouse (GL-26) tumor models. The in vitro and in vivo effects of these (64)Cu-DOTA-Abegrin conjugates were evaluated. The number of DOTA per Abegrin varied from 1.65 +/- 0.32 to 38.53 +/- 5.71 and the radiolabeling yield varied from 5.20 +/- 3.16% to 88.12 +/- 6.98% (based on 2 mCi (64)Cu per 50 microg DOTA-Abegrin conjugate). No significant difference in radioimmunoreactivity was found among these conjugates (between 59.78 +/- 1.33 % and 71.13 +/- 2.58 %). Micro-positron emission tomography studies revealed that (64)Cu-DOTA-Abegrin (1,000:1) had the highest tumor activity accumulation (49.41 +/- 4.54% injected dose/g at 71-hour postinjection for U87MG tumor). The receptor specificity of (64)Cu-DOTA-Abegrin was confirmed by effective blocking of MDA-MB-435 tumor uptake with coadministration of nonradioactive Abegrin. (64)Cu-DOTA-IgG exhibited background level tumor uptake at all time points examined. Integrin alpha(v)beta(3)-specific tumor imaging using (64)Cu-DOTA-Abegrin may be translated into the clinic to characterize the pharmacokinetics, tumor targeting efficacy, dose optimization, and dose interval of Abegrin and/or Abegrin conjugates. Chemotherapeutics or radiotherapeutics using Abegrin as the delivering vehicle may also be effective in treating integrin alpha(v)beta(3)-positive tumors.

  14. Risk of Emergent Bradycardia Associated with Initiation of Immediate- or Slow-Release Metoprolol

    PubMed Central

    Shin, Jaekyu; Gonzales, Marco; Pletcher, Mark J

    2013-01-01

    Objectives To estimate and compare the risk of emergent bradycardia associated with initiation of immediate-release (IR) and slow-release (SR) formulations of metoprolol. Design Retrospective analysis of administrative claims data. Data Source State of California Medicaid program (Medi-Cal) claims database. Patients A total of 31,574 adults initiating metoprolol between May 1, 2004, and November 1, 2009, without a pharmacy claim for a beta blocker within the previous 6 months of metoprolol initiation; patients with a primary or secondary diagnosis of symptomatic bradycardia, pacemaker, or implantable cardioverter-defibrillator placement before metoprolol initiation were excluded. Measurements and Main Results The study outcome was the time to first occurrence of emergent bradycardia, measured at an emergency department visit or hospitalization due to diagnosis of symptomatic bradycardia, after metoprolol initiation. We calculated the incidence and compared the risk of emergent bradycardia by using a proportional hazards model that included the metoprolol formulation with adjustment for total daily metoprolol dose and the use of other medications as time-varying covariates, as well as demographics and comorbidities. Among 31,574 patients initiating metoprolol, 18,516 (58.6%) initiated the IR formulation. The incidence of emergent bradycardia was 19.1 per 1000 person-years overall but was nearly twice as common in patients using the IR versus the SR formulation (24.1 per 1000 person-years in the IR group vs. 12.9 per 1000 person-years in the SR group; unadjusted hazard ratio [HR] 1.81; 95% CI 1.28-2.56). Adjustment for other medications also associated with symptomatic bradycardia (cytochrome P450 2D6 inhibitors, class I or III antiarrhythmics, and atrioventricular node–blocking agents), metoprolol dose, and other participant characteristics somewhat attenuated the association (adjusted HR 1.48, 95% CI 1.03-2.13). Conclusion The risk of emergent bradycardia

  15. The diagnostic value of supine blood pressure in hypertension

    PubMed Central

    Stańczyk, Adam; Gielerak, Grzegorz; Piotrowicz, Katarzyna; Banak, Małgorzata; Wójcik, Agnieszka

    2016-01-01

    Introduction Correct blood pressure (BP) measurement is crucial in the diagnosis of arterial hypertension (AH), and controversy exists whether supine BP should be treated as equal to sitting BP. The aim of this study was to evaluate the relation of supine BP to sitting BP and ambulatory BP with regard to identification of diagnostic cut-offs for hypertension. Material and methods This study included 280 patients with AH (mean age: 44.3 ±10.6 years). The following measurements of BP were performed and analyzed: 1) sitting office blood pressure measurement (OSBP and ODBP); 2) supine BP (supSBP and supDBP), measured automatically (5 times with a 2-minute interval) during evaluation by the Niccomo device (Medis, Germany); 3) 24-hour ambulatory blood pressure (ABP) monitoring. Results The mean supSBP and supDBP were found to be lower than OSBP and ODBP (130.9 ±14.2 vs. 136.6 ±15.5 mm Hg and 84.8 ±9.4 vs. 87.8 ±10.2 mm Hg, respectively; p < 0.000001). The correlations between ABP and supBP/OBP were moderate and strong (correlation coefficients in range 0.55–0.76). The ROC analysis revealed that mean supBP ≥ 130/80 mm Hg was more precise than OBP ≥ 140/90 mm Hg in diagnosing hypertension (AUC: 0.820 vs. 0.550; sensitivity 80.7% vs. 57.4%; specificity 83.2% vs. 52.7%; p < 0.0001) and the additive value derived mostly from its higher predictive power of identifying patients with increased night-time BP. Conclusions In young and middle-aged hypertensive patients the blood pressure during a 10-minute supine rest was lower than in the sitting position. The supine blood pressure ≥ 130/80 mm Hg was found to be a specific and sensitive threshold for hypertension. PMID:27186174

  16. Assessment of Worldwide Acute Kidney Injury, Renal Angina and Epidemiology in Critically Ill Children (AWARE): A Prospective Study to Improve Diagnostic Precision

    PubMed Central

    Basu, Rajit K; Kaddourah, Ahmad; Terrell, Tara; Mottes, Theresa; Arnold, Patricia; Jacobs, Judd; Andringa, Jennifer; Armor, Melissa; Hayden, Lauren; Goldstein, Stuart L

    2015-01-01

    Background Acute kidney injury (AKI) is associated with poor outcomes in critically ill children. Recent international consensus panels recommend standardized classification systems to improve the precision of AKI diagnosis, but there is a paucity of data to enable this refinement, particularly in pediatric critical care. Methods/Design This is a prospective observational study. We anticipate collecting data from more than 5500 critically ill children admitted to 32 pediatric intensive care units (PICUs) across the world, during the calendar year of 2014. Data will be collected continuously for three months at each center on all children older than 90 days and younger than 25 years admitted to the ICU. Demographic, resuscitative, and daily physiological and lab data will be captured at individual centers using MediData Rave™, a commercial system designed to manage and report clinical research data. Kidney specific measured variables include changes in serum creatinine and urine output, cumulative fluid overload (%), serum creatinine corrected for fluid balance, and KDIGO AKI stage. Urinary AKI biomarkers to be measured include: urinary neutrophil gelatinase lipocalin (NGAL), kidney injury molecule-1 (KIM-1), liver-type fatty acid binding protein (l-FABP), and interleukin-18 (IL-18). Biomarker combinations will be created from different pairs and triplets of urinary biomarkers. The primary analysis will compare the discrimination of these panels versus changes in creatinine for prediction of severe AKI by Day 7 of ICU admission. Secondary analysis will investigate the prediction of biomarkers for injury ‘time based phenotypes’: duration (>2 days), severity (KDIGO stage, use of renal replacement therapy), reversibility (time to return of serum creatinine to baseline), association with fluid overload > 10%, and disease association (sepsis, hypovolemia, hypoxemia, or nephrotoxic). Discussion The Assessment of Worldwide Acute Kidney Injury, Renal Angina and

  17. Dabigatran for the Treatment and Secondary Prevention of Venous Thromboembolism; A Cost-Effectiveness Analysis for the Netherlands

    PubMed Central

    Stevanović, J.; de Jong, L. A.; Kappelhoff, B. S.; Dvortsin, E. P.; Voorhaar, M.; Postma, M. J.

    2016-01-01

    Background Dabigatran was proven to have similar effect on the prevention of recurrence of venous thromboembolism (VTE) and a lower risk of bleeding compared to vitamin K antagonists (VKA). The aim of this study is to assess the cost-effectiveness (CE) of dabigatran for the treatment and secondary prevention in patients with VTE compared to VKAs in the Dutch setting. Methods Previously published Markov model was modified and updated to assess the CE of dabigatran and VKAs for the treatment and secondary prevention in patients with VTE from a societal perspective in the base-case analysis. The model was populated with efficacy and safety data from major dabigatran trials (i.e. RE-COVER, RECOVER II, RE-MEDY and RE-SONATE), Dutch specific costs, and utilities derived from dabigatran trials or other published literature. Univariate, probabilistic sensitivity and a number of scenario analyses evaluating various decision-analytic settings (e.g. the perspective of analysis, use of anticoagulants only for treatment or only for secondary prevention, or comparison to no treatment) were tested on the incremental cost-effectiveness ratio (ICER). Results In the base-case scenario, patients on dabigatran gained an additional 0.034 quality adjusted life year (QALY) while saving €1,598. Results of univariate sensitivity analysis were quite robust. The probability that dabigatran is cost-effective at a willingness-to-pay threshold of €20,000/QALY was 98.1%. From the perspective of healthcare provider, extended anticoagulation with dabigatran compared to VKAs was estimated at €2,158 per QALY gained. The ICER for anticoagulation versus no treatment in patients with equipoise risk of recurrent VTE was estimated at €33,379 per QALY gained. Other scenarios showed dabigatran was cost-saving. Conclusion From a societal perspective, dabigatran is likely to be a cost-effective or even cost-saving strategy for treatment and secondary prevention of VTE compared to VKAs in the

  18. Evaluation of a CdTe semiconductor based compact gamma camera for sentinel lymph node imaging

    SciTech Connect

    Russo, Paolo; Curion, Assunta S.; Mettivier, Giovanni; Esposito, Michela; Aurilio, Michela; Caraco, Corradina; Aloj, Luigi; Lastoria, Secondo

    2011-03-15

    Purpose: The authors assembled a prototype compact gamma-ray imaging probe (MediPROBE) for sentinel lymph node (SLN) localization. This probe is based on a semiconductor pixel detector. Its basic performance was assessed in the laboratory and clinically in comparison with a conventional gamma camera. Methods: The room-temperature CdTe pixel detector (1 mm thick) has 256x256 square pixels arranged with a 55 {mu}m pitch (sensitive area 14.08x14.08 mm{sup 2}), coupled pixel-by-pixel via bump-bonding to the Medipix2 photon-counting readout CMOS integrated circuit. The imaging probe is equipped with a set of three interchangeable knife-edge pinhole collimators (0.94, 1.2, or 2.1 mm effective diameter at 140 keV) and its focal distance can be regulated in order to set a given field of view (FOV). A typical FOV of 70 mm at 50 mm skin-to-collimator distance corresponds to a minification factor 1:5. The detector is operated at a single low-energy threshold of about 20 keV. Results: For {sup 99m}Tc, at 50 mm distance, a background-subtracted sensitivity of 6.5x10{sup -3} cps/kBq and a system spatial resolution of 5.5 mm FWHM were obtained for the 0.94 mm pinhole; corresponding values for the 2.1 mm pinhole were 3.3x10{sup -2} cps/kBq and 12.6 mm. The dark count rate was 0.71 cps. Clinical images in three patients with melanoma indicate detection of the SLNs with acquisition times between 60 and 410 s with an injected activity of 26 MBq {sup 99m}Tc and prior localization with standard gamma camera lymphoscintigraphy. Conclusions: The laboratory performance of this imaging probe is limited by the pinhole collimator performance and the necessity of working in minification due to the limited detector size. However, in clinical operative conditions, the CdTe imaging probe was effective in detecting SLNs with adequate resolution and an acceptable sensitivity. Sensitivity is expected to improve with the future availability of a larger CdTe detector permitting operation at shorter

  19. New perspectives on litigation and the public's health.

    PubMed

    Bontá, Diana; Praeger, Sandra; Schlichtmann, Jan

    2002-01-01

    This article provides redacted versions of three presentations by distinguished individuals with long experience in litigation or regulation to protect the public's health. A central theme is the need to develop partnerships to promote protection efforts. Jan Schlichtmann is internationally recognized for his representation of eight Massachusetts families engaged in legal action against two major companies, W. R. Grace and Beatrice Foods, in a fight to obtain justice in a groundbreaking case that has been the subject of many press and journal reports along with a nationally best-selling book and motion picture titled A Civil Action. His inspiring story of a long and difficult struggle to uncover the truth about contaminants in drinking water caused by buried wastes and to bring public health authorities and others together in a partnership to address the problem is a model of the use of litigation tools to protect the public's health. Diana Bontá, Director of the California Department of Health Services, discusses the efforts of her department to ensure the integrity of the Medi-Cal program that her department administers and the proper uses of litigation, including decisions to avoid litigation, for the purpose of protecting the public's health. She focuses on regulatory and legal efforts to protect her state's citizens and their environment, with an emphasis on the use of common sense in making decisions about whether to litigate and on partnering with advisory groups and members of the public as a means of aiding her department's accomplishment of its mission. Finally, Sandy Praeger, a state senator from Kansas, discusses efforts to use the law and regulation for the purpose of protecting the Kansas River. She stresses the importance of using sound judgment, backed by assessment of the legislative and physical environments, to make the right decisions regarding the use of the law for public health protection. She also points out that sometimes one can use the

  20. [Normative Database of Optical Coherence Tomography Parameters in Childhood].

    PubMed

    Queirós, Tatiana; Freitas, Cristina; Guimarães, Sandra

    2015-01-01

    Introdução: A tomografia de coerência óptica é um exame que permite obter imagens de alta resolução dos tecidos in vivo, possibilitando a medição das estruturas oculares, nomeadamente a camada de fibras nervosas da retina e a espessura macular. Como método não invasivo torna-se particularmente útil em crianças, contudo a sua aplicabilidade está limitada pela existência de valores normativos apenas para adultos.Objetivo: Estabelecer na idade pediátrica valores normativos para a espessura da camada de fibras nervosas da retina e espessura macular, averiguando a sua influência com o género, idade, refração, lateralidade e dominância ocular.Material e Métodos: Foram submetidas a exame oftalmológico e a Cirrus HD-tomografia de coerência óptica (Carl Zeiss Meditec) 153 crianças dos quatro aos 17 anos.Resultados: Obtiveram-se valores da espessura média global da camada de fibras nervosas da retina de 97,90 μm. Não se detectaram diferenças entre géneros e com a idade, mas sim consoante a lateralidade e dominância ocular. Verificou-se um aumento da espessura com refrações positivas. Com o protocolo Macular Cube 512 x 128 verificou-se que o campo central apresentou a menor espessura (250,35 μm), apresentando os rapazes maior espessura macular.Discussão: Os valores da espessura da camada de fibras nervosas da retina e da espessura macular obtidos são comparáveis a estudos recentes. A distribuição da espessura por quadrantes respeita a distribuição normal da camada de fibras nervosas da retina. A espessura macular revelou-se superior no género masculino (campo central e anel interno), dados estes também concordantes com estudos prévios.Conclusão: Estabelecemos as normativas da espessura da camada de fibras nervosas da retina e espessura macular em crianças portuguesas saudáveis, dados estes que reestruturam a avaliação e interpretação dos parâmetros obtidos pela tomografia de coerência óptica no diagnóstico de

  1. Prevalence of Hepatitis C Virus Genotypes Among Patients in Countries of the Eastern Mediterranean Regional Office of WHO (EMRO): A Systematic Review and Meta-Analysis

    PubMed Central

    Sadeghi, Farzin; Salehi-Vaziri, Mostafa; Almasi-Hashiani, Amir; Gholami-Fesharaki, Mohammad; Pakzad, Reza; Alavian, Seyed Moayed

    2016-01-01

    Context Hepatitis C virus (HCV) infection is a major global public health issue. The Eastern Mediterranean regional office (EMRO) of the world health organization (WHO) seems to have one of the highest prevalence rates worldwide, with at least 21.3 million HCV-infected patients. Objectives The aim of the present study was to review systematically all epidemiological data related to the prevalence of HCV genotypes in infected patients in EMRO countries. Data Sources A systematic search was conducted of peer-reviewed journals indexed in electronic databases (PubMed, Scopus, ISI, PakMediNet, and IMEMR, and Persian-specific databases including SID, Iran Medex, and MagIran). Study Selection A systematic search was performed with temporal limits (papers published between January 2000 up to June 2015), regarding the prevalence and distribution of HCV genotypes in EMRO countries. Data Extraction The prevalence rates of HCV genotypes were pooled by metan command in Stata 14. Statistical heterogeneity was explored using the I-square at the 5% significance level. Publication bias was assessed, graphically and statistically, by funnel plot and Begg and Egger tests. Results A total of 563 records were identified through the electronic search. Of these records, 134 studies comprising 67681 HCV-infected individuals were included in the meta-analysis. In Iran, subtype 1a was the predominant subtype with a rate of 42% (95% CI, 39 - 46), followed by subtype 3a, 35% (95% CI, 31 - 38). In Pakistan, Subtype 3a was the most common subtype with a rate of 56% (95% CI, 49 - 62), followed by subtype 3b, 10% (95% CI, 7 - 12). In Saudi Arabia and Egypt, genotype 4 was the most prevalent genotype with a rate of 65% (95% CI, 59 - 72) and 69% (95% CI, 36 - 100) respectively. In Tunisia and Morocco, subtype 1b was the most common subtype with a rate of 69% (95% CI, 50 - 88) and 32% (95% CI, 7 - 56) respectively. Conclusions The genotype distribution of HCV takes diverse patterns in EMRO countries

  2. How does parents' visual perception of their child's weight status affect their feeding style?

    PubMed

    Yilmaz, Resul; Erkorkmaz, Ünal; Ozcetin, Mustafa; Karaaslan, Erhan

    2013-01-01

    Introducción: El estilo de alimentación es uno de los factores prominentes que determina la ingesta de energía. Uno de los factores que influyen en el estilo de alimentación paterna es la percepción de los padres del estado de peso del niño. Objetivo: El propósito de este estudio fue evaluar la relación entre la percepción visual de la madre del estado de peso de su hijo y su estilo de alimentación. Método: Se realizó un estudio transversal con madres de 380 niños preescolares de 5 a 7 (6,14 años). Las puntuaciones de la percepción visual se midieron mediante unos dibujos y el estilo de alimentación materna se medió con el cuestionario validado “Parental Feeding Style Questionnaire”. Resultados: Las puntuaciones de las subescalas de las dimensiones de alimentación parental “alimentación emocional” y “animar a comer” eran bajas en niños con sobrepeso de acuerdo con la clasificación de la percepción visual. Las puntuaciones de las subescalas “alimentación emocional” y “control permisivo” eran estadísticamente distintas en los niños clasificados como correctamente percibidos e incorrectamente percibidos bajos por una mala percepción materna. Conclusión: Diversos estilos de alimentación se relacionaban con la percepción visual materna. El mejor abordaje para evitar la obesidad y el peso bajo podría estar en centrarse en conseguir una correcta percepción parental del estado de peso de sus hijos, mejorando así las habilidades paternas y conllevando la implantación de unos estilos de alimentación adecuados.

  3. Organic wastes decomposition technology, perspective for long-term autonomous missions

    NASA Astrophysics Data System (ADS)

    Viacheslav, Ilyin; Korshunov, Denis; Mardanov, Robert; Starkova, Lyubov; Deshevaya, Elena; Smirnov, Igor

    At present time there is no large problem in waste management in ISS space flight conditions, since spacecrafts "Progress" is used for it's removal from orbital station and the wastes burns in dense layers of Earth's atmosphere. However such method does not approach for far inter-planetary flights since interplanetary quarantine desires do not allow to deposit contaminated wastes outside the spacecraft. Essential part of wastes is formed by disposed means of personal hygiene and greenhouse wastes which are not safe from sanitary-epidemiological aspect. Above mentioned materials have one common feature: they can be subjected to biodegradation using different microbial compositions. Microbial decomposition of wastes as meets the main crite-ria of safety and power consumption. We investigated the effectiveness of method of disposed personal hygiene means biodegradation by anaerobic thermophiles with further purification of obtained decomposition products from chemical solvents with the help of mesophilic isolates in microaerophile conditions. Bacteria of Clostridium genera were selected for cellulolysis be-cause of their high specific endoglucanasic activity which less depends on substrate nature and relatively high growth rate on cellulose contaning substrates. As result some strains in case of optimal conditions (substrata pretreating, pH correction) decomposed means of personal hygiene with level of biodegradation up to 90With the purpose of purification, liqiud medi-ums originating from Closrtidium sp. exhibiting used like substrates for cellololitic fungi. It was shown that the cultures are able to change pH of media from slow-acid to neutral. Also the effectiveness of plant wastes biodegradation (vegetables homogenates) was studied using associations of mesophile aerobes trophically adapted to substrates. Rate of biodestruction of dry mass varied near 76To purify liquid products of biodegradation from chemicals cellulolytic fungal strains as well as bacterial

  4. Pediatric cardiothoracic program in Malaysia: a study based on the outcome of the program.

    PubMed

    Piros Kulandasamy Pillai, Cornelius; Yoshida, Yoshitoku; Justin Lawrence, Patrick; Yamamoto, Eiko; Reyer, Joshua A; Hamajima1, Nobuyuki

    2016-02-01

    Vulnerable communities in Malaysia have been facing issues of accessibility and availability for pediatric cardiac services for years due to long waiting times, high costs and a lack of pediatric cardiothoracic surgeons. To ease this situation, the government has allocated a certain amount of funds, introduced through the Pediatric Cardiothoracic Program (PCP), in which the patients are transported to the Narayana Health Institute of Cardiac Science (NH) in India to receive a heart operation following an eligibility check at MediAssist4U Sdn Bhd in Selangor, Malaysia, a facility appointed by the NH. This study aimed to determine the demographic incidence of congenital heart diseases of patients in this program and to evaluate the outcome of the program in association with post-operative mortality rate and the beneficial factors of the program. In this study, 241 patients who participated in this program from August 2008 to September 2012 were reviewed. Fisher's exact tests were applied to calculate p-values of categorical data. Out of 241, 11 patients were rejected because of their poor health condition for flight transportation to India, leaving 230 patients for analysis. The majority of patients were 1 to 4 years of age (57.8%), Malays (61.7%), from families of monthly household income less than RM 1,500 (86.5%) and with primary school-educated parents (86.5%). Patients could apply from any government hospital in Malaysia, but 34.8% of the patients were from the state of Johor. The region (Peninsular Malaysia and East Malaysia) of patients seeking pediatric cardiac services was significantly associated with race (p<0.001), low household income (p<0.001) and low education background of parents (p=0.004). The associations between the age group and diagnosis group (p=0.010) and between duration of hospitalization and outcome of medical management (p=0.013) were significant. Post-operative mortality rate was 1.7% (95% confidence interval, 0.5-4.4). In conclusion, the

  5. Pediatric cardiothoracic program in Malaysia: a study based on the outcome of the program

    PubMed Central

    Piros Kulandasamy Pillai, Cornelius; Yoshida, Yoshitoku; Justin Lawrence, Patrick; Yamamoto, Eiko; Reyer, Joshua A.; Hamajima1, Nobuyuki

    2016-01-01

    ABSTRACT Vulnerable communities in Malaysia have been facing issues of accessibility and availability for pediatric cardiac services for years due to long waiting times, high costs and a lack of pediatric cardiothoracic surgeons. To ease this situation, the government has allocated a certain amount of funds, introduced through the Pediatric Cardiothoracic Program (PCP), in which the patients are transported to the Narayana Health Institute of Cardiac Science (NH) in India to receive a heart operation following an eligibility check at MediAssist4U Sdn Bhd in Selangor, Malaysia, a facility appointed by the NH. This study aimed to determine the demographic incidence of congenital heart diseases of patients in this program and to evaluate the outcome of the program in association with post-operative mortality rate and the beneficial factors of the program. In this study, 241 patients who participated in this program from August 2008 to September 2012 were reviewed. Fisher’s exact tests were applied to calculate p-values of categorical data. Out of 241, 11 patients were rejected because of their poor health condition for flight transportation to India, leaving 230 patients for analysis. The majority of patients were 1 to 4 years of age (57.8%), Malays (61.7%), from families of monthly household income less than RM 1,500 (86.5%) and with primary school-educated parents (86.5%). Patients could apply from any government hospital in Malaysia, but 34.8% of the patients were from the state of Johor. The region (Peninsular Malaysia and East Malaysia) of patients seeking pediatric cardiac services was significantly associated with race (p<0.001), low household income (p<0.001) and low education background of parents (p=0.004). The associations between the age group and diagnosis group (p=0.010) and between duration of hospitalization and outcome of medical management (p=0.013) were significant. Post-operative mortality rate was 1.7% (95% confidence interval, 0.5–4.4). In

  6. [Prognostic value of absolute monocyte count in chronic lymphocytic leukaemia].

    PubMed

    Szerafin, László; Jakó, János; Riskó, Ferenc

    2015-04-01

    Bevezetés: Az alacsony perifériás lymphocyta- és magas monocytaszám kedvezőtlen prognózisra utal különböző típusú lymphomákban és egyéb daganatos megbetegedésekben. Krónikus lymphoid leukaemiában azonban az abszolút monocytaszám prognosztikus értékéről csak kevés adat ismert. Célkitűzés: A szerzők krónikus lymphoid leukaemiás betegeik diagnóziskor mért abszolút monocytaszámának hatását vizsgálták a kezelésig eltelt időre és a túlélésre. Módszer: 2005. január 1. és 2012. december 31. között diagnosztizált 223 krónikus lymphoid leukaemiás beteg adatait rögzítették. Értékelték a kezelést igénylő betegek arányát, a kezelésig eltelt idő és a túlélés relatív kockázatát, valamint a halálokokat a Rai-stádiumtól függően, a CD38-, ZAP-70-pozitivitásnak és az abszolút monocytaszámnak megfelelően. Eredmények: Rai 0, I., II., III. és IV. stádiumban a betegek 21,1%-a, 57,4%-a, 88,9%-a, 88,9%-a és 100%-a, CD38-, illetve ZAP-70-pozitivitás esetén a betegek 61,9%-a, illetve 60,8%-a, továbbá, ha az abszolút monocytaszámuk <0,25 G/l, 0,25–0,75 G/l és >0,75 G/l volt, akkor a betegek 76,9%-a, 21,2%-a és 66,2%-a szorult kezelésre. A kezelés elkezdéséig tartó medián idő, illetve a túlélés medián ideje a monocytaszámtól függően 19,5, 65 és 35,5 hónap, illetve 41,5, 65 és 49,5 hónap volt. A kezelésmegkezdés szükségességének relatív kockázata, RR = 1,62 (p<0,01) volt a 0,25 G/l alatti vagy 0,75 G/l feletti és a 0,25–0,75 G/l abszolút monocytaszámú betegek összehasonlításakor, míg a túlélésé RR = 2,41 (p<0,01) volt, ha a 0,25 G/l alatti és feletti abszolút monocytaszámú betegeket hasonlították össze. A relatív kockázatok Rai 0 stádiumú betegekben vizsgálva is szignifikánsak maradtak. A fő halálokok alacsony abszolút monocytaszám esetén fertőzések (41,7%) és a krónikus lymphoid leukaemia (58,3%), míg közepes és magas monocytasz

  7. Impact of Educational Program on the Management of Chronic Suppurative Otitis Media among Children.

    PubMed

    Elsayed Yousef, Yousseria; Abo El-Magd, Essam A; El-Asheer, Osama M; Kotb, Safaa

    2015-01-01

    Background. Chronic suppurative otitis media (CSOM) remains one of the most common childhood chronic infectious diseases worldwide, affecting diverse racial and cultural groups in both developing and industrialized countries. Aim of the Study. This study aimed to assess the impact of educational program on the management of children with CSOM. Subjects and Methods. An experimental study design was used. This study included 100 children of both sexes of 2 years and less of age with CSOM. Those children were divided into 3 groups: group I: it involved 50 children with CSOM (naive) who received the designed educational program; control group: it involved 50 children who were under the traditional treatment and failed to respond; group II: those children in the control group were given the educational program and followed up in the same way as group I and considered as group II. Tools of the Study. Tool I is a structured questionnaire interview sheet for mothers. It consists of four parts: (1) personal and sociodemographic characteristics of child and (2) data about risk factors of otitis media (3) assessment of maternal practice about care of children with suppurative otitis medi (4) diagnostic criteria for suppurative otitis media. Tool II is the educational program: an educational program was developed by the researchers based on the knowledge and practices needs. This study was carried out through a period of 9 months starting from September 2013 to May 2014. The educational program was implemented for mothers of children with CSOM in the form of 5 scheduled sessions at the time of diagnosis, after one week, 1, 3, and 6 months. Results. There were significant differences between children who received the educational program and control group regarding the response to treatment after one and 3 months. The percentages of complete cure increased progressively 32%, 60%, and 84% after 1, 3, and 6 months in group I while they were 24%, 44%, and 64% in group II

  8. [Fiability Study of Diabetes Empowerment Scale: Short Version].

    PubMed

    Aveiro, Marcelo; Santiago, Luiz Miguel; Ferreira, Pedro Lopes; Simões, José Augusto

    2015-01-01

    Objetivo: Avaliar a correlação entre o valor obtido pelo instrumento de medição Diabetes Empowerment Scale - Short Form e o controlo da pessoa com diabetes medido pelo valor da hemoglobina glicada A1c.Material e Métodos: Estudo observacional transversal pela aplicação do Diabetes Empowerment Scale - Short Form a pessoas com diabetes de três Unidades de Saúde Familiar da Região Centro de Portugal após realização de teste e reteste (primeiro por escrito e, passados cinco minutos, oralmente) para determinação da coerência interna através do valor de alfa de Cronbach em 20 elementos que não foram depois estudados. A aplicação a pacientes diabéticos foi feita após a consulta de enfermagem e antes da entrada na consulta médica. Foi realizada estatística descritiva e inferencial apos verificação da normalidade dos dados.Resultados: Na primeira fase o valor de alfa de Cronbach de 0,90 a 1,00 relativamente aos oito itens da escala. Na aplicação escrita, a média de resultados foi de 3,78 ± 0,71 e na aplicação oral de 3,79 ± 0,65, p = 0,629. A amostra da segunda fase foi de 81 pessoas com diabetes, sendo 55,6% do sexo masculino. A idade média foi de 68,5 ± 1,1 anos com uma HbA1c média de 6,8 ± 0,2 e um tempo de evolução desde o diagnóstico de 9,2 ± 0,9 anos. A média da pontuação final da escala foi de 4,1 ± 0,8. Verificou-se uma correlação significativa entre a pontuação final e os níveis de Hba1C (ÏÅ = -0,114; p = 0,312).Conclusão: A Escala de Capacidade de Controlo da Diabetes âÄì Versão Breve revelou ser uma escala fiável para medir a capacitação em doentes diabéticos em Portugal. Confirmou-se a presença de uma correlação estatisticamente significativa entre o resultado obtido no final da escala e o valor de HbA1c.

  9. Monte Carlo study of LDR seed dosimetry with an application in a clinical brachytherapy breast implant

    SciTech Connect

    Furstoss, C.; Reniers, B.; Bertrand, M. J.; Poon, E.; Carrier, J.-F.; Keller, B. M.; Pignol, J. P.; Beaulieu, L.; Verhaegen, F.

    2009-05-15

    A Monte Carlo (MC) study was carried out to evaluate the effects of the interseed attenuation and the tissue composition for two models of {sup 125}I low dose rate (LDR) brachytherapy seeds (Medi-Physics 6711, IBt InterSource) in a permanent breast implant. The effect of the tissue composition was investigated because the breast localization presents heterogeneities such as glandular and adipose tissue surrounded by air, lungs, and ribs. The absolute MC dose calculations were benchmarked by comparison to the absolute dose obtained from experimental results. Before modeling a clinical case of an implant in heterogeneous breast, the effects of the tissue composition and the interseed attenuation were studied in homogeneous phantoms. To investigate the tissue composition effect, the dose along the transverse axis of the two seed models were calculated and compared in different materials. For each seed model, three seeds sharing the same transverse axis were simulated to evaluate the interseed effect in water as a function of the distance from the seed. A clinical study of a permanent breast {sup 125}I implant for a single patient was carried out using four dose calculation techniques: (1) A TG-43 based calculation, (2) a full MC simulation with realistic tissues and seed models, (3) a MC simulation in water and modeled seeds, and (4) a MC simulation without modeling the seed geometry but with realistic tissues. In the latter, a phase space file corresponding to the particles emitted from the external surface of the seed is used at each seed location. The results were compared by calculating the relevant clinical metrics V{sub 85}, V{sub 100}, and V{sub 200} for this kind of treatment in the target. D{sub 90} and D{sub 50} were also determined to evaluate the differences in dose and compare the results to the studies published for permanent prostate seed implants in literature. The experimental results are in agreement with the MC absolute doses (within 5% for EBT

  10. [Contribution for the validation of the Portuguese version of EQ-5D].

    PubMed

    Ferreira, Pedro Lopes; Ferreira, Lara Noronha; Pereira, Luis Nobre

    2013-01-01

    doença.Conclusão: A versão portuguesa do EQ-5D tem uma boa aceitabilidade, fiabilidade e validade na medição do estado de saúde.

  11. Classificação geométrica de galáxias bianeladas através do metódo CART (Classification And Regression Trees)

    NASA Astrophysics Data System (ADS)

    Ormeño, M. I.; Faúndez-Abans, M.; Cavada, G.

    2003-08-01

    A importância deste trabalho deve-se à seleção de objetos ainda não tratados particularmente como uma família e ao emprego de procedimento estatístico robusto que não precisa de pressupostos ou condições de contorno. Contribui, assim, ao melhor entendimento do cenário das Galáxias Aneladas do diagrama de Hubble via classificação e estudo de subclasses. Selecionaram-se 100 galáxias possuidoras de dois anéis do Catalog of Southern Ringed Galaxies compilado por Ronald Buta, de modo a construir uma amostra completa em termos de conhecimento dos semi-eixos dos anéis interno e externo projetados no plano do céu. Visando uma possível classificação destas galáxias aneladas normais em famílias de acordo com as características geométricas dos anéis, empregou-se primeiramente a Análise de Aglomerados (ferramenta de classificação: medições de semelhança em um espaço bidimensional) para explorar a possível existência de famílias. As variáveis analisadas foram: os diâmetros interiores menores d(I) e maiores D(I), os diâmetros exteriores menores d(E) e maiores D(E), e os ângulos de inclinação dos semi-eixos maiores interiores q(I) e exteriores q(E) dos anéis. Como metodologia de discriminação, empregou-se a construção de Árvores de Classificação. As árvores de classificação constituem um método de discriminação alternativo aos modelos clássicos, tais como a Análise Discriminante e a Regressão Logística, onde uma base de dados é dividida em partições (subgrupos) da árvore por ação de um predictor (variável específica). Os pacotes estatísticos utilizados para o processamento da informação foram: SAS versão 8.0 (Statistical Analisys System) e CART versão 3.6.3. Esta análise estatística sugere a existência de três possíveis famílias de galáxias bianeladas, com base apenas na geometria dos anéis. Como forma exploratória inicial deste resultado, a construção de um diagrama BT (magnitude total) versus o

  12. The Role of Haemoglobin A1c in Screening Obese Children and Adolescents for Glucose Intolerance and Type 2 Diabetes.

    PubMed

    Galhardo, Júlia; Shield, Julian

    2015-01-01

    Introdução: Em 2012, um comité internacional de peritos em diabetes aconselhou a hemoglobina glicada como teste de rastreio de intolerância à glicose e diabetes mellitus tipo 2 no adulto e em idade pediátrica. O objetivo deste estudo foi avaliar a utilidade deste exame numa população de crianças e adolescentes obesos, maioritariamente de etnia caucasiana.Material e Métodos: Foram recrutados 226 doentes [índice de massa corporal z-score 3,35 ± 0,59, 90% caucasianos, 55% do sexo feminino, idade mediana de 12,3 (âmbito: 8,9 â 17,6) anos] referenciados à consulta de obesidade pediátrica de um hospital terciário, com critérios para rastreio de diabetes mellitus tipo 2. Situações de hemoglobinopatia ou de alteração da sobrevida eritrocitária foram excluídas. Todos os indivíduos foram submetidos a uma prova de tolerância à glicose oral e à medição da hemoglobina glicada.Resultados: Segundo a prova de tolerância à glicose oral, 13 (4,9%) eram pré-diabéticos e nenhum diabético. De acordo com a hemoglobina glicada, 32 seriam pré-diabéticos (29 falsos-positivos) e um diabético (falso positivo, sendo este, na realidade, apenas intolerante à glicose). Por outro lado, 10 pré-diabéticos não seriam identificados (falsos-negativos). A área sob a curva receiver operator characteristic analysis da hemoglobina glicada foi 0,59 (IC 95% 0,40 - 0,78), confirmando a sua reduzida capacidade de discriminação parapré-diabetes. Mais promissoras foram as áreas sob as curvas receiver operator characteristic analysis da glicemia em jejum (0,76; IC 95% 0,66 - 0,87), homeostasis model assessment for insulin resistance (0,77; IC 95% 0,64 - 0,90) e razão triglicerídeos:colesterol HDL (0,81; IC 95% 0,66 - 0,96).Discussão: Em Pediatria, particularmente em populações maioritariamente caucasianas, a hemoglobina glicada parece ser uma má ferramenta para diagnóstico de pré-diabetes.Conclusão: Pelo exposto, parece-nos prematura a utilização da

  13. Optimal cut-off value for homeostasis model assessment (HOMA) index of insulin-resistance in a population of patients admitted electively in a Portuguese cardiology ward.

    PubMed

    Timóteo, Ana Teresa; Miranda, Fernando; Carmo, Miguel Mota; Ferreira, Rui Cruz

    2014-01-01

    Introdução: A resistência à insulina é a chave fisiopatológica de explicação da Síndrome Metabólica. Apesar de claramente útil, o índice Homeostasis Model Assessment (uma medição da resistência à insulina) não tem sido aplicado sistematicamente na prática clínica. Uma das principais razões relaciona-se com a discrepância de valores limiares reportados em diferentes populações. Procurámos avaliar uma população portuguesa o valor limiar ideal e avaliar a sua relação com a Síndrome Metabólica. Material e Métodos: Selecionámos uma coorte de indivíduos admitidos eletivamente numa enfermaria de cardiologia com um IMC < 25 Kg/m2 e sem anomalias do metabolismo da glicose (glicémia em jejum < 100 mg/dL e sem diabetes). Utilizámos o percentil 90 da distribuição do índice Homeostasis Model Assessment para seleção do limiar adequado para resistência à insulina. Selecionouse também uma coorte de validação composta por 300 indivíduos, sem aplicação dos critérios de exclusão referidos anteriormente. Resultados: De uma população de 7 000 indivíduos e após aplicação dos critérios de exclusão, ficámos com 1 784 indivíduos para análise. O percentil 90 do índice foi 2,33. Na coorte de validação, aplicando esse limiar, 49,3% dos indivíduos apresentam resistência à insulina. Contudo, apenas 69,9% dos doentes com síndrome metabólica apresentam resistência à insulina com esse limiar. Por análise das curvas ROC, o limiar ideal para síndrome metabólica é 2,41. O índice Homeostasis Model Assessment correlacionou-se com o IMC (r = 0,371, p < 0,001) e é um preditor independente de presença de síndrome metabólica (OR 19,4, IC 95% 6,6 – 57,2, p < 0,001). Discussão: O nosso estudo mostrou que numa população portuguesa de doentes admitidos eletivamente numa enfermaria de cardiologia, o limiar pelo índice Homeostasis Model Assessment para resistência à insulina é 2,33 e para síndrome metabólica é 2

  14. Do we need hip-ankle radiographs to assess the coronal alignment and implant position after total knee replacement?

    PubMed Central

    Dargel, Jens; Oppermann, Johannes; Eysel, Peer; Penning, Lenhard

    2016-01-01

    Aims and Objectives: Restoration of the coronal alignment of the knee is known to be one of the major criteria of a successful total knee arthroplasty (TKA). It therefore appears to be mandatory to routinely assess the postoperative limb alignment using hip-ankle radiographs and to identify implants that may be at risk of premature failure. However, there is no clear consensus whether weight-bearing hip-ankle radiographs or rather standardized a-p knee-radiographs should be used to assess implant position and coronal alignment after TKA. It is the aim of the present study to investigate if implant position and the mechanical alignment after TKA can reproducibly be assessed using standardized a-p knee-radiographs or rather if weight-bearing hip-ankle radiographs are needed. Materials and Methods: This study was performed on 100 postoperative weight-bearing hip-ankle radiographs after conventional primary TKA. The true mechanical and anatomical femorotibial angle as well as coronal implant position (MPTA, LDFA) was assessed using the MediCAD software, which served as a control. The hip-ankle radiographs were then digitally cropped to 80%, 60% and 40% of the leg-length. In each cropped radiograph, tibial coronal implant position was assessed by referencing against the visible mid-shaft, whereas femoral implant position was referenced against the visible mid-shaft (anatomical axis) or against a surrogate mechanical axis, which was drawn perpendicular to the distal tangent of the femoral component. Each measurement was performed by three independent observers. The difference between the alignment parameters in the hip-ankle radiographs were statistically compared with the cropped radiographs and the inter-observer correlation coefficient (ICC) was calculated for each parameter. Results: The ICC for inter-observer agreement of measurement of the mechanical femorotibial angle was significantly higher in hip-ankle radiographs (.95) when compared with a radiograph cropped

  15. Biochemical and biophysical investigation of surfactant in neonatal gastric aspirate at birth.

    PubMed

    Bangyozova, Maya; Jordanova, Albena; Tsanova, Asya; Jekova, Neli; Chakarov, Decho; Doumanov, Jordan; Christova, Emilia; Lalchev, Zdravko

    2013-01-01

    Introdução: A melhor abordagem para detecção de deficiência de surfactante em recém-nascidos prematuros no nascimento permanece pouco clara e a decisão de aplicar surfactante exógeno é baseada principalmente no desenvolvimento de sinais clínicos e radiológicos da síndrome de angústia respiratória neonatal (NRDS). Objetivos: Estudamos as propriedades bioquímicas e biofísicas do aspirado gástrico (GA) de crianças nascidas prematuramente com NRDS e saudáveis nascidos a termo, com o objetivo de encontrar um método acessível para avaliação da maturidade do surfactante no nascimento. Material e Métodos: Quarenta e sete recém-nascidos, divididos em dois grupos foram incluídos no estudo. O primeiro grupo composto por 34 crianças saudáveis nascidas a termo (após 37 semanas de gestação). O segundo grupo incluiu 13 recém-nascidos prematuros (idade entre 26 - 32 semanas de gestação) desenvolveram sinais clínicos de NRDS para os quais foram tratados por ventilação assistida e surfactante exógeno. A análise bioquímica da proteína e lipídio da GA coletado no nascimento foi realizado. A composição de ácidos graxos das amostras GA foi determinada pelo detector de cromatografia de massa seletiva (GS-MSD) análise. As características da superfície (de equilíbrio, os valores máximo e mínimo de tensão de superfície) das amostras de AG foram medidos utilizando o método de gota pendente. Os dados foram comparados entre os grupos, utilizando o teste t de Student ou teste de Mann-Whitney análise. Os valores foram considerados significativamente diferentes se o valor de p ≤ 0,05. Resultados: A concentração média de fosfolipídeos em GA dos prematuros foi menor (295,7 g / ml vs 374,5 mg / ml) do que em crianças a termo e do conteúdo médio de proteína foi menor no GA dos bebês prematuros que o termo recém-nascidos (574,5 ng / ml vs 641,5 ug / ml). A medição das características de superfície dinâmicas da GA mostraram

  16. Towards a Moon Village: Young Lunar Explorers Report

    NASA Astrophysics Data System (ADS)

    Kamps, Oscar; Foing, Bernard; Batenburg, Peter

    2016-04-01

    facilitate the progress of the Moon Village initiative it is necessary to attract private industry investments. Potential sources range from technology testing in the moon environment and private R&D funding from science and academia fields, to space tourism, and more ambitious endeavors such as building a prototype launcher site as a ground segment for debris de-orbiting and satellite recycling activities. The Science and Technology team has identified key technologies and possible major scientific disciplines for a Moon Village and ranked them by importance and by Technology Readiness Level (TRL). In terms of basic technologies and objectives, rover exploration, life support systems, navigation and surveying technologies resulted to have the highest importance and readiness. Technologies for the development of the habitats (materials, modules connections, power supply, alternative energy technologies and energy storage) ended up on having high importance with medium-low technology readiness. Technologies intended to help the astronauts or improve techniques had low-medium importance together with low-medium TRL (e.g. space lift to transfer resources, bio cybernetic augmentation "Exoskeleton", jumping rover, telescope). After brainstorming for required technologies, the fo-cus was shifted to what kinds of science can be ex-pected to be performed, once a functional and usable habitat would be available. The group has categorized studies of planetary formation and the Solar System as a highly important scientific discipline with a medi-um-high TRL. Scientific areas with high-medium im-portance, but low technological readiness, were found to be ISRU, psychological effects, adaptations of life to low gravity and plant cultivation. The physiological effects of low-gravity on the body were considered of medium importance and readiness. The Engaging Stakeholders working group started by identifying the main stakeholders and groups that play a role or that could play a role towards