Sample records for potentially life threatening

  1. Thrombus in Transit: A Potentially Life-threatening Complication of Cerebral Sinus Thrombosis.

    PubMed

    Petracca, Martina; Calandrelli, Rosalinda; Broccolini, Aldobrando; Caliandro, Pietro; Della Marca, Giacomo; Frisullo, Giovanni; Morosetti, Roberta; Profice, Paolo; Lamendola, Priscilla; Pennestrì, Faustino; Pilato, Fabio

    2017-01-01

    We report the case of a 41-year-old, 7-weeks-pregnant patient, presenting with headache and generalized seizure due to cerebral venous thrombosis complicated by jugular thrombosis and thrombus dislocation into right cardiac cavities. The patient was treated with intravenous heparin, and underwent embolectomy in extracorporeal circulation. This case illustrates the variability of cerebral venous thrombosis progression and a potentially life-threatening condition even during anticoagulant therapy.

  2. Endovascular Management of Ureteroarterial Fistula: A Rare Potentially Life Threatening Cause of Hematuria

    PubMed Central

    Copelan, Alexander; Chehab, Monzer; Cash, Charles; Korman, Howard; Dixit, Purushottam

    2014-01-01

    Ureteroarterial fistula is a rare, potentially life-threatening cause of hematuria characterized by an abnormal channel between a ureter and artery. The rarity of this condition, complexity of predisposing risk factors and intermittence of symptoms may delay or obscure its diagnosis. With a high index of suspicion and careful angiographic evaluation, embarking on this condition is not only possible but sets the stage for curative intervention. We report a case of a ureteroarterial fistula presenting with intermittent hematuria, successfully diagnosed at angiography and managed with endovascular stent graft placement. PMID:25426238

  3. Life-threatening cryoglobulinemia: clinical and immunological characterization of 29 cases.

    PubMed

    Ramos-Casals, Manuel; Robles, Angel; Brito-Zerón, Pilar; Nardi, Norma; Nicolás, José M; Forns, Xavier; Plaza, Joan; Yagüe, Jordi; Sánchez-Tapias, Jose M; Font, Josep

    2006-12-01

    To analyze the etiology, clinical presentation, and outcomes of patients with life-threatening cryoglobulinemic vasculitis. We studied 209 consecutive patients with cryoglobulinemic vasculitis. A potentially life-threatening cryoglobulinemia was considered as the development of renal failure, vasculitic abdominal involvement, pulmonary hemorrhage, or central nervous system involvement. Twenty-nine (14%) patients had life-threatening cryoglobulinemic vasculitis. There were 17 women and 12 men, with a mean age of 57 years. In 17 (59%) patients, life-threatening cryoglobulinemia was the initial clinical feature of the disease. The 29 patients had a total of 33 life-threatening episodes, which included renal failure due to cryoglobulinemic glomerulonephritis (n = 18), intestinal vasculitis (n = 8), pulmonary hemorrhage (n = 4), and central nervous system involvement (n = 3). In comparison with a control group of age-sex-matched patients with milder cryoglobulinemic vasculitis, those with severe cryoglobulinemic vasculitis had a higher frequency of fever (28% versus 7%, P = 0.017), type II cryoglobulins (100% versus 59%, P = 0.008), low C3 levels (55% versus 20%, P = 0.001), and a higher mean value of cryocrit (11.4% versus 3.3%, P = 0.004). Nineteen (66%) of the 29 patients with life-threatening involvement died, with the mortality rate reaching 100% in patients with intestinal ischemia and pulmonary hemorrhage. Life-threatening cryoglobulinemic vasculitis was observed in 14% of our patients, with almost two-thirds of episodes occurring at the onset of the disease. Fever, high cryocrit levels, and low C3 levels were associated with this severe presentation. Two-thirds of the patients died, with mortality for pulmonary hemorrhage and intestinal ischemia reaching 100%.

  4. Gastric Ulcer Hemorrhage - a Potential Life-Threatening Complication of Intragastric Balloon Treatment of Obesity.

    PubMed

    Mojkowska, Aleksandra; Gazdzinski, Stefan; Fraczek, Mariusz; Wyleżoł, Mariusz

    2017-01-01

    Some morbidly obese patients do not qualify for bariatric surgery due to general health contraindications. Intragastric balloon treatment might be a therapeutic option in the above-mentioned cases. It can prime super-obese patients with end-stage disease for bariatric surgery. As a neoadjuvant therapy before surgery, it leads to a downstage of the disease by preliminary weight reduction, to an improvement in general health and, in summary, to a reduction of the perioperative risk. It is generally considered to be a safe method. However, due to the wide range of possible complications and unusual symptoms after intragastric balloon treatment, an interdisciplinary, instead of only a surgical or endoscopic, treatment and follow-up might be recommended in these patients. We here describe a potential life-threatening complication in the form of gastric bleeding as a consequence of intragastric balloon treatment and simultaneous aspirin taking and Helicobacter pylori infection. There have been reports of some complications of intragastric balloon treatment. However, to the best of our knowledge there were no reports concerning life-threatening hemorrhage from gastric ulcer. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

  5. Acute and Potentially Life-Threatening Tropical Diseases in Western Travelers—A GeoSentinel Multicenter Study, 1996–2011

    PubMed Central

    Jensenius, Mogens; Han, Pauline V.; Schlagenhauf, Patricia; Schwartz, Eli; Parola, Philippe; Castelli, Francesco; von Sonnenburg, Frank; Loutan, Louis; Leder, Karin; Freedman, David O.

    2013-01-01

    We performed a descriptive analysis of acute and potentially life-threatening tropical diseases among 82,825 ill western travelers reported to GeoSentinel from June of 1996 to August of 2011. We identified 3,655 patients (4.4%) with a total of 3,666 diagnoses representing 13 diseases, including falciparum malaria (76.9%), enteric fever (18.1%), and leptospirosis (2.4%). Ninety-one percent of the patients had fever; the median time from travel to presentation was 16 days. Thirteen (0.4%) patients died: 10 with falciparum malaria, 2 with melioidosis, and 1 with severe dengue. Falciparum malaria was mainly acquired in West Africa, and enteric fever was largely contracted on the Indian subcontinent; leptospirosis, scrub typhus, and murine typhus were principally acquired in Southeast Asia. Western physicians seeing febrile and recently returned travelers from the tropics need to consider a wide profile of potentially life-threatening tropical illnesses, with a specific focus on the most likely diseases described in our large case series. PMID:23324216

  6. Life-threatening Cerebral Edema Caused by Acute Occlusion of a Superior Vena Cava Stent

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

    Sofue, Keitaro, E-mail: keitarosofue@yahoo.co.jp; Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp; Arai, Yasuaki, E-mail: arai-y3111@mvh.biglobe.ne.jp

    A71-year-old man with advanced lung cancer developed a life-threatening cerebral edema caused by the acute occlusion of a superior vena cava (SVC) stent and was successfully treated by an additional stent placement. Although stent occlusion is a common early complication, no life-threatening situations have been reported until now. Our experience highlights the fact that acute stent occlusion can potentially lead to the complete venous shutdown of the SVC, resulting in life-threatening cerebral edema, after SVC stent placement. Immediate diagnosis and countermeasures are required.

  7. Biodegradable airway stents in infants - Potential life-threatening pitfalls.

    PubMed

    Sztanó, B; Kiss, G; Márai, K; Rácz, G; Szegesdi, I; Rácz, K; Katona, G; Rovó, L

    2016-12-01

    The solution of severe tracheobronchial obstructions in early childhood means a great challenge. Biodegradable stents were intended to be a minimally invasive temporary solution which may decrease the number of interventions and limit the possible complications of stenting procedures. However, our first experiences have brought out a new, - especially in childhood - potentially life-threatening complication of this concept. Five SX-ELLA biodegradable polydioxanone stents was applied in three patients because of severe tracheobronchial obstruction: congenital tracheomalacia (7 day-old), acquired tracheomalacia (10 month-old), and congenital trachea-bronchomalacia (10 month-old). The breathing of all children improved right after the procedure. We observed degradation of the stent from the 5th postoperative week which resulted in large intraluminar fragments causing significant airway obstruction: one patient died of severe pneumonia, the other baby required urgent bronchoscopy to remove the obstructing 'foreign body' from the trachea. In the third case repeated stent placements successfully maintained the tracheal lumen. Polydioxanone stents may offer an alternative to metallic or silastic stents for collapse or external compression of the trachea in children; however, large decaying fragments mean a potential risk especially in the small size pediatric airway. The fragmentation of the stent, which generally starts in the 4-6 postoperative weeks, may create large sharp pieces. These may be anchored to the mucosa and covered by crust leading to obstruction. As repeated interventions are required, we do not consider the application of biodegradable stents unambiguously advantageous. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Mobile phone use for contacting emergency services in life-threatening circumstances.

    PubMed

    Wu, Olivia; Briggs, Andrew; Kemp, Tom; Gray, Alastair; MacIntyre, Kate; Rowley, Jack; Willett, Keith

    2012-03-01

    The potential health benefits of mobile phone use have not been widely studied, except for telemedicine-type applications. This study seeks to determine whether initial contact with emergency services via a mobile phone in life-threatening situations is associated with potential health benefits when compared to contact via a landline. A record-linkage study was carried out in which data from all emergency dispatches for immediately life-threatening events from a United Kingdom county ambulance service were linked to the Patient Admission System at two major local hospitals. Mortality (at the scene, at the emergency department [ED], and during hospitalization); transfer to the ED; admission (inpatient care, and intensive care unit); and length of stay were analyzed for calls classified as Code Red (immediately life-threatening) by initial exposure (mobile phone vs. landline), while controlling for potential confounding variables. Of 354,199 ambulances dispatched to attend emergency incidents, 66% transported patients to the hospital while 2% stood down due to death at the scene. Mobile phone compared to landline reporting of emergencies resulted in significant reductions in the risk of death at the scene (odds ratio [OR] 0.77), but not for death in the ED or during inpatient admission. The risk of being transferred to the ED and subsequent inpatient admission were significantly lower with reporting from mobile phones compared to landline (OR 0.93 and OR 0.82, respectively). In this study, evidence of statistical association was demonstrated between the use of mobile phones to alert ambulance services in life-threatening situations and improved outcomes for patients. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Spirituality in the context of life-threatening illness and life-transforming change.

    PubMed

    Young, William C; Nadarajah, Sheeba R; Skeath, Perry R; Berger, Ann M

    2015-06-01

    Individuals with life-threatening illness often engage in some form of spirituality to meet increased needs for meaning and purpose. This study aimed to identify the role of spirituality in persons who had reported positive, life-transforming change in relation to life-threatening cancer or cardiac events, and to connect these roles to palliative and supportive care. A purposive sample of 10 cardiac survivors and 9 cancer survivors was recruited. Once the participants had given informed consent and passed screening in relation to life-transforming change and distress, they engaged in a semistructured one-hour qualitative interview on the theme of how their life-transforming change occurred in the context of their life-threatening illness. In the present article, our phenomenological analysis focuses on participants' references to purpose and meaning in their lives, with particular attention to the role and context of participants' spirituality. Participants mentioned spirituality, meaning, and purpose in many contexts, including connecting with family and friends, nature, art, music, and sometimes creating a relationship with God. Participants often accessed spirituality by enhancing connections in their own lives: with a higher power, people, their work, or themselves. These enhanced connections gave participants greater meaning and purpose in their lives, and substantially helped participants to adjust to their life-threatening illnesses. Understanding the roles and contexts of spirituality among patients with a life-threatening illness allows us to develop better palliative and supportive care plans. Spiritually oriented supportive care may include support groups, yoga, meditation, nature, music, prayer, or referral to spiritual or religious counselors. A quantitative scale is needed to help healthcare clinicians assess the spiritual and coping needs of individuals with life-threatening illness.

  10. Infections and apparent life-threatening events.

    PubMed

    Altman, Robin L; Li, Karl I; Brand, Donald A

    2008-05-01

    The need for routine sepsis evaluation in patients who have experienced an apparent life-threatening event but lack signs of infection remains controversial. To assess their risk of a serious occult bacterial infection, records were reviewed of 95 infants in whom infections were discovered during their inpatient evaluation after an apparent life-threatening event. Noted for each patient was the presence of any suggestive findings that would have prompted a physician to consider the given type of infection in the differential diagnosis. Thirty patients had bacterial infections; all but 5 had suggestive findings. The exceptions included 1 patient with pneumonia and 4 with urinary tract infections. None of the remaining 25 patients had occult bacterial infections. In patients with an apparent life-threatening event who appear well and lack signs suggestive of a serious bacterial infection, it may be possible to forego routine sepsis evaluation beyond a chest radiograph and urine culture without risking a serious missed diagnosis.

  11. Life threatening hyperkalemia and acidosis secondary to trimethoprim-sulfamethoxazole treatment.

    PubMed

    Margassery, S; Bastani, B

    2001-01-01

    We present a 77-year-old male with moderate chronic renal insufficiency from diabetic nephropathy who developed severe metabolic acidosis and life threatening hyperkalemia on treatment with regular dose of trimethoprim-sulfamethoxazole (TMP-SMZ) for urinary tract infection. The metabolic acidosis and hyperkalemia resolved upon appropriate medical intervention and discontinuation of TMP-SMZ. While hyperkalemia has commonly been reported with high dose of TMP-SMZ, severe metabolic acidosis is quite uncommon with regular dose TMP-SMZ. We emphasize that patients with renal tubular acidosis (RTA), renal insufficiency, aldosterone deficiency, old age with reduced renal mass and function, and angiotensin converting enzyme (ACE)-inhibitor therapy are at high risk of developing these severe and potentially life threatening complications.

  12. A substantial proportion of life-threatening injuries are sport-related.

    PubMed

    Meehan, William P; Mannix, Rebekah

    2013-05-01

    This study aimed to assess the proportion of all life-threatening injuries that are sport-related. We conducted a cross-sectional study of patients included in the National Hospital Ambulatory Medical Care Survey during the years 1999 to 2008. Life-threatening injuries were defined according to the International Classification of Diseases, Ninth Revision codes: skull fracture (800.x-802.xx, 803.x-804.xx), cervical spine fractures (805.xx-806.10), intracranial hemorrhage (852.xx-853.xx), traumatic pneumothorax/hemothorax (860.00-860.05), liver lacerations (864.xx), spleen lacerations (865.xx), aortic rupture (901.0; 902.0), gastric/duodenal rupture (537.89), heat stroke (992.0), and commotio cordis/heart contusion (861.01). Sport-related was defined by the external cause of injury codes, confirmed by text search. There were 300,394 observed emergency department visits during the study period. An estimated 0.5% (95% confidence interval [CI], 0.5%-0.6%) of all emergency department visits nationally were for life-threatening injuries. Of the life-threatening injuries, 14% (95% CI, 12%-17) were sport-related, representing 926,805 sport-related, life-threatening injuries nationally. A higher percentage (32%; 95% CI, 27%-38%) of life-threatening injuries sustained by children was sport-related when compared with adults (9%; 95% CI, 7%-11%). For adults aged 19 to 44 years, 12% (95% CI, 9%-15%) of life-threatening injuries were sport-related. For children aged 6 to 18 years, 39% (95% CI, 33%-46%) of life-threatening injuries were sport-related. Nearly a quarter (23%; 95% CI, 7%-55%) of pediatric cervical spine fractures was sport-related. The percentage of cervical spine fractures that were sport-related was lower for adults (7%; 95% CI, 4%-11%). Efforts should be made to prevent the number of sport-related, life-threatening injuries.

  13. A Substantial Proportion of Life-Threatening Injuries are Sport-Related

    PubMed Central

    Meehan, William P.; Mannix, Rebekah

    2013-01-01

    Objective To assess the proportion of all life-threatening injuries that are sport-related. Methods We conducted a cross-sectional study of patients included in the National Hospital Ambulatory Medical Care Survey (NHAMCS) during the years 1999–2008. Life-threatening injuries were defined as International Classification of Diseases 9 codes: skull fracture [800.x–802.xx, 803.x–804.xx], cervical spine fractures [805.xx–806.10], intracranial hemorrhage [852.xx–853.xx], traumatic pneumothorax/hemothorax [860.00–860.05], liver lacerations [864.xx], spleen lacerations [865.xx], aortic rupture [901.0; 902.0], gastric/duodenal rupture [537.89], heat stroke [992.0], and commotio cordis/heart contusion [861.01]. Sport-related was defined by external cause of injury codes, confirmed by text search. Results There were 300,394 observed emergency department visits during the study period. An estimated 0.5% (95% CI, 0.5 – 0.6) of all ED visits nationally were for life-threatening injuries. Of life-threatening injuries, 14% (95% CI, 12 – 17) were sport-related, representing 926,805 sport-related, life-threatening injuries nationally. A higher percentage (32%; 95% CI, 27 – 38) of life-threatening injuries sustained by children was sport-related when compared with adults (9%; 95% CI, 7 – 11). For adults aged 19–44 years, 12% (95% CI, 9 – 15) of life-threatening injuries were sport-related. For children aged 6–18 years, 39% (95% CI, 33 – 46) of life-threatening injuries were sport-related. Nearly a quarter (23%; 95% CI, 7 – 55) of pediatric cervical spine fractures was sport-related. The percentage of cervical spine fractures that were sport-related was lower for adults (7%; 95% CI, 4 – 11). Conclusion Efforts should be made to prevent the number of sport-related, life-threatening injuries. PMID:23603654

  14. Optical illusions and life-threatening traffic crashes: A perspective on aerial perspective.

    PubMed

    Redelmeier, Donald A; Raza, Sheharyar

    2018-05-01

    Aerial perspective illusion is a feature of visual perception where landscapes appear relatively close in clear light and distant in dim light. We hypothesized that bright sunlight might cause drivers to perceive distant terrain as relatively close and misinterpret the approach speed of surrounding landscape as unduly slow. This hypothesis would mean, in turn, that drivers in bright sunlight may underestimate their progress on the road, compensate by traveling at a faster baseline speed, and ultimately increase the prevailing risk of a life-threatening traffic crash. We conducted three pilot studies to illustrate how the illusion might contribute to a life- threatening traffic crash. The first illustration used a questionnaire to demonstrate that most respondents were mistaken when judging the distance between simple balls in different positions. The second illustration involved an experimental manipulation to assess whether aerial perspective influenced judgments about the relative positions of vehicles in traffic. The third illustration analyzed a segment of high-volume fast-speed traffic and found an increased frequency of speeding under bright sunlight. Together with past work based on the visual arts, these examples illustrate how an aerial perspective illusion can affect distance perception, may appear in realistic traffic situations, and could potentially contribute to the risk of a life-threatening traffic crash. An awareness of this hypothesis might lead to applications on how optical illusions could extend to everyday traffic and might potentially inform safety warnings to prevent life- threatening crashes. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Transgender youth and life-threatening behaviors.

    PubMed

    Grossman, Arnold H; D'Augelli, Anthony R

    2007-10-01

    Sexual minority status is a key risk factor for suicide among lesbian, gay, and bisexual youth; however, it has not been studied among transgender youth. Fifty-five transgender youth reported on their life-threatening behaviors. Nearly half of the sample reported having seriously thought about taking their lives and one quarter reported suicide attempts. Factors significantly related to having made a suicide attempt included suicidal ideation related to transgender identity; experiences of past parental verbal and physical abuse; and lower body esteem, especially weight satisfaction and thoughts of how others evaluate the youths' bodies. Sexual minority status is a key risk factor for life-threatening behaviors among transgender youth.

  16. Hypofibrinogenemia induced by tigecycline: a potentially life-threatening coagulation disorder.

    PubMed

    Sabanis, Nikolaos; Paschou, Eleni; Gavriilaki, Eleni; Kalaitzoglou, Asterios; Vasileiou, Sotirios

    2015-01-01

    A 74-year-old female patient with end-stage renal disease, undergoing periodic hemodialysis, was hospitalized due to infection by multidrug-resistant Acinetobacter baumannii after hip replacement surgery. She was treated with tigecycline, a glycylcycline agent. Subsequently she developed coagulation disorders as substantiated by increased international normalized ratio (INR), prolonged partial thromboplastin time (aPTT), and severe hypofibrinogenemia, followed by transaminasemia, cholestasis, and anemia. Ultrasonography and computed tomography revealed no underlying pathological entities. Tigecycline was discontinued and the patient underwent daily hemodialysis and received multiple fresh frozen plasma transfusions. Additionally, she was treated with colistin. Her clinical and laboratory status improved. We suggest that patients treated with tigecycline should be monitored for changes in INR, aPTT, and fibrinogen levels to avoid severe, life-threatening coagulation disturbances.

  17. Contrasting stories of life-threatening illness: a narrative inquiry.

    PubMed

    Sheilds, L; Molzahn, A; Bruce, A; Schick Makaroff, K; Stajduhar, K; Beuthin, R; Shermak, S

    2015-01-01

    Advances in science and technology have resulted in longer lives for people with life-threatening illnesses. However, little research compares the stories of people with different life-threatening illnesses. The objectives of this study were to explore and contrast how people story and re-story life-threatening illness specifically cancer, chronic kidney disease (CKD) and HIV. Narrative inquiry within a social constructionist perspective was used. A total of 113 in-depth interviews were conducted with 32 participants over a period of three years. Study participants included 32 people: 10 with cancer, 14 with CKD and 8 with HIV/AIDS. Participants varied in age (37-83 years old, mean=61.2 years), gender (17 men and 14 women), location (urban and rural), time post-diagnosis (median=8 years), intensity or invasiveness of treatment, and prognosis (continuous treatment, remission, cure, palliative). Participants described living with a life-threatening illness as a delicate balance. They focused on living their lives yet were fully and acutely aware of their own mortality. There was an undercurrent of sustained uncertainty that permeated their lives. Stories of life-threatening illness differed across the three illness groups and shifted over time as disease trajectories changed. Each disease brought specific challenges. With cancer, turning points and uncertainty were prominent. With CKD, a stealthy beginning to life-extending treatment through dialysis or transplant was evident, and with HIV, a shift from a perceived death sentence to a focus on hope and living was notable. Findings revealed that trajectories of illness for participants living with cancer, CKD and HIV are complex and differ markedly across the groups. Narratives shifted across all of the illness groups as participants navigated and re-storied the terrains of their life-threatening illness. Findings illuminated the need for health care providers to focus on person specific and contextualized aspects of

  18. Management of potentially life-threatening emergencies at 74 primary level hospitals in Mongolia: results of a prospective, observational multicenter study.

    PubMed

    Mendsaikhan, Naranpurev; Gombo, Davaa; Lundeg, Ganbold; Schmittinger, Christian; Dünser, Martin W

    2017-05-08

    While the capacities to care for and epidemiology of emergency and critically ill patients have been reported for secondary and tertiary level hospitals in Mongolia, no data exist for Mongolian primary level hospitals. In this prospective, observational multicenter study, 74 primary level hospitals of Mongolia were included. We determined the capacities of these hospitals to manage medical emergencies. Furthermore, characteristics of patients presenting with potentially life-threatening emergencies to these hospitals were evaluated during a 6 month period. An emergency/resuscitation room was available in 62.2% of hospitals. One third of the study hospitals had an operation theatre (32.4%). No hospital ran an intensive care unit or had trained emergency/critical care physicians or nurses available. Diagnostic resources were inconsistently available (sonography, 59.5%; echocardiography, 0%). Basic emergency procedures (wound care, 97.3%; foreign body removal, 86.5%; oxygen application, 85.2%) were commonly but advanced procedures (advanced cardiac life support, 10.8%; airway management, 13.5%; mechanical ventilation, 0%; renal replacement therapy, 0%) rarely available. During 6 months, 14,545 patients were hospitalized in the 74 study hospitals, of which 8.7% [n = 1267; median age, 34 (IQR 18-53) years; male gender, 54.4%] were included in the study. Trauma (excl. brain trauma) (20.4%), acute abdomen (16.9%) and heart failure (9.6%) were the most common conditions. Five-hundred-thirty patients (41.8%) were transferred to a secondary level hospital. The hospital mortality of patients not transferred was 3.2%. Capacities of Mongolian primary level hospitals to manage life-threatening emergencies are highly limited. Trauma, surgical and medical conditions make up the most common emergencies. In view of the fact that almost half of the patients with a potentially life-threatening emergency were transferred to secondary level hospitals and the mortality of those

  19. Incidence of death and potentially life-threatening near-miss events in living donor hepatic lobectomy: a world-wide survey.

    PubMed

    Cheah, Yee Lee; Simpson, Mary Ann; Pomposelli, James J; Pomfret, Elizabeth A

    2013-05-01

    The incidence of morbidity and mortality after living donor liver transplantation (LDLT) is not well understood because reporting is not standardized and relies on single-center reports. Aborted hepatectomies (AHs) and potentially life-threatening near-miss events (during which a donor's life may be in danger but after which there are no long-term sequelae) are rarely reported. We conducted a worldwide survey of programs performing LDLT to determine the incidence of these events. A survey instrument was sent to 148 programs performing LDLT. The programs were asked to provide donor demographics, case volumes, and information about graft types, operative morbidity and mortality, near-miss events, and AHs. Seventy-one programs (48%), which performed donor hepatectomy 11,553 times and represented 21 countries, completed the survey. The average donor morbidity rate was 24%, with 5 donors (0.04%) requiring transplantation. The donor mortality rate was 0.2% (23/11,553), with the majority of deaths occurring within 60 days, and all but 4 deaths were related to the donation surgery. The incidences of near-miss events and AH were 1.1% and 1.2%, respectively. Program experience did not affect the incidence of donor morbidity or mortality, but near-miss events and AH were more likely in low-volume programs (≤50 LDLT procedures). In conclusion, it appears that independently of program experience, there is a consistent donor mortality rate of 0.2% associated with LDLT donor procedures, yet increased experience is associated with lower rates of AH and near-miss events. Potentially life-threatening near-miss events and AH are underappreciated complications that must be discussed as part of the informed consent process with any potential living liver donor. Copyright © 2012 American Association for the Study of Liver Diseases.

  20. Collective Efficacy and the Contingent Consequences of Exposure to Life-Threatening Violence

    ERIC Educational Resources Information Center

    Browning, Christopher R.; Gardner, Margo; Maimon, David; Brooks-Gunn, Jeanne

    2014-01-01

    Neighborhood research has increasingly emphasized the potential for contextual characteristics to moderate the effects of youths' experiences on their outcomes. Drawing on collective efficacy theory, we examine the variable consequences of youths' exposures to life-threatening violence across neighborhoods. We argue that strong community normative…

  1. Severe or life-threatening asthma exacerbation: patient heterogeneity identified by cluster analysis.

    PubMed

    Sekiya, K; Nakatani, E; Fukutomi, Y; Kaneda, H; Iikura, M; Yoshida, M; Takahashi, K; Tomii, K; Nishikawa, M; Kaneko, N; Sugino, Y; Shinkai, M; Ueda, T; Tanikawa, Y; Shirai, T; Hirabayashi, M; Aoki, T; Kato, T; Iizuka, K; Homma, S; Taniguchi, M; Tanaka, H

    2016-08-01

    Severe or life-threatening asthma exacerbation is one of the worst outcomes of asthma because of the risk of death. To date, few studies have explored the potential heterogeneity of this condition. To examine the clinical characteristics and heterogeneity of patients with severe or life-threatening asthma exacerbation. This was a multicentre, prospective study of patients with severe or life-threatening asthma exacerbation and pulse oxygen saturation < 90% who were admitted to 17 institutions across Japan. Cluster analysis was performed using variables from patient- and physician-orientated structured questionnaires. Analysis of data from 175 patients with severe or life-threatening asthma exacerbation revealed five distinct clusters. Cluster 1 (n = 27) was younger-onset asthma with severe symptoms at baseline, including limitation of activities, a higher frequency of treatment with oral corticosteroids and short-acting beta-agonists, and a higher frequency of asthma hospitalizations in the past year. Cluster 2 (n = 35) was predominantly composed of elderly females, with the highest frequency of comorbid, chronic hyperplastic rhinosinusitis/nasal polyposis, and a long disease duration. Cluster 3 (n = 40) was allergic asthma without inhaled corticosteroid use at baseline. Patients in this cluster had a higher frequency of atopy, including allergic rhinitis and furred pet hypersensitivity, and a better prognosis during hospitalization compared with the other clusters. Cluster 4 (n = 34) was characterized by elderly males with concomitant chronic obstructive pulmonary disease (COPD). Although cluster 5 (n = 39) had very mild symptoms at baseline according to the patient questionnaires, 41% had previously been hospitalized for asthma. This study demonstrated that significant heterogeneity exists among patients with severe or life-threatening asthma exacerbation. Differences were observed in the severity of asthma symptoms and use of inhaled corticosteroids at baseline

  2. Factors predicting life-threatening infections with respiratory syncytial virus in adult patients.

    PubMed

    Park, Se Yoon; Kim, Taeeun; Jang, Young Rock; Kim, Min-Chul; Chong, Yong Pil; Lee, Sang-Oh; Choi, Sang-Ho; Kim, Yang Soo; Woo, Jun Hee; Kim, Sung-Han

    2017-05-01

    Respiratory syncytial virus (RSV) is a significant cause of acute respiratory illness with a clinical spectrum ranging from self-limiting upper respiratory infection to severe lower respiratory infection in elderly persons as well as young children. However, there are limited data on risk factors for life-threatening infections that could guide the appropriate use of antiviral agents in adult patients with RSV. We conducted a retrospective cohort study from October 2013 to September 2015. Adult patients with RSV who visited the emergency department were enrolled. Primary outcome was life-threatening infection (admission to intensive care unit, need for ventilator care or in-hospital death). A total of 227 patients were analysed. Thirty-four (15%) were classified as having life-threatening infections. By logistic regression, lower respiratory infection, chronic lung disease and bacterial co-infection were independent predictors of life-threatening infections. We developed a simple clinical scoring system using these variables (lower respiratory tract infection = score 4, chronic respiratory disease = score 3, bacterial co-infection = score 3 and fever ≥38 °C = score 2) to predict life-threatening infection. A score of >5 differentiated life-threatening RSV from non-life-threatening RSV with 82% sensitivity (95% CI, 66-93) and 72% specificity (95% CI, 65-78). The use of a clinical scoring system based on lower respiratory infection, chronic respiratory disease, bacterial co-infection and fever appears to be useful for outcome prediction and risk stratification in order to select patients who may need early antiviral therapy.

  3. [Life-threatening hemoptysis. Treatment with transcatheter embolization].

    PubMed

    Gimeno Peribáñez, M J; Madariaga, B; Alfonso Aguirán, E R; Medrano Peña, J; Fernández Gómez, J A; Herrera, M; de Gregorio Ariza, M A

    1999-09-01

    To evaluate the immediate and long-term efficacy of transcatheter embolization of bronchial, systemic and pulmonary arteries to treat life-threatening hemoptysis. Likewise, we propose the systematic treatment of life-threatening hemoptysis by means of transcatheter embolization. One hundred seven angiographies were performed on the same number of patients experiencing life-threatening hemoptysis with bleeding exceeding 150 ml in 24 hours. Before angiography, we rinsed the vessels with cold saline solution and adrenalin through the catheter. Thirty-three patients were female and 74 were male. Mean age was 52.3 years (range 12 to 75 years). Embolization was performed in 104 (3 in patients with recurrent hemoptysis) using polyvinyl alcohol and micro-coils. Bronchial and systemic arteries of the affected hemithorax (mammary and lateral thoracic arteries) were checked in all patients. If findings were negative or bleeding was recurrent, we also performed pulmonary arteriography. In two cases we were unable to catheterize the artery theoretically responsible for bleeding. Examination of both arterial and systemic vessels proved normal in one patient. The embolization technique was successful in 99% (103/104) of the cases and the rate of immediate clinical success was 95.1% (99/104). The mean time of follow-up was 43.2 months (range 3 to 66 months). Hemoptysis recurred in 15.3% (16 cases) within a mean 8.3 months (range 15 days to 48 months); embolization was repeated in 14 of these patients with satisfactory results, while two underwent surgery. In five patients (4.8%) we observed complications requiring no additional medical treatment: one instance of coil migration to the deep femoral artery, from which the coil was removed in a basket; two cases of bronchial artery extravasation with small mediastinal hematomas; and two hematomas at the points of puncture. Selective or supra-selective embolization of the arteries that feed the bronchi provides effective management of

  4. Life-threatening hypokalemia following rapid correction of respiratory acidosis.

    PubMed

    Hammond, Kendra; You, David; Collins, Eileen G; Leehey, David J; Laghi, Franco

    2013-01-01

    A 56-year-old woman with a history of paraplegia and chronic pain due to neuromyelitis optica (Devic's syndrome) was admitted to a spinal cord injury unit for management of a sacral decubitus ulcer. During the hospitalization, she required emergency transfer to the intensive care unit (ICU) because of progressive deterioration of respiratory muscle function, severe respiratory acidosis, obtundation and hypotension. Upon transfer to the ICU, arterial blood gas revealed severe acute-on-chronic respiratory acidosis (pH 7.00, PCO2 120 mm Hg, PO2 211 mm Hg). The patient was immediately intubated and mechanically ventilated. Intravenous fluid boluses of normal saline (10.5 L in about 24 h) and vasopressors were started with rapid correction of hypotension. In addition, she was given hydrocortisone. Within 40 min of initiation of mechanical ventilation, there was improvement in acute respiratory acidosis. Sixteen hours later, however, the patient developed life-threatening hypokalemia (K(+) of 2.1 mEq/L) and hypomagnesemia (Mg of 1.4 mg/dL). Despite aggressive potassium supplementation, hypokalemia continued to worsen over the next several hours (K(+) of 1.7 mEq/L). Urine studies revealed renal potassium wasting. We reason that the recalcitrant life-threatening hypokalemia was caused by several mechanisms including total body potassium depletion (chronic respiratory acidosis), a shift of potassium from the extracellular to intracellular space (rapid correction of respiratory acidosis with mechanical ventilation), increased sodium delivery to the distal nephron (normal saline resuscitation), hyperaldosteronism (secondary to hypotension plus administration of hydrocortisone) and hypomagnesemia. We conclude that rapid correction of respiratory acidosis, especially in the setting of hypotension, can lead to life-threatening hypokalemia. Serum potassium levels must be monitored closely in these patients, as failure to do so can lead to potentially lethal consequences

  5. Transgender Youth and Life-Threatening Behaviors

    ERIC Educational Resources Information Center

    Grossman, Arnold H.; D'Augelli, Anthony R.

    2007-01-01

    Sexual minority status is a key risk factor for suicide among lesbian, gay, and bisexual youth; however, it has not been studied among transgender youth. Fifty-five transgender youth reported on their life-threatening behaviors. Nearly half of the sample reported having seriously thought about taking their lives and one quarter reported suicide…

  6. Life-threatening motor vehicle crashes in bright sunlight

    PubMed Central

    Redelmeier, Donald A.; Raza, Sheharyar

    2017-01-01

    Abstract Bright sunlight may create visual illusions that lead to driver error, including fallible distance judgment from aerial perspective. We tested whether the risk of a life-threatening motor vehicle crash was increased when driving in bright sunlight. This longitudinal, case-only, paired-comparison analysis evaluated patients hospitalized because of a motor vehicle crash between January 1, 1995 and December 31, 2014. The relative risk of a crash associated with bright sunlight was estimated by evaluating the prevailing weather at the time and place of the crash compared with the weather at the same hour and location on control days a week earlier and a week later. The majority of patients (n = 6962) were injured during daylight hours and bright sunlight was the most common weather condition at the time and place of the crash. The risk of a life-threatening crash was 16% higher during bright sunlight than normal weather (95% confidence interval: 9–24, P < 0.001). The increased risk was accentuated in the early afternoon, disappeared at night, extended to patients with different characteristics, involved crashes with diverse features, not apparent with cloudy weather, and contributed to about 5000 additional patient-days in hospital. The increased risk extended to patients with high crash severity as indicated by ambulance involvement, surgical procedures, length of hospital stay, intensive care unit admission, and patient mortality. The increased risk was not easily attributed to differences in alcohol consumption, driving distances, or anomalies of adverse weather. Bright sunlight is associated with an increased risk of a life-threatening motor vehicle crash. An awareness of this risk might inform driver education, trauma staffing, and safety warnings to prevent a life-threatening motor vehicle crash. Level of evidence: Epidemiologic Study, level III. PMID:28072708

  7. Life-threatening motor vehicle crashes in bright sunlight.

    PubMed

    Redelmeier, Donald A; Raza, Sheharyar

    2017-01-01

    Bright sunlight may create visual illusions that lead to driver error, including fallible distance judgment from aerial perspective. We tested whether the risk of a life-threatening motor vehicle crash was increased when driving in bright sunlight.This longitudinal, case-only, paired-comparison analysis evaluated patients hospitalized because of a motor vehicle crash between January 1, 1995 and December 31, 2014. The relative risk of a crash associated with bright sunlight was estimated by evaluating the prevailing weather at the time and place of the crash compared with the weather at the same hour and location on control days a week earlier and a week later.The majority of patients (n = 6962) were injured during daylight hours and bright sunlight was the most common weather condition at the time and place of the crash. The risk of a life-threatening crash was 16% higher during bright sunlight than normal weather (95% confidence interval: 9-24, P < 0.001). The increased risk was accentuated in the early afternoon, disappeared at night, extended to patients with different characteristics, involved crashes with diverse features, not apparent with cloudy weather, and contributed to about 5000 additional patient-days in hospital. The increased risk extended to patients with high crash severity as indicated by ambulance involvement, surgical procedures, length of hospital stay, intensive care unit admission, and patient mortality. The increased risk was not easily attributed to differences in alcohol consumption, driving distances, or anomalies of adverse weather.Bright sunlight is associated with an increased risk of a life-threatening motor vehicle crash. An awareness of this risk might inform driver education, trauma staffing, and safety warnings to prevent a life-threatening motor vehicle crash. Epidemiologic Study, level III.

  8. Life-Threatening Hemolytic Anemia after Intrapleural Instillation of OK-432 for Treatment of Congenital Chylothorax.

    PubMed

    Sze, Steve W P; Ng, Pak C; Lam, Hugh S

    2016-01-01

    Recent reports have advocated treatment of congenital chylothorax with chemical pleurodesis via intrapleural administration of OK-432. Severe complications have not been reported, but recently we have encountered a life-threatening case of massive hemolysis after the procedure. The hemoglobin of the infant decreased from 8.7 to 3.1 g/dl within 48 h, with concomitant severe hyperbilirubinemia (472 μmol/l) requiring exchange transfusion. Frontline neonatologists should be aware of this rare but potentially life-threatening adverse reaction. In addition, it is possible that a longer indwelling time (3.5 vs. 0.5 h) for OK-432 pleurodesis may alter the therapeutic response. © 2016 S. Karger AG, Basel.

  9. Life-Threatening Thrombocytopenia Following Intravenous Contrast Media Infusion

    PubMed Central

    Kim, Minjeong; Park, Jisun

    2018-01-01

    Radiocontrast media-induced acute severe thrombocytopenia is a very rare complication and potentially life-threatening. Here, we report the case of a 63-year-old male patient with severe acute thrombocytopenia following first exposure to intravenous non-ionic contrast media without immediate allergic reactions. His platelet count dropped from 107000/µL to 2000/µL after six hours of radiocontrast infusion. After administration of corticosteroid and transfusion of platelet concentrates, the platelet count returned gradually to normal within 5 days. To the best of our knowledge, non-ionic contrast media-induced isolated acute severe thrombocytopenia following no signs or symptoms of immediate allergic reaction has never been described. PMID:29214792

  10. Minority Elderly Adaptation to Life-Threatening Events: An Overview with Methodological Consideration.

    ERIC Educational Resources Information Center

    Trimble, Joseph E.; And Others

    A review of pertinent research on the adaptation of ethnic minority elderly to life-threatening events (personal, man-made, or natural) exposes voids in the research, presents methodological considerations, and indicates that ethnic minority elderly are disproportionately victimized by life-threatening events. Unusually high numbers of…

  11. 20 CFR 416.1248 - Exclusion of gifts to children with life-threatening conditions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Exclusion of gifts to children with life... gifts to children with life-threatening conditions. In determining the resources of an individual who has not attained 18 years of age and who has a life-threatening condition, we will exclude any gifts...

  12. Life-Threatening Thrombocytopenia Following Intravenous Contrast Media Infusion.

    PubMed

    Park, Mihwa; Kim, Minjeong; Park, Jisun; Cho, Jinhyun

    2018-01-01

    Radiocontrast media-induced acute severe thrombocytopenia is a very rare complication and potentially life-threatening. Here, we report the case of a 63-year-old male patient with severe acute thrombocytopenia following first exposure to intravenous non-ionic contrast media without immediate allergic reactions. His platelet count dropped from 107000/μL to 2000/μL after six hours of radiocontrast infusion. After administration of corticosteroid and transfusion of platelet concentrates, the platelet count returned gradually to normal within 5 days. To the best of our knowledge, non-ionic contrast media-induced isolated acute severe thrombocytopenia following no signs or symptoms of immediate allergic reaction has never been described. © Copyright: Yonsei University College of Medicine 2018.

  13. Tachycardia may prognosticate life- or organ-threatening diseases in children with abdominal pain.

    PubMed

    Hayakawa, Itaru; Sakakibara, Hiroshi; Atsumi, Yukari; Hataya, Hiroshi; Terakawa, Toshiro

    2017-06-01

    Abdominal pain is common in children, but expeditious diagnosis of life- or organ-threatening diseases can be challenging. An evidence-based definition of tachycardia in children was established recently, but its diagnostic utility has not yet been studied. To test the hypothesis that abdominal pain with tachycardia may pose a higher likelihood of life- or organ-threatening diseases in children. A nested case-control study was conducted in a pediatric emergency department in 2013. Tachycardia was defined as a resting heart rate of more than 3 standard deviations above the average for that age. Life- or organ-threatening diseases were defined as "disorders that might result in permanent morbidity or mortality without appropriate intervention." A triage team recorded vital signs before emergency physicians attended patients. Patients with tachycardia (cases) and without tachycardia (controls) were systematically matched for age, sex, and month of visit. The groups were compared for the presence of life- or organ-threatening diseases. There were 1683 visits for abdominal pain, 1512 of which had vital signs measured at rest. Eighty-three patients experienced tachycardia, while 1429 did not. Fifty-eight cases and 58 controls were matched. Life- or organ-threatening diseases were more common in the case group (19%) than the control group (5%, p=0.043). The relative risk of tachycardia to the presence of the diseases was 3.7 (95% confidence interval 1.2-12.0). Tachycardia significantly increased the likelihood of life- or organ-threatening diseases. Tachycardia in children with abdominal pain should alert emergency physicians to the possibility of serious illness. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Incidence and management of life-threatening adverse events during cardiac catheterization for congenital heart disease.

    PubMed

    Lin, C Huie; Hegde, Sanjeet; Marshall, Audrey C; Porras, Diego; Gauvreau, Kimberlee; Balzer, David T; Beekman, Robert H; Torres, Alejandro; Vincent, Julie A; Moore, John W; Holzer, Ralf; Armsby, Laurie; Bergersen, Lisa

    2014-01-01

    Continued advancements in congenital cardiac catheterization and interventions have resulted in increased patient and procedural complexity. Anticipation of life-threatening events and required rescue measures is a critical component to preprocedural preparation. We sought to determine the incidence and nature of life-threatening adverse events in congenital and pediatric cardiac catheterization, risk factors, and resources necessary to anticipate and manage events. Data from 8905 cases performed at the 8 participating institutions of the Congenital Cardiac Catheterization Project on Outcomes were captured between 2007 and 2010 [median 1,095/site (range 133-3,802)]. The incidence of all life-threatening events was 2.1 % [95 % confidence interval (CI) 1.8-2.4 %], whereas mortality was 0.28 % (95 % CI 0.18-0.41 %). Fifty-seven life-threatening events required cardiopulmonary resuscitation, whereas 9 % required extracorporeal membrane oxygenation. Use of a risk adjustment model showed that age <1 year [odd ratio (OR) 1.9, 95 % CI 1.4-2.7, p < 0.001], hemodynamic vulnerability (OR 1.6, 95 % CI 1.1-2.3, p < 0.01), and procedure risk (category 3: OR 2.3, 95 % CI 1.3-4.1; category 4: OR 4.2, 95 % CI 2.4-7.4) were predictors of life-threatening events. Using this model, standardized life-threatening event ratios were calculated, thus showing that one institution had a life-threatening event rate greater than expected. Congenital cardiac catheterization and intervention can be performed safely with a low rate of life-threatening events and mortality; preprocedural evaluation of risk may optimize preparation of emergency rescue and bailout procedures. Risk predictors (age < 1, hemodynamic vulnerability, and procedure risk category) can enhance preprocedural patient risk stratification and planning.

  15. Sevoflurane therapy for life-threatening acute severe asthma: a case report.

    PubMed

    Ruszkai, Zoltán; Bokrétás, Gergely Péter; Bartha, Péter Töhötöm

    2014-10-01

    Acute severe asthma is a life-threatening form of bronchial constriction in which the progressively worsening airway obstruction is unresponsive to the usual appropriate bronchodilator therapy. Pathophysiological changes restrict airflow, which leads to premature closure of the airway on expiration, impaired gas exchange, and dynamic hyperinflation ("air-trapping"). Additionally, patients suffering from asthma for a prolonged period of time usually have serious comorbidities. These conditions constitute a challenge during the treatment of this disease. Therapeutic interventions are designed to reduce airway resistance and improve respiratory status. To achieve therapeutic goals, appropriate bronchodilator treatment is indispensable, and mechanical ventilation under adequate sedation may also be required. The volatile anesthetic agent, sevoflurane, meets both criteria; therefore, its use can be beneficial and should be considered. A 67-yr-old Caucasian male presented with acute life-threatening asthma provoked by an assumed upper airway infection and non-steroidal anti-inflammatory drug antipyretics, complicated by chronic atrial fibrillation and hemodynamic instability. Due to frequent premature ventricular contractions, conventional treatment was considered unsafe and discontinued, and sevoflurane inhalation was initiated via the AnaConDa (Anaesthetic Conserving Device). Symptoms of life-threatening bronchospasm resolved, and the patient's respiratory status improved within hours. Adequate sedation was also achieved without any hemodynamic adverse effects. The volatile anesthetic agent, sevoflurane, is used widely in anesthesia practice. Its utility for treatment of refractory bronchospasm has been appreciated for years; however, its administration was difficult within the environment of the intensive care unit due to the need for an anesthesia machine and a scavenging system. The introduction of the AnaConDa eliminates these obstacles and makes the use of

  16. Life-threatening complications associated with acute monocytic leukaemia after dental treatment.

    PubMed

    Koulocheris, P; Metzger, M C; Kesting, M R; Hohlweg-Majert, B

    2009-03-01

    It is highly recommended to conduct a prophylactic check for any dental problems on patients who suffer from leukaemia before chemotherapy begins. Bacteraemia caused by oral microflora may be very dangerous for patients with haematological malignancies. However, it should be noted that the prophylactic process itself might bring about life-threatening complications if there is only a short interval between dental treatment and the beginning of chemotherapy, or if the dental treatment is too aggressive. We present a case where this prophylactic procedure produced life-threatening complications for a patient with acute myeloid leukaemia.

  17. [Pre-hospital management of adults with life-threatening emergencies].

    PubMed

    Wattel, Francis; Dubois, François

    2012-01-01

    In France, acute life-threatening situations are handled by the French Secours a Personne (assistance to persons) and emergency medical facilities. An unequivocal success, this early management of life-threatening emergency situations relies upon centralized call reception, medical dispatching, and immediate on-site emergency medical care. We describe the different emergency care providers and steps involved in the response to emergency situations. Each call centre (Samu, phone number 15; Sapeurs-Pompiers, 18) provides a response tailored to the nature of incoming calls for assistance. A check-list of grounds for an "automatic response" by the SDIS (Service Départemental d'Incendie et de Secours--the French fire brigade) is in use, ensuring that firefighters are often the first on the spot, while the knowledge and skills of the dispatching physician are essential to ascertain the patient's needs, to preserve life and vital functions, and to ensure the patient is sent to the appropriate emergency healthcare facility. In life-threatening emergency situations, patients must be brought straight to the appropriate reference emergency healthcare facility, as quickly as possible, without prior admittance to an emergency department. This is the procedure for extremely acute emergency situations in the following areas: trauma (multiple trauma and/or uncontrolled bleeding, spinal cord trauma), delivery bleeding, other life-threatening situations such as ischemic heart disease, cardiac arrest (sudden death), cerebrovascular stroke and ensuing brain damage, some acute respiratory situations such as anaphylactic shock, foreign-body inhalation, electrocution, drowning, drug overdose, certain forms of poisoning, and conditions requiring initial hyperbaric oxygen (diving accidents, acute carbon monoxide and smoke poisoning). The reasons for suboptimal emergency care in life-threatening situations are currently a major issue, with medical facilities being reduced in some areas

  18. Brain activity and prosocial behavior in a simulated life-threatening situation.

    PubMed

    Zanon, Marco; Novembre, Giovanni; Zangrando, Nicola; Chittaro, Luca; Silani, Giorgia

    2014-09-01

    To study the neuronal basis of altruistic behavior, we investigated functional connectivity within brain networks of participants who exhibited either a self-benefit behavior or an altruistic one in a life-threatening situation simulated in a virtual environment. In particular, participants were asked to evacuate a virtual building on fire and, without being previously informed, they were faced with a decision on whether to stop and help a trapped virtual human, at the possible cost of losing their own life in the virtual experience. Group independent component analysis (gICA) applied on blood-oxygen-level-dependent (BOLD) functional images revealed significant differences between the group of participants who showed selfish behavior and those who acted prosocially. Specifically, an increased functional connectivity in the salience network, comprising the anterior insula (AI) and the anterior mid cingulate cortex (aMCC), was observed in the selfish group compared to the prosocial one. Conversely, higher ICA weights in the medial prefrontal cortex and temporo-parietal junction (TPJ), were observed in the prosocial group. The findings show that an increased functional connectivity of the salience network, which suggests an enhanced sensitivity to the threatening situation and potential danger for the individual, resulted in more selfish choices, while the engagement of the medial prefrontal and temporo-parietal cortices subserved prosocial behavior, possibly due to their role in perspective-taking. The study provides the first online neurophysiological measurement of prosocial decision-making during threatening situations, opening new avenues to the investigation of neuronal substrates of complex social behaviors. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Optimal Combination of Non-Invasive Tools for the Early Detection of Potentially Life-Threatening Emergencies in Gynecology

    PubMed Central

    Varas, Catalina; Ravit, Marion; Mimoun, Camille; Panel, Pierre; Huchon, Cyrille; Fauconnier, Arnaud

    2016-01-01

    Objectives Potentially life-threatening gynecological emergencies (G-PLEs) are acute pelvic conditions that may spontaneously evolve into a life-threatening situation, or those for which there is a risk of sequelae or death in the absence of prompt diagnosis and treatment. The objective of this study was to identify the best combination of non-invasive diagnostic tools to ensure an accurate diagnosis and timely response when faced with G-PLEs for patients arriving with acute pelvic pain at the Gynecological Emergency Department (ED). Methods The data on non-invasive diagnostic tools were sourced from the records of patients presenting at the ED of two hospitals in the Parisian suburbs (France) with acute pelvic pain between September 2006 and April 2008. The medical history of the patients was obtained through a standardized questionnaire completed for a prospective observational study, and missing information was completed with data sourced from the medical forms. Diagnostic tool categories were predefined as a collection of signs or symptoms. We analyzed the association of each sign/symptom with G-PLEs using Pearson’s Chi-Square or Fischer’s exact tests. Symptoms and signs associated with G-PLEs (p-value < 0.20) were subjected to logistic regression to evaluate the diagnostic value of each of the predefined diagnostic tools and in various combinations. Results The data of 365 patients with acute pelvic pain were analyzed, of whom 103 were confirmed to have a PLE. We analyzed five diagnostic tools by logistic regression: Triage Process, History-Taking, Physical Examination, Ultrasonography, and Biological Exams. The combination of History-Taking and Ultrasonography had a C-index of 0.83, the highest for a model combining two tools. Conclusions The use of a standardized self-assessment questionnaire for history-taking and focal ultrasound examination were found to be the most successful tool combination for the diagnosis of gynecological emergencies in a

  20. A comparison of "life threatening injury" concept in the Turkish Penal Code and trauma scoring systems.

    PubMed

    Fedakar, Recep; Aydiner, Ahmet Hüsamettin; Ercan, Ilker

    2007-07-01

    To compare accuracy and to check the suitability of the Glasgow Coma Scale (GCS), the Revised Trauma Score (RTS), the Injury Severity Score (ISS), the New Injury Severity Score (NISS) and the Trauma and Injury Severity Score (TRISS), the scoring systems widely used in international trauma studies, in the evaluation of the "life threatening injury" concept established by the Turkish Penal Code. The age, sex, type of trauma, type and localizations of wounds, GCS, RTS, ISS, NISS and TRISS values, the decision of life threatening injury of 627 trauma patients admitted to Emergency Department of the Uludag University Medical School Hospital in year 2003 were examined. A life-threatening injury was present in 35.2% of the cases examined. GCS, RTS, ISS, NISS and TRISS confirmed the decision of life threatening injury with percentages of 74.8%, 76.9%, 88.7%, 86.6% and 68.6%, respectively. The best cut-off point 14 was determined in the ISS system with 79.6% sensitivity and 93.6% specificity. All of the cases with sole linear skull fracture officially decided as life threatening injury had an ISS of 5, a NISS of 6 and the best scores of GCS (15), RTS (7.8408) and TRISS (100%). ISS and NISS appeared to be the best trauma scoring systems that can be used for the decision of life threatening injury, compared with GCS, RTS and TRISS. Thus, ISS and NISS can be acceptable for using the evaluation of the life threatening injury concept established by the Turkish Penal Code.

  1. Collective Efficacy and the Contingent Consequences of Exposure to Life-Threatening Violence1

    PubMed Central

    Browning, Christopher R.; Gardner, Margo; Maimon, David; Brooks-Gunn, Jeanne

    2014-01-01

    Neighborhood research has increasingly emphasized the potential for contextual characteristics to moderate the effects of youths’ experiences on their outcomes. Drawing on collective efficacy theory, we examine the variable consequences of youths’ exposures to life threatening violence across neighborhoods. We argue that strong community normative orientations supporting the control of violence diminish the negative effect of exposure to severe violence on subsequent mental health among urban youth. We also consider the extent to which the consequences of exposure to violence vary by gender. Employing data from the Project on Human Development in Chicago Neighborhoods, we estimate a series of multivariate, multilevel linear models of internalizing and externalizing symptoms. Results indicate that, for girls, exposure to life threatening violence (witnessing someone being attacked with a weapon or shot) increases both internalizing and externalizing symptoms. However, this effect achieves statistical significance only for girls who reside in lower collective efficacy neighborhoods. For boys, our analyses offered weaker evidence of violence exposure effects on mental health. Implications for research on the social context of mental health are discussed. PMID:24842460

  2. Fracture and distant migration of the Bard Recovery filter: a retrospective review of 363 implantations for potentially life-threatening complications.

    PubMed

    Tam, Matthew D; Spain, James; Lieber, Michael; Geisinger, Michael; Sands, Mark J; Wang, Weiping

    2012-02-01

    To report the occurrence of fracture of the Recovery filter and incidence of potentially life-threatening complications associated with fractured fragment migration. A retrospective study of images obtained after placement of Recovery inferior vena cava (IVC) filters from 2003 to 2006 was conducted at a single tertiary-care center. Images were reevaluated for fracture and migration; complications related to filter fracture were investigated. Kaplan-Meier survival analysis was performed to investigate the relationship between time in situ and fracture. A total of 363 Recovery filters were placed; 97 were retrieved, leaving 266 filters in situ (135 patients subsequently died of other causes). The following images were evaluated: 130 chest computed tomography (CT) scans, 153 abdominal CT scans, 254 chest radiographs, 148 radiographs of the abdomen/pelvis, and 106 cavagrams. Mean imaging follow-up interval was 18.4 months (maximum, 81.3 mo). No en bloc migration occurred outside the IVC. Twenty-six limb fractures (all short limbs) were identified in 20 patients; the earliest occurred at 4.1 months. Eight fragment migrations occurred into pulmonary arteries, seven into iliac/femoral veins, one into the right ventricle, and one into the renal vein. Seven fragments were intracaval near the filter, one was extracaval, and one could not be located. Kaplan-Meier survival estimates predicted a fracture rate of 40% at 5.5 years. Of the 20 patients with filter fractures, three died of unrelated causes and 17 remain asymptomatic. Recovery filter fractures occurred at the short limb only, with a suggested 5.5-year fracture risk of 40%. No life-threatening events occurred in patients with filter fracture. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

  3. Pregnancy-Related Coronary Artery Dissection: Recognition of a Life Threatening Process.

    PubMed

    Robinson, Julie R

    Pregnancy-related spontaneous coronary artery dissection (P-SCAD) is a rare but life-threatening condition of the peripartum and postpartum mother. The gold standard of diagnosing P-SCAD is a left cardiac catheterization; however, this diagnostic tool may not be used early because myocardial infarction is not typically a top differential diagnosis for women and especially young pregnant women presenting with acute chest pain. Providers and registered nurses, particularly those in the prehospital setting, the emergency department, and labor and delivery units, should be aware of signs, symptoms, potential risk factors, and diagnostic results that could indicate P-SCAD and initiate early and appropriate treatment to improve maternal outcomes.

  4. Understanding, Predicting, and Preventing Life Changing and Life Threatening Health Changes among Aging Veterans and Civilians with Spinal Cord Injury

    DTIC Science & Technology

    2017-10-01

    AWARD NUMBER: W81XWH-16-1-0629 TITLE: Understanding, Predicting, and Preventing Life-Changing and Life-Threatening Health Changes among Aging...Threatening Health Changes among Aging Veterans and Civilians with Spinal Cord Injury 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-16-1-0629 5c. PROGRAM... health conditions, such as pressure ulcers and infections, that occur either in isolation or in combination. Our purpose is to identify how multiple

  5. Life-Threatening Atypical Case of Acute Generalized Exanthematous Pustulosis.

    PubMed

    Tajmir-Riahi, Azadeh; Wörl, Petra; Harrer, Thomas; Schliep, Stefan; Schuler, Gerold; Simon, Miklos

    2017-01-01

    Antibiotics are known to cause severe cutaneous adverse reactions, such as the rare acute generalized exanthematous pustulosis (AGEP). Unlike Stevens-Johnson syndrome or toxic epidermal necrolysis, AGEP is rarely life-threatening. Systemic involvement is not typical, and if present usually coincides with a mild elevation of the hepatic enzymes and a decrease in renal function. Hence, AGEP is known to have a good prognosis and to be life-threatening only in elderly patients or patients with chronic diseases. Herein, we report a case of AGEP in a young healthy male leading to systemic inflammatory response syndrome and to treatment in an intensive care unit after being treated with 5 different antibiotics. Initial symptoms were not indicative for AGEP and the patient's course of disease led promptly to critical cardiorespiratory symptoms and systemic inflammatory response syndrome. We assume that the administration of the 5 different antibiotics resulted in type IV allergy as well as secondary infection with Enterococcus faecium and Staphylococcus aureus, while the underlying periodontitis also contributed to the severity of this case. © 2017 S. Karger AG, Basel.

  6. The under reporting of recruitment strategies in research with children with life-threatening illnesses: A systematic review

    PubMed Central

    Hudson, Briony F; Oostendorp, Linda JM; Candy, Bridget; Vickerstaff, Victoria; Jones, Louise; Lakhanpaul, Monica; Bluebond-Langner, Myra; Stone, Paddy

    2016-01-01

    Background: Researchers report difficulties in conducting research with children and young people with life-limiting conditions or life-threatening illnesses and their families. Recruitment is challenged by barriers including ethical, logistical and clinical considerations. Aim: To explore how children and young people (aged 0–25 years) with life-limiting conditions or life-threatening illnesses and their families were identified, invited and consented to research published in the last 5 years. Design: Systematic review. Data sources: MEDLINE, PsycINFO, Web of Science, Sciences Citation Index and SCOPUS were searched for original English language research published between 2009 and 2014, recruiting children and young people with life-limiting conditions or life-threatening illness and their families. Results: A total of 215 studies – 152 qualitative, 54 quantitative and 9 mixed methods – were included. Limited recruitment information but a range of strategies and difficulties were provided. The proportion of eligible participants from those screened could not be calculated in 80% of studies. Recruitment rates could not be calculated in 77%. A total of 31% of studies recruited less than 50% of eligible participants. Reasons given for non-invitation included missing clinical or contact data, or clinician judgements of participant unsuitability. Reasons for non-participation included lack of interest and participants’ perceptions of potential burdens. Conclusion: All stages of recruitment were under reported. Transparency in reporting of participant identification, invitation and consent is needed to enable researchers to understand research implications, bias risk and to whom results apply. Research is needed to explore why consenting participants decide to take part or not and their experiences of research recruitment. PMID:27609607

  7. The Encounter With Life-Threatening Danger: Its Nature and Impact.

    ERIC Educational Resources Information Center

    Noyes, Russell, Jr.

    1981-01-01

    A factor analysis of questionnaire responses from (N=189) victims of life-threatening accidents identified three dimensions of the altered state of consciousness produced by dangerous circumstances. These dimensions, included depersonalization, hyperalertness, and mystical consciousness, appeared meaningful in terms of the endangered personality's…

  8. Identifying and treating a life-threatening disease.

    PubMed

    Cole, Beverley

    2014-02-01

    Meningococcal septicaemia is a life-threatening condition that all nurses working in emergency and urgent care settings are likely to come across during their careers. This article presents, and reflects on, a case study involving a woman with the disease whose signs and symptoms were atypical, and who was not therefore diagnosed with the condition immediately. The author aims to raise awareness among emergency nurses and nurse practitioners of the atypical signs and symptoms of the infection, and its consequences. The article also discusses how referring to patient scenarios can improve practice.

  9. Can we identify patients at risk of life-threatening allergic reactions to food?

    PubMed

    Turner, P J; Baumert, J L; Beyer, K; Boyle, R J; Chan, C-H; Clark, A T; Crevel, R W R; DunnGalvin, A; Fernández-Rivas, M; Gowland, M H; Grabenhenrich, L; Hardy, S; Houben, G F; O'B Hourihane, J; Muraro, A; Poulsen, L K; Pyrz, K; Remington, B C; Schnadt, S; van Ree, R; Venter, C; Worm, M; Mills, E N C; Roberts, G; Ballmer-Weber, B K

    2016-09-01

    Anaphylaxis has been defined as a 'severe, life-threatening generalized or systemic hypersensitivity reaction'. However, data indicate that the vast majority of food-triggered anaphylactic reactions are not life-threatening. Nonetheless, severe life-threatening reactions do occur and are unpredictable. We discuss the concepts surrounding perceptions of severe, life-threatening allergic reactions to food by different stakeholders, with particular reference to the inclusion of clinical severity as a factor in allergy and allergen risk management. We review the evidence regarding factors that might be used to identify those at most risk of severe allergic reactions to food, and the consequences of misinformation in this regard. For example, a significant proportion of food-allergic children also have asthma, yet almost none will experience a fatal food-allergic reaction; asthma is not, in itself, a strong predictor for fatal anaphylaxis. The relationship between dose of allergen exposure and symptom severity is unclear. While dose appears to be a risk factor in at least a subgroup of patients, studies report that individuals with prior anaphylaxis do not have a lower eliciting dose than those reporting previous mild reactions. It is therefore important to consider severity and sensitivity as separate factors, as a highly sensitive individual will not necessarily experience severe symptoms during an allergic reaction. We identify the knowledge gaps that need to be addressed to improve our ability to better identify those most at risk of severe food-induced allergic reactions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Life-threatening autoimmune warm hemolytic anemia following treatment for multiple sclerosis with alemtuzumab.

    PubMed

    Meunier, Benoit; Rico, Audrey; Seguier, Julie; Boutiere, Clemence; Ebbo, Mikael; Harle, Jean Robert; Schleinitz, Nicolas; Pelletier, Jean

    2018-05-01

    Alemtuzumab is a humanized monoclonal antibody directed at CD52 approved as a disease-modifying therapy for relapsing forms of multiple sclerosis (MS). To describe a case of a life-threatening autoimmune anemia occurring after a first course of alemtuzumab for relapsing-remitting MS in a 28-year-old male. Case report. A 28-year-old male developed a life-threatening autoimmune anemia occurring 11 months after first alemtuzumab course. We report the third case of autoimmune hemolytic anemia following treatment with alemtuzumab in a young MS patient. Due to the severity of this adverse event, neurologists using this treatment should be alert.

  11. Guidelines for Managing Life-Threatening Food Allergies in Massachusetts Schools

    ERIC Educational Resources Information Center

    Sheetz, Anne H.; Goldman, Patricia G.; Millett, Kathleen; Franks, Jane C.; McIntyre, C. Lynne; Carroll, Constance R.; Gorak, Diane; Harrison, Christanne Smith; Carrick, Michele Abu

    2004-01-01

    During the past decade, prevalence of food allergies among children increased. Caring for children with life-threatening food allergies has become a major challenge for school personnel Prior to 2002, Massachusetts did not provide clear guidelines to assist schools in providing a safe environment for these children and preparing for an emergency…

  12. Relationship of external influence to parental distress in decision making regarding children with a life-threatening illness.

    PubMed

    Miller, Victoria A; Luce, Mary Frances; Nelson, Robert M

    2011-01-01

    To examine the relationship of external influence to parental distress when making a decision about research or treatment for a child with a life-threatening illness and to test potential moderators of this relationship. Parents (n = 219) who made a decision about research or treatment for a child completed measures of external influence, distress, decision-making preference, and coping. More external influence was associated with more hostility, uncertainty, and confusion. Decision-making preference and coping style moderated the relationship between external influence and distress: More external influence was associated with more distress when decision-making preference was low and task-focused coping was high. External influence appears to be related to distress in parents making research and treatment decisions for children with life-threatening illnesses. However, it is important to consider parent characteristics, such as decision-making preference and coping style, when examining the effects of contextual factors on distress during decision making.

  13. Cervical abscess: a life-threatening complication of infectious mononucleosis.

    PubMed

    Westmore, G A

    1990-04-01

    The former view of infectious mononucleosis as an invariably benign disease has been modified in recent years by reports of life-threatening complications. A case is presented of a deep cervical abscess complicating infectious mononucleosis which came close to a fatal conclusion. The implications for the management of the illness are discussed in the light of this rare event, no exactly similar instance of which has been recorded.

  14. Patterns of decision making by wives of patients with life-threatening cardiac disease.

    PubMed

    Hall, Patricia; Sanford, Julie T; Demi, Alice S

    2008-08-01

    Implementation of the Patient Self-Determination Act (PSDA) in the United States has transferred decision making from the responsibility of health care professionals to the responsibility of family members. Dilemmas occurring as a result of this responsibility may cause stress and conflict among family members. The purpose of this study is to describe the patterns of decision making by family members of patients with life-threatening cardiac disease. Purposive sampling is used to select 10 wives of patients with life-threatening cardiovascular disease. Data are gathered through unstructured interviews and are analyzed using grounded theory and theory triangulation. Analysis of the data reveal three patterns of decision making: advocacy, acquiescence, and abdication.

  15. Epiglottitis and necrotizing fasciitis: a life-threatening complication of infectious mononucleosis.

    PubMed

    Caballero, Miguel; Sabater, Francisco; Traserra, Jose; Alòs, Llucia; Bernal-Sprekelsen, Manuel

    2005-10-01

    Life-threatening cervical complications associated with infectious mononucleosis are rare. The combination of acute epiglottitis and subsequent necrotizing fasciitis of the head and neck in a patient with infectious mononucleosis has not been reported to date.A 47-year-old female with infectious mononucleosis and epiglottitis was admitted to hospital for i.v. therapy. Owing to her poor clinical condition and the spread of the infection to the throat and superior mediastinum, as evidenced by CT, a cervical debridement was performed. After cervical debridement, histological findings were consistent with necrotizing fasciitis. The bacteria identified were Streptococcus viridans, Veilonella spp. and Capnocytophaga spp. The patient was hospitalized for 33 days.Mononucleosis, usually a benign condition, may be associated with life-threatening septic complications in the neck and chest. Serial CT or MRI scans are necessary to assess the development of the infection in the deep layers of the neck. Rapid medical treatment, extensive surgical debridement and intensive care are vital.

  16. 21 CFR 312.84 - Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... applications for drugs to treat life-threatening and severely-debilitating illnesses. 312.84 Section 312.84... Severely-debilitating Illnesses § 312.84 Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and severely-debilitating illnesses. (a) FDA's application of the...

  17. 21 CFR 312.84 - Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... applications for drugs to treat life-threatening and severely-debilitating illnesses. 312.84 Section 312.84... Severely-debilitating Illnesses § 312.84 Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and severely-debilitating illnesses. (a) FDA's application of the...

  18. 21 CFR 312.84 - Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... applications for drugs to treat life-threatening and severely-debilitating illnesses. 312.84 Section 312.84... Severely-debilitating Illnesses § 312.84 Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and severely-debilitating illnesses. (a) FDA's application of the...

  19. 21 CFR 312.84 - Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... applications for drugs to treat life-threatening and severely-debilitating illnesses. 312.84 Section 312.84... Severely-debilitating Illnesses § 312.84 Risk-benefit analysis in review of marketing applications for drugs to treat life-threatening and severely-debilitating illnesses. (a) FDA's application of the...

  20. Preparing School Personnel to Assist Students with Life-Threatening Food Allergies.

    ERIC Educational Resources Information Center

    Hay, Genevieve H.; And Others

    1994-01-01

    Knowledge of and preparation for life-threatening food allergies will enable school personnel to better respond to students who have severe allergic reactions. Given the high incidence of food-related anaphylaxis in public places, teachers and school personnel should be aware of and prepared to handle severe food allergy reactions. (SM)

  1. Life-threatening intrathyroidal parathyroid adenoma

    PubMed Central

    Dogan, Ugur; Koc, Umit; Mayir, Burhan; Habibi, Mani; Dogan, Berna; Gomceli, Ismail; Bulbuller, Nurullah

    2015-01-01

    Acute primary hyperparathyroidism and parathyroid crisis are characterized by life-threatening hypercalcemia, a rare disorder. A 69-year-old female patient presented at our hospital’s neurology clinic with weakness, nausea, vomiting, depression, and hypercalcemia. Treatment of hypercalcemia resulted in no improvement in neurological symptoms, indicating resistance to treatment. Thyroid ultrasonography and parathyroid scintigraphy revealed hypoechoic nodules in the right lobe, pieces of nodules in the left lobe, and high serum calcium and parathyroid hormone levels. After provision of intensive medical treatment including hydration, diuresis, and bisphosphonate infusion resulted in only minimal decrease in the calcium level, urgent surgical treatment was performed. Frozen biopsy of the right intrathyroidal giant parathyroid adenoma in the right lobe confirmed initial diagnosis of primary hyperparathyroidism. Based on the biopsy findings, right parathyroidectomy and right total and left subtotal thyroidectomy were performed. Histopathologic examination revealed a parathyroid adenoma localized inside large thyroid nodules. Review of the findings resulted in diagnosis of intrathyroidal parathyroid adenoma. Symptoms of hypercalcemia improved rapidly during the postoperative period. PMID:25785164

  2. A Life-Threatening Mediastinal Hematoma After Central Venous Port System Implantation

    PubMed Central

    Sarach, Janine; Zschokke, Irin; Melcher, Gian A.

    2015-01-01

    Patient: Female, 68 Final Diagnosis: Mediastinal hematoma Symptoms: Agitation • severe hemodynamic instability • severe respiratory distress Medication: — Clinical Procedure: Cardiopulmonary resuscitation • reintubation • thoracic drain Specialty: Surgery Objective: Diagnostic/therapeutic accidents Background: We report a case of surgical central venous port system implantation using Seldinger’s technique with a life-threatening mediastinal hematoma due to the perforation of the superior vena cava. Case Report: A 68-year-old woman was admitted to our institution for port implantation. Open access to the cephalic vein and 2 punctures of the right subclavian vein were unsuccessful. Finally, the port catheter could be placed into the superior vena cava using Seldinger’s technique. As blood aspiration via the port catheter was not possible, fluoroscopy was performed, revealing mediastinal contrast extravasation without contrasting the venous system. A new port system could be placed in the correct position without difficulties. After extubation, the patient presented with severe respiratory distress and required consecutive cardiopulmonary resuscitation and reintubation. The CT scan showed a significant hematoma in the lower neck and posterior mediastinum with tracheal compression. We assumed a perforation of the superior vena cava with the tip of the guidewire using Seldinger’s technique. Long-term intensive treatment with prolonged ventilation and tracheotomy was necessary. The port system had to be subsequently explanted due to infection. Conclusions: Mediastinal hematoma is a rare but life-threatening complication associated with central venous catheterization using Seldinger’s technique. Perforation occurs most often during central venous catheterization in critical care. Mediastinal hematoma is an example of a mechanical complication occurring after central venous catheterization, which has been described only a few times in the literature to

  3. Detection of Life Threatening Ventricular Arrhythmia Using Digital Taylor Fourier Transform.

    PubMed

    Tripathy, Rajesh K; Zamora-Mendez, Alejandro; de la O Serna, José A; Paternina, Mario R Arrieta; Arrieta, Juan G; Naik, Ganesh R

    2018-01-01

    Accurate detection and classification of life-threatening ventricular arrhythmia episodes such as ventricular fibrillation (VF) and rapid ventricular tachycardia (VT) from electrocardiogram (ECG) is a challenging problem for patient monitoring and defibrillation therapy. This paper introduces a novel method for detection and classification of life-threatening ventricular arrhythmia episodes. The ECG signal is decomposed into various oscillatory modes using digital Taylor-Fourier transform (DTFT). The magnitude feature and a novel phase feature namely the phase difference (PD) are evaluated from the mode Taylor-Fourier coefficients of ECG signal. The least square support vector machine (LS-SVM) classifier with linear and radial basis function (RBF) kernels is employed for detection and classification of VT vs. VF, non-shock vs. shock and VF vs. non-VF arrhythmia episodes. The accuracy, sensitivity, and specificity values obtained using the proposed method are 89.81, 86.38, and 93.97%, respectively for the classification of Non-VF and VF episodes. Comparison with the performance of the state-of-the-art features demonstrate the advantages of the proposition.

  4. Detection of Life Threatening Ventricular Arrhythmia Using Digital Taylor Fourier Transform

    PubMed Central

    Tripathy, Rajesh K.; Zamora-Mendez, Alejandro; de la O Serna, José A.; Paternina, Mario R. Arrieta; Arrieta, Juan G.; Naik, Ganesh R.

    2018-01-01

    Accurate detection and classification of life-threatening ventricular arrhythmia episodes such as ventricular fibrillation (VF) and rapid ventricular tachycardia (VT) from electrocardiogram (ECG) is a challenging problem for patient monitoring and defibrillation therapy. This paper introduces a novel method for detection and classification of life-threatening ventricular arrhythmia episodes. The ECG signal is decomposed into various oscillatory modes using digital Taylor-Fourier transform (DTFT). The magnitude feature and a novel phase feature namely the phase difference (PD) are evaluated from the mode Taylor-Fourier coefficients of ECG signal. The least square support vector machine (LS-SVM) classifier with linear and radial basis function (RBF) kernels is employed for detection and classification of VT vs. VF, non-shock vs. shock and VF vs. non-VF arrhythmia episodes. The accuracy, sensitivity, and specificity values obtained using the proposed method are 89.81, 86.38, and 93.97%, respectively for the classification of Non-VF and VF episodes. Comparison with the performance of the state-of-the-art features demonstrate the advantages of the proposition.

  5. Prospective effect of community distress and subcultural orientation on mortality following life-threatening diseases in later life.

    PubMed

    Wen, Ming; Christakis, Nicholas A

    2006-07-01

    We conducted a prospective and contextual study to examine the effects of community social-economic-physical distress and subcultural orientation on mortality following onset of 13 life-threatening diseases in later life. We also examined the inter-relationship between the effects of community social, economic and physical distress (i.e. poverty, physical disorder and low collective efficacy) and subcultural orientation (i.e. anomie and tolerance of risk behaviour) on the survival chances of seriously ill older patients. Three data sources were combined to construct the working sample: 1990 Census data, the 1994-95 PHDCN-CS, and the COSI data. Fifty-one ZIP code areas in Chicago and 12,672 elderly patients were studied. Community distress (HR = 1.04; 95% CI = (1.01, 1.07)) and anomie (HR = 1.26; 95% CI = (1.02, 1.54)) are found to be significantly and positively associated with a higher hazard of death. Moreover, community anomie contributes to the effect of community distress on post-hospitalisation mortality. The social, economic, physical and cultural environment in which people live appears to exert a significant impact on whether older people facing life-threatening illness live or die.

  6. Acute or chronic life-threatening diseases associated with Epstein-Barr virus infection.

    PubMed

    Okano, Motohiko; Gross, Thomas G

    2012-06-01

    Infectious mononucleosis (IM) is one of the representative, usually benign, acute diseases associated with primary Epstein-Barr virus (EBV) infection. IM is generally self-limiting and is characterized mostly by transient fever, lymphadenopathy and hepatosplenomegaly. However, very rarely primary EBV infection results in severe or fatal conditions such as hemophagocytic lymphohistiocytosis together with fulminant hepatitis designated as severe or fatal IM or EBV-associated hemophagocytic lymphohistiocytosis alone. In addition, chronic EBV-associated diseases include Burkitt's lymphoma, undifferentiated nasopharyngeal carcinoma, Hodgkin lymphoma, T-cell lymphoproliferative disorder (LPD)/lymphoma, natural killer-cell LPD including leukemia or lymphoma, gastric carcinoma, pyothorax-associated lymphoma and senile B-cell LPD as well as chronic active EBV infection and LPD/lymphoma in patients with immunodeficiency. The number of chronic life-threatening diseases linked to the EBV infection is increasingly reported and many of these diseases have a poor prognosis. This review will focus on the historical, pathogenetic, diagnostic, therapeutic and prophylactic issues of EBV-associated life-threatening diseases.

  7. Creating connections to life during life-threatening illness: Creative activity experienced by elderly people and occupational therapists

    PubMed Central

    la Cour, Karen; Josephsson, Staffan; Luborsky, Mark

    2014-01-01

    Objective The aim of this study was to discover and characterize components of engagement in creative activity as occupational therapy for elderly people dealing with life-threatening illness, from the perspective of both clients and therapists. Despite a long tradition of use in clinical interventions, key questions remain little addressed concerning how and why people seek these activities and the kinds of benefits that may result. Method Qualitative interviews were conducted with 8 clients and 7 therapists participating in creative workshops using crafts at a nursing home in Sweden. Analysis of the interviews was conducted using a constant comparative method. Findings Engaging in creative activity served as a medium that enabled creation of connections to wider culture and daily life that counters consequences of terminal illness, such as isolation. Creating connections to life was depicted as the core category, carried out in reference to three subcategories: (1) a generous receptive environment identified as the foundation for engaging in creative activity; (2) unfolding creations—an evolving process; (3) reaching beyond for possible meaning horizons. Conclusion The findings suggest that the domain of creative activity can enable the creation of connections to daily life and enlarge the experience of self as an active person, in the face of uncertain life-threatening illness. Ultimately, the features that participants specify can be used to refine and substantiate the use of creative activities in intervention and general healthcare. PMID:16389735

  8. Hope in action—facing cardiac death: A qualitative study of patients with life-threatening disease

    PubMed Central

    Schaufel, Margrethe Aase; Nordrehaug, Jan Erik; Malterud, Kirsti

    2011-01-01

    Coping with existential challenges is important when struck by serious disease, but apart from cancer and palliative care little is known about how patients deal with such issues and maintain hope. To explore how patients with life-threatening heart disease experience hope when coping with mortality and other existential challenges, we conducted a qualitative study with semi-structured interviews. We made a purposive sample of 11 participants (26–88 years) who had experienced life-threatening disease: eight participants with serious heart disease, two with cancer, and one with severe chronic obstructive pulmonary disease. Analysis was by systematic text condensation. The findings showed that hope could enhance coping and diminish existential distress when patients were confronted with mortality and other existential challenges. Hope was observed as three types of dynamic work: to shift perception of mortality from overwhelming horror toward suppression or peaceful acceptance, to foster reconciliation instead of uncertainty when adapting to the new phase of life, and to establish go-ahead spirit instead of resignation as their identity. Meaning of life could, hence, be sustained in spite of serious threats to the persons' future, everyday life, and self-conception. The work of hoping could be supported or disturbed by relationships with family, friends, and health care professionals. Hope can be regarded as an active, dynamic state of existential coping among patients with life-threatening disease. Physicians may support this coping and thereby provide personal growth and alleviation of existential distress by skillfully identifying, acknowledging, and participating in the work of hoping performed by the patient. PMID:21423599

  9. Hope in action-facing cardiac death: A qualitative study of patients with life-threatening disease.

    PubMed

    Schaufel, Margrethe Aase; Nordrehaug, Jan Erik; Malterud, Kirsti

    2011-03-18

    Coping with existential challenges is important when struck by serious disease, but apart from cancer and palliative care little is known about how patients deal with such issues and maintain hope. To explore how patients with life-threatening heart disease experience hope when coping with mortality and other existential challenges, we conducted a qualitative study with semi-structured interviews. We made a purposive sample of 11 participants (26-88 years) who had experienced life-threatening disease: eight participants with serious heart disease, two with cancer, and one with severe chronic obstructive pulmonary disease. Analysis was by systematic text condensation. The findings showed that hope could enhance coping and diminish existential distress when patients were confronted with mortality and other existential challenges. Hope was observed as three types of dynamic work: to shift perception of mortality from overwhelming horror toward suppression or peaceful acceptance, to foster reconciliation instead of uncertainty when adapting to the new phase of life, and to establish go-ahead spirit instead of resignation as their identity. Meaning of life could, hence, be sustained in spite of serious threats to the persons' future, everyday life, and self-conception. The work of hoping could be supported or disturbed by relationships with family, friends, and health care professionals. Hope can be regarded as an active, dynamic state of existential coping among patients with life-threatening disease. Physicians may support this coping and thereby provide personal growth and alleviation of existential distress by skillfully identifying, acknowledging, and participating in the work of hoping performed by the patient.

  10. Role of Rhinovirus C in Apparently Life-Threatening Events in Infants, Spain

    PubMed Central

    García, M. Luz; Pozo, Francisco; Reyes, Noelia; Pérez-Breña, Pilar; Casas, Inmaculada

    2009-01-01

    To assess whether infants hospitalized after an apparently life-threatening event had an associated respiratory virus infection, we analyzed nasopharyngeal aspirates from 16 patients. Nine of 11 infants with positive virus results were infected by rhinoviruses. We detected the new genogroup of rhinovirus C in 6 aspirates. PMID:19788827

  11. Life-threatening haemothorax: a rare presentation of pulmonary arteriovenous malformation.

    PubMed

    Kundu, Somenath; Mitra, Subhra; Mukherjee, Shubhasis; Chakravorty, Anushree

    2010-11-01

    Arteriovenous malformations of the lung are rare pulmonary vascular disorders which can suddenly lead to life threatening complications. Haemothorax due to rupture of a pulmonary arteriovenous malformation (PAVM) is very rare. We report here a case of a 39 year-old lady who presented with an acute onset of shortness of breath due to right-sided massive haemothorax and was subsequently detected to have pulmonary as well as cerebral arteriovenous malformation (CAVM).

  12. Fluoroscopy-free Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for controlling life threatening postpartum hemorrhage

    PubMed Central

    Stensaeth, Knut Haakon; Sovik, Edmund; Haig, Ingrid Natasha Ylva; Skomedal, Erna; Jorgensen, Arve

    2017-01-01

    Background Severe postpartum hemorrhage occurs in 1/1000 women giving birth. This condition is often dramatic and may be life threatening. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has in recent years been introduced as a novel treatment for hemorrhagic shock. We present a series of fluoroscopy-free REBOA for controlling life threatening postpartum hemorrhage. Methods In 2008 an ‘aortic occlusion kit’ was assembled and used in three Norwegian university hospitals. The on-call interventional radiologist (IR) was to be contacted with a response time < 30 minutes in case of life threatening PPH. Demographics and characteristics were noted from the medical records. Results This retrospective study includes 36 patients treated with fluoroscopy-free REBOA for controlling severe postpartum hemorrhage in the years 2008–2015. The REBOA success rate was 100% and no patients died from REBOA related complications. Uterine artery embolization was performed in 17 (47%) patients and a hysterectomy in 16 (44%) patients. A short (11cm) introducer length was strongly associated with iliac artery thrombus formation (ρ = 0.50, P = 0.002). In addition, there was a strong negative correlation between uterine artery embolization and hysterectomy (ρ = -0.50, P = 0.002). Conclusions Our Norwegian experience indicates the clinical safety and feasibility of REBOA in life threatening PPH. Also, REBOA can be used in an emergency situation without the use of fluoroscopy with a high degree of technical success. It is important that safety implementation of REBOA is established, especially through limited aortic balloon occlusion time and a thorough balloon deflation regime. PMID:28355242

  13. Effect of psychosocial stressors on patients with Crohn's disease: threatening life experiences and family relations.

    PubMed

    Slonim-Nevo, Vered; Sarid, Orly; Friger, Michael; Schwartz, Doron; Chernin, Elena; Shahar, Ilana; Sergienko, Ruslan; Vardi, Hillel; Rosenthal, Alexander; Mushkalo, Alexander; Dizengof, Vitaly; Ben-Yakov, Gil; Abu-Freha, Naim; Munteanu, Daniella; Gaspar, Nava; Eidelman, Leslie; Segal, Arik; Fich, Alexander; Greenberg, Dan; Odes, Shmuel

    2016-09-01

    Threatening life experiences and adverse family relations are major psychosocial stressors affecting mental and physical health in chronic illnesses, but their influence in Crohn's disease (CD) is unclear. We assessed whether these stressors would predict the psychological and medical condition of CD patients. Consecutive adult CD patients completed a series of instruments including demography, Patient Harvey-Bradshaw Index (P-HBI), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), short-form survey instrument (SF-36), brief symptom inventory (BSI), family assessment device (FAD), and list of threatening life experiences (LTE). Associations of FAD and LTE with P-HBI, SIBDQ, SF-36, and BSI were examined by multiple linear and quantile regression analyses. The cohort included 391 patients, mean age 38.38±13.95 years, 59.6% women, with intermediate economic status. The median scores were as follows: P-HBI 4 (2-8), FAD 1.67 (1.3-2.1), LTE 1 (0-3), SF-36 physical health 43.75 (33.7-51.0), SF-36 mental health 42.99 (34.1-51.9), and BSI-Global Severity Index 0.81 (0.4-1.4). The SIBDQ was 47.27±13.9. LTE was associated with increased P-HBI in all quantiles and FAD in the 50% quantile. FAD and LTE were associated with reduced SIBDQ (P<0.001). Higher LTE was associated with lower SF-36 physical and mental health (P<0.001); FAD was associated with reduced mental health (P<0.001). FAD and LTE were associated positively with GSI in all quantiles; age was associated negatively. CD patients with more threatening life experiences and adverse family relations were less healthy both physically and mentally. Physicians offering patients sociopsychological therapy should relate to threatening life experiences and family relations.

  14. Miraculous Meaning: Threatened Meaning Increases Belief in Miracles.

    PubMed

    Routledge, Clay; Roylance, Christina; Abeyta, Andrew A

    2017-06-01

    For many, religious belief is a source of meaning and a resource for coping with life stressors that have the potential to undercut meaning. In the present study, we sought to further probe the connection between religion and meaning by focusing on the potential for threatened meaning to inspire belief in miraculous testimonials. We threatened meaning with a meaninglessness manipulation and then had participants read testimonials in which people described miraculous experiences involving supernatural agents and rate the extent to which they believed these testimonials to be credible and true. Meaning threat, relative to a control condition, increased belief in miraculous stories.

  15. 20 CFR 416.1248 - Exclusion of gifts to children with life-threatening conditions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Exclusion of gifts to children with life-threatening conditions. 416.1248 Section 416.1248 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Resources and Exclusions § 416.1248 Exclusion of...

  16. Life-threatening event reduces subjective well-being through activating avoidance motivation: a longitudinal study.

    PubMed

    Van Dijk, Dina; Seger-Guttmann, Tali; Heller, Daniel

    2013-04-01

    Drawing on the approach-avoidance theory, we have examined the role of avoidance motivation in explaining the negative effects of a life-threatening event on subjective well-being (SWB). Residents of the south of Israel were surveyed during heavy missile attacks in January 2009 (T1; n = 283), and again after 6 months (T2; n = 212) and 1 year (T3; n = 154). During the missile attacks, we also surveyed a group from the center of the country (T1; n = 102), not exposed to the attacks. The results indicate that avoidance motivation was activated by the life threat and further mediated its detrimental influence on SWB measures (positive/negative affects, anxiety, and subjective health). Moreover, within the southern sample, the drop in avoidance motivation over time mediated the parallel drop in SWB. In contrast to avoidance motivation, approach motivation remained stable over time and was related to positive emotions. The role of avoidance and approach motivations in life-threatening situations is further discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  17. Parental spirituality in life-threatening pediatric cancer.

    PubMed

    Nicholas, David B; Barrera, Maru; Granek, Leeat; D'Agostino, Norma Mammone; Shaheed, Jenny; Beaune, Laura; Bouffet, Eric; Antle, Beverley

    2017-01-01

    This study addressed parental spirituality in the context of pediatric cancer with a poor prognosis. Drawing upon previous research implementing a longitudinal grounded theory design examining parental hope, 35 parents were interviewed regarding their experiences with an emergent description of the role of spirituality in parents' daily lives. Spirituality included religious beliefs and practices, notions of a higher force or cosmos, relationship with a divine being, as well as elements emerging from meaning-making and relationships. Parental expectations of spirituality remained relatively constant across data collection time points (3-9 months postdiagnosis), although limited variation occurred relative to shifting circumstance (e.g., deterioration of the child's condition). Spirituality appeared to offer: greater acceptance of parents' inability to protect their child from harm related to her/his life-threatening illness, guidance and emotion decompression, and support from one's faith community. Recommendations for integrating spiritual assessment in clinical care practice are offered.

  18. [Structural requirements for the management of patients with highly contagious life-threatening infectious diseases: update 2015].

    PubMed

    Grünewald, Thomas

    2015-07-01

    The care of highly contagious life-threatening infectious diseases (HLID) requires specialized treatment facilities that are capable of strict isolation measures and appropriate medical treatment. The German approach to the management of these diseases, which is maintained by the Permanent Working Group of Medical Competence and Treatment Centers for Highly Contagious and Life-Threatening Diseases (STAKOB) is adjusted in the present publication with regards to recent experiences and upcoming needs. Clear synergies in using infrastructures and bundling of resources have led to similar efforts at the European level. The German concept, therefore, has a pioneering role. This update is intended to improve professional patient care and also minimize the risk of disease spread and transmission.

  19. Resolution of a life-threatening complication after lung radiofrequency ablation.

    PubMed

    Andreetti, Claudio; Maurizi, Giulio; Cassiano, Francesco; Rendina, Erino Angelo

    2014-10-01

    Lung radiofrequency ablation (RFA) is an option for the treatment of unresectable lung cancer. Clinical investigators have previously warned against severe complications associated with this procedure. We report a case of life-threatening complication after lung RFA for non-operable non-small-cell lung cancer consisting of pulmonary abscess evolving into a bronchopleural fistula, severe pneumothorax and septic pleuritis, which was successfully treated with a multimodal conservative approach. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  20. Successful use of recombinant factor VIIa in a preterm infant with life-threatening haematuria.

    PubMed

    Faust, Kirstin; Tröger, Birthe; Kahl, Fritz; Schumacher, Marius; Göpel, Wolfgang; Härtel, Christoph

    2009-10-01

    We report the case of a preterm male infant with a gestational age of 28 + 1 weeks and birth weight of 715 g who presented with life-threatening haematuria on day 28 of life. The haematuria was unresponsive to administration of platelet concentrates and fresh frozen plasma, but then successfully treated with recombinant factor VIIa. The resulting obstructive uropathy was managed by continuous bladder irrigation through suprapubic and urethral catheters. No other adverse affects were noted, and the boy was discharged from the hospital on day 108 of life.

  1. Somatic Maintenance Resources in the Honeybee Worker Fat Body Are Distributed to Withstand the Most Life-Threatening Challenges at Each Life Stage

    PubMed Central

    Seehuus, Siri-Christine; Taylor, Simon; Petersen, Kjell; Aamodt, Randi M.

    2013-01-01

    In a global transcriptome analysis of three natural and three manipulated honeybee worker phenotypes at different ages, we have investigated the distribution of investment in somatic maintenance of the fat body. Gene expression is modulated so that the bees are able to resist the most life-threatening challenges at the actual life stage. Different modes of maintenance and repair are regulated, apparently to meet the environmental challenges most detrimental to survival and reproductive potential for the hive. We observed a broad down-regulation of genomic and cellular maintenance in the short-lived foragers and nurse bees compared to the long-lived winter bees. Our results show that survival and reproduction of the entire hive is given priority over the individual bees, hence supporting the idea of the honeybee society as a superorganism. Our results also fit the disposable soma theory of aging. PMID:23940531

  2. Hepatic laceration as a life-threatening complication of umbilical venous catheterization.

    PubMed

    Gülcan, Hande; Hanta, Deniz; Törer, Birgin; Temiz, Adbülkerim; Demir, Senay

    2011-01-01

    Umbilical venous catheterization is an intravenous infusion route for maintenance fluids, medications, blood products, and parenteral nutrition in preterm neonates. However, this procedure may be associated with several complications, such as infection, thrombosis, vessel perforation, and cardiac and hepatic injuries. Hepatic laceration is a rare but life-threatening complication of umbilical venous catheterization that is a result of direct injury through the liver parenchyma. Here, we present a preterm newborn with hepatic laceration as a rare and serious complication of umbilical venous catheterization.

  3. Perineal Pseudoaneurysm from Traumatic Foley Removal Leads to Recurrent Life-Threatening Hematuria.

    PubMed

    Liang, Lorraine Min-Shan; Xue, Jingbing; Erturk, Erdal

    2015-01-01

    Hematuria resulting from urethral traumatic catheter insertion and removal is often encountered. Usually, hematuria resolves with conservative measures. We report a case of traumatic Foley removal leading to intermittent life-threatening hematuria resulting in blood loss anemia requiring multiple transfusions and multiple episodes of hypotension requiring pressors. A pelvic angiogram revealed a pseudoaneurysm of the left pudendal artery, which was treated with microcoil embolization leading to resolution of bleeding.

  4. [Reduced number of fatal and life-threatening reactions to food. Reporting by the medical profession has resulted in effective measures].

    PubMed

    Foucard, Tony; Yman, Ingrid Malmheden; Nordvall, Lennart

    The results from the Swedish system for reporting severe and fatal reactions caused by food for the period 1993-96 were published in Lakartidningen in 1997. We now report the results for the period 1997-2003. The number of fatal cases has decreased from 1.75 to 0.86 per year and the number of life-threatening cases from 3 to I per year. The most gratifying result was the large decrease in severe reactions caused by soy, from 3 deaths and 6 life-threatening cases during the first 4-year period to just one life-threatening case during the following 7-year period. This reduction is probably largely due to an increased awareness of identified risk persons, but also to a reduced use of soy protein. The ongoing study illustrates the usefulness of a national system for reporting severe and fatal reactions caused by food.

  5. Life-threatening bleeding in a case of autoantibody-induced factor VII deficiency.

    PubMed

    Okajima, K; Ishii, M

    1999-02-01

    A male patient presented with life-threatening bleeding induced by autoantibody-induced factor VII (F.VII) deficiency. This patient had macroscopic hematuria, skin ecchymosis, gastrointestinal bleeding, and a neck hematoma that was causing disturbed respiration. He developed acute renal failure and acute hepatic failure, probably due to obstruction of the ureters and the biliary tract, respectively. Although activated partial thromboplastin time was normal, prothrombin time (PT) was remarkably prolonged at 71.8 seconds compared to 14.0 seconds in a normal control. Both the immunoreactive level of F.VII antigen and the F.VII activity of the patient's plasma samples were < 1.0% of normal. Although an equal part of normal plasma was added to the patient's plasma, PT was not corrected. The patient's plasma inhibited F.VII activity. These findings suggested the presence of a plasma inhibitor for F.VII. After administration of large doses of methylprednisolone, PT was gradually shortened and plasma levels of F.VII increased over time. Bleeding, acute renal failure, and acute hepatic failure improved markedly following the steroid treatment. These observations suggest that life-threatening bleeding can be induced by autoantibody-induced F.VII deficiency and that immunosuppressive therapy using large doses of steroid can be successful in inhibiting the production of the autoantibody.

  6. Near-Death-Like Experiences without Life-Threatening Conditions or Brain Disorders: A Hypothesis from a Case Report

    PubMed Central

    Facco, Enrico; Agrillo, Christian

    2012-01-01

    Near-death experiences (NDEs) are profound psychic experiences commonly occurring in life-threatening conditions. They include feeling a sense of peace, of seeing a bright light, encountering deceased relatives or religious figures, and of transcending space and time. To explain them, it has been suggested that they stem from brain disorders and/or psychological reactions to approaching death, a sort of wishful thinking in response to the perceived threat. This is a report on a case with most of the features typical of NDEs except that it occurred entirely without any life-threatening conditions. This evidence is theoretically incompatible with either of the above hypotheses, suggesting that a broader interpretation of the phenomenon is needed. PMID:23162522

  7. Advance care planning for adolescent patients with life-threatening neurological conditions: a survey of Japanese paediatric neurologists.

    PubMed

    Yotani, Nobuyuki; Kizawa, Yoshiyuki; Shintaku, Haruo

    2017-01-01

    To evaluate current attitudes and barriers to advance care planning for adolescent patients with life-threatening conditions among paediatric neurologists. Cross-sectional study. A self-reported questionnaire was administered to assess the practice of advance care planning, advance directives and barriers to advance care planning for adolescent patients with life-threatening conditions. All board-certified paediatric neurologists in Japan were surveyed and those who had experience in taking care of adolescent patients with decision-making capacity were analysed. We compared the results with those of paediatric haematologists reported previously. In total, 186 paediatric neurologists were analysed. If the patient's prognosis was <3 months, only about 30% of paediatric neurologists reported having discussions with patients, such as 'do not attempt resuscitation' orders (28%) and ventilator use (32%), whereas more than 70% did discuss these topics with patients' families. About half of the paediatric neurologists did not discuss advance directives at the end of life with their patients, whereas over 75% did discuss advance directives with patients' families. Compared with paediatric haematologists, paediatric neurologists had more end-of-life discussions with patients, such as where treatment and care will take place, do not attempt resuscitation orders, and the use of a ventilator, if the patient's prognosis was >1 year. About half or less of the paediatric neurologists discussed advance care planning and advance directives with their adolescent patients who had life-threatening conditions, even if the patient's prognosis was <3 months. They tended to discuss advance care planning and advance directives more with families than with patients themselves.

  8. Embolization as the treatment for a life-threatening mandibular arteriovenous malformation.

    PubMed

    Loureiro, Caio Cesar de Souza; Falchet, Paula Cristina Felix; Gavranich, João; Lobo Leandro, Luiz Fernando

    2010-03-01

    Mandibular arteriovenous malformation is a severe vascular pathological condition that may lead to life-threatening hemorrhages. In child and teenaged patients, a conservative treatment is preferred to avoid profuse blood loss and/or mutilating alterations in the still-growing patients' face. The aim of this article was to present a case of an 11-year-old boy with an arteriovenous malformation involving the left mandible and treated by means of endovascular embolization with direct lesional delivery of N-butyl-cyanoacrylate glue through transfemoral catheterization.

  9. Are first rib fractures a marker for other life-threatening injuries in patients with major trauma? A cohort study of patients on the UK Trauma Audit and Research Network database

    PubMed Central

    Sammy, Ian Ayenga; Chatha, Hridesh; Lecky, Fiona; Bouamra, Omar; Fragoso-Iñiguez, Marisol; Sattout, Abdo; Hickey, Michael; Edwards, John E

    2017-01-01

    Background First rib fractures are considered indicators of increased morbidity and mortality in major trauma. However, this has not been definitively proven. With an increased use of CT and the potential increase in detection of first rib fractures, re-evaluation of these injuries as a marker for life-threatening injuries is warranted. Methods Patients sustaining rib fractures between January 2012 and December 2013 were investigated using data from the UK Trauma Audit and Research Network. The prevalence of life-threatening injuries was compared in patients with first rib fractures and those with other rib fractures. Multivariate logistic regression was performed to determine the association between first rib fractures, injury severity, polytrauma and mortality. Results There were 1683 patients with first rib fractures and 8369 with fractures of other ribs. Life-threatening intrathoracic and extrathoracic injuries were more likely in patients with first rib fractures. The presence of first rib fractures was a significant predictor of injury severity (Injury Severity Score >15) and polytrauma, independent of mechanism of injury, age and gender with an adjusted OR of 2.64 (95% CI 2.33 to 3.00) and 2.01 (95% CI 1.80 to 2.25), respectively. Risk-adjusted mortality was the same in patients with first rib fractures and those with other rib fractures (adjusted OR 0.97, 95% CI 0.79 to 1.19). Conclusion First rib fractures are a marker of life-threatening injuries in major trauma, though they do not independently increase mortality. Management of patients with first rib fractures should focus on identification and treatment of associated life-threatening injuries. PMID:28119351

  10. Perineal Pseudoaneurysm from Traumatic Foley Removal Leads to Recurrent Life-Threatening Hematuria

    PubMed Central

    Xue, Jingbing; Erturk, Erdal

    2015-01-01

    Abstract Hematuria resulting from urethral traumatic catheter insertion and removal is often encountered. Usually, hematuria resolves with conservative measures. We report a case of traumatic Foley removal leading to intermittent life-threatening hematuria resulting in blood loss anemia requiring multiple transfusions and multiple episodes of hypotension requiring pressors. A pelvic angiogram revealed a pseudoaneurysm of the left pudendal artery, which was treated with microcoil embolization leading to resolution of bleeding. PMID:27579388

  11. Interleukin-13 associates with life-threatening rhinovirus infections in infants and young children.

    PubMed

    Caballero, Mauricio T; Hijano, Diego R; Acosta, Patricio L; Mateu, Cecilia G; Marcone, Débora N; Linder, Jodell E; Talarico, Laura B; Elder, John M; Echavarria, Marcela; Miller, Eva Kathryn; Polack, Fernando P

    2018-04-17

    Delineate risk factors associated with severe hypoxemia (O 2 sat ≤87%) in infants and children younger than 2 years hospitalized with single pathogen HRV infection. Prospective study in a yearly catchment population of 56 560 children <2 years old between 2011 and 2013 in Argentina. All children with respiratory signs and O 2 sat <93% on admission were included. HRV infections were identified by reverse transcriptase-polymerase chain reaction. Epidemiologic, clinical, viral, and immunological risk factors were assessed. Among 5012 hospitalized patients, HRV was detected as a single pathogen in 347 (6.92%) subjects. Thirty-two (9.2%) had life-threatening disease. Traditional risk factors for severe bronchiolitis did not affect severity of illness. HRV viral load, HRV groups, and type II and III interferons did not associate with severe hypoxemia. Interleukin-13 Levels in respiratory secretions at the time of admission (OR = 7.43 (3-18.4); P < 0.001 for IL-13 >10 pg/mL) predisposed to life-threatening disease. Targeted interventions against IL-13 should be evaluated to decrease severity of HRV illness in infancy and early childhood. © 2018 Wiley Periodicals, Inc.

  12. Life-threatening asthma and anaphylaxis in schools: a treatment model for school-based programs.

    PubMed

    Murphy, Kevin R; Hopp, Russell J; Kittelson, Eleanor B; Hansen, Geri; Windle, Mary L; Walburn, John N

    2006-03-01

    Pediatric asthma is the No. 1 chronic disease in childhood and is responsible for significant morbidity and mortality. In Nebraska, the number of asthma-related deaths is greater than the national average, and in 1998, 2 students died of acute asthma attacks while attending school in the Omaha public schools (OPSs). In response, we designed and implemented a program to respond to this problem. To implement and study a school-based program for the treatment of life-threatening asthma and anaphylaxis in the OPSs. The Emergency Response to Life-Threatening Asthma or Systemic Allergic Reactions (Anaphylaxis) Protocol was designed and evaluated in 78 OPSs from 1998 to 2003. Nurses and school staff were trained in the protocol, which required the use of nebulized albuterol and/or intramuscular epinephrine in conjunction with an emergency response procedure. Outcomes were measured by improvement in acute care in schools and survival of students. In the 5 years of evaluation, 98 students were treated successfully. One student died. Of those treated with the protocol, equal numbers had at school both asthma action plans (AAPs) and metered-dose inhalers (MDIs), MDIs only, or neither AAPs nor MDIs. As a result of the program, there has been an increased awareness from parents, teachers, and physicians about the necessity of an emergency response program. In 2002, an outcome of the OPS program resulted in the formation of Attack on Asthma Nebraska to ensure that Nebraska schools have the education, training, and medications to respond to anyone experiencing a life-threatening asthma or anaphylaxis attack at school. The following year, a revised protocol was approved by the Nebraska State Board of Education for use in all Nebraska schools. Emergency response protocols provide protection for children while in school. This program should serve as a national model for other school-based programs for children and adolescents with asthma and anaphylaxis.

  13. ProThera Biologics, Inc.: a novel immunomodulator and biomarker for life-threatening diseases.

    PubMed

    Lim, Yow-Pin

    2013-02-01

    ProThera Biologics is a development stage bio-therapeutics company in East Providence, Rhode Island. The company was founded in 2002 to focus on the critical role and commercial potential of Inter-alpha Inhibitor Proteins (IAIP) for treating acute life-threatening inflammatory diseases. The discovery research originated in the basic research laboratories of the co-founders, Yow-Pin Lim, MD, PhD, and Douglas C. Hixson, PhD, at Rhode Island Hospital, a Lifespan partner. The company is backed by the Slater Technology Fund and has received research grants from the Rhode Island State Science and Technology Council (RI STAC) as well as continuous funding from the National Institutes of Health (NIH), with several Phase I and II Small Business Innovation Research (SBIR) grants over the past 10 years. ProThera has developed a novel process to purify Inter-alpha Inhibitor Proteins from source material, and has conducted groundbreaking research into the usage of IAIP to fight systemic inflammation.

  14. Are first rib fractures a marker for other life-threatening injuries in patients with major trauma? A cohort study of patients on the UK Trauma Audit and Research Network database.

    PubMed

    Sammy, Ian Ayenga; Chatha, Hridesh; Lecky, Fiona; Bouamra, Omar; Fragoso-Iñiguez, Marisol; Sattout, Abdo; Hickey, Michael; Edwards, John E

    2017-04-01

    First rib fractures are considered indicators of increased morbidity and mortality in major trauma. However, this has not been definitively proven. With an increased use of CT and the potential increase in detection of first rib fractures, re-evaluation of these injuries as a marker for life-threatening injuries is warranted. Patients sustaining rib fractures between January 2012 and December 2013 were investigated using data from the UK Trauma Audit and Research Network. The prevalence of life-threatening injuries was compared in patients with first rib fractures and those with other rib fractures. Multivariate logistic regression was performed to determine the association between first rib fractures, injury severity, polytrauma and mortality. There were 1683 patients with first rib fractures and 8369 with fractures of other ribs. Life-threatening intrathoracic and extrathoracic injuries were more likely in patients with first rib fractures. The presence of first rib fractures was a significant predictor of injury severity (Injury Severity Score >15) and polytrauma, independent of mechanism of injury, age and gender with an adjusted OR of 2.64 (95% CI 2.33 to 3.00) and 2.01 (95% CI 1.80 to 2.25), respectively. Risk-adjusted mortality was the same in patients with first rib fractures and those with other rib fractures (adjusted OR 0.97, 95% CI 0.79 to 1.19). First rib fractures are a marker of life-threatening injuries in major trauma, though they do not independently increase mortality. Management of patients with first rib fractures should focus on identification and treatment of associated life-threatening injuries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) [year]. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. The Importance of Awareness and Communication for the Inclusion of Young People with Life-Limiting and Life-Threatening Conditions in Mainstream Schools and Colleges

    ERIC Educational Resources Information Center

    Asprey, Anthea; Nash, Tricia

    2006-01-01

    Anthea Asprey and Tricia Nash both belong to the Children's Hospice South West Research Group, based at the University of Exeter. In this article, they report one aspect of a research project designed to determine the adequacy of support for young people with life-limiting and life-threatening conditions in the education system. They describe here…

  16. Recognizing Life-threatening Features of Dengue in Children and Health Seeking Behavior in Dengue Emergency Amongst Parents and Carers: A Cross-sectional study in Gombak District, Malaysia.

    PubMed

    Ariffin, F; Ramli, A S; Naim, N; Selamat, M I; Syed-Jamal, S J

    2014-10-01

    Dengue is life-threatening and the paediatric population is highly susceptible to complications. Deterioration can occur rapidly and ability to recognise early warning signs is crucial. This study aims to determine the knowledge and awareness of parents and carers and to predict their ability in recognising life-threatening symptoms and signs of dengue in children and to assess their health-seeking behaviour in dengue emergency. Methods This is a crosssectional study involving parents and carers of children ≤ 12 years old in schools and kindergartens in the Gombak district. Demographic details, knowledge on life-threatening symptoms and signs of dengue and health-seeking behaviour were collected using a self-administered questionnaire and knowledge scoring was done. The questionnaire was pilot tested with a Cronbach alpha of 0.82. The results were analysed using SPSS version 20.0. Results Total respondents were 866 with 44.8% men and 55.2% women. The mean age was 40.3 years (SD ± 5.7). Knowledge score of dengue life threatening features among respondents were good (30.0%) to average (56.8%). Respondents were able to recognise fever (98.5%), petechial rash (97.1%) and bleeding (65.2%) but were less able to recognise abdominal pain (22.3%) and passing less urine (28.2%) as life threatening dengue features. However, the ability to recognise fever is a poor predictor in recognising life threatening dengue in children compared to all other symptoms which were good predictors. A respondent that recognise stomach pain or neck stiffness were five times more likely to recognise life-threatening dengue. Respondents preferred to bring their children to the clinic (50.8%) or hospital (37.8%) themselves Instead of calling for ambulance. Worryingly, some would give antipyretics (3.6%) or wait for improvements (7.8%). Conclusion Concerted efforts by the schools, healthcare professionals and health authorities are required to educate parents and carers to identify life-threatening

  17. Life-threatening hypophosphatemia and/or phosphate depletion in a patient with acute lymphoblastic leukemia: a rare case report.

    PubMed

    Soyoral, Yasemin; Aslan, Mehmet; Ebinc, Senar; Dirik, Yaren; Demir, Cengiz

    2014-11-01

    Acute severe hypophosphatemia can be life threatening and is associated with mortality and impaired cardiac and respiratory function. Several conditions including decreased absorption or increased urinary phosphate excretion, shifts from the extracellular to intracellular compartments, and phosphate consumption by rapidly proliferating cells are known to induce moderate to severe acute hypophosphatemia. Although hypophosphatemia and/or phosphate depletion in patients with acute or chronic myeloid leukemia have been reported in the literature, hypophosphatemia due to acute lymphoblastic leukemia (ALL) is very rare. We report a case of history of ALL complicated by life-threatening hypophosphatemia manifesting as generalized muscle weakness, fatigue, acute shortness of breath, and difficulty in standing up and walking for 3 days. Serum inorganic phosphate levels were consistently low (0.06 mmol/L). The patient was hospitalized and thought to have a relapsed ALL.Anticancer agents and oral phosphate (660 mg twice daily) were administered. On the second day of treatment, the patient began to improve, and the patient gradually fully recovered within 5 days.We suggested that this hypophosphatemia was induced by a shift of phosphorus into leukemic cells that rapidly replicated in the tissues and excessive cellular phosphate consumption by rapidly proliferating cells. Serum phosphate levels should always be monitored,especially in suspected life-threatening manifestation in relapsed ALL.

  18. The epidemiology of life-threatening complications associated with reproductive process in public hospitals in Argentina.

    PubMed

    Karolinski, A; Mercer, R; Micone, P; Ocampo, C; Mazzoni, A; Fontana, O; Messina, A; Winograd, R; Frers, M C; Nassif, J C; Elordi, H C; Lapidus, A; Taddeo, C; Damiano, M; Lambruschini, R; Muzzio, C; Pecker, B; Natale, S; Nowacki, D; Betular, A; Breccia, G; Di Biase, L; Montes Varela, D; Dunaiewsky, A; Minsk, E; Fernández, D; Martire, L; Huespe, M; Laterra, C; Spagnuolo, R; Gregoris, C

    2013-12-01

    To analyse life-threatening obstetric complications that occurred in public hospitals in Argentina. Multicentre collaborative cross-sectional study. Twenty-five hospitals included in the Perinatal Network of Buenos Aires Metropolitan Area. Women giving birth in participating hospitals during a 1-year period. All cases of severe maternal morbidity (SMM) and maternal mortality (MM) during pregnancy (including miscarriage and induced abortion), labour and puerperium were included. Data were collected prospectively. Identification criteria, main causes and incidence of SMM; case-fatality rates, morbidity-mortality index and effective intervention's use rate. A total of 552 women with life-threatening conditions were identified: 518 with SMM, 34 with MM. Identification criteria for SMM were case-management (48.9%), organ dysfunction (15.2%) and mixed criteria (35.9%). Incidence of SMM was 0.8% (95% confidence interval [95% CI] 0.73-0.87%) and hospital maternal death ratio was 52.3 per 100 000 live births (95% CI 35.5-69.1). Main causes of MM were abortion complications and puerperal sepsis; main causes of SMM were postpartum haemorrhage and hypertension. Overall case-fatality rate was 6.2% (95% CI 4.4-8.6): the highest due to sepsis (14.8%) and abortion complications (13.3%). Morbidity-mortality index was 15:1 (95% CI 7.5-30.8). Use rate of known effective interventions to prevent or treat main causes of MM and SMM was 52.3% (95% CI 46.9-57.7). This study describes the importance of life-threatening obstetric complications that took place in public hospitals with comprehensive obstetric care and the low utilisation of known effective interventions that may decrease rates of SMM and MM. It also provides arguments that justify the need to develop a surveillance system for SMM. © 2013 RCOG.

  19. Aggressive Treatment of Life-Threatening Hypophosphatemia During Recovery From Fulminant Hepatic Failure: A Case Report.

    PubMed

    Bissell, Brittany D; Davis, Jason E; Flannery, Alexander H; Adkins, David A; Thompson Bastin, Melissa L

    2018-06-01

    Acute liver failure secondary to acetaminophen overdose can be a life-threatening condition, characterized by severe electrolyte derangements. Hepatocyte regeneration is associated with phosphorous utilization and is a known complication of liver recovery following injury. We report the case of profound, life-threatening hypophosphatemia following recovery from acute fulminant liver failure. As the liver enzymes normalized, serum phosphorous levels plummeted. Our patient required an aggressive, individualized phosphorus replacement regimen, which resulted in a continuous infusion of intravenous (IV) sodium phosphate, titrated to a maximum rate of 30 mmol/h or 0.5 mmol/kg/h. The patient required over 400 mmol of total IV and oral phosphorous over the course of 48 hours. An aggressive approach to phosphorous replacement was done safely and effectively. Traditional replacement protocols are not adequate to sustain patients with this degree of hypophosphatemia. This is the first report to utilize a continuous infusion of phosphate with a maximum reported rate (0.5 mmol/kg/h). Our report summarizes a novel and safe approach for clinicians to maximally support these patients through high-dose, continuous infusion phosphorous administration.

  20. Life-threatening methemoglobinemia after unintentional ingestion of antifreeze admixtures containing sodium nitrite in the construction sites.

    PubMed

    Sohn, C H; Seo, D W; Ryoo, S M; Lee, J H; Kim, W Y; Lim, K S; Oh, B J

    2014-01-01

    Construction workers are exposed to a wide variety of health hazards such as poisoning at the construction sites. Various forms of poisoning incidents in construction workers have been reported. However, studies on methemoglobinemia caused by unintentional ingestion of antifreeze admixtures containing sodium nitrite at the construction sites have not been reported yet. The aim of this study was to evaluate life-threatening methemoglobinemia after unintentional ingestion of antifreeze admixtures containing sodium nitrite at the construction sites and describe similar incidents involving ingestion of antifreeze admixtures in Korea. Retrospective observational case series study on patients with methemoglobinemia after unintentional ingestion of antifreeze admixtures containing sodium nitrite admitted to the emergency department (ED) from January 1, 2010 to December 31, 2012 and cases reported to the Korea Occupational Safety and Health Agency (KOSHA) was performed. Results. Six victims were admitted to our ED. They had methemoglobin levels ranging from 32.4% to 71.5% and all of them recovered after receiving one (2 mg/kg) or two doses infusion of methylene blue. From the data of the KOSHA, six incidents that caused 27 victims were identified. Of 27 victims, five were included in the ED cases. For all incidents, antifreeze admixtures were not contained in their original containers and all new containers did not have a new label. All workers mistook antifreeze admixtures for water. Among the 28 victims included in this study, four died. Unintentional ingestion of antifreeze admixtures containing sodium nitrite at the construction sites can cause life-threatening methemoglobinemia. There is a need to store and label potentially hazardous materials properly to avoid unintentional ingestion at the construction sites.

  1. Potentially life-threatening coagulopathy associated with simultaneous reduction in coagulation and fibrinolytic function in pediatric acute leukemia after hematopoietic stem-cell transplantation.

    PubMed

    Ishihara, Takashi; Nogami, Keiji; Matsumoto, Tomoko; Nomura, Akitaka; Takeshita, Yasufumi; Ochi, Satoshi; Shima, Midori

    2017-07-01

    The pathogenesis of sinusoidal obstruction syndrome (SOS) and thrombotic microangiopathy (TMA) after hematopoietic stem cell transplantation (HSCT) is poorly understood, and limited information is available on global hemostatic function in HSCT. We assessed changes in coagulation and fibrinolysis using a simultaneous thrombin and plasmin generation assay (T/P-GA) during HSCT. Measurements of endogenous thrombin potential (T-EP) and plasmin peak height (P-Peak) using T/P-GA in six pediatric acute leukemia patients treated with HSCT were compared to normal plasma. In the SOS case, the ratios of T-EP and P-Peak to normal were simultaneously decreased at four weeks post-HSCT (Pre; ~1.1/1.1-1.4, Week+4; 0.14/0.0084, respectively). Similarly, in the TMA patient, both ratios were decreased at 3 weeks and recovered after 8 weeks (Pre; 1.2/~0.95, Week+3; 0.59/0.22, Week+8; 1.2/0.64-0.85). In the other patients, when SOS/TMA was not evident, the T/P-GA data remained within normal limits. These findings suggest that the simultaneous reduction of coagulation and fibrinolytic function in patients developing SOS/TMA can lead to a life-threatening coagulopathy. Further research is warranted to clarify global hemostatic function after HSCT to establish optimal supportive therapy for these critical clinical disorders of hemostasis.

  2. Life-Threatening Mannitol-Induced Hyperkalemia in Neurosurgical Patients.

    PubMed

    Fanous, Andrew A; Tick, Robert C; Gu, Eugene Y; Fenstermaker, Robert A

    2016-07-01

    Mannitol is the most commonly used intraoperative hypertonic solution in patients undergoing craniotomy. However, its use has been reported to be associated with hyperkalemia, which can occasionally be life threatening. In this report, we discuss the case of a patient who had intraoperative cardiac arrest secondary to mannitol-induced hyperkalemia during a craniotomy for tumor resection. In addition, we provide a comprehensive review of the literature concerning similar cases previously reported, as well as a discussion of the pathophysiology of mannitol-induced hyperkalemia. Review of the literature suggests that patients prone to this phenomenon are young and healthy individuals with normal preoperative and postoperative cardiopulmonary and renal functions. The literature also suggests that the total dose of mannitol, as well as its rate of infusion, may play a role in the development of this phenomenon. Knowledge of the existence of mannitol-induced hyperkalemia is paramount for the neurosurgeon and the anesthesiologist, because early treatment with insulin and calcium can quickly restore normal cardiac rhythm and prevent intraoperative death. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Neural correlates of the behavioral-autonomic interaction response to potentially threatening stimuli

    PubMed Central

    Farrow, Tom F. D.; Johnson, Naomi K.; Hunter, Michael D.; Barker, Anthony T.; Wilkinson, Iain D.; Woodruff, Peter W. R.

    2013-01-01

    Subjective assessment of emotional valence is typically associated with both brain activity and autonomic arousal. Accurately assessing emotional salience is particularly important when perceiving threat. We sought to characterize the neural correlates of the interaction between behavioral and autonomic responses to potentially threatening visual and auditory stimuli. Twenty-five healthy male subjects underwent fMRI scanning whilst skin conductance responses (SCR) were recorded. One hundred and eighty pictures, sentences, and sounds were assessed as “harmless” or “threatening.” Individuals' stimulus-locked, phasic SCRs and trial-by-trial behavioral assessments were entered as regressors into a flexible factorial design to establish their separate autonomic and behavioral neural correlates, and convolved to examine psycho-autonomic interaction (PAI) effects. Across all stimuli, “threatening,” compared with “harmless” behavioral assessments were associated with mainly frontal and precuneus activation with specific within-modality activations including bilateral parahippocampal gyri (pictures), bilateral anterior cingulate cortex (ACC) and frontal pole (sentences), and right Heschl's gyrus and bilateral temporal gyri (sounds). Across stimulus modalities SCRs were associated with activation of parieto-occipito-thalamic regions, an activation pattern which was largely replicated within-modality. In contrast, PAI analyses revealed modality-specific activations including right fusiform/parahippocampal gyrus (pictures), right insula (sentences), and mid-cingulate gyrus (sounds). Phasic SCR activity was positively correlated with an individual's propensity to assess stimuli as “threatening.” SCRs may modulate cognitive assessments on a “harmless–threatening” dimension, thereby modulating affective tone and hence behavior. PMID:23335893

  4. Life-threatening hematuria requiring transcatheter embolization following radiofrequency ablation of renal cell carcinoma.

    PubMed

    Roach, H; Whittlestone, T; Callaway, M P

    2006-01-01

    Radiofrequency ablation is increasingly being acknowledged as a valid treatment for renal cell carcinoma in patients in whom definitive curative resection is deemed either undesirable or unsafe. A number of published series have shown the technique to have encouraging results and relatively low complication rates. In this article, we report a case of delayed life-threatening hematuria requiring transcatheter embolization of a bleeding intrarenal artery in a patient who had undergone imaging-guided radiofrequency ablation of a 3 cm renal cell carcinoma. To our knowledge, such a complication has not been reported previously.

  5. Life-Threatening Hypokalemic Paralysis in a Young Bodybuilder

    PubMed Central

    Cheung, Kitty K. T.; So, Wing-Yee; Kong, Alice P. S.; Ma, Ronald C. W.; Chow, Francis C. C.

    2014-01-01

    We report a case of life-threatening hypokalemia in a 28-year-old bodybuilder who presented with sudden onset bilateral lower limbs paralysis few days after his bodybuilding competition. His electrocardiogram (ECG) showed typical u-waves due to severe hypokalemia (serum potassium 1.6 mmol/L, reference range (RR) 3.5–5.0 mmol/L). He was admitted to the intensive care unit (ICU) and was treated with potassium replacement. The patient later admitted that he had exposed himself to weight loss agents of unknown nature, purchased online, and large carbohydrate loads in preparation for the competition. He made a full recovery after a few days and discharged himself from the hospital against medical advice. The severe hypokalemia was thought to be caused by several mechanisms to be discussed in this report. With the ever rising number of new fitness centers recently, the ease of online purchasing of almost any drug, and the increasing numbers of youngsters getting into the bodybuilding arena, clinicians should be able to recognize the possible causes of sudden severe hypokalemia in these patients in order to revert the pathophysiology. PMID:24660073

  6. Life-threatening hypokalemic paralysis in a young bodybuilder.

    PubMed

    Cheung, Kitty K T; So, Wing-Yee; Kong, Alice P S; Ma, Ronald C W; Chow, Francis C C

    2014-01-01

    We report a case of life-threatening hypokalemia in a 28-year-old bodybuilder who presented with sudden onset bilateral lower limbs paralysis few days after his bodybuilding competition. His electrocardiogram (ECG) showed typical u-waves due to severe hypokalemia (serum potassium 1.6 mmol/L, reference range (RR) 3.5-5.0 mmol/L). He was admitted to the intensive care unit (ICU) and was treated with potassium replacement. The patient later admitted that he had exposed himself to weight loss agents of unknown nature, purchased online, and large carbohydrate loads in preparation for the competition. He made a full recovery after a few days and discharged himself from the hospital against medical advice. The severe hypokalemia was thought to be caused by several mechanisms to be discussed in this report. With the ever rising number of new fitness centers recently, the ease of online purchasing of almost any drug, and the increasing numbers of youngsters getting into the bodybuilding arena, clinicians should be able to recognize the possible causes of sudden severe hypokalemia in these patients in order to revert the pathophysiology.

  7. A case report of life-threatening acute dysphagia in dermatomyositis: Challenges in diagnosis and treatment.

    PubMed

    Kwon, Kyoung Min; Lee, Jung Soo; Kim, Yeo Hyung

    2018-04-01

    Although dysphagia is a known complication of dermatomyositis, sudden onset of dysphagia without the notable aggravation of other symptoms can make the diagnosis and treatment challenging. A 53-year-old male diagnosed as dermatomyositis 1 month ago came to our emergency department complaining of a sudden inability to swallow solid foods and liquids. The patient showed generalized edema, but the muscle power was not different compared with 1 month ago. Serum creatine kinase level was lower than that measured 2 weeks ago. Computed tomography scan of the larynx, chest, abdomen, and pelvis, an esophagogastroduodenoscopy, and brain magnetic resonance imaging were unremarkable. A videofluoroscopic swallowing study revealed inadequate pharyngeal contraction and slightly decreased upper esophageal sphincter opening with silent aspiration. Treatment with oral prednisolone, intravenous methylprednisolone, azathioprine, and intravenous immunoglobulins was applied. During the course of medical treatment for life-threatening dysphagia, he continued with rehabilitative therapy. He could swallow saliva at 2 months and showed normal swallowing function at 3 months from the onset of dysphagia. Dysphagia has not recurred for 3 years after recovery. A multidisciplinary approach is necessary to diagnose severe acute dysphagia due to exacerbation of underlying dermatomyositis rather than other structural or neurological causes. Appropriate supportive care is important because dysphagia can be life-threatening and last for a long time.

  8. Threatening scenes but not threatening faces shorten time-to-contact estimates.

    PubMed

    DeLucia, Patricia R; Brendel, Esther; Hecht, Heiko; Stacy, Ryan L; Larsen, Jeff T

    2014-08-01

    We previously reported that time-to-contact (TTC) judgments of threatening scene pictures (e.g., frontal attacks) resulted in shortened estimations and were mediated by cognitive processes, and that judgments of threatening (e.g., angry) face pictures resulted in a smaller effect and did not seem cognitively mediated. In the present study, the effects of threatening scenes and faces were compared in two different tasks. An effect of threatening scene pictures occurred in a prediction-motion task, which putatively requires cognitive motion extrapolation, but not in a relative TTC judgment task, which was designed to be less reliant on cognitive processes. An effect of threatening face pictures did not occur in either task. We propose that an object's explicit potential of threat per se, and not only emotional valence, underlies the effect of threatening scenes on TTC judgments and that such an effect occurs only when the task allows sufficient cognitive processing. Results are consistent with distinctions between predator and social fear systems and different underlying physiological mechanisms. Not all threatening information elicits the same responses, and whether an effect occurs at all may depend on the task and the degree to which the task involves cognitive processes.

  9. Situational and Age-Dependent Decision Making during Life Threatening Distress in Myotis macrodactylus.

    PubMed

    Huang, Xiaobin; Kanwal, Jagmeet S; Jiang, Tinglei; Long, Zhenyu; Luo, Bo; Yue, Xinke; Gu, Yongbo; Feng, Jiang

    2015-01-01

    Echolocation and audiovocal communication have been studied extensively in bats. The manner in which these abilities are incorporated within escape behaviors during life-threatening distress is largely unknown. Here we tested the hypothesis that behavioral response profiles expressed during distress are relatively stereotypic given their evolutionary adaptations to avoid predators. We subjected juvenile and adult big-footed myotis (Myotis macrodactylus) to a sequence of three types of life threatening distress: 1) trapping them in a mist-net (environmental threat), 2) approaching them when trapped (predator threat), and 3) partially restraining their freedom to move (arrest), and recorded their escape behavior in each of the three conditions. Response profiles differed across individuals and with the context in which they were expressed. During environmental and predator threat, bats displayed significantly more biting and wing-flapping behaviors and emitted more echolocation pulses than during arrest. Response profiles also varied with age. During arrest, juveniles were more likely than adults to emit distress calls and vice-versa for biting and wing flapping during environmental and predator threat. Overall, individualized response profiles were classified into ten clusters that were aligned along two divergent response trajectories when viewed within two-dimensional, multifactorial decision space. Juvenile behaviors tended to follow a predominantly "social-dependence" trajectory, whereas adult behaviors were mostly aligned along a "self-reliance" trajectory. We conclude that bats modify their vocal behavior and make age-appropriate and contextually adaptive decisions when distressed. This decision-making ability is consistent with observations in other social species, including humans.

  10. Situational and Age-Dependent Decision Making during Life Threatening Distress in Myotis macrodactylus

    PubMed Central

    Huang, Xiaobin; Kanwal, Jagmeet S.; Jiang, Tinglei; Long, Zhenyu; Luo, Bo; Yue, Xinke; Gu, Yongbo; Feng, Jiang

    2015-01-01

    Echolocation and audiovocal communication have been studied extensively in bats. The manner in which these abilities are incorporated within escape behaviors during life-threatening distress is largely unknown. Here we tested the hypothesis that behavioral response profiles expressed during distress are relatively stereotypic given their evolutionary adaptations to avoid predators. We subjected juvenile and adult big-footed myotis (Myotis macrodactylus) to a sequence of three types of life threatening distress: 1) trapping them in a mist-net (environmental threat), 2) approaching them when trapped (predator threat), and 3) partially restraining their freedom to move (arrest), and recorded their escape behavior in each of the three conditions. Response profiles differed across individuals and with the context in which they were expressed. During environmental and predator threat, bats displayed significantly more biting and wing-flapping behaviors and emitted more echolocation pulses than during arrest. Response profiles also varied with age. During arrest, juveniles were more likely than adults to emit distress calls and vice-versa for biting and wing flapping during environmental and predator threat. Overall, individualized response profiles were classified into ten clusters that were aligned along two divergent response trajectories when viewed within two-dimensional, multifactorial decision space. Juvenile behaviors tended to follow a predominantly “social-dependence” trajectory, whereas adult behaviors were mostly aligned along a “self-reliance” trajectory. We conclude that bats modify their vocal behavior and make age-appropriate and contextually adaptive decisions when distressed. This decision-making ability is consistent with observations in other social species, including humans. PMID:26181328

  11. Does decisional conflict differ across race and ethnicity groups? A study of parents whose children have a life-threatening illness.

    PubMed

    Knapp, Caprice; Sberna-Hinojosa, Melanie; Baron-Lee, Jacqueline; Curtis, Charlotte; Huang, I-Chan

    2014-05-01

    Children with life-threatening illnesses and their families may face a myriad of medical decisions in their lifetimes. Oftentimes these complicated medical decisions cause disagreements among patients, families, and providers about what is the best course of action. Although no evidence exists, it is possible that conflict may affect subgroups of the population differently. This study aims to investigate how decisional conflict varies among racial and ethnic subgroups. Two hundred sixty-six surveys were completed with parents whose children have a life-threatening illness. All children lived in Florida and were enrolled in the Medicaid program. The Decisional Conflict Scale, overall and broken down into its five distinct subscales, was used to assess parental decision-making. Descriptive, bivariate, and multivariate analyses were conducted. Subgroup analyses were conducted on Latino respondents. Our bivariate results suggest that minority parents report less Effective Decision Making (p<0.05) and report less Support in Decision Making (p<0.05) compared to white, non-Hispanic parents. For the subgroup analysis, we found that those who identify as Mexican American and Central/South American report having greater Uncertainty in Choosing Options (p<0.05) and less Values Clarity (p<0.05) as compared to Puerto Rican or Cuban Americans. Results from the multivariate analyses suggest that those whose primary language is not English are associated with greater Uncertainty in Choosing Options (p<0.05). Values Clarity was lower for children who were diagnosed with their life-threatening condition at birth (p<0.05) as compared to children diagnosed at a later time. Our study is the first to describe racial and ethnic differences in decisional conflict of parents of children with life-threatening illnesses. Significant differences exist by race, ethnicity, language spoken, and diagnosis time across several subdomains of decisional conflict. These differences are important to

  12. Transcatheter treatment of life-threatening lower gastrointestinal bleeding due to advanced pelvic malignancy.

    PubMed

    Spinosa, D J; Angle, J F; McGraw, J K; Maurer, E J; Hagspiel, K D; Matsumoto, A H

    1998-01-01

    We present two patients with life-threatening, massive, lower gastrointestinal (GI) bleeding and locally advanced cervical carcinoma. Selective pelvic arteriography demonstrated that the site of bleeding originated from a pseudoaneurysm of the right internal iliac artery with fistulous communication to the sigmoid colon in one patient and from the left internal iliac artery into the rectum in the second patient. Transcatheter embolotherapy was then performed using balloon occlusion in one patient and coil embolization in the second patient. The iliac arteries should also be evaluated in patients with pelvic cancer who present with lower GI bleeding.

  13. Genome-wide association of implantable cardioverter-defibrillator activation with life-threatening arrhythmias.

    PubMed

    Murray, Sarah S; Smith, Erin N; Villarasa, Nikki; Nahey, Tara; Lande, Jeff; Goldberg, Harold; Shaw, Marian; Rosenthal, Lawrence; Ramza, Brian; Alaeddini, Jamshid; Han, Xinqiang; Damani, Samir; Soykan, Orhan; Kowal, Robert C; Topol, Eric J

    2012-01-01

    To identify genetic factors that would be predictive of individuals who require an implantable cardioverter-defibrillator (ICD), we conducted a genome-wide association study among individuals with an ICD who experienced a life-threatening arrhythmia (LTA; cases) vs. those who did not over at least a 3-year period (controls). Most individuals that receive implantable cardioverter-defibrillators never experience a life-threatening arrhythmia. Genetic factors may help identify who is most at risk. Patients with an ICD and extended follow-up were recruited from 34 clinical sites with the goal of oversampling those who had experienced LTA, with a cumulative 607 cases and 297 controls included in the analysis. A total of 1,006 Caucasian patients were enrolled during a time period of 13 months. Arrhythmia status of 904 patients could be confirmed and their genomic data were included in the analysis. In this cohort, there were 704 males, 200 females, and the average age was 73.3 years. We genotyped DNA samples using the Illumina Human660 W Genotyping BeadChip and tested for association between genotype at common variants and the phenotype of having an LTA. We did not find any associations reaching genome-wide significance, with the strongest association at chromosome 13, rs11856574 at P = 5×10⁻⁶. Loci previously implicated in phenotypes such as QT interval (measure of the time between the start of the Q wave and the end of the T wave as measured by electrocardiogram) were not found to be significantly associated with having an LTA. Although powered to detect such associations, we did not find common genetic variants of large effect associated with having a LTA in those of European descent. This indicates that common gene variants cannot be used at this time to guide ICD risk-stratification. ClinicalTrials.gov NCT00664807.

  14. Life-threatening macroglossia after posterior fossa surgery: a surgical positioning problem?

    PubMed

    Vermeersch, G; Menovsky, T; De Ridder, D; De Bodt, M; Saldien, V; Van de Heyning, P

    2014-01-01

    A 55-year-old woman was operated in the lateral park bench position with significant neck flexion and oral packing. Macroglossia was noticed immediately postoperatively after endotracheal extubation. The patient was reintubated for 13 days and subsequently required a tracheostoma. After the placement of the tracheostoma and the removal of the endotracheal tube, the congestion of the tongue decreased markedly within 24 hours. Macroglossia is a rare complication following posterior fossa procedures with few cases reported so far. It can cause airway obstruction, which could be a life-threatening complication, and it therefore requires prompt treatment. The aetiology of postoperative macroglossia remains uncertain and has been attributed to arterial, venous and lymphatic compression, mechanical compression, or neurogenic causes. This article describes new insights into aetiology and also describes preventive measures and possible treatment.

  15. Effectiveness of storytelling interventions on psychosocial outcomes in adult patients with a life-threatening illness: a systematic review protocol.

    PubMed

    Schoenau, Mai Nanna; Jackson, Inger Marie

    2016-06-01

    The objective of this review is to identify the effectiveness of storytelling interventions on psychosocial outcomes. In this review, storytelling is where adult patients with a life-threatening illness tell their illness story, facilitated by a healthcare professional.Specifically the review questions are.

  16. Life-threatening metabolic alkalosis in Pendred syndrome

    PubMed Central

    Kandasamy, Narayanan; Fugazzola, Laura; Evans, Mark; Chatterjee, Krishna; Karet, Fiona

    2011-01-01

    Introduction Pendred syndrome, a combination of sensorineural deafness, impaired organification of iodide in the thyroid and goitre, results from biallelic defects in pendrin (encoded by SLC26A4), which transports chloride and iodide in the inner ear and thyroid respectively. Recently, pendrin has also been identified in the kidneys, where it is found in the apical plasma membrane of non-α-type intercalated cells of the cortical collecting duct. Here, it functions as a chloride–bicarbonate exchanger, capable of secreting bicarbonate into the urine. Despite this function, patients with Pendred syndrome have not been reported to develop any significant acid–base disturbances, except a single previous reported case of metabolic alkalosis in the context of Pendred syndrome in a child started on a diuretic. Case report We describe a 46-year-old female with sensorineural deafness and hypothyroidism, who presented with severe hypokalaemic metabolic alkalosis during inter-current illnesses on two occasions, and who was found to be homozygous for a loss-of-function mutation (V138F) in SLC26A4. Her acid–base status and electrolytes were unremarkable when she was well. Conclusion This case illustrates that, although pendrin is not usually required to maintain acid–base homeostasis under ambient condition, loss of renal bicarbonate excretion by pendrin during a metabolic alkalotic challenge may contribute to life-threatening acid–base disturbances in patients with Pendred syndrome. PMID:21551164

  17. Myasthenia gravis: descriptive analysis of life-threatening events in a recent nationwide registry.

    PubMed

    Ramos-Fransi, A; Rojas-García, R; Segovia, S; Márquez-Infante, C; Pardo, J; Coll-Cantí, J; Jericó, I; Illa, I

    2015-07-01

    Myasthenia gravis (MG) may become life-threatening if patients have respiratory insufficiency or dysphagia. This study aimed to determine the incidence, demographic characteristics, risk factors, response to treatment and outcome of these life-threatening events (LTEs) in a recent, population-based sample of MG patients. A retrospective analysis of MG patients who presented with an LTE between 2000 and 2013 was performed. Participants were identified from a neuromuscular diseases registry in Spain that includes 648 patients with MG (NMD-ES). Sixty-two (9.56%) patients had an LTE. Thirty-two were classified as class V according to the MG Foundation of America, and 30 as class IVB. Fifty per cent were previously diagnosed with MG and median duration of the disease before the LTE was 24 months (3-406). The most common related factor was infection (n = 18). All patients received intravenous human immunoglobulin; 11 had a second infusion and six had plasma exchange. Median time to feeding tube removal was 13 days (1-434). Median time to weaning from ventilation was 12 days (3-176), and it was significantly shorter in late onset MG (≥50 years) (P = 0.019). LTEs improved <2 weeks in 55.8% but did not improve until after 1 month in 20% of patients. Four patients died. No other factors influenced mortality or duration of LTEs. The percentage of LTEs in MG patients was low, particularly amongst those previously diagnosed and treated for the disease. The significant percentage of treatment-resistant LTEs indicates that more effective treatment approaches are needed for this vulnerable sub-population. © 2015 EAN.

  18. [Severe apparent life-threatening event during "skin-to-skin": treatment with hypothermia].

    PubMed

    Marin, N; Valverde, E; Cabañas, F

    2013-10-01

    'Skin-to-skin' in healthy newborn infants is currently routine practice in Spanish maternity wards. This practice has shown benefits in increasing the duration of breast-feeding and maternal bonding behaviour with no significant adverse events. Early sudden deaths and severe apparent life-threatening events (ALTE) during the first 24 hours of life are infrequent, but well recognised. Risk factors during 'skin to skin' have been established. These events can lead to high neonatal morbidity and mortality. Hypothermia is now the standard of care for moderate to severe hypoxic-ischaemic encephalopathy and has shown to reduce mortality and neurological morbidity in children with hypoxic-ischaemic brain injury. Although there are no clinical trials that evaluate hypothermia after a severe ALTE, neonates who suffer it should be considered for this treatment. We present a case of a healthy newborn who had an ALTE during skin-to-skin with his mother and was treated with hypothermia. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  19. Post-traumatic stress disorder associated with life-threatening motor vehicle collisions in the WHO World Mental Health Surveys.

    PubMed

    Stein, Dan J; Karam, Elie G; Shahly, Victoria; Hill, Eric D; King, Andrew; Petukhova, Maria; Atwoli, Lukoye; Bromet, Evelyn J; Florescu, Silvia; Haro, Josep Maria; Hinkov, Hristo; Karam, Aimee; Medina-Mora, María Elena; Navarro-Mateu, Fernando; Piazza, Marina; Shalev, Arieh; Torres, Yolanda; Zaslavsky, Alan M; Kessler, Ronald C

    2016-07-22

    Motor vehicle collisions (MVCs) are a substantial contributor to the global burden of disease and lead to subsequent post-traumatic stress disorder (PTSD). However, the relevant literature originates in only a few countries, and much remains unknown about MVC-related PTSD prevalence and predictors. Data come from the World Mental Health Survey Initiative, a coordinated series of community epidemiological surveys of mental disorders throughout the world. The subset of 13 surveys (5 in high income countries, 8 in middle or low income countries) with respondents reporting PTSD after life-threatening MVCs are considered here. Six classes of predictors were assessed: socio-demographics, characteristics of the MVC, childhood family adversities, MVCs, other traumatic experiences, and respondent history of prior mental disorders. Logistic regression was used to examine predictors of PTSD. Mental disorders were assessed with the fully-structured Composite International Diagnostic Interview using DSM-IV criteria. Prevalence of PTSD associated with MVCs perceived to be life-threatening was 2.5 % overall and did not vary significantly across countries. PTSD was significantly associated with low respondent education, someone dying in the MVC, the respondent or someone else being seriously injured, childhood family adversities, prior MVCs (but not other traumatic experiences), and number of prior anxiety disorders. The final model was significantly predictive of PTSD, with 32 % of all PTSD occurring among the 5 % of respondents classified by the model as having highest PTSD risk. Although PTSD is a relatively rare outcome of life-threatening MVCs, a substantial minority of PTSD cases occur among the relatively small proportion of people with highest predicted risk. This raises the question whether MVC-related PTSD could be reduced with preventive interventions targeted to high-risk survivors using models based on predictors assessed in the immediate aftermath of the MVCs.

  20. Acute poisoning following ingestion of medicines: initial management. How to treat life-threatening complications and to evaluate the risk of delayed effects and psychological distress.

    PubMed

    2010-12-01

    activated charcoal, provided the patient is fully conscious and capable of swallowing safely. Gastric lavage carries a risk of serious adverse effects. It is only justified in the rare cases in which the patient's life is at risk following ingestion of a drug that is not adsorbed by activated charcoal. Ipecac syrup should not be used under any circumstances. Purging and gastric lavage are not part of initial management. Few antidotes are suitable for use in the early stages of poisoning. Acetylcysteine can be used for some cases of paracetamol poisoning, and naloxone for some types of opioid poisoning. Paracetamol poisoning can cause life-threatening hepatocellular necrosis. Activated charcoal should be administered as soon as possible. Acetylcysteine protects the liver when administered within 24 hours after paracetamol ingestion. Paracetamol serum assay can be useful for guiding patient management. In practice, acetylcysteine should be given when access to emergency medical intervention is not feasible within 8 to 10 hours after paracetamol ingestion. Intravenous naloxone is useful for respiratory depression due to opioid poisoning, but its duration of action is often shorter than that of opioids, making continuous monitoring necessary. Hospital monitoring is warranted in case of potentially severe poisoning; this includes patients at increased risk, patients having taken a potentially lethal substance at a toxic or unknown dose. Some pharmacological substances and formulations can have delayed effects. In case of self-poisoning, the risk of short-term relapse should be evaluated, even when the patient's condition is not life-threatening. Hospital admission should be proposed, or sometimes imposed, until the acute risk of suicide has subsided. In practice, when faced with acute drug poisoning, the first step is to implement life-support measures, to gather and communicate prognostic information and details of any treatments to the ambulance crew or hospital team.

  1. Discharge diagnoses in infants with apparent life-threatening event.

    PubMed

    Okada, Kazuko; Miyako, Motoko; Honma, Satoshi; Wakabayashi, Yasuko; Sugihara, Shigetaka; Osawa, Makiko

    2003-10-01

    There are various identifiable diseases or conditions that can be associated with an apparent life-threatening event (ALTE) in infancy. The present study was carried out to investigate the etiology of ALTE based on the discharge diagnoses. A protocol for the complete work-up used to examine the cause of ALTE was designed, and was carried out for 69 infants with ALTE. Gastroesophageal reflux disease (GERD) was demonstrated in 38 cases, and chronic gastric volvulus (CGV) was diagnosed in 21 (associated with GERD in 13 infants). Four cases of pertussis and two cases each of sepsis, laryngomalacia, respiratory immaturity, and premature ventricular contractions were found. Others cases presented with pneumonia, meningitis, intussuception, food allergy, epilepsy, and adenoid vegetations. In 12 of the 69 infants with ALTE, no abnormalities were found in any of the studies performed, including two patients with breath-holding spells. In 17 cases, two or more possibly contributing findings were diagnosed. It is important to recognize that gastroesophageal impairments such as GERD or CGV could be responsible for many incidences of ALTE in infancy. The authors recommend a trial be established to investigate the causes of ALTE, including gastroesophageal evaluations in all infants with ALTE.

  2. A retrospective population-based study of primigravid women on the potential effect of threatened miscarriage on obstetric outcome.

    PubMed

    Mulik, Varsha; Bethel, Jackie; Bhal, K

    2004-04-01

    The aim of this study was to ascertain any potential link between threatened miscarriage and obstetric outcome. Threatened miscarriage was associated independently with an increased incidence of abruption (OR 2.8, 2.0-3.7), unexplained antepartum haemorrhage (APH) (OR 2.3, 1.1-5.1) and preterm delivery (OR 2.0, 1.3-3.3). The incidence of low and very low birth weight deliveries, although significantly higher compared with the control population, was not affected independently by this early pregnancy complication on logistic regression (OR 1.3, 0.8-1.9). The early neonatal mortality rates were significantly higher in the threatened miscarriage group, which on logistic regression was due independently to preterm delivery, placental abruption and low birth weight deliveries. All forms of APH were significantly higher in term deliveries complicated by threatened miscarriage. Pregnancies presenting with threatened miscarriage should be highlighted as 'high risk' for a suboptimal obstetric outcome and a prospective observational trial followed by a randomised-controlled trial may be needed to establish whether the need exists for increased feto-maternal surveillance in this cohort of women.

  3. The List of Threatening Experiences: the reliability and validity of a brief life events questionnaire.

    PubMed

    Brugha, T S; Cragg, D

    1990-07-01

    During the 23 years since the original work of Holmes & Rahe, research into stressful life events on human subjects has tended towards the development of longer and more complex inventories. The List of Threatening Experiences (LTE) of Brugha et al., by virtue of its brevity, overcomes difficulties of clinical application. In a study of 50 psychiatric patients and informants, the questionnaire version of the list (LTE-Q) was shown to have high test-retest reliability, and good agreement with informant information. Concurrent validity, based on the criterion of independently rated adversity derived from a semistructured life events interview, making use of the Life Events and Difficulties Scales (LEDS) method developed by Brown & Harris, showed both high specificity and sensitivity. The LTE-Q is particularly recommended for use in psychiatric, psychological and social studies in which other intervening variables such as social support, coping, and cognitive variables are of interest, and resources do not allow for the use of extensive interview measures of stress.

  4. Near-death experiences in non-life-threatening events and coma of different etiologies.

    PubMed

    Charland-Verville, Vanessa; Jourdan, Jean-Pierre; Thonnard, Marie; Ledoux, Didier; Donneau, Anne-Francoise; Quertemont, Etienne; Laureys, Steven

    2014-01-01

    Near death experiences (NDEs) are increasingly being reported as a clearly identifiable physiological and psychological reality of clinical significance. However, the definition and causes of the phenomenon as well as the identification of NDE experiencers is still a matter of debate. To date, the most widely used standardized tool to identify and characterize NDEs in research is the Greyson NDE scale. Using this scale, retrospective and prospective studies have been trying to estimate their incidence in various populations but few studies have attempted to associate the experiences' intensity and content to etiology. This retrospective investigation assessed the intensity and the most frequently recounted features of self-reported NDEs after a non-life-threatening event (i.e., "NDE-like" experience) or after a pathological coma (i.e., "real NDE") and according to the etiology of the acute brain insult. We also compared our retrospectively acquired data in anoxic coma with historical data from the published literature on prospective post-anoxic studies using the Greyson NDE scale. From our 190 reports who met the criteria for NDE (i.e., Greyson NDE scale total score >7/32), intensity (i.e., Greyson NDE scale total score) and content (i.e., Greyson NDE scale features) did not differ between "NDE-like" (n = 50) and "real NDE" (n = 140) groups, nor within the "real NDE" group depending on the cause of coma (anoxic/traumatic/other). The most frequently reported feature was peacefulness (89-93%). Only 2 patients (1%) recounted a negative experience. The overall NDE core features' frequencies were higher in our retrospective anoxic cohort when compared to historical published prospective data. It appears that "real NDEs" after coma of different etiologies are similar to "NDE-like" experiences occurring after non-life threatening events. Subjects reporting NDEs retrospectively tend to have experienced a different content compared to the prospective experiencers.

  5. Long-term prognosis of patients with life-threatening ventricular arrhythmias induced by coronary artery spasm.

    PubMed

    Rodríguez-Mañero, Moisés; Oloriz, Teresa; le Polain de Waroux, Jean-Benoit; Burri, Haran; Kreidieh, Bahij; de Asmundis, Carlos; Arias, Miguel A; Arbelo, Elena; Díaz Fernández, Brais; Fernández-Armenta, Juan; Basterra, Nuria; Izquierdo, María Teresa; Díaz-Infante, Ernesto; Ballesteros, Gabriel; Carrillo López, Andrés; García-Bolao, Ignacio; Benezet-Mazuecos, Juan; Expósito-García, Victor; Larraitz-Gaztañaga; Martínez-Sande, Jose Luis; García-Seara, Javier; González-Juanatey, Jose Ramón; Peinado, Rafael

    2018-05-01

    Coronary artery spasm (CAS) is associated with ventricular arrhythmias (VA). Much controversy remains regarding the best therapeutic interventions for this specific patient subset. We aimed to evaluate the clinical outcomes of patients with a history of life-threatening VA due to CAS with various medical interventions, as well as the need for ICD placement in the setting of optimal medical therapy. A multicentre European retrospective survey of patients with VA in the setting of CAS was aggregated and relevant clinical and demographic data was analysed. Forty-nine appropriate patients were identified: 43 (87.8%) presented with VF and 6 (12.2%) with rapid VT. ICD implantation was performed in 44 (89.8%). During follow-up [59 (17-117) months], appropriate ICD shocks were documented in 12. In 8/12 (66.6%) no more ICD therapies were recorded after optimizing calcium channel blocker (CCB) therapy. SCD occurred in one patient without ICD. Treatment with beta-blockers was predictive of appropriate device discharge. Conversely, non-dihydropyridine CCB therapy was significantly protective against VAs. Patients with life-threatening VAs secondary to CAS are at particularly high-risk for recurrence, especially when insufficient medical therapy is administered. Non-dihydropyridine CCBs are capable of suppressing episodes, whereas beta-blocker treatment is predictive of VAs. Ultimately, in spite of medical intervention, some patients exhibited arrhythmogenic events in the long-term, suggesting that ICD implantation may still be indicated for all.

  6. Genome-Wide Association of Implantable Cardioverter-Defibrillator Activation With Life-Threatening Arrhythmias

    PubMed Central

    Murray, Sarah S.; Smith, Erin N.; Villarasa, Nikki; Nahey, Tara; Lande, Jeff; Goldberg, Harold; Shaw, Marian; Rosenthal, Lawrence; Ramza, Brian; Alaeddini, Jamshid; Han, Xinqiang; Damani, Samir; Soykan, Orhan; Kowal, Robert C.; Topol, Eric J.

    2012-01-01

    Objectives To identify genetic factors that would be predictive of individuals who require an implantable cardioverter-defibrillator (ICD), we conducted a genome-wide association study among individuals with an ICD who experienced a life-threatening arrhythmia (LTA; cases) vs. those who did not over at least a 3-year period (controls). Background Most individuals that receive implantable cardioverter-defibrillators never experience a life-threatening arrhythmia. Genetic factors may help identify who is most at risk. Methods Patients with an ICD and extended follow-up were recruited from 34 clinical sites with the goal of oversampling those who had experienced LTA, with a cumulative 607 cases and 297 controls included in the analysis. A total of 1,006 Caucasian patients were enrolled during a time period of 13 months. Arrhythmia status of 904 patients could be confirmed and their genomic data were included in the analysis. In this cohort, there were 704 males, 200 females, and the average age was 73.3 years. We genotyped DNA samples using the Illumina Human660 W Genotyping BeadChip and tested for association between genotype at common variants and the phenotype of having an LTA. Results and Conclusions We did not find any associations reaching genome-wide significance, with the strongest association at chromosome 13, rs11856574 at P = 5×10−6. Loci previously implicated in phenotypes such as QT interval (measure of the time between the start of the Q wave and the end of the T wave as measured by electrocardiogram) were not found to be significantly associated with having an LTA. Although powered to detect such associations, we did not find common genetic variants of large effect associated with having a LTA in those of European descent. This indicates that common gene variants cannot be used at this time to guide ICD risk-stratification. Trial Registration ClinicalTrials.gov NCT00664807 PMID:22247754

  7. Life-Threatening Complication During Percutaneous Ablation of Adrenal Gland Metastasis: Takotsubo Syndrome

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

    Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Buy, Xavier, E-mail: Xavier.buy@chru-strasbourg.f; Zickler, Pierre, E-mail: pierre.zickler@chru-strasbourg.f

    2010-06-15

    A rare life-threatening complication during percutaneous cryoablation of an adrenal gland metastasis from a lung carcinoma is reported. The patient presented hypertensive crisis at the beginning of the thawing cycle, followed by electrocardiographic change which necessitated interruption of the procedure and his transfer to the intensive care unit with suspicion of heart infarct. There was a slight increase in cardiac enzyme levels, and ventricular angiography demonstrated transient hypokinesis-dyskinesis of the mid left ventricular segments without apical involvement, while the coronary arteries showed no significant stenosis on coronarography. These findings led to the diagnosis of Takotsubo cardiomyopathy left ventricular dysfunction syndrome.more » This is the first case of Takotsubo cardiomyopathy occurring as a complication during percutaneous ablation of an adrenal gland tumor.« less

  8. Evaluation of Therapeutics for Advanced-Stage Heart Failure and Other Severely-Debilitating or Life-Threatening Diseases.

    PubMed

    Prescott, J S; Andrews, P A; Baker, R W; Bogdanffy, M S; Fields, F O; Keller, D A; Lapadula, D M; Mahoney, N M; Paul, D E; Platz, S J; Reese, D M; Stoch, S A; DeGeorge, J J

    2017-08-01

    Severely-debilitating or life-threatening (SDLT) diseases include conditions in which life expectancy is short or quality of life is greatly diminished despite available therapies. As such, the medical context for SDLT diseases is comparable to advanced cancer and the benefit vs. risk assessment and development of SDLT disease therapeutics should be similar to that of advanced cancer therapeutics. A streamlined development approach would allow patients with SDLT conditions earlier access to therapeutics and increase the speed of progression through development. In addition, this will likely increase the SDLT disease therapeutic pipeline, directly benefiting patients and reducing the economic and societal burden of SDLT conditions. Using advanced-stage heart failure (HF) as an example that illustrates the concepts applicable to other SDLT indications, this article proposes a streamlined development paradigm for SDLT disease therapeutics and recommends development of aligned global regulatory guidance. © 2017 American Society for Clinical Pharmacology and Therapeutics.

  9. Climate change may threaten habitat suitability of threatened plant species within Chinese nature reserves

    PubMed Central

    Wan, Jizhong

    2016-01-01

    Climate change has the potential to alter the distributions of threatened plant species, and may therefore diminish the capacity of nature reserves to protect threatened plant species. Chinese nature reserves contain a rich diversity of plant species that are at risk of becoming more threatened by climate change. Hence, it is urgent to identify the extent to which future climate change may compromise the suitability of threatened plant species habitats within Chinese nature reserves. Here, we modelled the climate suitability of 82 threatened plant species within 168 nature reserves across climate change scenarios. We used Maxent modelling based on species occurrence localities and evaluated climate change impacts using the magnitude of change in climate suitability and the degree of overlap between current and future climatically suitable habitats. There was a significant relationship between overlap with current and future climate suitability of all threatened plant species habitats and the magnitude of changes in climate suitability. Our projections estimate that the climate suitability of more than 60 threatened plant species will decrease and that climate change threatens the habitat suitability of plant species in more than 130 nature reserves under the low, medium, and high greenhouse gas concentration scenarios by both 2050s and 2080s. Furthermore, future climate change may substantially threaten tree plant species through changes in annual mean temperature. These results indicate that climate change may threaten plant species that occur within Chinese nature reserves. Therefore, we suggest that climate change projections should be integrated into the conservation and management of threatened plant species within nature reserves. PMID:27326373

  10. Management of life-threatening calcium channel blocker overdose with continuous veno-venous hemodiafiltration with charcoal hemoperfusion

    PubMed Central

    Garg, Suneel K.; Goyal, Pankaj K.; Kumar, Rahul; Juneja, Deven; Bhasin, Alka; Singh, Omender

    2014-01-01

    Cases of calcium channel blocker overdose reported from India are few, and although rare, they are associated with high mortality. Management includes fluids, vasopressors, calcium gluconate or chloride, glucagon infusion, and hyperinsulinemia-euglycemia therapy along with some rescue therapies tried in anecdotal reports. We report here a case of life-threatening overdose of amlodipine with shock, refractory to conventional therapies. Salvage therapy with continuous veno-venous hemodiafiltration using charcoal hemoperfusion with prior infusion of intravenous lipid emulsion resulted in a successful outcome. PMID:24987241

  11. Assessing potential radiological harm to fukushima recovery workers.

    PubMed

    Scott, Bobby R

    2011-01-01

    A radiological emergency exists at the Fukushima Daiichi (Fukushima I) nuclear power plant in Japan as a result of the March 11, 2011 magnitude 9.0 earthquake and the massive tsunami that arrived later. News media misinformation related to the emergency triggered enormous social fear worldwide of the radioactivity that is being released from damaged fuel rods. The heroic recovery workers are a major concern because they are being exposed to mostly gamma radiation during their work shifts and life-threatening damage to the radiosensitive bone marrow could occur over time. This paper presents a way in which the bone marrow equivalent dose (in millisieverts), as estimated per work shift, could be used along with the hazard function model previously developed for radiological risk assessment to repeatedly check for potential life-threatening harm (hematopoietic system damage) to workers. Three categories of radiation hazard indication are proposed: 1, life-threatening damage unlikely; 2, life-threatening damage possible; 3, life-threatening damage likely. Categories 2 and 3 would be avoided if the whole body effective dose did not exceed the annual effective dose limit of 250 mSv. For down-wind populations, hormetic effects (activated natural protective processes) are much more likely than are deleterious effects.

  12. Risk stratification personalised model for prediction of life-threatening ventricular tachyarrhythmias in patients with chronic heart failure.

    PubMed

    Frolov, Alexander Vladimirovich; Vaikhanskaya, Tatjana Gennadjevna; Melnikova, Olga Petrovna; Vorobiev, Anatoly Pavlovich; Guel, Ludmila Michajlovna

    2017-01-01

    The development of prognostic factors of life-threatening ventricular tachyarrhythmias (VTA) and sudden cardiac death (SCD) continues to maintain its priority and relevance in cardiology. The development of a method of personalised prognosis based on multifactorial analysis of the risk factors associated with life-threatening heart rhythm disturbances is considered a key research and clinical task. To design a prognostic and mathematical model to define personalised risk for life-threatening VTA in patients with chronic heart failure (CHF). The study included 240 patients with CHF (mean-age of 50.5 ± 12.1 years; left ventricular ejection fraction 32.8 ± 10.9%; follow-up period 36.8 ± 5.7 months). The participants received basic therapy for heart failure. The elec-trocardiogram (ECG) markers of myocardial electrical instability were assessed including microvolt T-wave alternans, heart rate turbulence, heart rate deceleration, and QT dispersion. Additionally, echocardiography and Holter monitoring (HM) were performed. The cardiovascular events were considered as primary endpoints, including SCD, paroxysmal ventricular tachycardia/ventricular fibrillation (VT/VF) based on HM-ECG data, and data obtained from implantable device interrogation (CRT-D, ICD) as well as appropriated shocks. During the follow-up period, 66 (27.5%) subjects with CHF showed adverse arrhythmic events, including nine SCD events and 57 VTAs. Data from a stepwise discriminant analysis of cumulative ECG-markers of myocardial electrical instability were used to make a mathematical model of preliminary VTA risk stratification. Uni- and multivariate Cox logistic regression analysis were performed to define an individualised risk stratification model of SCD/VTA. A binary logistic regression model demonstrated a high prognostic significance of discriminant function with a classification sensitivity of 80.8% and specificity of 99.1% (F = 31.2; c2 = 143.2; p < 0.0001). The method of personalised risk

  13. Emergency medical dispatch priority in chest pain patients due to life threatening conditions: A cohort study examining circadian variations and impact of the education.

    PubMed

    Rawshani, Araz; Rawshani, Nina; Gelang, Carita; Andersson, Jan-Otto; Larsson, Anna; Bång, Angela; Herlitz, Johan; Gellerstedt, Martin

    2017-06-01

    We examined the accuracy in assessments of emergency dispatchers according to their education and time of the day. We examined this in chest pain patients who were diagnosed with a potentially life-threatening condition (LTC) or died within 30days. Among 2205 persons, 482 died, 1631 experienced an acute coronary syndrome (ACS), 1914 had a LTC. Multivariable logistic regression was used to study how time of the call and the dispatcher's education were associated with the risk of missing to give priority 1 (the highest). Among patients who died, a 7-fold increase in odds of missing to give priority 1 was noted at 1.00pm, as compared with midnight. Compared with assistant nurses, odds ratio for dispatchers with no (medical) training was 0.34 (95% CI 0.14 to 0.77). Among patients with an ACS, odds ratio for calls arriving before lunch was 2.02 (95% CI 1.22 to 3.43), compared with midnight. Compared with assistant nurses, odds ratio for operators with no training was 0.23 (95% CI 0.13 to 0.40). Similar associations were noted for those with any LTC. Dispatcher's education was not associated with the patient's survival. In this group of patients, which experience substantial mortality and morbidity, the risk of not obtaining highest dispatch priority was increased up to 7-fold during lunchtime. Dispatch operators without medical education had the lowest risk, compared with nurses and assistant nurses, of missing to give priority 1, at the expense of lower positive predictive value. What is already known about this subject? Use of the emergency medical service (EMS) increases survival among patients with acute coronary syndromes. It is unknown whether the efficiency - as judged by the ability to identify life-threatening cases among patients with chest pain - varies according to the dispatcher's educational level and the time of day. What does this study add? We provide evidence that the dispatcher's education does not influence survival among patients calling the EMS due

  14. Life After the Event: A Review of Basic Life Support Training for Parents Following Apparent Life-Threatening Events and Their Experience and Practices Following Discharge.

    PubMed

    Macken, W L; Clarke, N; Nadeem, M; Coghlan, D

    2017-05-10

    Apparent Life-Threatening Events (ALTEs) are a common presentation to paediatric hospitals and represent a significant cause of parental anxiety. Basic Life Support (BLS) training is recommended for all caregivers following ALTEs. This study aimed to assess the rate of caregiver BLS training and reviewed parents experience following discharge. Parents were interviewed by phone following discharge. Over the study period 25 children attended the Emergency Department with ALTE, 17/25 (68%) were trained and 13/17 (76%) were contactable for interview. All parents found training decreased their anxiety level and were interested in attending for re-training. BLS resuscitation was subsequently required by 2/13 (15%) of children. Non-medical grade monitors were in use by 10/13 (77%) of caregivers following discharge. Caregivers are eager to engage in BLS training and it effectively reduces their caregiver anxiety. We recommend an increase in instructor staff and use of group re-training post discharge.

  15. Near-death experiences in non-life-threatening events and coma of different etiologies

    PubMed Central

    Charland-Verville, Vanessa; Jourdan, Jean-Pierre; Thonnard, Marie; Ledoux, Didier; Donneau, Anne-Francoise; Quertemont, Etienne; Laureys, Steven

    2014-01-01

    Background: Near death experiences (NDEs) are increasingly being reported as a clearly identifiable physiological and psychological reality of clinical significance. However, the definition and causes of the phenomenon as well as the identification of NDE experiencers is still a matter of debate. To date, the most widely used standardized tool to identify and characterize NDEs in research is the Greyson NDE scale. Using this scale, retrospective and prospective studies have been trying to estimate their incidence in various populations but few studies have attempted to associate the experiences' intensity and content to etiology. Methods: This retrospective investigation assessed the intensity and the most frequently recounted features of self-reported NDEs after a non-life-threatening event (i.e., “NDE-like” experience) or after a pathological coma (i.e., “real NDE”) and according to the etiology of the acute brain insult. We also compared our retrospectively acquired data in anoxic coma with historical data from the published literature on prospective post-anoxic studies using the Greyson NDE scale. Results: From our 190 reports who met the criteria for NDE (i.e., Greyson NDE scale total score >7/32), intensity (i.e., Greyson NDE scale total score) and content (i.e., Greyson NDE scale features) did not differ between “NDE-like” (n = 50) and “real NDE” (n = 140) groups, nor within the “real NDE” group depending on the cause of coma (anoxic/traumatic/other). The most frequently reported feature was peacefulness (89–93%). Only 2 patients (1%) recounted a negative experience. The overall NDE core features' frequencies were higher in our retrospective anoxic cohort when compared to historical published prospective data. Conclusions: It appears that “real NDEs” after coma of different etiologies are similar to “NDE-like” experiences occurring after non-life threatening events. Subjects reporting NDEs retrospectively tend to have

  16. The investigation of life-threatening child abuse and Munchausen syndrome by proxy.

    PubMed Central

    Evans, D

    1995-01-01

    The use of covert video surveillance in the investigation of suspected life-threatening child abuse and Munchausen syndrome by proxy raises important ethical questions. That the recently reported provision of this facility in North Staffordshire was not presented to a Local Research Ethics Committee (LREC) for approval as a research exercise raises important questions about the ethical review of research and practice. The case made for avoiding such review is first set out and then examined. The three main premisses which form the basis of the view that LREC approval is not required are identified and tested in turn. The conclusion is that there is an undeniable element of research involved in the procedure and that the welfare of all those subjected to the surveillance would be best protected by the submission of the protocol to an independent committee for ethical assessment. PMID:7776355

  17. Endovascular treatment of life-threatening pseudoaneurysm of the hepatic artery after pancreaticoduodenectomy.

    PubMed

    Narumi, Shunji; Hakamda, Kenichi; Toyoki, Yoshikazu; Noda, Hiroshi; Sato, Toshiyuki; Morohashi, Hajime; Mitsui, Toshihito; Yoshihara, Syuichi; Sasaki, Mutsuo

    2007-01-01

    Pseudoaneurysm is a life-threatening complication after pancreaticoduodenectomy. An endovascular covered stent was employed for treatment of pseudoaneurysm of the common hepatic artery after pancreaticoduodenectomy. A 77-year-old female underwent pylorus-preserving pancreaticoduodenectomy for lower bile duct cancer. She complained of hematochezia but upper gastrointestinal endoscopy did not find a bleeding source. Angiography was performed and pseudoaneurysm of the common hepatic artery was discovered. Since no collateral perfusion to the liver was detected, embolization of the common hepatic artery was considered to expose the patient to the danger of severe hepatic dysfunction. Successful exclusion of the pseudoaneurysm was completed with an endovascular covered stent. Inflow of the hepatic artery was secured and no hepatic dysfunction developed. Patency of the stent was confirmed at 5 months follow-up. An endovascular covered stent can be a feasible modality for selected cases of the hepatic arterial pseudoaneurysm.

  18. 75 FR 77496 - Endangered and Threatened Species; Proposed Threatened and Not Warranted Status for Subspecies...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-10

    ... Threatened Wildlife and Plants is found to present substantial scientific and commercial information, we make... plants, and any distinct population segment of any species of vertebrate fish or wildlife which... data available. Species Information A thorough review of the taxonomy, life history, and ecology of the...

  19. Simulated life-threatening emergency during robot-assisted surgery.

    PubMed

    Huser, Anna-Sophia; Müller, Dirk; Brunkhorst, Violeta; Kannisto, Päivi; Musch, Michael; Kröpfl, Darko; Groeben, Harald

    2014-06-01

    With the increasing use of robot-assisted techniques for urologic and gynecologic surgery in patients with severe comorbidities, the risk of a critical incidence during surgery increases. Due to limited access to the patient the start of effective measures to treat a life-threatening emergency could be delayed. Therefore, we tested the management of an acute emergency in an operating room setting with a full-size simulator in six complete teams. A full-size simulator (ISTAN, Meti, CA), modified to hold five trocars, was placed in a regular operating room and connected to a robotic system. Six teams (each with three nurses, one anesthesiologist, two urologists or gynecologists) were introduced to the scenario. Subsequently, myocardial fibrillation occurred. Time to first chest compression, removal of the robot, first defibrillation, and stabilization of circulation were obtained. After 7 weeks the simulation was repeated. The time to the start of chest compressions, removal of the robotic system, and first defibrillation were significantly improved at the second simulation. Time for restoration of stable circulation was improved from 417 ± 125 seconds to 224 ± 37 seconds (P=0.0054). Unexpected delays occurred during the first simulation because trocars had been removed from the patient but not from the robot, thus preventing the robot to be moved. Following proper training, resuscitation can be started within seconds. A repetition of the simulation significantly improved time for all steps of resuscitation. An emergency simulation of a multidisciplinary team in a real operating room setting can be strongly recommended.

  20. Trihexyphenidyl for acute life-threatening episodes due to a dystonic movement disorder in Rett syndrome.

    PubMed

    Gika, Artemis D; Hughes, Elaine; Goyal, Sushma; Sparkes, Matthew; Lin, Jean-Pierre

    2010-02-15

    In Rett syndrome (RS), acute life-threatening episodes (ALTEs) are usually attributed to epilepsy or autonomic dysfunction but they can represent a movement disorder (MD). We describe three girls with RS who experienced ALTEs from an early age. These were long considered epileptic until video-EEG in Patients 1 and 3 revealed their non-epileptic nature. A primary dystonic mechanism was suspected and Patients 1 and 2 were treated with Trihexyphenidyl with significantly reduced frequency of the ALTEs. Patient 3 died before Trihexyphenidyl was tried. Trihexyphenidyl in RS patients with similar presentations can modify the dystonia and prevent ALTEs. (c) 2009 Movement Disorder Society.

  1. Primary gastric Burkitt lymphoma: a rare cause of life-threatening haematemesis.

    PubMed

    Ayoub, Fares; Forde, Justin J; Patel, Niraj; Markham, Merry

    2017-08-22

    Lymphomas are the second most common gastric malignancy following gastric adenocarcinoma. The majority of gastric lymphomas are either mucosa-associated lymphoid tissue lymphomas or diffuse large B-cell lymphomas. Primary gastric Burkitt lymphoma is a subtype of non-Hodgkin's lymphoma and represents an aggressive and rare malignancy with only a small number of cases reported worldwide. Clinical and radiological presentation is non-specific and mimics other gastric lymphomas. Diagnosis is established with pathological evaluation. Due to the paucity of cases, treatment of this condition is not well studied and is extrapolated from paediatric and adult literature of Burkitt lymphoma not isolated to the stomach. We present the case of a male patient with primary gastric Burkitt lymphoma who initially presented with life-threatening haematemesis, later achieving complete remission with treatment. We discuss the epidemiology, presentation and management of gastric Burkitt lymphoma. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Life-threatening gastrointestinal system bleeding in Hodgkin disease: multidetector CT findings and review of the literature.

    PubMed

    Akpinar, Erhan; Türkbey, Bariş; Cil, Barbaros Erhan; Canyiğit, Murat; Dündar, Ziya; Balkanci, Ferhun

    2007-06-01

    Acute lower gastrointestinal system (GIS) bleeding is a life-threatening condition. Immediate determination of the origin of the bleeding is crucial, since hemostatic management must be initiated as rapidly as possible. Colonoscopy, radionuclide studies, and conventional angiography are considered the most important methods for assessing the origin of the bleeding. There are few published reports about the feasibility of computed tomography (CT) in acute GIS bleeding. We present multidetector CT (MDCT) findings in a case of Hodgkin disease status one month post-chemotherapy (CHOP protocol; cyclophosphamide, doxorubicin, vincristine, prednisone) that presented with acute lower GIS bleeding.

  3. Challenges in the management of massive intraorbital and hemifacial arteriovenous malformation as causing life-threatening epistaxis.

    PubMed

    Manuel, Anura Michelle; Kalimuthu, Santhi; Pathmanathan, Sitra Siri; Narayanan, Prepageran; Zainal Abidin, Zurina; Azmi, Khairul; Khalil, Alizan

    2017-04-01

    Arteriovenous malformations are congenital lesions that may evolve with time and manifest in a plethora of presentations. They can occur as torrential epistaxis when it extensively involves the facial region. Multi-imaging modalities are available to assist in characterizing the structure of the lesion as well as its location and extent. This complex disease requires a multidisciplinary team approach with preoperative embolization and surgery. We present a rare cause of life-threatening epistaxis in a gentleman with a longstanding orbital and hemifacial arteriovenous malformation and discuss the complexities involved in its management. Copyright © 2017. Published by Elsevier Taiwan.

  4. In-hospital organization of primary care of patients presenting a life-threatening emergency: A French national survey in 32 university hospitals.

    PubMed

    Quintard, Hervé; Severac, Mathilde; Martin, Claude; Ichai, Carole

    2015-08-01

    The development of specialized units dedicated to life-threatening management has demonstrated to improve the prognosis of patients requiring such treatments. However, apart those focused on trauma and stroke, networks are still lacking in France. Despite, the implementation of standardisation of practices and guidelines, particularly in prehospital care, in-hospital clinical practices at admission remain heterogenous. This survey aimed to assess the structural and human organization of teaching hospitals in France concerning the primary in-hospital care for critically ill patients. A questionnaire of 45 items was sent by e-mail to 32 teaching hospitals between January and March 2013. It included information related to the description of the emergency department, of ICUs, and both structural and human organizations for primary in-hospital care of life-threatening patients. Seventy-five percent of teaching hospitals answered to the survey. Seven hundred to 1400 patients were admitted to emergency units per week and among them 10 to 20 were admitted for critically ill conditions. These latter were addressed in a specialized room of the emergency unit (Service d'admission des urgences vitales [SAUV]) in 40% of hospitals and in specialized room in ICU in 18% of cases. Intensivists were involved in 50% of hospitals, emergency physicians in 26% and it was mixed in 24% of hospitals. This survey is the first to assess the in-hospital organization of primary care for instable and life-threatening patients in France. Our results confirmed the extreme heterogeneity of structural and human organizations for primary in-hospital care of patients presenting at least one organ failure. Thus, a consensus is probably needed to homogenize and improve our practices. Copyright © 2015 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  5. Recombinant activated factor VII (NovoSeven): addition to replacement therapy in acute, uncontrolled and life-threatening bleeding.

    PubMed

    Mayo, A; Misgav, M; Kluger, Y; Geenberg, R; Pauzner, D; Klausner, J; Ben-Tal, O

    2004-07-01

    Recombinant activated factor VII (rFVIIa, NovoSeven) has been used off-label for various conditions. A protocol for its use in acute, uncontrolled life-threatening bleeding, was devised and employed. A haematologist/transfusion specialist was assigned as a member of the team. The clinical data were reviewed and summarized. A scoring system for the assessment and monitoring of coagulopathy was employed. Each parameter of prothrombin time (PT), activated partial thromboplastin time (aPTT), platelet number and fibrinogen level was allocated points according to the degree of abnormality. Three scoring levels emerged. Between April 2001 and April 2003, 13 patients received rFVIIa for acute, uncontrolled life-threatening bleeding. Nine of 13 patients remained alive for 15 days or longer after rFVIIa infusion. All patients who experienced a reduction or cessation of bleeding after rFVIIa infusion, also had a lower coagulopathy score after replacement therapy, prior to rFVIIa infusion, compared with their score at rFVIIa request. There was a reduction in the average use of blood products after rFVIIa infusion. The coagulopathy score was statistically predictive of response to rFVIIa and survival. In an area where very little data exists, we report the usefulness of rFVIIa. We propose that transfusion replacement should aim to correct coagulopathy before infusion of rFVIIa and that a haematologist/transfusion specialist should be involved in the management of these patients. A prognostically significant coagulopathy scoring system is offered.

  6. Infantile Apparent Life-Threatening Events, an Educational Review

    PubMed Central

    Aminiahidashti, Hamed

    2015-01-01

    Many physicians have received a frantic call from anxious parents stating that their child had stopped breathing, become limp, or turned blue but then had recovered quickly. An apparent life-threatening event (ALTE) is defined as “an episode that is frightening to the observer, and is characterized by some combination of apnea, color change, marked change in muscle tone, choking, gagging, or coughing”. The incidence of ALTE is reported to be 0.05% to 6%. The knowledge about the most common causes and factors associated with higher risk of ALTE could be resulted in a more purposeful approach, improving the decision making process, and benefiting both children and parents. The aim of this review article was to report the epidemiology, etiology, evaluation, management, and disposition of ALTE. Infants with an ALTE might present no signs of acute illness and are commonly managed in the emergency settings that often require significant medical attention; hence, the emergency medicine personnel should be aware of the its clinical importance. There is no specific treatment for ALTE; therefore, the clinical evaluations should be focused on the detection of the underlying causes, which will define the outcomes and prognosis. ALTE is a confusing entity, representing a constellation of descriptive symptoms and signs; in other words, it is not a diagnosis. There are multiple possible etiologies and difficulties in evaluating and managing infants with these events, which are challenges to primary care physicians, emergency medicine specialists, and subspecialty pediatricians. The evaluation of these events in infants includes a detailed history, appropriate physical examination, diagnostic tests guided by obtained clues from the history and physical examination, and observation in the emergency department. PMID:26512363

  7. An assessment of meaning in life-threatening illness: development of the Healing Experience in All Life Stressors (HEALS).

    PubMed

    Sloan, Danetta Hendricks; BrintzenhofeSzoc, Karlynn; Kichline, Tiffany; Baker, Karen; Pinzon, Jean-Paul; Tafe, Christina; Li, Lingsheng; Cheng, M Jennifer; Berger, Ann

    2017-01-01

    Patients with life-threatening or chronic illness report an experience of increased positive psychological, social, and/or spiritual change during diagnosis and/or treatment of their illness, even in the face of unfavorable prognosis. This transformation begins through the ability to make their life meaningful by forming meaningful connections that emerge through self-introspection and relationships with a divine entity, nature, and other people. The Healing Experience in All Life Stressors (HEALS) assessment provides a way to identify distress-causing changes that may interfere with the development of meaning and psycho-social-spiritual homeostasis. Preliminary examination of responses to items on the HEALS and examination of the factor structure. The 48-item HEALS questionnaire was developed using a multistep process: literature review for concept development, item generation from qualitative data, and face and content validity by expert panel. In the current study, HEALS was completed by 100 patients diagnosed with life-limiting disease and seen by the palliative care team at a large research institution in the US. Exploratory factor analysis techniques were used to determine scale structure of the instrument. Outcome testing of sample adequacy using Kaiser-Meyer-Olkin statistic was 0.75, which exceeds the recommended value of 0.60. The HEALS show very good internal consistency with a Cronbach's a of 0.94. Overall results of the exploratory factor analysis established a four-factor questionnaire: 1) religion; 2) spirituality, demonstrated by a) interaction with a religious community and b) belief in higher power; 3) intrapersonal; and 4) interpersonal relationships expressed through psychological changes resulting in enhanced outlook and improvement in relationships with family and friends. This study involved the initial step to commence the process of scale validation, with promising outcomes identifying subscales as an effective way to assess the construct of

  8. Recurrent life-threatening reactions to platelet transfusion in an aplastic anaemia patient with a paroxysmal nocturnal haemoglobinuria clone.

    PubMed

    Mohamed, M; Bates, G; Richardson, D; Burrows, L

    2014-09-01

    A 60-year-old woman was diagnosed with non-severe aplastic anaemia when she presented with anaemia and thrombocytopenia. She developed recurrent life-threatening hypotensive reactions during transfusion of leukodepleted platelet concentrates, and washed platelet concentrates prevented the development of such reactions subsequently. A paroxysmal nocturnal haemoglobinuria clone was detected on investigating for aplastic anaemia, which has been speculated to play a role in the recurrent hypotensive reactions. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  9. [Value of brain MR imaging in infants with a severe idiopathic apparent life threatening event].

    PubMed

    Christophe, C; Boutemy, R; Christiaens, F; Fonteyne, C; Ziereisen, F; Dan, B

    2000-01-01

    Prognostic value of a magnetic resonance imaging (MRI) scoring system in infants with a severe apparent life threatening event (ALTE). Ten infants with an ALTE (aged between 6 and 31 weeks) were clinically graded according to the PRISM score and evaluated with EEG, evoked potentials and MRI. The 18 MRIs obtained were distributed in 3 classes according to the delay after which they were obtained; class A (n=5): within the first 48 hours after the event, class B (n=7): between day 3 and 8 and class C (n=6): between day 9 and 50. The 18 MRIs were evaluated retrospectively using a scoring system based on 3 categories of lesions: edema, basal ganglia injury and watershed injuries. Five infants died between day 2 and day 15 after the event. The five surviving infants had follow up neurodevelopmental testing after 38 to 77 months. There was no correlation between the 5 MRIs of class A and the neurological outcome. For the MRIs of class B and C, the scoring system can be of great value when combined with the scores of EEG, EP and PRISM. The scoring system for MRI performed within 48 hours after the event is falsely reassuring. MRI can be helpful as early as 3 days after the event when combined with the score of the electrophysiological investigations and the PRISM.

  10. Effect of threatening life experiences and adverse family relations in ulcerative colitis: analysis using structural equation modeling and comparison with Crohn's disease.

    PubMed

    Slonim-Nevo, Vered; Sarid, Orly; Friger, Michael; Schwartz, Doron; Sergienko, Ruslan; Pereg, Avihu; Vardi, Hillel; Singer, Terri; Chernin, Elena; Greenberg, Dan; Odes, Shmuel

    2017-05-01

    We published that threatening life experiences and adverse family relations impact Crohn's disease (CD) adversely. In this study, we examine the influence of these stressors in ulcerative colitis (UC). Patients completed demography, economic status (ES), the Patient-Simple Clinical Colitis Activity Index (P-SCCAI), the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), the Short-Form Health Survey (SF-36), the Brief Symptom Inventory (BSI), the Family Assessment Device (FAD), and the List of Threatening Life Experiences (LTE). Analysis included multiple linear and quantile regressions and structural equation modeling, comparing CD. UC patients (N=148, age 47.55±16.04 years, 50.6% women) had scores [median (interquartile range)] as follows: SCAAI, 2 (0.3-4.8); FAD, 1.8 (1.3-2.2); LTE, 1.0 (0-2.0); SF-36 Physical Health, 49.4 (36.8-55.1); SF-36 Mental Health, 45 (33.6-54.5); Brief Symptom Inventory-Global Severity Index (GSI), 0.5 (0.2-1.0). SIBDQ was 49.76±14.91. There were significant positive associations for LTE and SCAAI (25, 50, 75% quantiles), FAD and SF-36 Mental Health, FAD and LTE with GSI (50, 75, 90% quantiles), and ES with SF-36 and SIBDQ. The negative associations were as follows: LTE with SF-36 Physical/Mental Health, SIBDQ with FAD and LTE, ES with GSI (all quantiles), and P-SCCAI (75, 90% quantiles). In structural equation modeling analysis, LTE impacted ES negatively and ES impacted GSI negatively; LTE impacted GSI positively and GSI impacted P-SCCAI positively. In a split model, ES had a greater effect on GSI in UC than CD, whereas other path magnitudes were similar. Threatening life experiences, adverse family relations, and poor ES make UC patients less healthy both physically and mentally. The impact of ES is worse in UC than CD.

  11. Protocol for a systematic review of screening tools for fear of recurrent illness in common life-threatening diseases.

    PubMed

    Jones, Jenny; Kane, Paul; Polson, Rob; Leslie, Stephen J; Hulbert-Williams, Nicholas J; Simard, Sébastien; Ozakinci, Gozde; Hubbard, Gill

    2015-03-19

    A myocardial infarction (MI) ('heart attack') can be intensely stressful, and the impact of this event can leave patients with clinically significant post-MI stress symptoms. Untreated stress can make heart disease worse. Few tools are available that screen for specific thoughts or beliefs that can trigger post-MI stress responses. In other life-threatening illnesses, fear of recurrence (FoR) of illness has been identified as a key stressor, and screening tools have been developed to identify this. The aim of this review is to identify FoR screening tools used in other common life-threatening diseases that report on the development of the tool, to assess if there are any that can be adapted for use in MI survivors so that those with high levels of FoR can be identified and helped. The review will evaluate full FoR screening tools and methods of measurement used in common life-threatening disease clinical populations. The Campbell and Cochrane Libraries, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsycINFO, MEDLINE, Embase, Applied Social Sciences Index and Abstracts (ASSIA), Published International Literature on Traumatic Stress (PILOTS), Social Services Abstracts, Sociological Abstracts, Web of Knowledge, Health and Psychosocial Instruments and SCOPUS databases will be searched for relevant studies published from database inception. Reference lists and published reviews/meta-analyses will also be searched. All titles and abstracts will be screened and relevant full-text versions retrieved by two reviewers, who will then extract all the data. Each will independently review all data extracted by the other. Selected studies will also be assessed by two independent researchers using the COnsensus-based standards for the Selection of health status measurement INstruments (COSMIN) checklist and other quality criteria. This will be done to evaluate the degree to which their measurement properties meet the standards for good methodological quality

  12. A successful treatment of life-threatening bleeding from polycystic kidneys with antifibrinolytic agent tranexamic acid.

    PubMed

    Vujkovac, Bojan; Sabovic, Miso

    2006-10-01

    We describe a successful treatment of a severe, persistent bleeding from both kidneys in a patient with autosomal dominant polycystic kidney disease (ADPKD) with tranexamic acid (TXA), a potent antifibrinolytic agent. The bleeding could not be controlled by intensive conservative treatment, it became life-threatening and urgent bilateral nephrectomy was intended. Since local and systemic hyperfibrinolysis play a role in bleeding in ADPKD patients, we tried TXA treatment. In fact, the massive bleeding promptly stopped, and haematuria gradually ceased. Removal of both kidneys was prevented. After 5 days both ureters became obstructed by blood clots, but placing J-catheters in each pyelon successfully solved this complication. Our case shows that it is reasonable to try antifibrinolytic treatment with TXA in such devastating uncontrolled bleeding.

  13. A pre-test and post-test study of the physical and psychological effects of out-of-home respite care on caregivers of children with life-threatening conditions.

    PubMed

    Remedios, Cheryl; Willenberg, Lisa; Zordan, Rachel; Murphy, Andrea; Hessel, Gail; Philip, Jennifer

    2015-03-01

    Respite services are recommended as an important support for caregivers of children with life-threatening conditions. However, the benefits of respite have not been convincingly demonstrated through quantitative research. To determine the impact of out-of home respite care on levels of fatigue, psychological adjustment, quality of life and relationship satisfaction among caregivers of children with life-threatening conditions. A mixed-methods, pre-test and post-test study A consecutive sample of 58 parental caregivers whose children were admitted to a children's hospice for out-of-home respite over an average of 4 days. Caregivers had below-standard levels of quality of life compared to normative populations. Paired t-tests demonstrated that caregivers' average psychological adjustment scores significantly improved from pre-respite (mean = 13.9, standard error = 0.71) to post-respite (mean = 10.7, standard error = 1); p < 0.001, 95% confidence interval: 1.25-5.11). Furthermore, caregivers' average fatigue scores significantly improved from pre-respite (mean = 14.3, standard error = 0.85) to post-respite (mean = 10.9, standard error = 1.01; p < 0.001, 95% confidence interval: 1.69-7.94), and caregivers' average mental health quality of life scores significantly improved from pre-respite (mean = 44.2, standard error = 1.8) to post-respite (mean = 49.1, standard error = 1.6; p < 0.01, 95% confidence interval: -9.56 to 0.36). Qualitative data showed caregivers sought respite for relief from intensive care provision and believed this was essential to their well-being. Findings indicate the effectiveness of out-of-home respite care in improving the fatigue and psychological adjustment of caregivers of children with life-threatening conditions. Study outcomes inform service provision and future research efforts in paediatric palliative care. © The Author(s) 2015.

  14. [Implantable ECG recorder revealed the diagnosis in a baby with apparent life-threatening events].

    PubMed

    Hoorntje, T M; Langerak, W; Blokland-Loggers, H E; Sreeram, N

    1999-09-25

    A 14-month-old boy went through episodes of cyanosis and brief loss of consciousness. Extensive investigations failed to lead to a diagnosis, until an implanted ECG recorder revealed ECG abnormalities suggestive of strangulation. Interviews with the father and mother showed that this was indeed the case. The diagnosis of 'Münchhausen by proxy' was made. Psychiatric assistance and home help were called in. The child recovered well. If there is a suspicion of arrhythmia as the cause of apparent life-threatening events, prolonged ECG recordings are necessary. In a clinical environment it is possible to make continuous ECG recordings during a limited period. An insertable recorder allows continuous ECG recordings during a syncopal event and can be used for prolonged monitoring. The patient presented is the youngest infant in the world in whom such a device has been implanted.

  15. The challenge of implementing the Important Bird Area program in a megadiversity and mega-threatened country

    Treesearch

    Jaqueline M. Goerck; David C. Wege

    2005-01-01

    Brazil is a megadiversity country but also has the highest number of threatened bird species in the neotropics. There are over 100 species of birds threatened with extinction in Brazil. Some of the most threatened birds occur in the highly threatened Atlantic Forest hotspot of Brazil. BirdLife International started an Important Bird Areas (IBA) program in Brazil by...

  16. An assessment of meaning in life-threatening illness: development of the Healing Experience in All Life Stressors (HEALS)

    PubMed Central

    Sloan, Danetta Hendricks; BrintzenhofeSzoc, Karlynn; Kichline, Tiffany; Baker, Karen; Pinzon, Jean-Paul; Tafe, Christina; Li, Lingsheng; Cheng, M Jennifer; Berger, Ann

    2017-01-01

    Context Patients with life-threatening or chronic illness report an experience of increased positive psychological, social, and/or spiritual change during diagnosis and/or treatment of their illness, even in the face of unfavorable prognosis. This transformation begins through the ability to make their life meaningful by forming meaningful connections that emerge through self-introspection and relationships with a divine entity, nature, and other people. The Healing Experience in All Life Stressors (HEALS) assessment provides a way to identify distress-causing changes that may interfere with the development of meaning and psycho–social–spiritual homeostasis. Objective Preliminary examination of responses to items on the HEALS and examination of the factor structure. Method The 48-item HEALS questionnaire was developed using a multistep process: literature review for concept development, item generation from qualitative data, and face and content validity by expert panel. In the current study, HEALS was completed by 100 patients diagnosed with life-limiting disease and seen by the palliative care team at a large research institution in the US. Exploratory factor analysis techniques were used to determine scale structure of the instrument. Results Outcome testing of sample adequacy using Kaiser–Meyer–Olkin statistic was 0.75, which exceeds the recommended value of 0.60. The HEALS show very good internal consistency with a Cronbach’s a of 0.94. Overall results of the exploratory factor analysis established a four-factor questionnaire: 1) religion; 2) spirituality, demonstrated by a) interaction with a religious community and b) belief in higher power; 3) intrapersonal; and 4) interpersonal relationships expressed through psychological changes resulting in enhanced outlook and improvement in relationships with family and friends. Conclusion This study involved the initial step to commence the process of scale validation, with promising outcomes identifying

  17. Coping with Life-Threat and General Life Conflict: Two Diverse Beasts.

    ERIC Educational Resources Information Center

    Feifel, Herman

    There is a widely held clincial contention that people use similar coping strategies in facing life-threatening situations as they do in dealing with general life quandries. To examine this hypothesis, male cancer patients (N=74), male heart disease patients (N=77), elderly persons (N=73), male patients with nonlife-threatening illnesses or…

  18. Life threatening acute pneumonitis during low dose methotrexate treatment for rheumatoid arthritis: a case report and review of the literature.

    PubMed Central

    Ridley, M G; Wolfe, C S; Mathews, J A

    1988-01-01

    A patient is described with definite rheumatoid arthritis (RA) who developed life threatening acute pneumonitis after receiving a total dose of only 12.5 mg methotrexate (MTX). This complication has been previously described, but this is probably the lowest reported dose before development of pneumonitis in a patient with RA. The possible significance of this case is discussed in the light of recent reports suggesting an increased susceptibility of patients with RA to the pulmonary toxicity of MTX. Images PMID:3052323

  19. Is hockey just a game? Contesting meanings of the ice hockey life projects through a career-threatening injury.

    PubMed

    Ronkainen, Noora J; Ryba, Tatiana V

    2017-05-01

    This study is situated within an existential-narrative theoretical framework to examine the impact of career-threatening injury on professional ice hockey players' well-being and career construction. Professional ice hockey culture is construed as a privileged space characterised by hegemonic masculinity, fierce competition as well as high-risk behaviours often resulting in sports injuries. In this paper, we analyse two players' life stories with a particular focus on injury as a boundary situation involving social and temporal breakdown and re-evaluation of meaning of sporting life projects. Emergent narratives surrounding existential themes of loss of meaning and loneliness in the face of injury were analysed in connection with players' search for authenticity and realignment with self-concept. Each player developed resistant narratives to the dominant ethos of professional sport in order to restore well-being and sense of self. The relational aspects of injury are highlighted in practical recommendations.

  20. Tension pneumothorax, is it a really life-threatening condition?

    PubMed Central

    2013-01-01

    Background Tension pneumothorax is a life-threatening occurrence that is infrequently the consequence of spontaneous pneumothorax. The aim of this study was to identify the risk factors for the development of tension pneumothorax and its effect on clinical outcomes. Methods We reviewed patients who were admitted with spontaneous pneumothorax between August 1, 2003 and December 31, 2011. Electronic medical records and the radiological findings were reviewed with chest x-ray and high-resolution computed tomography scans that were retrieved from the Picture Archiving Communication System. Results Out of the 370 patients included in this study, tension pneumothorax developed in 60 (16.2%). The bullae were larger in patients with tension pneumothorax than in those without (23.8 ± 16.2 mm vs 16.1 ± 19.1 mm; P = 0.007). In addition, the incidence of tension pneumothorax increased with the lung bulla size. Fibrotic adhesion was more prevalent in the tension pneumothorax group than in that without (P = 0.000). The bullae were large in patients with fibrotic adhesion than in those without adhesion (35.0 ± 22.3 mm vs 10.4 ± 11.5 mm; P = 0.000). On multivariate analysis, the size of bullae (odds ratio (OR) = 1.03, P = 0.001) and fibrotic adhesion (OR = 10.76, P = 0.000) were risk factors of tension pneumothorax. Hospital mortality was 3.3% in the tension pneumothorax group and it was not significantly different from those patients without tension pneunothorax (P = 0.252). Conclusions Tension pneumothorax is not uncommon, but clinically fatal tension pneumothorax is extremely rare. The size of the lung bullae and fibrotic adhesion contributes to the development of tension pneumothorax. PMID:24128176

  1. A rare case of acute pancreatitis and life-threatening hemolytic anemia associated with Epstein-Barr virus infection in a young healthy adult.

    PubMed

    Singh, Sukhchain; Khosla, Pam

    2016-01-01

    Epstein-Barr virus (EBV) is a common infection that affects 95% of adults worldwide at some point during life. It is usually asymptomatic or causes a self-limiting clinical syndrome known as infectious mononucleosis. It rarely causes complications. Here, we present a case of a healthy 21-year-old female college student who suffered from severe pancreatitis and life-threatening autoimmune hemolytic anemia in association with EBV infection, and we also discuss the common presentation of EBV infection and the diagnosis and treatment of simple and complicated EBV infection. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  2. Oropharyngeal Dysphagia Is Strongly Correlated With Apparent Life-Threatening Events.

    PubMed

    Duncan, Daniel R; Amirault, Janine; Mitchell, Paul D; Larson, Kara; Rosen, Rachel L

    2017-08-01

    The aim of the present study was to investigate the prevalence of oropharyngeal dysfunction with resultant aspiration in patients admitted after apparent life-threatening events (ALTE) and to determine whether historical characteristics could predict this oropharyngeal dysphagia and aspiration risk. We retrospectively reviewed the records of all patients admitted to Boston Children's Hospital between 2012 and 2015 with a diagnosis of ALTE to determine the frequency of evaluation for oropharyngeal dysphagia using video fluoroscopic swallow studies (VFSS) and clinical feeding evaluations, to determine the prevalence of swallowing dysfunction in subjects admitted after ALTE and to compare presenting historical characteristics to swallow study results. A total of 188 children were admitted with a diagnosis of ALTE of which 29% (n = 55) had an assessment of swallowing by VFSS. Of those who had a VFSS, 73% (n = 40) had evidence of aspiration or penetration on VFSS. Of all of the diagnostic tests ordered on patients with ALTEs, the VFSS had the highest rate of abnormalities of any test ordered. None of the historical characteristics of ALTE predicted which patients were at risk for aspiration. In patients who had both clinical feeding evaluations and VFSS, observed clinical feedings incorrectly identified 26% of patients as having no oropharyngeal dysphagia when in fact aspiration was present on VFSS. Oropharyngeal dysphagia with aspiration is the most common diagnosis identified in infants presenting with ALTEs. The algorithm for ALTE should be revised to include an assessment of VFSS as clinical feeding evaluations are inadequate to assess for aspiration.

  3. Crouzon’s Syndrome with Life-Threatening Ear Bleed: Ruptured Jugular Vein Diverticulum Treated by Endovascular Embolization

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

    Mondel, Prabath Kumar, E-mail: prabathmondel@gmail.com; Anand, Sunanda, E-mail: sunandaanand@gmail.com; Limaye, Uday S., E-mail: uslkem@gmail.com

    Crouzon’s syndrome is the commonest variety of syndromic craniosynostosis. Life-threatening ear bleed due to ruptured jugular venous diverticulum in Crouzon’s syndrome has not been described previously. In patients with syndromic craniosynostosis, definitive repair of jugular diverticulum by open surgery is fraught with high risk of bleeding, poor functional outcomes, and even death. A 24-year-old woman with Crouzon’s syndrome presented with conductive hearing loss and recurrent episodes of torrential bleeding from her left ear. On computed tomography, a defect in the roof of jugular fossa containing jugular venous diverticulum immediately inferior to the bony external auditory canal was seen. The clinicalmore » presentation, imaging features, and endovascular management of Crouzon’s syndrome due to a ruptured jugular venous diverticulum is described.« less

  4. The use of recombinant factor VIIa in a patient with Noonan syndrome and life-threatening bleeding.

    PubMed

    Tofil, Nancy M; Winkler, Margaret K; Watts, Raymond G; Noonan, Jacqueline

    2005-05-01

    To present a case report of a patient with Noonan syndrome who developed life-threatening gastrointestinal bleeding shortly after cardiac surgery that was successfully treated with recombinant factor VIIa. Case report. Pediatric intensive care unit of a children's hospital. Ten-month-old with Noonan syndrome and massive gastrointestinal bleeding resulting in severe hypovolemic shock. Recombinant factor VIIa was used in this patient's severe bleeding associated with Noonan syndrome after no other supportive measures were successful. Recombinant Factor VIIa significantly decreased the patient's bleeding and allowed his hypovolemic shock to improve. Ultimately, the patient made a complete recovery. Noonan syndrome has a constellation of both cardiac and noncardiac malformations including an increased risk of bleeding, and recombinant factor VIIa is an important agent in the treatment of significant bleeding.

  5. [Life-threatening sleepwalking (Elpenor's syndrome) in a 10-year-old child].

    PubMed

    Madigand-Tordjman, M-A; Egler, P-J; Bertran, F; Jokic, M; Guénolé, F

    2017-06-01

    Though benign in the majority of cases, sleepwalking sometimes causes injuries due, among other causes, to falls. Such accidents can be life-threatening - a situation that has been termed Elpenor syndrome (in reference to an accident experienced by a character in Homer's epic The Odyssey) - in particular when entailing defenestration. This syndrome has been described in adults and adolescents; we report here a case in a child. This 10-year-old girl was admitted at night to our hospital after a 3-m fall at home. She was alert (Glasgow score, 15) at admission; a frontal wound and a deformation of the right wrist were noted. Brain CT scans showed a frontal skull fracture and frontal lobe contusion, wrist x-rays showed a displaced right fracture. The patient underwent urgent neurosurgery (wound excision and suture after reduction of skull fracture) and closed reduction and immobilization of the wrist fracture, both under general anesthesia. She underwent a psychiatric assessment in the intensive care unit 3 days after her fall. She was alert, well-oriented in time and space, and spoke fluently. She had no memory of her fall, only remembering going to bed in the evening before the accident and waking up in the ambulance on the way to the hospital. She displayed no sign of a concurrent mental illness and no suicidal ideas. Her parents reported that the evening of the accident she and her two brothers had all fallen asleep about 11:00 pm while watching TV, in the double bed of the guest room, placed just beside its window. At approximately 1:00 am, her father, who was going to bed and had just made noise in the hall, heard a cry from the guest room. He entered the room immediately and saw the opened window and his daughter lying on the outside ground; the brothers only awakened after the fall. The family had returned 2 days before from a 6-month stay in the United States, with jet-lag, sleep deprivation, and a disorganized sleep/wake rhythm in the patient. There was

  6. Life-threatening postpartum hemolysis, elevated liver functions tests, low platelets syndrome versus thrombocytopenic purpura - Therapeutic plasma exchange is the answer.

    PubMed

    Nasa, Prashant; Dua, J M; Kansal, Sudha; Chadha, Geeta; Chawla, Rajesh; Manchanda, Manav

    2011-04-01

    The differential diagnosis of life-threatening microangiopathic disorders in a postpartum female includes severe preeclampsia-eclampsia, hemolysis, elevated liver functions tests, low platelets syndrome and thrombotic thrombocytopenic purpura. There is considerable overlapping in the clinical and laboratory findings between these conditions, and hence an exact diagnosis may not be always possible. However, there is considerable maternal mortality and morbidity associated with these disorders. This case underlines the complexity of pregnancy-related microangiopathies regarding their differential diagnosis, multiple organ dysfunction and role of therapeutic plasma exchange in their management.

  7. Life-history correlates of extinction risk and recovery potential.

    PubMed

    Hutchings, Jeffrey A; Myers, Ransom A; García, Verónica B; Lucifora, Luis O; Kuparinen, Anna

    2012-06-01

    Extinction risk is inversely associated with maximum per capita population growth rate (r(max)). However, this parameter is not known for most threatened species, underscoring the value in identifying correlates of r(max) that, in the absence of demographic data, would indirectly allow one to identify species and populations at elevated risk of extinction and their associated recovery potential. We undertook a comparative life-history analysis of 199 species from three taxonomic classes: Chondrichthyes (e.g., sharks; n = 82), Actinopterygii (teleost or bony fishes; n = 47), and Mammalia (n = 70, including 16 marine species). Median r(max) was highest for (and similar between) terrestrial mammals (0.71) and teleosts (0.43), significantly lower among chondrichthyans (0.26), and lower still in marine mammals (0.07). Age at maturity was the primary (and negative) correlate of r(max). In contrast, although body size was negatively correlated with r(max) in chondrichthyans and mammals, evidence of an association in teleosts was equivocal, and fecundity was not related to r(max) in fishes, despite recurring assertions to the contrary. Our analyses suggest that age at maturity can serve as a universal predictor of extinction risk in fishes and mammals when r(max) itself is unknown. Moreover, in contrast to what is generally expected, the recovery potential of teleost fishes does not differ from that of terrestrial mammals. Our findings are supportive of the application of extinction-risk criteria that are based on generation time and that are independent of taxonomic affinity.

  8. Bio-psychosocial determinants of time lost from work following non life threatening acute orthopaedic trauma

    PubMed Central

    2010-01-01

    Background To determine factors predicting the duration of time away from work following acute orthopaedic non life threatening trauma Methods Prospective cohort study conducted at four hospitals in Victoria, Australia. The cohort comprised 168 patients aged 18-64 years who were working prior to the injury and sustained a range of acute unintentional orthopaedic injuries resulting in hospitalization. Baseline data was obtained by survey and medical record review. Multivariate Cox proportional hazards regression analysis was used to examine the association between potential predictors and the duration of time away from work during the six month study. The study achieved 89% follow-up. Results Of the 168 participants recruited to the study, 68% returned to work during the six month study. Multivariate Cox proportional hazards regression analysis identified that blue collar work, negative pain attitudes with respect to work, high initial pain intensity, injury severity, older age, initial need for surgery, the presence of co-morbid health conditions at study entry and an orthopaedic injury to more than one region were associated with extended duration away from work following the injury. Participants in receipt of compensation who reported high social functioning at two weeks were 2.58 times more likely to have returned to work than similar participants reporting low social functioning. When only those who had returned to work were considered, the participant reported reason for return to work " to fill the day" was a significant predictor of earlier RTW [RR 2.41 (95% C.I 1.35-4.30)] whereas "financial security" and "because they felt able to" did not achieve significance. Conclusions Many injury-related and psycho social factors affect the duration of time away from work following orthopaedic injury. Some of these are potentially modifiable and may be amenable to intervention. Further consideration of the reasons provided by participants for returning to work may

  9. Bio-psychosocial determinants of time lost from work following non life threatening acute orthopaedic trauma.

    PubMed

    Clay, Fiona J; Newstead, Stuart V; Watson, Wendy L; Ozanne-Smith, Joan; McClure, Roderick J

    2010-01-05

    To determine factors predicting the duration of time away from work following acute orthopaedic non life threatening trauma Prospective cohort study conducted at four hospitals in Victoria, Australia. The cohort comprised 168 patients aged 18-64 years who were working prior to the injury and sustained a range of acute unintentional orthopaedic injuries resulting in hospitalization. Baseline data was obtained by survey and medical record review. Multivariate Cox proportional hazards regression analysis was used to examine the association between potential predictors and the duration of time away from work during the six month study. The study achieved 89% follow-up. Of the 168 participants recruited to the study, 68% returned to work during the six month study. Multivariate Cox proportional hazards regression analysis identified that blue collar work, negative pain attitudes with respect to work, high initial pain intensity, injury severity, older age, initial need for surgery, the presence of co-morbid health conditions at study entry and an orthopaedic injury to more than one region were associated with extended duration away from work following the injury. Participants in receipt of compensation who reported high social functioning at two weeks were 2.58 times more likely to have returned to work than similar participants reporting low social functioning. When only those who had returned to work were considered, the participant reported reason for return to work " to fill the day" was a significant predictor of earlier RTW [RR 2.41 (95% C.I 1.35-4.30)] whereas "financial security" and "because they felt able to" did not achieve significance. Many injury-related and psycho social factors affect the duration of time away from work following orthopaedic injury. Some of these are potentially modifiable and may be amenable to intervention. Further consideration of the reasons provided by participants for returning to work may provide important opportunities for social

  10. Life-threatening emphysematous liver abscess associated with poorly controlled diabetes mellitus: a case report.

    PubMed

    Takano, Yuichi; Hayashi, Masafumi; Niiya, Fumitaka; Nakanishi, Toru; Hanamura, Shotaro; Asonuma, Kunio; Yamamura, Eiichi; Gomi, Kuniyo; Kuroki, Yuichiro; Maruoka, Naotaka; Inoue, Kazuaki; Nagahama, Masatsugu

    2017-03-06

    Emphysematous liver abscesses are defined as liver abscesses accompanied by gas formation. The fatality rate is extremely high at 27%, necessitating prompt intensive care. The patient was a 69-year-old Japanese man with type 2 diabetes. He visited the emergency outpatient department for fever and general malaise that had been ongoing for 2 weeks. Abdominal computed tomography revealed an abscess 5 cm in diameter accompanied by gas formation in the right hepatic lobe. Markedly impaired glucose tolerance was observed with a blood sugar level of 571 mg/dL and a glycated hemoglobin level of 14.6%. The patient underwent emergency percutaneous abscess drainage, and intensive care was subsequently initiated. Klebsiella pneumoniae was detected in both the abscess cavity and blood cultures. The drain was removed 3 weeks later, and the patient was discharged. Emphysematous liver abscesses are often observed in patients with poorly controlled diabetes, and the fatality rate is extremely high. Fever and malaise occasionally mask life-threatening infections in diabetic patients, necessitating careful examination.

  11. Gas gangrene of the breast: management of a potential life-threatening infection.

    PubMed

    Delotte, Jérôme; Karimdjee, Babou Soilihi; Cua, Eric; Pop, Daniel; Bernard, Jean-Louis; Bongain, André; Benchimol, Daniel

    2009-01-01

    Gas gangrene of the breast is a rare infection and potentially mortal. We report a case of a fast extension of a painful right breast erythema whose starting point was a right parasternal cutaneous abscess. A diagnosis of gas gangrene of the right breast was made. A right mammectomy was carried out in Emergency and an antibiotherapy adapted to the germs was given. Mixed anaerobic and aerobic florae are often responsible for the infection. Its medico-surgical management is an emergency.

  12. Potential Habitats for Exotic Life Within the Life Supporting Zone

    NASA Astrophysics Data System (ADS)

    Leitner, Johannes J.; Firneis, Maria G.; Hitzenberger, Regina

    2010-05-01

    Questions like "Are we alone in the universe?", "How unique is Earth as a planet?" or "How unique is water-based life in the universe?" still are nowhere near of being answered. In recent years, discussions on these topics are more and more influenced by questions whether water is really the only possible solvent, or which conditions are necessary for life to evolve in planetary habitats. A change in our present geocentric mindset on the existence of life is required, in order to address these new questions [see also 1]. In May 2009 a new research platform at the University of Vienna was initiated in order to contribute to the solution of these questions. One task is to find essential biomarkers relevant to the problem of the detection of exotic life. In this context exotic life means: life, which is not necessarily based on a double bond between carbon and oxygen (C=O) and not on water as the only possible solvent. At present little is known about metabolistic systems, which are not based on C=O or on metabolisms which are operative in alternative solvents and a high effort of future laboratory work is necessary to open this window for looking for exotic life. To address the whole spectrum of life the concept of a general life supporting zone is introduced in order to extend the classical habitable zone (which is based on liquid water on a planetary surface, [2]). The life supporting zone of a planetary system is composed of different single "habitable zones" for the liquid phases of specific solvents and composites between water and other solvents. Besides exoplanetary systems which seem to be the most promising place for exotic life in our present understanding, some potential places could also exist within our Solar System and habitats like the subsurface of Enceladus, liquid ethane/methane lakes on Titan or habitable niches in the Venus atmosphere will also be taken into account. A preliminary list of appropriate solvents and their abundances in the Solar

  13. Life-threatening postpartum hemolysis, elevated liver functions tests, low platelets syndrome versus thrombocytopenic purpura – Therapeutic plasma exchange is the answer

    PubMed Central

    Nasa, Prashant; Dua, J. M.; Kansal, Sudha; Chadha, Geeta; Chawla, Rajesh; Manchanda, Manav

    2011-01-01

    The differential diagnosis of life-threatening microangiopathic disorders in a postpartum female includes severe preeclampsia–eclampsia, hemolysis, elevated liver functions tests, low platelets syndrome and thrombotic thrombocytopenic purpura. There is considerable overlapping in the clinical and laboratory findings between these conditions, and hence an exact diagnosis may not be always possible. However, there is considerable maternal mortality and morbidity associated with these disorders. This case underlines the complexity of pregnancy-related microangiopathies regarding their differential diagnosis, multiple organ dysfunction and role of therapeutic plasma exchange in their management. PMID:21814380

  14. Bandit strategies evaluated in the context of clinical trials in rare life-threatening diseases.

    PubMed

    Villar, Sofía S

    2018-04-01

    In a rare life-threatening disease setting the number of patients in the trial is a high proportion of all patients with the condition (if not all of them). Further, this number is usually not enough to guarantee the required statistical power to detect a treatment effect of a meaningful size. In such a context, the idea of prioritizing patient benefit over hypothesis testing as the goal of the trial can lead to a trial design that produces useful information to guide treatment, even if it does not do so with the standard levels of statistical confidence. The idealised model to consider such an optimal design of a clinical trial is known as a classic multi-armed bandit problem with a finite patient horizon and a patient benefit objective function. Such a design maximises patient benefit by balancing the learning and earning goals as data accumulates and given the patient horizon. On the other hand, optimally solving such a model has a very high computational cost (many times prohibitive) and more importantly, a cumbersome implementation, even for populations as small as a hundred patients. Several computationally feasible heuristic rules to address this problem have been proposed over the last 40 years in the literature. In this article we study a novel heuristic approach to solve it based on the reformulation of the problem as a Restless bandit problem and the derivation of its corresponding Whittle index rule. Such rule was recently proposed in the context of a clinical trial in Villar et al (2015). We perform extensive computational studies to compare through both exact value calculations and simulated values the performance of this rule, other index rules and simpler heuristics previously proposed in the literature. Our results suggest that for the two and three-armed case and a patient horizon less or equal than a hundred patients, all index rules are a priori practically identical in terms of the expected proportion of success attained when all arms start

  15. Design changes in continuous-flow left ventricular assist devices and life-threatening pump malfunctions.

    PubMed

    Soltani, Sajjad; Kaufmann, Friedrich; Vierecke, Juliane; Kretzschmar, Alexandra; Hennig, Ewald; Stein, Julia; Hetzer, Roland; Krabatsch, Thomas; Potapov, Evgenij V

    2015-06-01

    The implantable continuous-flow left ventricular assist devices (LVADs) HeartMate II (HM II) and HeartWare HVAD (HW) underwent design modifications. The impact of these changes on life-threatening pump malfunctions was evaluated. We retrospectively analysed pump malfunctions due to thrombosis or cable damage in patients supported with primarily implanted HM II (n = 191) and HW (n = 347), separated into patients supported with the old and new pump designs. In 2010, the cable strain relief of the HM II device was improved (132 patients with old and 79 with new) and sealed grafts were introduced (68 patients with sealed inflow connector and outflow graft and 125 without). In 2011, titanium sintering of the inflow cannula of HW pumps was introduced (137 patients with a non-sintered and 210 with a sintered inflow cannula). The median support time was 1.12 (0-6.1) years for all HM II and 0.59 (0-4.2) years for all HW patients. The cumulative rate of events per patient-year (EPPY) was 0.11 in HM II patients, compared with 0.09 EPPY in HW patients (P = 0.32). After introduction of the new cable design, incidence of cable damage in HM II patients dropped from 0.06 to 0 EPPY (P = 0.03), whereas pump thrombosis increased from 0.02 to 0.14 EPPY (P < 0.001) after the sealed graft was introduced. Pump thrombosis occurred in 4% of patients supported with HW with a sintered inflow cannula vs 15% with a non-sintered pump; the incidence changed from 0.10 to 0.07 EPPY in sintered pumps (P = 0.45). Kaplan-Meier analysis showed no differences over a period of 2.5 years for events when the HM II cohort with sealed graft and new cable design (n = 68) was compared with the HW group with a sintered cannula (P = 0.14). The modified cable strain relief of the HM II pump and the sintering of the inflow cannula of the HW pump demonstrated a significant reduction in the incidence of life-threatening pump-related complications, whereas the sealed inflow connector and outflow graft seem to be

  16. Endogenous Nocardial Endophthalmitis in an Immunosuppressed Patient: A Serious Warning of an Underlying Life Threatening and Blinding Disorder.

    PubMed

    Trehan, Hemant; Kaushik, Jaya; Jain, Vaibhav Kumar; Parihar, Jitendra Kumar Singh; Avasthi, Abhijit

    2017-01-01

    To report a case of bilateral endogenous nocardial endophthalmitis with central nervous system involvement in an immunocompromised individual with an extremely poor outcome. A 35-year-old man with a history of long-term, prescribed oral steroid use for membranoproliferative glomerulonephritis presented with profound bilateral vision loss. Patient's diagnosis of bilateral endogenous nocardial endophthalmitis was delayed. Nocardia was finally isolated from a brain biopsy after a repeat magnetic resonance imaging revealed a brain abscess. With anti-nocardia therapy, patient improved systemically, but the visual outcome was poor, with no light perception in both eyes. Ocular nocardiosis is a serious vision and life threatening disorder, particularly in patients on immunosuppressive therapy. A high index of suspicion is required for successful treatment.

  17. Broncho-esophageal fistula leading to lung abscess: A life-threatening emergency detected on FDG PET/CT in a case of carcinoma of middle third esophagus.

    PubMed

    Puranik, Ameya D; Purandare, Nilendu C; Agrawal, Archi; Shah, Sneha; Rangarajan, Venkatesh

    2013-07-01

    Sinister undesirable pathologies often accompany malignancies. Though the entire emphasis is on cancer management, these benign conditions are more life-threatening than the primary malignancy itself. We report an interesting imaging finding of broncho-esophageal fistula leading to lung abscess on (18)F- fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) in large middle esophageal cancer, which due to early detection, was promptly managed.

  18. Deriving protection thresholds for threatened and endangered species potentially exposed to pesticides

    EPA Science Inventory

    The Endangered Species Act requires specific and stringent protection to threatened and endangered species and their critical habitat. Therefore, protective methods for risk assessment for such species are needed. Species sensitivity distributions (SSDs) are a common tool used fo...

  19. Ceftriaxone-induced immune hemolytic anemia as a life-threatening complication of antibiotic treatment of 'chronic Lyme disease'.

    PubMed

    De Wilde, Maarten; Speeckaert, Marijn; Callens, Rutger; Van Biesen, Wim

    2017-04-01

    'Chronic Lyme disease' is a controversial condition. As any hard evidence is lacking that unresolved systemic symptoms, following an appropriately diagnosed and treated Lyme disease, are related to a chronic infection with the tick-borne spirochaetes of the Borrelia genus, the term 'chronic Lyme disease' should be avoided and replaced by the term 'post-treatment Lyme disease syndrome.' The improper prescription of prolonged antibiotic treatments for these patients can have an impact on the community antimicrobial resistance and on the consumption of health care resources. Moreover, these treatments can be accompanied by severe complications. In this case report, we describe a life-threatening ceftriaxone-induced immune hemolytic anemia with an acute kidney injury (RIFLE-stadium F) due to a pigment-induced nephropathy in a 76-year-old woman, who was diagnosed with a so-called 'chronic Lyme disease.'

  20. Parental Explicit Heuristics in Decision-making for Children With Life-threatening Illnesses

    PubMed Central

    Renjilian, Chris B.; Womer, James W.; Carroll, Karen W.; Kang, Tammy I.

    2013-01-01

    OBJECTIVE: To identify and illustrate common explicit heuristics (decision-making aids or shortcuts expressed verbally as terse rules of thumb, aphorisms, maxims, or mantras and intended to convey a compelling truth or guiding principle) used by parents of children with life-threatening illnesses when confronting and making medical decisions. METHODS: Prospective cross-sectional observational study of 69 parents of 46 children who participated in the Decision-making in Pediatric Palliative Care Study between 2006 and 2008 at the Children’s Hospital of Philadelphia. Parents were guided individually through a semistructured in-depth interview about their experiences and thoughts regarding making medical decisions on behalf of their ill children, and the transcribed interviews were qualitatively analyzed. RESULTS: All parents in our study employed explicit heuristics in interviews about decision-making for their children, with the number of identified explicit heuristics used by an individual parent ranging from tens to hundreds. The heuristics served 5 general functions: (1) to depict or facilitate understanding of a complex situation; (2) to clarify, organize, and focus pertinent information and values; (3) to serve as a decision-making compass; (4) to communicate with others about a complex topic; and (5) to justify a choice. CONCLUSIONS: Explicit heuristics played an important role in decision-making and communication about decision-making in our population of parents. Recognizing explicit heuristics in parent interactions and understanding their content and functions can aid clinicians in their efforts to partner with parents in the decision-making process. PMID:23319524

  1. Parental explicit heuristics in decision-making for children with life-threatening illnesses.

    PubMed

    Renjilian, Chris B; Womer, James W; Carroll, Karen W; Kang, Tammy I; Feudtner, Chris

    2013-02-01

    To identify and illustrate common explicit heuristics (decision-making aids or shortcuts expressed verbally as terse rules of thumb, aphorisms, maxims, or mantras and intended to convey a compelling truth or guiding principle) used by parents of children with life-threatening illnesses when confronting and making medical decisions. Prospective cross-sectional observational study of 69 parents of 46 children who participated in the Decision-making in Pediatric Palliative Care Study between 2006 and 2008 at the Children's Hospital of Philadelphia. Parents were guided individually through a semistructured in-depth interview about their experiences and thoughts regarding making medical decisions on behalf of their ill children, and the transcribed interviews were qualitatively analyzed. All parents in our study employed explicit heuristics in interviews about decision-making for their children, with the number of identified explicit heuristics used by an individual parent ranging from tens to hundreds. The heuristics served 5 general functions: (1) to depict or facilitate understanding of a complex situation; (2) to clarify, organize, and focus pertinent information and values; (3) to serve as a decision-making compass; (4) to communicate with others about a complex topic; and (5) to justify a choice. Explicit heuristics played an important role in decision-making and communication about decision-making in our population of parents. Recognizing explicit heuristics in parent interactions and understanding their content and functions can aid clinicians in their efforts to partner with parents in the decision-making process.

  2. Conveying hope in consultations with patients with life-threatening diseases: the balance between supporting and challenging the patient.

    PubMed

    Werner, Anne; Steihaug, Sissel

    2017-06-01

    There is limited knowledge about the communication of hope and denial in consultations with patients with life-threatening diseases on a practical level. In this study, we explored a real-life medical consultation between a doctor and a patient with incurable cancer, focusing on conveying hope. We found one consultation especially suited for illustrating how a physician can convey and reinforce hope without attaching it to curative treatment. The consultation was analysed using a method for discourse analysis, where we took as a point of departure that discourse means language in use. The doctor communicated in a recognising manner, expressing respect for the patient as a subject and an authority of his own experiences. The doctor and patient succeeded in creating a good working alliance characterised by warmth and trust. Within this context, there was room for the doctor to challenge the patient's views and communicate disagreement. The doctor succeeds in conveying and maintaining hope. Within a good working alliance with the patient the doctor can convey hope by balancing between supporting and challenging him. Exploring and grasping the patient's real concerns is essential for being able to relieve and comfort him and convey hope.

  3. Minimal invasive treatment of life-threatening bleeding caused by cardiopulmonary resuscitation-associated liver injury: a case report.

    PubMed

    Næss, Pål Aksel; Engeseth, Kristian; Grøtta, Ole; Andersen, Geir Øystein; Gaarder, Christine

    2016-05-29

    Life-threatening bleeding caused by liver injury due to chest compressions is a rare complication in otherwise successful cardiopulmonary resuscitation. Surgical intervention has been suggested to achieve bleeding control; however, reported mortality is high. In this report, we present a brief literature review and a case report in which use of a less invasive strategy was followed by an uneventful recovery. A 37-year-old white woman was admitted after out-of-hospital cardiac arrest. Bystander cardiopulmonary resuscitation was immediately performed, followed by advanced cardiopulmonary resuscitation that included tracheal intubation, mechanical chest compressions, and external defibrillation with return of spontaneous circulation. Upon hospital admission, the patient's blood pressure was 94/45 mmHg and her heart rate was 110 beats per minute. Her electrocardiogram showed no signs of ST-segment elevations or Q-wave development. Coronary angiography revealed a proximal thrombotic occlusion of the left anterior descending coronary artery. Successful recanalization, after thrombus aspiration and balloon dilation followed by stent implant, was verified with normalized anterograde flow. Immediately after the patient's arrival in the intensive cardiac care unit, a drop in her blood pressure to 60/30 mmHg and a hemoglobin concentration of 4.5 g/dl were noticed. Transfusion was started, and bedside abdominal ultrasound examination revealed free intraperitoneal fluid. Computed tomography of the abdomen revealed liver injury with active extravasation from the cranial surface of the right lobe and a massive hemoperitoneum. The patient was coagulopathic and acidotic with a body temperature of 33.5 °C. A minimally invasive treatment strategy, including angiography and selective trans-catheter arterial embolization, were performed in combination with percutaneous evacuation of 4.5 L of intraperitoneal blood. After completion of these procedures, the patient was

  4. Life- threatening hemothorax due to the inferior pulmonary ligament injury without obvious organ injuries: a case report.

    PubMed

    Kim, Jae Jun; Kim, Yong Hwan; Choi, Si Young; Jeong, Seong Cheol; Moon, Seok Whan

    2015-03-21

    Traumatic hemothorax is usually associated with obvious organ injuries, such as rib fractures, pulmonary injuries, and other mediastinal injuries. We present a rare case in which a 42-year- old Korean man who fell off of a roof, approximately 3 meters in height, resulting in a life-threatening hemothorax without obvious injuries to the thoracic organs. Chest CT showed a large amount of hemothorax in the right side of the thoracic cavity, and an active bleeding, presumably from the posterior intercostal or the phrenic artery, with a focal aneurysmal change. The emergency thoracotomy was performed to bring the active bleeding under control. The operative findings showed there were only the inferior pulmonary ligament tears, and the active bleeding from it. The postoperative course was uneventful and the patient was discharged without any complications. We should consider the inferior pulmonary ligamental injury as one of causes for traumatic hemothorax.

  5. Reactions to threatening health messages.

    PubMed

    Ten Hoor, Gill A; Peters, Gjalt-Jorn Y; Kalagi, Janice; de Groot, Lianne; Grootjans, Karlijne; Huschens, Alexander; Köhninger, Constanze; Kölgen, Lizan; Pelssers, Isabelle; Schütt, Toby; Thomas, Sophia; Ruiter, Robert A C; Kok, Gerjo

    2012-11-21

    Threatening health messages that focus on severity are popular, but frequently have no effect or even a counterproductive effect on behavior change. This paradox (i.e. wide application despite low effectiveness) may be partly explained by the intuitive appeal of threatening communication: it may be hard to predict the defensive reactions occurring in response to fear appeals. We examine this hypothesis by using two studies by Brown and colleagues, which provide evidence that threatening health messages in the form of distressing imagery in anti-smoking and anti-alcohol campaigns cause defensive reactions. We simulated both Brown et al. experiments, asking participants to estimate the reactions of the original study subjects to the threatening health information (n = 93). Afterwards, we presented the actual original study outcomes. One week later, we assessed whether this knowledge of the actual study outcomes helped participants to more successfully estimate the effectiveness of the threatening health information (n = 72). Results showed that participants were initially convinced of the effectiveness of threatening health messages and were unable to anticipate the defensive reactions that in fact occurred. Furthermore, these estimates did not improve after participants had been explained the dynamics of threatening communication as well as what the effects of the threatening communication had been in reality. These findings are consistent with the hypothesis that the effectiveness of threatening health messages is intuitively appealing. What is more, providing empirical evidence against the use of threatening health messages has very little effect on this intuitive appeal.

  6. EVALUATION OF RELATIVE SENSITIVITY OF THREATENED AND ENDANGERED SPECIES TO CONTAMINANTS

    EPA Science Inventory

    Water quality criteria have been developed by U.S. EPA for the protection of aquatic life. An implicit goal of water quality criteria (WQC) that has been reinforced by the Endangered Species Act, is that WQC are protective of threatened and endangered species. This assumption has...

  7. Impact, meaning and need for help and support: The experience of parents caring for children with disabilities, life-limiting/life-threatening illness or technology dependence.

    PubMed

    Whiting, Mark

    2013-03-01

    Parenting a child with complex needs or disabilities is a challenging proposition. This study, which drew upon of the experiences of the parents of 34 children (in 33 families), set out to explore the themes of impact, need for help and support and meaning/sense-making as they were related by parents. Data were collected using semi-structured interviews, and an emerging theoretical framework was validated through the use of a series of mind-maps(®) which were presented to individual parents as the basis for a second round (verificational) interview. Parents were nominated into the study by health care professions who were asked to identify the subject children to one of three separate sub-groups: children with a disability; children with a life-limiting/life-threatening illness or children with a technology dependence. Comparisons were made between the three study sub-groups in order to identify areas of consistency and of inconsistency. A fourth study theme - 'battleground' emerged from entirely within the data set. Sense-making occupied a central position within the overall theoretical framework for the study and parental perception of 'battleground' presented as significant element of parental sense-making, particularly in the context of their relationships with professional staff. © The Author(s) 2012.

  8. Reactions to threatening health messages

    PubMed Central

    2012-01-01

    Background Threatening health messages that focus on severity are popular, but frequently have no effect or even a counterproductive effect on behavior change. This paradox (i.e. wide application despite low effectiveness) may be partly explained by the intuitive appeal of threatening communication: it may be hard to predict the defensive reactions occurring in response to fear appeals. We examine this hypothesis by using two studies by Brown and colleagues, which provide evidence that threatening health messages in the form of distressing imagery in anti-smoking and anti-alcohol campaigns cause defensive reactions. Methods We simulated both Brown et al. experiments, asking participants to estimate the reactions of the original study subjects to the threatening health information (n = 93). Afterwards, we presented the actual original study outcomes. One week later, we assessed whether this knowledge of the actual study outcomes helped participants to more successfully estimate the effectiveness of the threatening health information (n = 72). Results Results showed that participants were initially convinced of the effectiveness of threatening health messages and were unable to anticipate the defensive reactions that in fact occurred. Furthermore, these estimates did not improve after participants had been explained the dynamics of threatening communication as well as what the effects of the threatening communication had been in reality. Conclusions These findings are consistent with the hypothesis that the effectiveness of threatening health messages is intuitively appealing. What is more, providing empirical evidence against the use of threatening health messages has very little effect on this intuitive appeal. PMID:23171445

  9. Validation of the "Quality of Life in Life-Threatening Illness--Family Carer Version" (QOLLTI-F) in German-speaking carers of advanced cancer patients.

    PubMed

    Schur, Sophie; Ebert-Vogel, Alexandra; Amering, Michaela; Masel, Eva Katharina; Neubauer, Marie; Schrott, Andrea; Sibitz, Ingrid; Watzke, Herbert; Schrank, Beate

    2014-10-01

    Palliative care is a multidisciplinary approach that focuses on the improvement of quality of life (QOL) of patients as well as their families. QOL research in palliative care has so far primarily focused on patients, but interest in the QOL of their relatives is increasing. For instruments measuring QOL in relatives, data on psychometric properties are often limited, and so far, none has been available in German. This study translates and validates the "Quality of Life in Life-Threatening Illness-Family Carer Version" (QOLLTI-F) in German-speaking carers of advanced cancer patients. The QOLLTI-F was translated from English into German according to the World Health Organisation's recommendations and validated in informal caregivers of terminally ill cancer patients of three Viennese hospitals. Hope was measured to assess concurrent validity; traumatic stress, anxiety, depression and subjective burden were measured to assess discriminant validity. Internal consistency, test-retest reliability and discriminative power were established. The scale's factor structure was explored using a set of factor analyses. Of the 308 caregivers participating in the study, 42 completed the QOLLTI-F retest after a mean of 5 days. The internal consistency was α = 0.85 for the overall scale, Pearson correlation between test and retest lay at r = 0.92. As expected, a significant positive correlation was found with hope (r = 0.40) and significant negative correlations with traumatic stress (r = -0.41), depression (r = -0.51), anxiety (r = -0.52) and overall subjective burden (r = -0.55). The original seven-factor structure was not reproduced, but the scale showed a stable four-factor structure with factors capturing (1) feelings about carers' own life, (2) professional care, (3) interaction with the patient and others and (3) carers' outlook on life. This study provides a sound translation and validation of the first QOL assessment tool for caregivers of

  10. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial

    PubMed Central

    Griffiths, Roland R; Johnson, Matthew W; Carducci, Michael A; Umbricht, Annie; Richards, William A; Richards, Brian D; Cosimano, Mary P; Klinedinst, Margaret A

    2016-01-01

    Cancer patients often develop chronic, clinically significant symptoms of depression and anxiety. Previous studies suggest that psilocybin may decrease depression and anxiety in cancer patients. The effects of psilocybin were studied in 51 cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety. This randomized, double-blind, cross-over trial investigated the effects of a very low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of psilocybin administered in counterbalanced sequence with 5 weeks between sessions and a 6-month follow-up. Instructions to participants and staff minimized expectancy effects. Participants, staff, and community observers rated participant moods, attitudes, and behaviors throughout the study. High-dose psilocybin produced large decreases in clinician- and self-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety. At 6-month follow-up, these changes were sustained, with about 80% of participants continuing to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life/self, mood, relationships, and spirituality to the high-dose experience, with >80% endorsing moderately or greater increased well-being/life satisfaction. Community observer ratings showed corresponding changes. Mystical-type psilocybin experience on session day mediated the effect of psilocybin dose on therapeutic outcomes. Trial Registration ClinicalTrials.gov identifier: NCT00465595 PMID:27909165

  11. Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial.

    PubMed

    Griffiths, Roland R; Johnson, Matthew W; Carducci, Michael A; Umbricht, Annie; Richards, William A; Richards, Brian D; Cosimano, Mary P; Klinedinst, Margaret A

    2016-12-01

    Cancer patients often develop chronic, clinically significant symptoms of depression and anxiety. Previous studies suggest that psilocybin may decrease depression and anxiety in cancer patients. The effects of psilocybin were studied in 51 cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety. This randomized, double-blind, cross-over trial investigated the effects of a very low (placebo-like) dose (1 or 3 mg/70 kg) vs. a high dose (22 or 30 mg/70 kg) of psilocybin administered in counterbalanced sequence with 5 weeks between sessions and a 6-month follow-up. Instructions to participants and staff minimized expectancy effects. Participants, staff, and community observers rated participant moods, attitudes, and behaviors throughout the study. High-dose psilocybin produced large decreases in clinician- and self-rated measures of depressed mood and anxiety, along with increases in quality of life, life meaning, and optimism, and decreases in death anxiety. At 6-month follow-up, these changes were sustained, with about 80% of participants continuing to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life/self, mood, relationships, and spirituality to the high-dose experience, with >80% endorsing moderately or greater increased well-being/life satisfaction. Community observer ratings showed corresponding changes. Mystical-type psilocybin experience on session day mediated the effect of psilocybin dose on therapeutic outcomes. ClinicalTrials.gov identifier: NCT00465595. © The Author(s) 2016.

  12. 75 FR 2106 - Endangered and Threatened Species; Take of Anadromous Fish

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-14

    ... and Threatened Species; Take of Anadromous Fish AGENCY: National Marine Fisheries Service (NMFS... NMFS regulations (50 CFR parts 222-226) governing listed fish and wildlife permits. Species Covered in... steelhead not to exceed 2 percent of the total number of fish captured for each life stage and species...

  13. Conveying hope in consultations with patients with life-threatening diseases: the balance between supporting and challenging the patient

    PubMed Central

    Werner, Anne; Steihaug, Sissel

    2017-01-01

    Objective There is limited knowledge about the communication of hope and denial in consultations with patients with life-threatening diseases on a practical level. In this study, we explored a real-life medical consultation between a doctor and a patient with incurable cancer, focusing on conveying hope. Design and methods We found one consultation especially suited for illustrating how a physician can convey and reinforce hope without attaching it to curative treatment. The consultation was analysed using a method for discourse analysis, where we took as a point of departure that discourse means language in use. Results The doctor communicated in a recognising manner, expressing respect for the patient as a subject and an authority of his own experiences. The doctor and patient succeeded in creating a good working alliance characterised by warmth and trust. Within this context, there was room for the doctor to challenge the patient’s views and communicate disagreement. Conclusions The doctor succeeds in conveying and maintaining hope. Within a good working alliance with the patient the doctor can convey hope by balancing between supporting and challenging him. Exploring and grasping the patient’s real concerns is essential for being able to relieve and comfort him and convey hope. PMID:28585884

  14. Attitudes of the Life Threatened Hospitalized Elderly

    ERIC Educational Resources Information Center

    Moore, Robert J.; Newton, James H.

    1977-01-01

    This article deals with a survey of 29 elderly patients' attitudes toward death, dying, aging, life's meaning, security, pain, and interpersonal relationships. This paper was presented at the annual Canadian Psychological Association meeting, Toronto, Ontario, June 1976. (Author)

  15. 40 CFR 230.30 - Threatened and endangered species.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., fish and reptiles. (b) Possible loss of values: The major potential impacts on threatened or endangered... species include adequate good quality water, spawning and maturation areas, nesting areas, protective cover, adequate and reliable food supply, and resting areas for migratory species. Each of these...

  16. Life-threatening Duodenal Ulcer Bleeding from a Ruptured Gastroduodenal Artery Aneurysm in a Patient with Neurofibromatosis Type 1.

    PubMed

    Im, Kyu Sung; Kim, Sunyong; Lim, Jun Uk; Jeon, Jung Won; Shin, Hyun Phil; Cha, Jae Myung; Joo, Kwang Ro; Lee, Joung Il; Park, Jae Jun

    2015-09-01

    Vasculopathy is rarely reported in neurofibromatosis type 1, but when it occurs it primarily involves the aorta and its main branches. Among vasculopathies, aneurysmal dilatation is the most common form. Although several case reports concerning aneurysms or pseudoaneurysms of visceral arteries in neurofibromatosis type 1 patients have been reported, there are no reports describing gastroduodenal artery aneurysms associated with neurofibromatosis type 1. We experienced a case of life-threatening duodenal ulcer bleeding from a ruptured gastroduodenal artery aneurysm associated with neurofibromatosis type 1. We treated our patient by transarterial embolization after initial endoscopic hemostasis. To our knowledge, this is the first reported case of its type. High levels of suspicion and prompt diagnosis are required to select appropriate treatment options for patients with neurofibromatosis type 1 experiencing upper gastrointestinal bleeding. Embolization of the involved arteries should be considered an essential treatment over endoscopic hemostasis alone to achieve complete hemostasis and to prevent rebleeding.

  17. Life-threatening hypersplenism due to idiopathic portal hypertension in early childhood: case report and review of the literature

    PubMed Central

    2010-01-01

    Background Idiopathic portal hypertension (IPH) is a disorder of unknown etiology and is characterized clinically by portal hypertension, splenomegaly, and hypersplenism accompanied by pancytopenia. This study evaluates the pathogenic concept of the disease by a systematic review of the literature and illustrates novel pathologic and laboratory findings. Case Presentation We report the first case of uncontrolled splenic hyperperfusion and enlargement with subsequent hypersplenism leading to life-threatening complications of IPH in infancy and emergent splenectomy. Conclusions Our results suggest that splenic NO and VCAM-1, rather than ET-1, have a significant impact on the development of IPH, even at a very early stage of disease. The success of surgical interventions targeting the splenic hyperperfusion suggests that the primary defect in the regulation of splenic blood flow seems to be crucial for the development of IPH. Thus, beside other treatment options splenectomy needs to be considered as a prime therapeutic option for IPH. PMID:20961440

  18. Climate Predictions Accelerate Decline for Threatened Macrozamia Cycads from Queensland, Australia

    PubMed Central

    Laidlaw, Melinda J.; Forster, Paul I.

    2012-01-01

    Changes in the potential habitat of five allopatric species of threatened Macrozamia cycads under scenarios of increased ambient temperature were examined. A lack of seed dispersal, poor recruitment, low seedling survival, obligate pollinator mutualisms and continued habitat loss have led to extant populations being largely restricted to refugia. Models predict that the area of suitable habitat will further contract and move upslope, resulting in a reduced incidence within protected areas with increasing annual mean temperature. Areas of potential habitat for all five species are also predicted to become increasingly isolated from one another, further reducing the exchange between metapopulations and subpopulations, exacerbating existing threatening processes. PMID:24832522

  19. Life-threatening subdural hematoma after aortic valve replacement in a patient with Heyde syndrome: a case report.

    PubMed

    Uchida, Tetsuro; Hamasaki, Azumi; Ohba, Eiichi; Yamashita, Atsushi; Hayashi, Jun; Sadahiro, Mitsuaki

    2017-08-08

    Heyde syndrome is known as a triad of calcific aortic stenosis, anemia due to gastrointestinal bleeding from angiodysplasia, and acquired type 2A von Willebrand disease. This acquired hemorrhagic disorder is characterized by the loss of the large von Willebrand factor multimers due to the shear stress across the diseased aortic valve. The most frequently observed type of bleeding in these patients is mucosal or skin bleeding, such as epistaxis, followed by gastrointestinal bleeding. On the other hand, intracranial hemorrhage complicating Heyde syndrome is extremely rare. A 77-year-old woman presented to our hospital with severe aortic stenosis and severe anemia due to gastrointestinal bleeding and was diagnosed with Heyde syndrome. Although aortic valve replacement was performed without recurrent gastrointestinal bleeding, postoperative life-threatening acute subdural hematoma occurred with a marked midline shift. Despite prompt surgical evacuation of the hematoma, she did not recover consciousness and she died 1 month after the operation. Postoperative subdural hematoma is rare, but it should be kept in mind as a devastating hemorrhagic complication, especially in patients with Heyde syndrome.

  20. Safety and Efficacy of Lysergic Acid Diethylamide-Assisted Psychotherapy for Anxiety Associated With Life-threatening Diseases

    PubMed Central

    Gasser, Peter; Holstein, Dominique; Michel, Yvonne; Doblin, Rick; Yazar-Klosinski, Berra; Passie, Torsten; Brenneisen, Rudolf

    2014-01-01

    Abstract A double-blind, randomized, active placebo-controlled pilot study was conducted to examine safety and efficacy of lysergic acid diethylamide (LSD)-assisted psychotherapy in 12 patients with anxiety associated with life-threatening diseases. Treatment included drug-free psychotherapy sessions supplemented by two LSD-assisted psychotherapy sessions 2 to 3 weeks apart. The participants received either 200 μg of LSD (n = 8) or 20 μg of LSD with an open-label crossover to 200 μg of LSD after the initial blinded treatment was unmasked (n = 4). At the 2-month follow-up, positive trends were found via the State-Trait Anxiety Inventory (STAI) in reductions in trait anxiety (p = 0.033) with an effect size of 1.1, and state anxiety was significantly reduced (p = 0.021) with an effect size of 1.2, with no acute or chronic adverse effects persisting beyond 1 day after treatment or treatment-related serious adverse events. STAI reductions were sustained for 12 months. These results indicate that when administered safely in a methodologically rigorous medically supervised psychotherapeutic setting, LSD can reduce anxiety, suggesting that larger controlled studies are warranted. PMID:24594678

  1. Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases.

    PubMed

    Gasser, Peter; Holstein, Dominique; Michel, Yvonne; Doblin, Rick; Yazar-Klosinski, Berra; Passie, Torsten; Brenneisen, Rudolf

    2014-07-01

    A double-blind, randomized, active placebo-controlled pilot study was conducted to examine safety and efficacy of lysergic acid diethylamide (LSD)-assisted psychotherapy in 12 patients with anxiety associated with life-threatening diseases. Treatment included drug-free psychotherapy sessions supplemented by two LSD-assisted psychotherapy sessions 2 to 3 weeks apart. The participants received either 200 μg of LSD (n = 8) or 20 μg of LSD with an open-label crossover to 200 μg of LSD after the initial blinded treatment was unmasked (n = 4). At the 2-month follow-up, positive trends were found via the State-Trait Anxiety Inventory (STAI) in reductions in trait anxiety (p = 0.033) with an effect size of 1.1, and state anxiety was significantly reduced (p = 0.021) with an effect size of 1.2, with no acute or chronic adverse effects persisting beyond 1 day after treatment or treatment-related serious adverse events. STAI reductions were sustained for 12 months. These results indicate that when administered safely in a methodologically rigorous medically supervised psychotherapeutic setting, LSD can reduce anxiety, suggesting that larger controlled studies are warranted.

  2. Acid Gastroesophageal Reflux Disease and Apparent Life-Threatening Events: Simultaneous pH-metry and Cardiorespiratory Monitoring.

    PubMed

    Macchini, Francesco; Morandi, Anna; Cognizzoli, Paola; Farris, Giorgio; Gentilino, Valerio; Zanini, Andrea; Leva, Ernesto

    2017-02-01

    To investigate the prevalence and the characteristics of gastroesophageal reflux disease (GERD) in infants with apparent life threatening events (ALTE). Infants with at least one episode of ALTE in absence of predisposing factors were included. All infants underwent a cardiorespiratory recording with simultaneous 24-hour pH-monitoring. Patients were divided into 3 groups according to the severity of GERD: A. Reflux Index (RI) <3%, B. RI = 3-7%, C. RI >7%. Monthly evaluations were performed and the anti-reflux therapy was maintained till normalization of monitoring and clinic. 41 infants were enrolled. GERD was found in 80% of patients (moderate in 54%, severe in 27%). A normalization of the cardiorespiratory tracks was recorded on average after 1 month for group A, 7 months for the group B and 9.5 months for group C. A significant difference was registered between group A and both group B and C (P < 0.0001), as well as between the group B and C (P < 0.05). GERD influences significantly the time of normalization of the cardiorespiratory monitoring in infants with ALTE. GERD diagnosis and treatment are mandatory in these patients. Copyright © 2016. Published by Elsevier B.V.

  3. Diagnosis of Life-Threatening Alpha-Gal Food Allergy Appears to Be Patient Driven

    PubMed Central

    Flaherty, Mary Grace; Kaplan, Samantha Jan; Jerath, Maya R.

    2017-01-01

    Objective: Patients exhibiting life-threatening symptoms associated with the alpha-gal food allergy (delayed urticaria or anaphylaxis due to mammalian meat) are frequently undiagnosed, causing unnecessary emergency department (ED) and health care visits, and extensive pain and suffering. This study aimed to determine the path to diagnosis experienced by alpha-gal patients. Methods: Semistructured interviews were conducted from March to June 2016 with a chronological systematic sample of approximately 10% of patients diagnosed with alpha-gal and treated by the University of North Carolina Allergy and Immunology Clinic (n = 28). Main outcome measures included average length of time between first symptoms’ appearance and diagnosis, number and type of health care encounters en route to diagnosis, and typical symptom severity. Results: Six interviewees (21%) were diagnosed within a year of experiencing symptoms, of the remaining 22, mean time to diagnosis was 7.1 years. In over 100 medical encounters (including 28 ED visits and 2 urgent care) the correct diagnosis or effective diagnosing referral occurred less than 10% of the time. Seventy-one percent (20/28) described their first symptoms as severe. More patients found the allergist specializing in this condition on their own (n = 12; 43%) than those who were formally diagnosed or received referrals (n = 10; 36%) through the health care system. Conclusions: The medical community is challenged to stay abreast of emerging and newly uncovered illnesses through traditional medical literature communication channels. Presently, patients more often discover a diagnosis of alpha-gal allergy by using information resources on their own than by presenting to the ED with anaphylaxis. PMID:28447914

  4. Rare, threatened, and endangered plant species southwest Florida and potential OCS activity impacts

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

    McCoy, E.D.

    1981-11-01

    This report on rare, threatened, and endangered plants of southwest Florida is a compilation of all species so designated or considered for listing by Federal, State, and private agencies or organizations. Of 274 species in Pinellas, Hillsborough, Manatee, Sarasota, Charlotte, Lee, Collier, and Monroe Counties, 43 occurring in coastal habitats will be most affected by Outer Continental Shelf development.

  5. 77 FR 20773 - Endangered and Threatened Species; Proposed Threatened Status for Subspecies of the Ringed Seal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-06

    ...-XZ59 Endangered and Threatened Species; Proposed Threatened Status for Subspecies of the Ringed Seal... conducted special independent peer review of the December 2010 status review report of the ringed seal... ochotensis), and Ladoga (Phoca hispida ladogensis) subspecies of ringed seals as threatened (75 FR 77476). On...

  6. Predicting the Impact of Climate Change on Threatened Species in UK Waters

    PubMed Central

    Jones, Miranda C.; Dye, Stephen R.; Fernandes, Jose A.; Frölicher, Thomas L.; Pinnegar, John K.; Warren, Rachel; Cheung, William W. L.

    2013-01-01

    Global climate change is affecting the distribution of marine species and is thought to represent a threat to biodiversity. Previous studies project expansion of species range for some species and local extinction elsewhere under climate change. Such range shifts raise concern for species whose long-term persistence is already threatened by other human disturbances such as fishing. However, few studies have attempted to assess the effects of future climate change on threatened vertebrate marine species using a multi-model approach. There has also been a recent surge of interest in climate change impacts on protected areas. This study applies three species distribution models and two sets of climate model projections to explore the potential impacts of climate change on marine species by 2050. A set of species in the North Sea, including seven threatened and ten major commercial species were used as a case study. Changes in habitat suitability in selected candidate protected areas around the UK under future climatic scenarios were assessed for these species. Moreover, change in the degree of overlap between commercial and threatened species ranges was calculated as a proxy of the potential threat posed by overfishing through bycatch. The ensemble projections suggest northward shifts in species at an average rate of 27 km per decade, resulting in small average changes in range overlap between threatened and commercially exploited species. Furthermore, the adverse consequences of climate change on the habitat suitability of protected areas were projected to be small. Although the models show large variation in the predicted consequences of climate change, the multi-model approach helps identify the potential risk of increased exposure to human stressors of critically endangered species such as common skate (Dipturus batis) and angelshark (Squatina squatina). PMID:23349829

  7. Predicting the impact of climate change on threatened species in UK waters.

    PubMed

    Jones, Miranda C; Dye, Stephen R; Fernandes, Jose A; Frölicher, Thomas L; Pinnegar, John K; Warren, Rachel; Cheung, William W L

    2013-01-01

    Global climate change is affecting the distribution of marine species and is thought to represent a threat to biodiversity. Previous studies project expansion of species range for some species and local extinction elsewhere under climate change. Such range shifts raise concern for species whose long-term persistence is already threatened by other human disturbances such as fishing. However, few studies have attempted to assess the effects of future climate change on threatened vertebrate marine species using a multi-model approach. There has also been a recent surge of interest in climate change impacts on protected areas. This study applies three species distribution models and two sets of climate model projections to explore the potential impacts of climate change on marine species by 2050. A set of species in the North Sea, including seven threatened and ten major commercial species were used as a case study. Changes in habitat suitability in selected candidate protected areas around the UK under future climatic scenarios were assessed for these species. Moreover, change in the degree of overlap between commercial and threatened species ranges was calculated as a proxy of the potential threat posed by overfishing through bycatch. The ensemble projections suggest northward shifts in species at an average rate of 27 km per decade, resulting in small average changes in range overlap between threatened and commercially exploited species. Furthermore, the adverse consequences of climate change on the habitat suitability of protected areas were projected to be small. Although the models show large variation in the predicted consequences of climate change, the multi-model approach helps identify the potential risk of increased exposure to human stressors of critically endangered species such as common skate (Dipturus batis) and angelshark (Squatina squatina).

  8. Wearable cardioverter defibrillator: a life vest till the life boat (ICD) arrives.

    PubMed

    Francis, Johnson; Reek, Sven

    2014-01-01

    It is well established that implantable cardioverter defibrillator (ICD) is a life saving device ensuring protection against life threatening ventricular arrhythmias. But there are certain situations like a recent myocardial infarction where the standard guidelines do not recommend the implantation of an ICD while the patient can still be at a risk of demise due to a life threatening ventricular arrhythmia. There could also be a temporary indication for protection while explanting an infected ICD system. The wearable cardioverter defibrillator (WCD) is a device which comes to the rescue in such situations. In this brief review, we discuss the historical aspects of the development of a WCD, technical aspects as well as the clinical trial data and real world scenario of its use. Copyright © 2013 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  9. Early life adversity potentiates the effects of later life stress on cumulative physiological dysregulation.

    PubMed

    Dich, Nadya; Hansen, Åse Marie; Avlund, Kirsten; Lund, Rikke; Mortensen, Erik Lykke; Bruunsgaard, Helle; Rod, Naja Hulvej

    2015-01-01

    Previous research indicates that early life adversity may heighten stress reactivity and impair mechanisms for adaptive coping, suggesting that experience of stress in early life may also potentiate adults' physiological vulnerability to stress in later life. The study tested this hypothesis by investigating whether the experience of stressful events and circumstances (SEC) in childhood or adolescence amplified the effect of adulthood SEC on physiological dysregulation (allostatic load, AL) in later midlife. Observational data were used in the present study. Physiological functioning was measured in later midlife (participants' age ranged from 49 to 63 years). Both childhood/adolescence and adulthood SEC were reported retrospectively on the same occasion. Participants were 5309 Danish men and women from Copenhagen Aging and Midlife Biobank (CAMB). SEC included socioeconomic and family factors. The AL index was based on nine cardiovascular, metabolic, and immune biomarkers. Experience of SEC in both early life and adulthood independently predicted higher AL. In men, experience of SEC in early life also potentiated the effect of SEC in adulthood on AL. The results provide further insight into the mechanisms behind the "biological embedding" of childhood stress.

  10. Addressing Potential Cumulative Impacts of Development on Threatened Species: The Case of the Endangered Black-Throated Finch

    PubMed Central

    Vanderduys, Eric Peter; Reside, April E.; Grice, Anthony; Rechetelo, Juliana

    2016-01-01

    Where threatened biodiversity is adversely affected by development, policies often state that "no net loss" should be the goal and biodiversity offsetting is one mechanism available to achieve this. However, developments are often approved on an ad hoc basis and cumulative impacts are not sufficiently examined. We demonstrate the potential for serious threat to an endangered subspecies when multiple developments are planned. We modelled the distribution of the black-throated finch (Poephila cincta cincta) using bioclimatic data and Queensland's Regional Ecosystem classification. We overlaid granted, extant extractive and exploratory mining tenures within the known and modelled ranges of black-throated finches to examine the level of incipient threat to this subspecies in central Queensland, Australia. Our models indicate that more than half of the remaining P. cincta cincta habitat is currently under extractive or exploratory tenure. Therefore, insufficient habitat exists to offset all potential development so "no net loss" is not possible. This has implications for future conservation of this and similarly distributed species and for resource development planning, especially the use of legislated offsets for biodiversity protection. PMID:26934622

  11. Lack of utility of telemetry monitoring for identification of cardiac death and life-threatening ventricular dysrhythmias in low-risk patients with chest pain.

    PubMed

    Hollander, Judd E; Sites, Frank D; Pollack, Charles V; Shofer, Frances S

    2004-01-01

    Low-risk patients with chest pain are often admitted to monitored beds; however, the use of telemetry beds in this cohort is not evidence based. We tested the hypothesis that monitoring admitted low-risk patients with chest pain for dysrhythmia is low yield (<1% detection of life-threatening dysrhythmias requiring treatment). We conducted a prospective cohort study of emergency department (ED) patients with chest pain with a Goldman risk score of less than 8%, a normal initial creatine kinase-MB level, and a negative initial troponin I level admitted to non-ICU monitored beds. Investigators followed the hospital course daily. The main outcome was cardiovascular death and life-threatening ventricular dysrhythmia during telemetry. Of 3,681 patients with chest pain who presented to the ED, 1,750 patients were admitted to non-ICU monitored beds. Of these, 1,029 patients had a Goldman risk score of less than 8%, a troponin I level of less than 0.3 ng/mL, and a creatine kinase-MB level of less than 5 ng/mL (accounting for 59% of all chest pain telemetry admissions). During hospitalization, there were no patients with sustained ventricular tachycardia/ventricular fibrillation requiring treatment on the telemetry service (0%; 95% confidence interval [CI] 0% to 0.3%). There were 2 deaths: neither was cardiovascular in nature or preventable by monitoring (cardiovascular preventable death rate=0%; 95% CI 0.0% to 0.3%). The routine use of telemetry monitoring for low-risk patients with chest pain is of limited utility. Admission to nonmonitored beds might help alleviate ED crowding without increasing risk of adverse events caused by dysrhythmia in patients with a Goldman risk of less than 8%, an initial troponin I level of less than 0.3 ng/mL, and a creatine kinase-MB level of less than 5 ng/mL.

  12. Barriers to emergency obstetric care services: accounts of survivors of life threatening obstetric complications in Malindi District, Kenya.

    PubMed

    Echoka, Elizabeth; Makokha, Anselimo; Dubourg, Dominique; Kombe, Yeri; Nyandieka, Lillian; Byskov, Jens

    2014-01-01

    Pregnancy-related mortality and morbidity in most low and middle income countries can be reduced through early recognition of complications, prompt access to care and appropriate medical interventions following obstetric emergencies. We used the three delays framework to explore barriers to emergency obstetric care (EmOC) services by women who experienced life threatening obstetric complications in Malindi District, Kenya. A facility-based qualitative study was conducted between November and December 2010. In-depth interviews were conducted with 30 women who experienced obstetric "near miss" at the only public hospital with capacity to provide comprehensive EmOC services in the district. Findings indicate that pregnant women experienced delays in making decision to seek care and in reaching an appropriate care facility. The "first" delay was due to lack of birth preparedness, including failure to identify a health facility for delivery services regardless of antenatal care and to seek care promptly despite recognition of danger signs. The "second" delay was influenced by long distance and inconvenient transport to hospital. These two delays resulted in some women arriving at the hospital too late to save the life of the unborn baby. Delays in making the decision to seek care when obstetric complications occur, combined with delays in reaching the hospital, contribute to ineffective treatment upon arrival at the hospital. Interventions to reduce maternal mortality and morbidity must adequately consider the pre-hospital challenges faced by pregnant women in order to influence decision making towards addressing the three delays.

  13. Adverse Drug Events caused by Serious Medication Administration Errors

    PubMed Central

    Sawarkar, Abhivyakti; Keohane, Carol A.; Maviglia, Saverio; Gandhi, Tejal K; Poon, Eric G

    2013-01-01

    OBJECTIVE To determine how often serious or life-threatening medication administration errors with the potential to cause patient harm (or potential adverse drug events) result in actual patient harm (or adverse drug events (ADEs)) in the hospital setting. DESIGN Retrospective chart review of clinical events that transpired following observed medication administration errors. BACKGROUND Medication errors are common at the medication administration stage for hospitalized patients. While many of these errors are considered capable of causing patient harm, it is not clear how often patients are actually harmed by these errors. METHODS In a previous study where 14,041 medication administrations in an acute-care hospital were directly observed, investigators discovered 1271 medication administration errors, of which 133 had the potential to cause serious or life-threatening harm to patients and were considered serious or life-threatening potential ADEs. In the current study, clinical reviewers conducted detailed chart reviews of cases where a serious or life-threatening potential ADE occurred to determine if an actual ADE developed following the potential ADE. Reviewers further assessed the severity of the ADE and attribution to the administration error. RESULTS Ten (7.5% [95% C.I. 6.98, 8.01]) actual adverse drug events or ADEs resulted from the 133 serious and life-threatening potential ADEs, of which 6 resulted in significant, three in serious, and one life threatening injury. Therefore 4 (3% [95% C.I. 2.12, 3.6]) serious and life threatening potential ADEs led to serious or life threatening ADEs. Half of the ten actual ADEs were caused by dosage or monitoring errors for anti-hypertensives. The life threatening ADE was caused by an error that was both a transcription and a timing error. CONCLUSION Potential ADEs at the medication administration stage can cause serious patient harm. Given previous estimates of serious or life-threatening potential ADE of 1.33 per 100

  14. Drug-induced life-threatening arrhythmias and sudden cardiac death: A clinical perspective of long QT, short QT and Brugada syndromes.

    PubMed

    Ramalho, Diogo; Freitas, João

    2018-05-01

    Sudden cardiac death is a major public health challenge, which can be caused by genetic or acquired structural or electrophysiological abnormalities. These abnormalities include hereditary channelopathies: long QT, short QT and Brugada syndromes. These syndromes are a notable concern, particularly in young people, due to their high propensity for severe ventricular arrhythmias and sudden cardiac death. Current evidence suggests the involvement of an increasing number of drugs in acquired forms of long QT and Brugada syndromes. However, drug-induced short QT syndrome is still a rarely reported condition. Therefore, there has been speculation on its clinical significance, since few fatal arrhythmias and sudden cardiac death cases have been described so far. Drug-induced proarrhythmia is a growing challenge for physicians, regulatory agencies and the pharmaceutical industry. Physicians should weigh the risks of potentially fatal outcomes against the therapeutic benefits, when making decisions about drug prescriptions. Growing concerns about its safety and the need for more accurate predictive models for drug-induced fatal outcomes justify further research in these fields. The aim of this article is to comprehensively and critically review the recently published evidence with regard to drug-induced life-threatening arrhythmias and sudden cardiac death. This article will take into account the provision of data to physicians that are useful in the identification of the culprit drugs, and thus, contribute to the prompt recognition and management of these serious clinical conditions. Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. A study of family carers of people with a life-threatening illness. 2: Implications of the needs assessment.

    PubMed

    Scott, G

    2001-07-01

    This is the second of two articles that consider the findings of a Carers' Assessment of Difficulties Index (CADI) (Nolan et al, 1998) delivered in a palliative care context. It analyses the implications of these findings for practitioners concerned with the delivery of palliative care to such carers and their families. The development of support strategies and services addressing their needs are also presented against a backdrop of transactional stress theory. For people new to caring, recommendations for the local service include early intervention through informational support and validation of their emotional responses to caring; for longer-term carers they include assistance with cognitive reappraisal of the stressfulness of caring and regular 'respite' and socializing opportunities. These are taking place in a political climate that finally recognizes the contribution and value of carers (Department of Health, 1999). The research behind these carer identity and recognition initiatives aims to apply the spirit of public recognition and practical wisdom of palliative care expertise by responding sensitively to the specific needs of carers of people with a life-threatening illness.

  16. Life After Traumatic Injury: How the Body Responds

    MedlinePlus

    ... Traumatic Injury: How the Body Responds Inside Life Science View All Articles | Inside Life Science Home Page Life After Traumatic Injury: How the ... Threatening Bacterial Infection Remains Mysterious This Inside Life Science article also appears on LiveScience . Learn about related ...

  17. Psychological Well-Being and Family Environment of Siblings of Children with Life Threatening Illness.

    PubMed

    Humphrey, Lisa M; Hill, Douglas L; Carroll, Karen W; Rourke, Mary; Kang, Tammy I; Feudtner, Chris

    2015-11-01

    The psychological well-being of siblings of children with life threatening illness remains largely uncharted. Pediatric cancer research suggests that a supportive family environment may protect the psychological well-being of siblings. We hypothesized that (1) siblings of pediatric palliative care patients would show clinical/behavioral scores that were elevated but that rates of serious psychopathology would be comparable to the general population of children their age; and (2) higher family functioning scores would be associated with lower clinical scores and higher adaptive scores for these siblings. We conducted an observational study with families in which a patient receiving palliative care had one or more siblings between the ages of 6 and 11. Parents completed the Behavioral Assessment System for Children, Second Edition (BASC-2) to assess the siblings' psychological well-being and the Family Assessment Device (FAD) to assess the family environment. Twenty-four parents reported data for 30 siblings. Only three siblings scored in the clinical range on a BASC-2 composite clinical scale, and 11 siblings scored in the at-risk range on one or more composite scales. Higher FAD scores predicted significantly higher externalization composite clinical scores (7.54, 95% CI: 1.12, 13.97, p < 0.05) and significantly higher behavioral composite scores (7.88, 95% CI: 1.55, 14.21, p < 0.05). Siblings of pediatric palliative care patients are not experiencing lower psychological well-being than the general population. The prediction that a positive family environment would be associated with higher levels of psychological health was supported.

  18. Mapping Indigenous land management for threatened species conservation: An Australian case-study

    PubMed Central

    Renwick, Anna R.; Robinson, Catherine J.; Garnett, Stephen T.; Leiper, Ian; Possingham, Hugh P.; Carwardine, Josie

    2017-01-01

    Much biodiversity lives on lands to which Indigenous people retain strong legal and management rights. However this is rarely quantified. Here we provide the first quantitative overview of the importance of Indigenous land for a critical and vulnerable part of biodiversity, threatened species, using the continent of Australia as a case study. We find that three quarters of Australia’s 272 terrestrial or freshwater vertebrate species listed as threatened under national legislation have projected ranges that overlap Indigenous lands. On average this overlap represents 45% of the range of each threatened species while Indigenous land is 52% of the country. Hotspots where multiple threatened species ranges overlap occur predominantly in coastal Northern Australia. Our analysis quantifies the vast potential of Indigenous land in Australia for contributing to national level conservation goals, and identifies the main land management arrangements available to Indigenous people which may enable them to deliver those goals should they choose to do so. PMID:28291797

  19. Mapping Indigenous land management for threatened species conservation: An Australian case-study.

    PubMed

    Renwick, Anna R; Robinson, Catherine J; Garnett, Stephen T; Leiper, Ian; Possingham, Hugh P; Carwardine, Josie

    2017-01-01

    Much biodiversity lives on lands to which Indigenous people retain strong legal and management rights. However this is rarely quantified. Here we provide the first quantitative overview of the importance of Indigenous land for a critical and vulnerable part of biodiversity, threatened species, using the continent of Australia as a case study. We find that three quarters of Australia's 272 terrestrial or freshwater vertebrate species listed as threatened under national legislation have projected ranges that overlap Indigenous lands. On average this overlap represents 45% of the range of each threatened species while Indigenous land is 52% of the country. Hotspots where multiple threatened species ranges overlap occur predominantly in coastal Northern Australia. Our analysis quantifies the vast potential of Indigenous land in Australia for contributing to national level conservation goals, and identifies the main land management arrangements available to Indigenous people which may enable them to deliver those goals should they choose to do so.

  20. Prevalence of epilepsy and seizure disorders as causes of apparent life- threatening event (ALTE) in children admitted to a tertiary hospital.

    PubMed

    Anjos, Alessandra Marques dos; Nunes, Magda Lahorgue

    2009-09-01

    To determine the prevalence and describe clinical characteristics of seizure disorders and epilepsy as causes of apparent life- threatening event (ALTE) in children admitted at the emergency and followed in a tertiary hospital. Cross-sectional study with prospective data collection using specific guidelines to determine the etiology of ALTE. During the study, 30 (4.2%) children admitted to the hospital had a diagnosis of ALTE. There was a predominance of males (73%) and term infants (70%). Neonatal neurological disorders and neuropsychomotor development delay were found respectively in 13.4% and 10% of the cases. Etiological investigation revealed that 50% of the cases were idiopathic, and 13.4% were caused by epilepsy or seizure disorders. Although all patients had recurrent ALTE events, epilepsy had not been previously suspected. Epilepsy should be included in the differential diagnosis of ALTE, particularly when events are recurrent.

  1. 78 FR 31498 - Endangered and Threatened Wildlife and Plants; Proposed Threatened Status for Leavenworthia...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-24

    ...; 4500030113] RIN 1018-AY73 Endangered and Threatened Wildlife and Plants; Proposed Threatened Status for... annual member of the mustard family (Brassicaceae) known only from two counties in Kentucky. Plants are... make up the flower), and leafless stems. Leaves typically disappear by the time the plant is in fruit...

  2. How Does Air Pollution Threaten Basic Human Rights? The Case Study of Bulgaria

    ERIC Educational Resources Information Center

    Ahmedova, Aylin Hasanova

    2016-01-01

    The main purpose of this article is to analyze the relationship between air pollution and human rights. It investigates whether air pollution threatens basic human rights such as the right to health, life, and the environment. Air pollution represents a major threat both to health and to the environment. Despite the adoption of numerous…

  3. Methemoglobinemia hemotoxicity of some antimalarial 8-aminoquinoline analogues and their hydroxylated derivatives: density functional theory computation of ionization potentials

    USDA-ARS?s Scientific Manuscript database

    The administration of primaquine (PQ), an essential drug for treatment and radical cure of malaria, can lead to methemoglobin formation and life-threatening hemolysis for glucose-6-phosphate dehydrogenase deficient patients. The ionization potential (IP, a quantitative measure of the ability to lose...

  4. Life-threatening heat stroke presenting with ST elevations: a report of consecutive cases during the heat wave in Austria in July 2013.

    PubMed

    Lassnig, Elisabeth; Dinkhauser, Patrick; Maurer, Edwin; Eber, Bernd

    2014-08-01

    Heat stroke is a life-threatening condition due to an acute thermoregulatory failure during exposure to high environmental temperatures. We report a series of four cases (three exertional, one classic heat stroke) during the heat wave of July 2013 in Austria. All of them presented with a core temperature > 41 °C, central nervous dysfunction, acute respiratory and renal failure, disseminated intravascular coagulation, rhabdomyolysis, and severe electrocardiographic changes, two cases even mimicking ST-elevation myocardial infarction. The patients were cooled to normal temperature with the "Arctic sun" external cooling system within hours. Electrocardiographic changes resolved quickly. All patients primarily recovered from multiple organ dysfunction and could be discharged from intensive care unit. Unfortunately, the two elder patients died 1 week and 5 weeks later because of late complications.

  5. 78 FR 23983 - Endangered and Threatened Wildlife and Plants; Threatened Status for Eriogonum codium

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... substrates that support these and other rare endemic plants (see Species Information sections) within the... large-scale rare plant surveys on the Hanford Site that were initiated in 1994 by TNC and the DOE, as... Service 50 CFR Part 17 Endangered and Threatened Wildlife and Plants; Threatened Status for Eriogonum...

  6. Effect of Applied Potential on Fatigue Life of Electropolished Nitinol Wires

    NASA Astrophysics Data System (ADS)

    Sivan, Shiril; Di Prima, Matthew; Weaver, Jason D.

    2017-09-01

    Nitinol is used as a metallic biomaterial in medical devices due to its shape memory and pseudoelastic properties. The clinical performance of nitinol depends on factors which include the surface finish, the local environment, and the mechanical loads to which the device is subjected. Preclinical evaluations of device durability are performed with fatigue tests while electrochemical characterization methods such as ASTM F2129 are employed to evaluate corrosion susceptibility by determining the rest potential and breakdown potential. However, it is well established that the rest potential of a metal surface can vary with the local environment. Very little is known regarding the influence of voltage on fatigue life of nitinol. In this study, we developed a fatigue testing method in which an electrochemical system was integrated with a rotary bend wire fatigue tester. Samples were fatigued at various strain levels at electropotentials anodic and cathodic to the rest potential to determine if it could influence fatigue life. Wires at potentials negative to the rest potential had a significantly higher number of cycles to fracture than wires held at potentials above the breakdown potential. For wires for which no potential was applied, they had fatigue life similar to wires at negative potentials.

  7. Neonatal isolated ACTH deficiency (IAD): a potentially life-threatening but treatable cause of neonatal cholestasis.

    PubMed

    Alsaleem, Mahdi; Saadeh, Lina; Misra, Amrit; Madani, Shailender

    2016-08-17

    Isolated ACTH deficiency (IAD) is a rare cause of neonatal cholestasis and hypoglycaemia. This diagnosis has a 20% mortality potential if unrecognised. We describe a case of an infant presenting with cholestatic jaundice and hypoglycaemia. The patient had laboratory findings suggestive of IAD, which was later confirmed with molecular genetic testing. One of the mutations this patient had is a new finding. The patient was started on glucocorticoid replacement therapy after which his bilirubin and glucose levels normalised. 2016 BMJ Publishing Group Ltd.

  8. Risk factors and management of severe life-threatening anaphylaxis in patients with clonal mast cell disorders.

    PubMed

    Valent, P

    2014-07-01

    Several different risk factors and conditions may predispose to severe life-threatening anaphylaxis. Systemic mastocytosis (SM) is one such condition. Although many SM patients are suffering from mild or even no mediator-related symptoms, others have recurrent episodes of severe anaphylaxis, with clear signs of a mast cell activation syndrome (MCAS) despite prophylactic therapy with anti-mediator-type drugs. In several of these patients, an IgE-dependent allergy is diagnosed. The severity and frequency of MCAS reactions neither correlate with the burden of neoplastic mast cells nor with the levels of specific IgE or the basal tryptase level. However, there is a relationship between severe anaphylaxis in SM and the type of allergen. Notably, many of these patients suffer from hymenoptera venom allergy. Currently recommended therapies include the prophylactic use of anti-mediator-type drugs, long-term immunotherapy for hymenoptera venom allergic patients, and epinephrine-self-injector treatment for emergency situations. In patients who present with an excess burden of mast cells, such as smouldering SM, cytoreductive therapy with cladribine (2CdA) may reduce the frequency of severe events. For the future, additional treatment options, such as IgE-depletion or the use of tyrosine kinase inhibitors blocking IgE-dependent mediator secretion as well as KIT activation, may be useful alternatives. © 2014 John Wiley & Sons Ltd.

  9. 78 FR 59334 - Endangered and Threatened Wildlife and Plants; Threatened Status and Designation of Critical...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-26

    ... and Threatened Wildlife and Plants; Threatened Status and Designation of Critical Habitat for Oregon... of public comment period and notice of public hearing. SUMMARY: We, the U.S. Fish and Wildlife Service (Service), recently published a proposed listing and proposed designation of critical habitat for...

  10. The needs of siblings of children with a life-threatening illness, part 2: Psychometric validation of the IBesFEMS.

    PubMed

    Olivier d'avignon, Marianne; Dumont, Serge; Valois, Pierre; Cohen, S Robin

    2017-02-01

    Life-threatening illnesses in children have a significant impact on the lives of their brothers and sisters. Consequently, special attention must be paid to the specific needs of these siblings to help them cope with their situations. To address this issue, we developed an inventory of the needs of the adolescent siblings of severely ill children, the Inventaire des Besoins de la Fratrie d'Enfants Malades Sévèrement (IBesFEMS) [Needs Inventory for Siblings of Critically Ill Children]. The present article describes a preliminary validation study of this new instrument. In a prospective cohort study, the 48-item instrument was administered via a website or paper to 58 siblings. Our study revealed that the measure has an estimated internal consistency of 0.96 and a temporal stability intraclass correlation coefficient (ICC) of 0.86 (p < 0.01). Its convergence validity is also satisfactory. Our findings suggest that the IBesFEMS is highly relevant for pediatric palliative care clinicians and researchers. Future studies should investigate its factorial structure and predictive validities.

  11. Miscarriage - threatened

    MedlinePlus

    ... might take place before the 20th week of pregnancy. Causes Some pregnant women have some vaginal bleeding , with ... injuries or stress during the first trimester of pregnancy can cause threatened miscarriage. It occurs in almost half of ...

  12. Quality of life for children with life-limiting and life-threatening illnesses: description and evaluation of a regional, collaborative model for pediatric palliative care.

    PubMed

    Rogers, Susan K; Gomez, Carlos F; Carpenter, Philip; Farley, Jean; Holson, Debbie; Markowitz, Miriam; Rood, Brian; Smith, Karen; Nigra, Peter

    2011-05-01

    The care of children in the U.S. with life-limiting illnesses is inadequate. Misallocated resources, flawed assumptions and models of care, and a lack of appropriate professional education foster a costly, inefficient system that falls short of its true potential. This article details the evolution of a regional, shared approach to address these issues, the District of Columbia Pediatric Palliative Care Collaboration (DCPPCC), and includes its evolution, preliminary clinical results, and assessment of barriers encountered.

  13. Typhoid ulcer causing life-threatening bleeding from Dieulafoy's lesion of the ileum in a seven-year-old child: a case report.

    PubMed

    Ezzat, Rajan Fuad; Hussein, Hiwa A; Baban, Trifa Shawkat; Rashid, Abbas Tahir; Abdullah, Khaled Musttafa

    2010-06-03

    We describe a case of rare complication of typhoid fever in a seven-year-old child and review the literature with regard to other rare causes of bleeding per rectum. Dieulafoy's lesion is an uncommon but important cause of recurrent gastrointestinal bleeding. Dieulafoy's lesion located extragastrically is rare. We report a case of typhoid ulcer with Dieulafoy's lesion of the ileum causing severe life-threatening bleeding and discuss the management of this extremely uncommon entity. As a complication of typhoid fever, a seven-year-old Kurdish girl from Northern Iraq developed massive fresh bleeding per rectum. During colonoscopy and laparotomy, she was discovered to have multiple bleeding ulcers within the Dieulafoy's lesion in the terminal ileum and ileocecal region. Although there is no practical way of predicting the occurrence of such rare complications, we emphasize in this case report the wide array of pathologies that can result from typhoid fever.

  14. Status of endangered and threatened plant species on Nevada Test Site: a survey. Part 2. Threatened species

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

    Rhoads, W.A.; Cochrane, S.A.; Williams, M.P.

    This is the second of a two-part study of plant species on the Nevada Test Site (NTS) that are listed as possibly threatened or endangered by the U.S. Fish and Wildlife Service (FWS). This study was undertaken as a response by DOE to comply with the Endangered Species Act of 1973 (the Act). Part 1 treated species listed under terms of the Act as proposed endangered species. Part 2 primarily treats those species listed as threatened species candidates. Among the 15 species that grow on NTS and appeared in the Federal Register lists of candidate threatened species we report three:more » Astragalus funereus, Coryphantha vivipara var. rosea, and Gilia ripleyi, that should be considered as threatened. Two other species which occur on NTS and were not included on either the threatened or endangered lists should also be classified as threatened: Penstemon thurberi var. anestius and Sclerocactus polyancistrus. Of the 12 other species originally listed in the Federal Register, eight are of sufficient interest to warrant continued monitoring under a category we suggest as ''Plants of Special Concern.'' The other four do not appear to require any protective measures or surveillance at this time. We suggest critical habitats for those species recommended for threatened status and note that some suggested critical habitats may serve for more than one species and may also include habitats for some species of special concern. Updated information about species covered in Part 1 suggests that Trifolium andersonii var. beatleyae, earlier considered endangered, should now be recommended to be removed from endangered or threatened status because of more widespread distribution than was known to us at the time Part 1 was published.« less

  15. Tranexamic acid in life-threatening military injury and the associated risk for infectious complications

    PubMed Central

    Lewis, C. J.; Li, P.; Stewart, L.; Weintrob, A. C.; Carson, M. L.; Murray, C. K.; Tribble, D. R.; Ross, J. D.

    2015-01-01

    Background Tranexamic acid (TXA) has been shown to reduce mortality from severe hemorrhage. Although recent data suggest that TXA has anti-inflammatory properties, few analyses have investigated the impact of TXA on infectious complications in trauma patients. We examined the association between TXA administration and infection risk among injured military personnel. Methods Patients administered TXA were matched by injury severity score to patients who did not receive TXA. Conditional logistic regression was used to examine risk factors associated with infections within 30 days. A Cox proportional analysis evaluated risk factors in a time-to-first infection model. Results A total of 335 TXA recipients were matched to 626 patients not administered TXA. A greater proportion of TXA recipients had an infection compared to the comparative group (P <0.001). The univariate analysis estimated an unadjusted odds ratio (OR) of 2.5 (95 per cent confidence interval [CI]: 1.8–3.4) for the association of TXA with infection risk; however, upon multivariable analysis, TXA administration was not significant (OR: 1.3; CI: 0.8–1.9). Blast injuries, intensive care unit (ICU) admission, and receipt of ≥10 units of blood within 24 hours post-injury were independently associated with infection risk. The Cox proportional model confirmed association with ICU admission and blood transfusions. Moreover, traumatic amputations were also significantly associated with a reduced time-to-first infection. Conclusion In life-threatening military injuries matched for injury severity, TXA recipients did not have a higher risk for infections nor was time to developed infections shorter than in non-recipients. Extent of blood loss, blast injuries, extremity amputations, and intensive care stay were associated with infections. PMID:26791625

  16. 76 FR 14883 - Endangered and Threatened Species; Proposed Threatened Status for Distinct Population Segments of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... the Bearded Seal AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... bearded seal (Erignathus barbatus) as threatened under the Endangered Species Act of 1973, as amended (ESA... bearded seal as threatened under the ESA. Based on the status of these DPSs, we also proposed protective...

  17. 76 FR 6755 - Endangered and Threatened Species; Extension of Public Comment Period on Proposed Threatened...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-08

    ... Status for Distinct Population Segments of the Bearded Seal AGENCY: National Marine Fisheries Service...) of the bearded seal (Erignathus barbatus) as threatened under the Endangered Species Act of 1973, as... seal as threatened under the ESA. Based on the status of these DPSs, we also proposed protective...

  18. Investing in threatened species conservation: does corruption outweigh purchasing power?

    PubMed

    Garnett, Stephen T; Joseph, Liana N; Watson, James E M; Zander, Kerstin K

    2011-01-01

    In many sectors, freedom in capital flow has allowed optimization of investment returns through choosing sites that provide the best value for money. These returns, however, can be compromised in countries where corruption is prevalent. We assessed where the best value for money might be obtained for investment in threatened species that occur at a single site, when taking into account corruption. We found that the influence of corruption on potential investment decisions was outweighed by the likely value for money in terms of pricing parity. Nevertheless global conservation is likely to get best returns in terms of threatened species security by investing in "honest" countries than in corrupt ones, particularly those with a high cost of living.

  19. 76 FR 9734 - Endangered and Threatened Species; Proposed Threatened Status for Distinct Population Segments of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ... Population Segments of the Bearded Seal AGENCY: National Marine Fisheries Service (NMFS), National Oceanic... Segments (DPSs) of the bearded seal (Erignathus barbatus) as threatened under the Endangered Species Act of... Segments (DPSs) of the bearded seal as threatened under the ESA. Based on the status of these DPSs, we also...

  20. Prenatal Diagnosis of a Segmental Small Bowel Volvulus with Threatened Premature Labor

    PubMed Central

    Mottet, Nicolas; Ramanah, Rajeev; Riethmuller, Didier

    2017-01-01

    Fetal primary small bowel volvulus is extremely rare but represents a serious life-threatening condition needing emergency neonatal surgical management to avoid severe digestive consequences. We report a case of primary small bowel volvulus with meconium peritonitis prenatally diagnosed at 27 weeks and 4 days of gestation during threatened premature labor with reduced fetal movements. Ultrasound showed a small bowel mildly dilated with thickened and hyperechogenic intestinal wall, with a typical whirlpool configuration. Normal fetal development allowed continuation of pregnancy with ultrasound follow-up. Induction of labor was decided at 37 weeks and 2 days of gestation because of a significant aggravation of intestinal dilatation appearing more extensive with peritoneal calcifications leading to the suspicion of meconium peritonitis, associated with reduced fetal movements and reduced fetal heart rate variability, for neonatal surgical management with a good outcome. PMID:29230337

  1. 78 FR 40162 - Endangered and Threatened Wildlife and Plants; Notice of Availability of a Technical/Agency Draft...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-03

    ...-FF04E00000] Endangered and Threatened Wildlife and Plants; Notice of Availability of a Technical/Agency Draft... recovery potential. Restoring an endangered or threatened animal or plant to the point where it is again a... about the species' biology, and magnitude of threats. Therefore, this recovery plan only establishes...

  2. 77 FR 34349 - Endangered and Threatened Species; Take of Anadromous Fish

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-11

    ... and Threatened Species; Take of Anadromous Fish AGENCY: National Marine Fisheries Service (NMFS... Department of Fish and Wildlife (ODFW) pursuant to the protective regulations promulgated for Pacific salmon... hatchery fish to support fishing opportunities while minimizing potential risks to natural-origin spring...

  3. Mortality Risks for Forest Trees Threatened with Gypsy Moth Infestation

    Treesearch

    Owen W. Herrick; David A. Gansner; David A. Gansner

    1987-01-01

    Presents guidelines for estimating potential tree mortality associated with gypsy moth defoliation. A tree's crown condition, crown position, and species group can be used to assign probabilities of death. Forest-land managers need such information to develop marking guides and implement silvicultural treatments for forest trees threatened with gypsy moth...

  4. Typhoid ulcer causing life-threatening bleeding from Dieulafoy's lesion of the ileum in a seven-year-old child: a case report

    PubMed Central

    2010-01-01

    Introduction We describe a case of rare complication of typhoid fever in a seven-year-old child and review the literature with regard to other rare causes of bleeding per rectum. Dieulafoy's lesion is an uncommon but important cause of recurrent gastrointestinal bleeding. Dieulafoy's lesion located extragastrically is rare. We report a case of typhoid ulcer with Dieulafoy's lesion of the ileum causing severe life-threatening bleeding and discuss the management of this extremely uncommon entity. Case presentation As a complication of typhoid fever, a seven-year-old Kurdish girl from Northern Iraq developed massive fresh bleeding per rectum. During colonoscopy and laparotomy, she was discovered to have multiple bleeding ulcers within the Dieulafoy's lesion in the terminal ileum and ileocecal region. Conclusion Although there is no practical way of predicting the occurrence of such rare complications, we emphasize in this case report the wide array of pathologies that can result from typhoid fever. PMID:20525295

  5. [Prenatal intestinal volvulus: A life-threatening event with good long-term outcome].

    PubMed

    Raherison, R; Grosos, C; Lemale, J; Blondiaux, E; Sabourdin, N; Dahan, S; Rosenblatt, J; Guilbert, J; Jouannic, J-M; Mitanchez, D; Audry, G; Auber, F

    2012-04-01

    . Median duration of parenteral nutrition was 29 days (range, 6-667 days). None of the patients had cystic fibrosis. Unlike postnatal volvulus, most prenatal volvulus occurs without malrotation. Although prenatal volvulus is a life-threatening condition, our results suggest that good long-term outcome can be achieved in most cases. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  6. Natriuretic Peptides, 6-Min Walk Test, and Quality-of-Life Questionnaires as Clinically Meaningful Endpoints in HF Trials.

    PubMed

    Ferreira, João Pedro; Duarte, Kevin; Graves, Todd L; Zile, Michael R; Abraham, William T; Weaver, Fred A; Lindenfeld, JoAnn; Zannad, Faiez

    2016-12-20

    The Expedited Access for Premarket Approval and De Novo Medical Devices Intended for Unmet Medical Need for Life Threatening or Irreversibly Debilitating Diseases or Conditions document was issued as a guidance for industry and for the Food and Drug Administration. The Expedited Access Pathway was designed as a new program for medical devices that demonstrated the potential to address unmet medical needs for life threatening or irreversibly debilitating conditions. The Food and Drug Administration would consider assessments of a device's effect on intermediate endpoints that, when improving in a congruent fashion, are reasonably likely to predict clinical benefit. The purpose of this review is to provide evidence to support the use of 3 such intermediate endpoints: natriuretic peptides, such as N-terminal pro-B-type natriuretic peptide/B-type natriuretic peptide, the 6-min walk test distance, and health-related quality of life in heart failure. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  7. Threatened & Endangered Species and the Private Landowner

    Treesearch

    USDA Forest Service

    1997-01-01

    Have you ever asked one of these questions about threatened and endangered species? What are threatened and endangered species? I wouldn't know an endangered species if I stepped on one; how am I supposed to know if I have one on my property? Isn't the process of extinction natural? How can I enhance my property to support an endangered or threatened...

  8. Aetiology and prognostic factors of patients with AIDS presenting life-threatening acute respiratory failure.

    PubMed

    Torres, A; El-Ebiary, M; Marrades, R; Miró, J M; Gatell, J M; Sanchez-Nieto, J M; Xaubet, A; Agustí, C; Rodriguez-Roisin, R

    1995-11-01

    Respiratory failure is a significant contributor to morbidity and mortality in patients with the acquired immune deficiency syndrome (AIDS). We performed a study to investigate the aetiology, prognostic factors, and short- and long-term outcome of AIDS patients with life-threatening respiratory failure and pulmonary infiltrates. Forty-two AIDS patients (29 of whom required mechanical ventilation), admitted to a Respiratory Intensive Care Unit (ICU) from 1985 to 1992 because of severe respiratory failure (arterial oxygen tension/fractional inspiratory oxygen (Pa,O2/FI,O2) ratio at hospital admission 19 +/- 14 kPa (mean +/- SD)) and diffuse pulmonary infiltrates, were studied for evaluation of the aetiology and outcome. Necropsy studies were performed in 14 out of 23 (61%) patients who died. Pneumocystis carinii was the most common aetiology of pulmonary infiltrates (28 patients (67%)). Overall, 19 patients survived (45%) and 23 (55%) died. A multivariate analysis of prognostic factors influencing the outcome of the whole population showed that the presence of P. carinii pneumonia and the requirement for mechanical ventilation (MV) were the major determinants of outcome for this type of patient. The median survival time after ICU discharge for P. carinii pneumonia patients was lower (49 days) when compared to that of the remaining patients (154 days). Median survival time after ICU discharge for patients needing MV (112 days) did not differ from that observed in patients not requiring artificial ventilatory support (154 days). Although the ICU survival rate in this study was reasonable, 55% for the whole population, and 36% for P. carinii pneumonia patients, the poor outcome after ICU discharge, in particular for P. carinii pneumonia patients, deserves the reassessment of ICU admission criteria for this type of AIDS population.

  9. Investing in Threatened Species Conservation: Does Corruption Outweigh Purchasing Power?

    PubMed Central

    Garnett, Stephen T.; Joseph, Liana N.; Watson, James E. M.; Zander, Kerstin K.

    2011-01-01

    In many sectors, freedom in capital flow has allowed optimization of investment returns through choosing sites that provide the best value for money. These returns, however, can be compromised in countries where corruption is prevalent. We assessed where the best value for money might be obtained for investment in threatened species that occur at a single site, when taking into account corruption. We found that the influence of corruption on potential investment decisions was outweighed by the likely value for money in terms of pricing parity. Nevertheless global conservation is likely to get best returns in terms of threatened species security by investing in “honest” countries than in corrupt ones, particularly those with a high cost of living. PMID:21818383

  10. Classification and Reporting of Potentially Proarrhythmic Common Genetic Variation in Long QT Syndrome Genetic Testing.

    PubMed

    Giudicessi, John R; Roden, Dan M; Wilde, Arthur A M; Ackerman, Michael J

    2018-02-06

    The acquired and congenital forms of long QT syndrome represent 2 distinct but clinically and genetically intertwined disorders of cardiac repolarization characterized by the shared final common pathway of QT interval prolongation and risk of potentially life-threatening arrhythmias. Over the past 2 decades, our understanding of the spectrum of genetic variation that (1) perturbs the function of cardiac ion channel macromolecular complexes and intracellular calcium-handling proteins, (2) underlies acquired/congenital long QT syndrome susceptibility, and (3) serves as a determinant of QT interval duration in the general population has grown exponentially. In turn, these molecular insights led to the development and increased utilization of clinically impactful genetic testing for congenital long QT syndrome. However, the widespread adoption and potential misinterpretation of the 2015 American College of Medical Genetics and Genomics variant classification and reporting guidelines may have contributed unintentionally to the reduced reporting of common genetic variants, with compelling epidemiological and functional evidence to support a potentially proarrhythmic role in patients with congenital and acquired long QT syndrome. As a result, some genetic testing reports may fail to convey the full extent of a patient's genetic susceptibility for a potentially life-threatening arrhythmia to the ordering healthcare professional. In this white paper, we examine the current classification and reporting (or lack thereof) of potentially proarrhythmic common genetic variants and investigate potential mechanisms to facilitate the reporting of these genetic variants without increasing the risk of diagnostic miscues. © 2018 American Heart Association, Inc.

  11. Potential targets in the search for extraterrestrial life.

    NASA Technical Reports Server (NTRS)

    Klein, H. P.

    1972-01-01

    Discussion of the potential for increasing understanding of the origins of terrestrial life by examination of other planets. If living organisms should be found on another planet, they could only have been transported from an inhabited planet or originated independently. The fundamental chemical and structural attributes of terrestrial organisms are so remarkably uniform that any living forms outside the terrestrial blueprint would almost certainly be regarded as alien organisms. It has been shown experimentally by various investigators that life can exist in an extremely wide range of temperatures and pressures. The presence of an atmosphere appears to be necessary.

  12. A Cough Deteriorating Gross Hematuria: A Clinical Sign of a Forthcoming Life-Threatening Rupture of an Intraparenchymal Aneurysm of Renal Artery (Wunderlich's Syndrome)

    PubMed Central

    Anastasiou, Ioannis; Pournaras, Christos; Mitropoulos, Dionysios; Constantinides, Constantinos A.

    2013-01-01

    Macroscopic hematuria regards the 4% to 20% of all urological visits. Renal artery aneurysms (RAAs) are detected in approximately 0.01%–1% of the general population, while intraparenchymal renal artery aneurysms (IPRAAs) are even more rarely detected in less than 10% of patients with RAAs. We present a case of a 58-year-old woman that came into the emergency room (ER) complaining of a gross hematuria during the last four days. Although in the ER room the first urine sample was clear after a cough episode, a severe gross hematuria began which led to a hemodynamically unstable patient. Finally, a radical nephrectomy was performed, and an IPRAA was the final diagnosis. A cough deteriorating hematuria could be attributed to a ruptured intraparenchymal renal artery aneurysm, which even though constitutes a rare entity, it is a life-threatening medical emergency. PMID:23864981

  13. Life-saving implantable cardioverter defibrillator therapy in cardiac AL amyloidosis

    PubMed Central

    Patel, Ketna S; Hawkins, Philip N; Whelan, Carol J; Gillmore, Julian D

    2014-01-01

    Cardiac involvement is the main determinant of prognosis in systemic monoclonal immunoglobulin light chain (AL) amyloidosis. Ventricular arrhythmias and sudden cardiac death are not uncommon. The electrical events that precede sudden death, and their potential to be treated effectively, remain undefined. There are no European guidelines for the use of implantable cardioverter defibrillator (ICD) in amyloidosis. ICDs in general are not usually offered to patients with a life expectancy of less than 1 year. We describe a patient who presented with cardiac AL amyloidosis who underwent prophylactic ICD implantation for the prevention of sudden cardiac death during treatment with chemotherapy, in whom life-threatening ventricular arrhythmia was successfully terminated over a 3-year period. PMID:25535224

  14. Measuring the quality of life of people at the end of life: The McGill Quality of Life Questionnaire-Revised.

    PubMed

    Cohen, S Robin; Sawatzky, Richard; Russell, Lara B; Shahidi, Javad; Heyland, Daren K; Gadermann, Anne M

    2017-02-01

    The McGill Quality of Life Questionnaire has been widely used with people with life-threatening illnesses without modification since its publication in 1996. With use, areas for improvement have emerged; therefore, various minor modifications were tested over time. To revise the McGill Quality of Life Questionnaire (McGill Quality of Life Questionnaire-Revised) while maintaining or improving its psychometric properties and length, keeping it as close as possible to the McGill Quality of Life Questionnaire to enable reasonable comparison with existing McGill Quality of Life Questionnaire literature. Data sets from eight studies were used (four studies originally used to develop the McGill Quality of Life Questionnaire, two to develop new McGill Quality of Life Questionnaire versions, and two with unrelated purposes). The McGill Quality of Life Questionnaire-Revised was developed using analyses of measurement invariance, confirmatory factor analysis, and calculation of correlations with the McGill Quality of Life Questionnaire's global quality of life item. Data were from 1702 people with life-threatening illnesses recruited from acute and palliative care units, palliative home care services, and oncology and HIV/AIDS outpatient clinics. The McGill Quality of Life Questionnaire-Revised consists of 14 items (plus the global quality of life item). A new Physical subscale was created combining physical symptoms and physical well-being and a new item on physical functioning. The Existential subscale was reduced to four items. The revised Support subscale, renamed Social, focuses more on relationships. The Psychological subscale remains unchanged. Confirmatory factor analysis results provide support for the measurement structure of the McGill Quality of Life Questionnaire-Revised. The overall scale has good internal consistency reliability ( α = 0.94). The McGill Quality of Life Questionnaire-Revised improves on and can replace the McGill Quality of Life

  15. Naming Potentially Endangered Parasites: Foliicolous Mycobiota of Dimorphandra wilsonii, a Highly Threatened Brazilian Tree Species.

    PubMed

    da Silva, Meiriele; Pinho, Danilo B; Pereira, Olinto L; Fernandes, Fernando M; Barreto, Robert W

    2016-01-01

    A survey of foliicolous fungi associated with Dimorphandra wilsonii and Dimorphandra mollis (Fabaceae) was conducted in the state of Minas Gerais, Brazil. Dimorphandra wilsonii is a tree species native to the Brazilian Cerrado that is listed as critically endangered. Fungi strictly depending on this plant species may be on the verge of co-extinction. Here, results of the pioneering description of this mycobiota are provided to contribute to the neglected field of microfungi conservation. The mycobiota of D. mollis, which is a common species with a broad geographical distribution that co-occurs with D. wilsonii, was examined simultaneously to exclude fungal species occurring on both species from further consideration for conservation because microfungi associated with D. wilsonii should not be regarded as under threat of co-extinction. Fourteen ascomycete fungal species were collected, identified, described and illustrated namely: Byssogene wilsoniae sp. nov., Geastrumia polystigmatis, Janetia dimorphandra-mollis sp. nov., Janetia wilsoniae sp. nov., Johansonia chapadiensis, Microcalliopsis dipterygis, Phillipsiella atra, Piricauda paraguayensis, Pseudocercospora dimorphandrae sp. nov., Pseudocercosporella dimorphandrae sp. nov., Ramichloridiopsis wilsoniae sp. and gen. nov., Stomiopeltis suttoniae, Trichomatomyces byrsonimae and Vesiculohyphomyces cerradensis. Three fungi were exclusively found on D. wilsonii and were regarded as potentially threatened of extinction: B. wilsoniae, J. wilsoniae and R. wilsoniae.

  16. Naming Potentially Endangered Parasites: Foliicolous Mycobiota of Dimorphandra wilsonii, a Highly Threatened Brazilian Tree Species

    PubMed Central

    da Silva, Meiriele; Pinho, Danilo B.; Pereira, Olinto L.; Fernandes, Fernando M.; Barreto, Robert W.

    2016-01-01

    A survey of foliicolous fungi associated with Dimorphandra wilsonii and Dimorphandra mollis (Fabaceae) was conducted in the state of Minas Gerais, Brazil. Dimorphandra wilsonii is a tree species native to the Brazilian Cerrado that is listed as critically endangered. Fungi strictly depending on this plant species may be on the verge of co-extinction. Here, results of the pioneering description of this mycobiota are provided to contribute to the neglected field of microfungi conservation. The mycobiota of D. mollis, which is a common species with a broad geographical distribution that co-occurs with D. wilsonii, was examined simultaneously to exclude fungal species occurring on both species from further consideration for conservation because microfungi associated with D. wilsonii should not be regarded as under threat of co-extinction. Fourteen ascomycete fungal species were collected, identified, described and illustrated namely: Byssogene wilsoniae sp. nov., Geastrumia polystigmatis, Janetia dimorphandra-mollis sp. nov., Janetia wilsoniae sp. nov., Johansonia chapadiensis, Microcalliopsis dipterygis, Phillipsiella atra, Piricauda paraguayensis, Pseudocercospora dimorphandrae sp. nov., Pseudocercosporella dimorphandrae sp. nov., Ramichloridiopsis wilsoniae sp. and gen. nov., Stomiopeltis suttoniae, Trichomatomyces byrsonimae and Vesiculohyphomyces cerradensis. Three fungi were exclusively found on D. wilsonii and were regarded as potentially threatened of extinction: B. wilsoniae, J. wilsoniae and R. wilsoniae. PMID:26910334

  17. 50 CFR 17.12 - Endangered and threatened plants.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... WILDLIFE AND PLANTS (CONTINUED) ENDANGERED AND THREATENED WILDLIFE AND PLANTS Lists § 17.12 Endangered and threatened plants. (h) * * * Species Scientific name Common name Historic range Family Status When listed... 50 Wildlife and Fisheries 2 2013-10-01 2013-10-01 false Endangered and threatened plants. 17.12...

  18. Translocation of threatened plants as a conservation measure in China.

    PubMed

    Liu, Hong; Ren, Hai; Liu, Qiang; Wen, XiangYing; Maunder, Michael; Gao, JiangYun

    2015-12-01

    We assessed the current status of plant conservation translocation efforts in China, a topic poorly reported in recent scientific literature. We identified 222 conservation translocation cases involving 154 species, of these 87 were Chinese endemic species and 101 (78%) were listed as threatened on the Chinese Species Red List. We categorized the life form of each species and, when possible, determined for each case the translocation type, propagule source, propagule type, and survival and reproductive parameters. A surprisingly large proportion (26%) of the conservation translocations in China were conservation introductions, largely implemented in response to large-scale habitat destruction caused by the Three-Gorge Dam and another hydropower project. Documentation and management of the translocations varied greatly. Less than half the cases had plant survival records. Statistical analyses showed that survival percentages were significantly correlated with plant life form and the type of planting materials. Thirty percent of the cases had records on whether or not individuals flowered or fruited. Results of information theoretic model selection indicated that plant life form, translocation type, propagule type, propagule source, and time since planting significantly influenced the likelihood of flowering and fruiting on the project level. We suggest that the scientific-based application of species conservation translocations should be promoted as part of a commitment to species recovery management. In addition, we recommend that the common practice of within and out of range introductions in nature reserves to be regulated more carefully due to its potential ecological risks. We recommend the establishment of a national office and database to coordinate conservation translocations in China. Our review effort is timely considering the need for a comprehensive national guideline for the newly announced nation-wide conservation program on species with extremely

  19. Quality of Life Theory II. Quality of Life as the Realization of Life Potential: A Biological Theory of Human Being

    PubMed Central

    Ventegodt, Soren; Merrick, Joav; Andersen, Niels Jorgen

    2003-01-01

    This review presents one of the eight theories of the quality of life (QOL) used for making the SEQOL (self-evaluation of quality of life) questionnaire or the quality of life as realizing life potential. This theory is strongly inspired by Maslow and the review furthermore serves as an example on how to fulfill the demand for an overall theory of life (or philosophy of life), which we believe is necessary for global and generic quality-of-life research.Whereas traditional medical science has often been inspired by mechanical models in its attempts to understand human beings, this theory takes an explicitly biological starting point. The purpose is to take a close view of life as a unique entity, which mechanical models are unable to do. This means that things considered to be beyond the individual's purely biological nature, notably the quality of life, meaning in life, and aspirations in life, are included under this wider, biological treatise. Our interpretation of the nature of all living matter is intended as an alternative to medical mechanism, which dates back to the beginning of the 20th century. New ideas such as the notions of the human being as nestled in an evolutionary and ecological context, the spontaneous tendency of self-organizing systems for realization and concord, and the central role of consciousness in interpreting, planning, and expressing human reality are unavoidable today in attempts to scientifically understand all living matter, including human life. PMID:14570994

  20. Parenting under pressure: a grounded theory of parenting young children with life-threatening congenital heart disease.

    PubMed

    Rempel, Gwen R; Ravindran, Vinitha; Rogers, Laura G; Magill-Evans, Joyce

    2013-03-01

    To report a grounded theory study to describe the process of parenting young children who have survived hypoplastic left heart syndrome to inform parent-focused interventions. Technological advances in paediatric cardiology worldwide have improved the survival rates for young children with hypoplastic left heart syndrome who undergo staged surgical palliation. These children, however, are at risk for life-threatening complications and parents are charged with the responsibility to monitor their children at home with minimal support and guidance from healthcare professionals once home. A constructivist grounded theory study. The study was conducted in 2006-2008. Participants were 25 parents (15 mothers, 10 fathers) and 28 grandparents (17 grandmothers, 11 grandfathers) of 15 young children (6 months-4·5 years) who had undergone the Sano surgical approach for hypoplastic left heart syndrome. The 53 interviews were digitally recorded, transcribed and analysed using open and focused coding, constant comparative analysis and memoing. A process of Parenting under Pressure emerged that was characterized by four overlapping and re-emerging phases: (1) realizing and adjusting to the inconceivable; (2) growing increasingly attached; (3) watching for and accommodating the unexpected; and (4) encountering new challenges. In-depth understanding of the phases of Parenting under Pressure provides direction for nurses to support parents of children who survive hypoplastic left heart syndrome. Interventions that help carers of children with complex health conditions move through the phases of our Parenting under Pressure process may help them safeguard the survival of their children, and their own survival as parents as they manage multiple demands. © 2012 Blackwell Publishing Ltd.

  1. Life history determines genetic structure and evolutionary potential of host-parasite interactions.

    PubMed

    Barrett, Luke G; Thrall, Peter H; Burdon, Jeremy J; Linde, Celeste C

    2008-12-01

    Measures of population genetic structure and diversity of disease-causing organisms are commonly used to draw inferences regarding their evolutionary history and potential to generate new variation in traits that determine interactions with their hosts. Parasite species exhibit a range of population structures and life-history strategies, including different transmission modes, life-cycle complexity, off-host survival mechanisms and dispersal ability. These are important determinants of the frequency and predictability of interactions with host species. Yet the complex causal relationships between spatial structure, life history and the evolutionary dynamics of parasite populations are not well understood. We demonstrate that a clear picture of the evolutionary potential of parasitic organisms and their demographic and evolutionary histories can only come from understanding the role of life history and spatial structure in influencing population dynamics and epidemiological patterns.

  2. Potential of protein kinase inhibitors for treating herpesvirus associated disease

    PubMed Central

    Li, Renfeng; Hayward, S. Diane

    2013-01-01

    Herpesviruses are ubiquitous human pathogens that establish life-long persistent infections. Clinical manifestations range from mild self-limiting outbreaks such as childhood rashes and cold sores to the more severe and life threatening outcomes of disseminated infection, encephalitis and cancer. Nucleoside analog drugs that target viral DNA replication provide the primary means of treatment. However, extended use of these drugs can result in selection for drug resistant strains, particularly in immunocompromised patients. In this review, we will present recent observations about the participation of cellular protein kinases in herpesvirus biology and discuss the potential for targeting these protein kinases as well as the herpesvirus encoded protein kinases as an anti-herpesvirus therapeutic strategy. PMID:23608036

  3. Communication about life-sustaining therapy: insights from the Adaptive Leadership Framework

    PubMed Central

    Neglia, Elizabeth; Anderson, Ruth A.; Brandon, Debra; Docherty, Sharron L.

    2014-01-01

    Objective Effective provider and caregiver communication is central to quality care during treatment for life-threatening illnesses. The study aim was to analyze communication patterns between providers and a parent of an infant with a life-threatening disease using the Adaptive Leadership Framework, which is an activity that involves mobilizing others to adapt to a difficult situation. Method A secondary analysis was conducted on one case using 23 interviews with providers and mother of an infant diagnosed with Hurler’s syndrome. The interviews focused on decision-making challenges in regard to the infant’s treatment and were conducted over a 1-year period (pre-transplant, study entry, monthly, after a life-threatening event or substantial change in treatment and at 1-year post enrollment). Content analysis was used to identify and categorize communication patterns using concepts from the Adaptive Leadership Framework. Results Infant illness events and parent-provider caregiving were chronicled across a 1-year trajectory. Despite the life-threatening nature of Hurler’s disease, the parent and providers did not discuss palliative care or end-of-life. The parent sought direction and answers from the providers. The Adaptive Leadership Framework suggested how communication approaches were often mismatched with the needs of the parent. Discussion The results of the study accentuate the need to improve communication between provider and parents about end-of-life for their child. Adaptive Leadership illuminates how providers can influence a parent’s behavior when facing a challenging situation. This study suggests that Adaptive Leadership is a useful framework to guide research about healthcare communication in dealing with challenging issues. PMID:25309745

  4. Effectiveness of influenza vaccine against life-threatening RT-PCR-confirmed influenza illness in US children, 2010-2012.

    PubMed

    Ferdinands, Jill M; Olsho, Lauren E W; Agan, Anna A; Bhat, Niranjan; Sullivan, Ryan M; Hall, Mark; Mourani, Peter M; Thompson, Mark; Randolph, Adrienne G

    2014-09-01

    No studies have examined the effectiveness of influenza vaccine against intensive care unit (ICU) admission associated with influenza virus infection among children. In 2010-2011 and 2011-2012, children aged 6 months to 17 years admitted to 21 US pediatric intensive care units (PICUs) with acute severe respiratory illness and testing positive for influenza were enrolled as cases; children who tested negative were PICU controls. Community controls were children without an influenza-related hospitalization, matched to cases by comorbidities and geographic region. Vaccine effectiveness was estimated with logistic regression models. We analyzed data from 44 cases, 172 PICU controls, and 93 community controls. Eighteen percent of cases, 31% of PICU controls, and 51% of community controls were fully vaccinated. Compared to unvaccinated children, children who were fully vaccinated were 74% (95% CI, 19% to 91%) or 82% (95% CI, 23% to 96%) less likely to be admitted to a PICU for influenza compared to PICU controls or community controls, respectively. Receipt of 1 dose of vaccine among children for whom 2 doses were recommended was not protective. During the 2010-2011 and 2011-2012 US influenza seasons, influenza vaccination was associated with a three-quarters reduction in the risk of life-threatening influenza illness in children. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  5. Life-threatening bleeding and radiologic intervention after aesthetic surgeries with minimal invasive approaches: report of two cases.

    PubMed

    Kim, Youn-Hwan; Kim, Jong-Do; Visconti, Giuseppe; Kim, Jeong-Tae

    2010-10-01

    In this article, the authors report two cases of life-threatening bleeding after cosmetic surgeries that have been successfully treated with radiologic intervention. A 25-year-old female and a 35-year-old female presented at their institutions because of postoperative bleeding after intraoral mandibular angle ostectomy and endoscopic-guided trans-axillary breast augmentation, respectively. A ruptured traumatic pseudo-aneurysm of the right superficial temporal artery was diagnosed in the first case and a haematoma posterior to the right pectoralis major, due to active bleeding from a perforator of internal mammary artery, in the second case. Attempts were made to stop the haemorrhage using standard methods, but failed. Therefore, superselective microcatheter angioembolisation has been successfully performed in both the cases. At 22-month follow-up for the first case and at 12-month follow-up for the second case, the patients are asymptomatic and the cosmetic outcomes are being preserved. With radiologic intervention, the authors gained satisfactory results in the above-mentioned situations. Using this, with only local anaesthesia and the absence of incisions, a precise approach with immediate treatment to the haemorrhaging site is possible. This can be an excellent solution for arterial bleeding that is difficult to access anatomically after aesthetic surgeries, and in selected cases. Furthermore, this procedure is less disfiguring and preserves the aesthetic surgery outcomes. Copyright 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Life history determines genetic structure and evolutionary potential of host–parasite interactions

    PubMed Central

    Barrett, Luke G.; Thrall, Peter H.; Burdon, Jeremy J.; Linde, Celeste C.

    2009-01-01

    Measures of population genetic structure and diversity of disease-causing organisms are commonly used to draw inferences regarding their evolutionary history and potential to generate new variation in traits that determine interactions with their hosts. Parasite species exhibit a range of population structures and life-history strategies, including different transmission modes, life-cycle complexity, off-host survival mechanisms and dispersal ability. These are important determinants of the frequency and predictability of interactions with host species. Yet the complex causal relationships between spatial structure, life history and the evolutionary dynamics of parasite populations are not well understood. We demonstrate that a clear picture of the evolutionary potential of parasitic organisms and their demographic and evolutionary histories can only come from understanding the role of life history and spatial structure in influencing population dynamics and epidemiological patterns. PMID:18947899

  7. Panhypopituitarism presenting as life-threatening heart failure caused by an inherited microdeletion in 1q25 including LHX4.

    PubMed

    Filges, Isabel; Bischof-Renner, Andrea; Röthlisberger, Benno; Potthoff, Christian; Glanzmann, René; Günthard, Joëlle; Schneider, Jacques; Huber, Andreas R; Zumsteg, Urs; Miny, Peter; Szinnai, Gabor

    2012-02-01

    Clinical presentation of hypopituitarism in the neonate may be variable, ranging from absent to severe nonspecific symptoms and may be life-threatening in patients with adrenocorticotropic hormone deficiency. The LIM homeobox gene 4 (LHX4) transcription factor regulates early embryonic development of the anterior pituitary gland. Autosomal dominant mutations in LHX4 cause congenital hypopituitarism with variable combined pituitary hormone deficiency (CPHD). We report on a neonate with unexplained heart failure and minor physical anomalies, suggesting a midline defect. She was diagnosed with complete CPHD. Cardiac function was rescued by replacement with hydrocortisone and thyroxine; hypoglycaemia stopped under growth hormone therapy. Magnetic resonance imaging revealed a dysgenetic pituitary gland suggesting an early developmental defect. Array comparative genomic hybridization showed a maternally inherited 1.5-megabase microdeletion in 1q25.2q25.3, including the LHX4 gene. Haploinsufficiency of LHX4 likely explains the predominant pituitary phenotype in the proposita and we suggest variable intrafamilial penetrance of the inherited microdeletion. To the best of our knowledge, we are the first to report on heart failure as a rare nonspecific symptom of treatable CPHD in the newborn. Variably penetrant pituitary insufficiency, including this severe and atypical presentation, can be correlated with LHX4 insufficiency and highlights the role of LHX4 for pituitary development.

  8. Teachers Communicating about Life-Limiting Conditions, Death and Bereavement

    ERIC Educational Resources Information Center

    Robinson, Sally; Ekins, Alison; Durrant, Ian; Summers, Kathryn

    2018-01-01

    The number of children with life-limiting or life-threatening conditions in England is double what it was at the millennium. These conditions include cystic fibrosis, cancer, organ failure and severe neurological injuries. The Teaching for Life project aimed to explore the needs of teachers working in English schools in relation to working with…

  9. Hematozoa in two populations of the threatened red-billed chough in Spain.

    PubMed

    Blanco, G; Merino, S; Tella, J L; Fargallo, J A; Gajón, A

    1997-07-01

    The prevalence of hematozoa in two populations of red-billed choughs (Pyrrhocorax pyrrhocorax) was sampled in 1992 and 1994 in Spain. Two blood parasites infected red-billed choughs. A species of Plasmodium, possibly Plasmodium relictum, and the piroplasm Babesia frugilegica, are described for the first time from this host. Low prevalence (1/178, < 1%) of hematozoa in these populations, was evidence for a lack of effects of blood parasites on the life history and conservation of this threatened species in at least the two populations studied.

  10. "It's not about treatment, it's how to improve your life": The lived experience of occupational therapy in palliative care.

    PubMed

    Badger, Sarah; Macleod, Rod; Honey, Anne

    2016-06-01

    A key aim of palliative care is to improve the quality-of-life of people with a life-threatening illness. Occupational therapists are well positioned to contribute to this aim due to their broad range of interventions, client-centeredness and focus on occupation. However, there is a limited understanding of how occupational therapy contributes to the end-of-life experience, which is crucial to providing optimal care. The aim of this study is to investigate the lived experience of occupational therapy in palliative care for people with a life-threatening illness. A hermeneutic interpretive phenomenological approach was adopted. Semi-structured interviews were conducted with eight participants recruited from inpatient and outpatient sectors of a specialist palliative care hospital in Sydney, Australia. The two themes developed from participant responses were: (1) occupational therapy provides comfort and safety and (2) trusting the occupational therapist to know what is needed. This study gives insight into the ways in which people with a life-threatening illness experience occupational therapy in palliative care. In addition, it provides a starting point to guide practice that is attentive to the needs of people with a life-threatening illness at end-of-life, thus enhancing client-centered care.

  11. Assessment of quality of life in children with peanut allergy.

    PubMed

    Avery, Natalie J; King, Rosemary M; Knight, Susan; Hourihane, Jonathan O'B

    2003-10-01

    Children with a peanut allergy (PA) are faced with food and social restrictions due to the potentially life-threatening nature of their disease, for which there is no cure or treatment. This inevitably impacts upon their quality of life (QoL). QoL of 20 children with PA and 20 children with insulin-dependent diabetes mellitus (IDDM) was measured using two disease-specific QoL questionnaires (higher scores correspond to a poorer QoL). One questionnaire was designed by us and the other was adapted from the Vespid Allergy QoL questionnaire. We gave subjects cameras to record how their QoL is affected over a 24-h period. Response rates for both questionnaires were 100%. Mean ages were 9.0 and 10.4 years for PA and IDDM subjects, respectively. Children with a PA reported a poorer quality of life than children with IDDM: mean scores were 54.85 for PA subjects and 46.40 for diabetics (p = 0.004) in questionnaire 1 and 54.30 and 34.50 (pthreatened by potential hazards within their environment, felt more restricted by their PA regarding physical activities, and worried more about being away from home. However, they felt safe when carrying epinephrine kits and were positive about eating at familiar restaurants. The QoL in children with PA is more impaired than in children with IDDM. Their anxiety may be considered useful in some situations, promoting better adherence to allergen avoidance advice and rescue plans.

  12. Potential effects of mercury on threatened California black rails

    USGS Publications Warehouse

    Tsao, Danika C.; Miles, A. Keith; Takekawa, John Y.; Woo, Isa

    2009-01-01

    San Francisco Bay (SFB) estuary sediments contain high levels of mercury (Hg), and tidal marsh resident species may be vulnerable to Hg contamination. We examined Hg concentrations in California black rails, a threatened waterbird species that inhabits SFB tidal salt marshes. We captured 127 black rails during the prebreeding and postbreeding seasons and examined the influence of site, sex, and year on Hg, methylmercury (MeHg), and also selenium (Se) concentrations in feathers and blood. Feather Hg concentrations averaged 6.94 ??g/g dry weight (dw) and MeHg and Se concentrations in blood averaged 0.38 and 0.42 ??g/g wet weight (ww). We used Akaike's information criterion model selection process to evaluate the importance of year, site, sex, and age on patterns of MeHg concentrations; sex and year were the most important of these factors. Feather Hg concentrations (dw) were higher in males (8.22 ??g/g) than females (6.63 ??g/g) and higher in adult birds (7.36 ??g/g) than in hatch-year birds (4.61 ??g/g). A substantial portion of SFB black rail populations may be at risk of reproductive effects due to MeHg contamination, as 32-78% of feathers and <10% of blood samples exceeded no observed adverse effect levels. Sea level rise and other anthropogenic threats to endemic tidal marsh species such as black rails may be exacerbated by the presence of MeHg. Further study of population demographics and toxicological effects would further elucidate the effects of MeHg contamination on black rail populations in SFB. ?? 2008 Springer Science+Business Media, LLC.

  13. Transarterial endovascular treatment in the management of life-threatening carotid blowout syndrome in head and neck cancer patients: review of the literature.

    PubMed

    Dequanter, D; Shahla, M; Paulus, P; Aubert, C; Lothaire, P

    2013-12-01

    Carotid blowout syndrome is a rare but devastating complication in patients with head and neck malignancy, and is associated with high morbidity and mortality. Bleeding from the carotid artery or its branches is a well-recognized complication following treatment or recurrence of head and neck cancer. It is an emergency situation, and the classical approach to save the patient's life is to ligate the carotid artery. But the surgical treatment is often technically difficult. Endovascular therapies were recently reported as good alternatives to surgical ligation. Retrospective review of three cases of acute or threatened carotid hemorrhage managed by endovascular therapies. Two patients presented with acute carotid blowout, and one patient with a sentinel bleed. Two patients had previously been treated with surgery and chemo radiation. One patient was treated by chemo radiation. Two had developed pharyngocutaneous fistulas, and one had an open necrosis filled wound that surrounded the carotid artery. In two patients, stent placement resolved the acute hemorrhage. In one patient, superselective embolization was done. Mean duration follow-up was 10.2 months. No patient had residual sequelae of stenting or embolization. Management of carotid blow syndrome is very critical and difficult. A multidisciplinary approach is very important in the management of carotid blow syndrome. Correct and suitable management can be life saving. An endovascular technique is a good and effective alternative with much lower morbidity rates than surgical repair or ligation. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  14. Amygdala neural activity reflects spatial attention towards stimuli promising reward or threatening punishment

    PubMed Central

    Peck, Christopher J; Salzman, C Daniel

    2014-01-01

    Humans and other animals routinely identify and attend to sensory stimuli so as to rapidly acquire rewards or avoid aversive experiences. Emotional arousal, a process mediated by the amygdala, can enhance attention to stimuli in a non-spatial manner. However, amygdala neural activity was recently shown to encode spatial information about reward-predictive stimuli, and to correlate with spatial attention allocation. If representing the motivational significance of sensory stimuli within a spatial framework reflects a general principle of amygdala function, then spatially selective neural responses should also be elicited by sensory stimuli threatening aversive events. Recordings from amygdala neurons were therefore obtained while monkeys directed spatial attention towards stimuli promising reward or threatening punishment. Neural responses encoded spatial information similarly for stimuli associated with both valences of reinforcement, and responses reflected spatial attention allocation. The amygdala therefore may act to enhance spatial attention to sensory stimuli associated with rewarding or aversive experiences. DOI: http://dx.doi.org/10.7554/eLife.04478.001 PMID:25358090

  15. Vibration perception threshold for sight-threatening retinopathy screening in type 2 diabetic outpatients.

    PubMed

    Shen, Jing; Hu, Yanyun; Liu, Fang; Zeng, Hui; Li, Lianxi; Zhao, Jun; Zhao, Jungong; Zheng, Taishan; Lu, Huijuan; Lu, Fengdi; Bao, Yuqian; Jia, Weiping

    2013-10-01

    threshold and the severity of diabetic retinopathy. vibration perception threshold was a potential screening method for diabetic retinopathy, and its optimal cut-off for prompting high risk of sight-threatening retinopathy was 18 V. Copyright © 2013 John Wiley & Sons, Ltd.

  16. 75 FR 81584 - Endangered and Threatened Species; Recovery Plan for the Sperm Whale

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ... potential threats based on the best available science and presents guidance for use by agencies and... and Threatened Species; Recovery Plan for the Sperm Whale AGENCY: National Marine Fisheries Service... for the sperm whale. SUMMARY: The National Marine Fisheries Service (NMFS) announces the adoption of...

  17. 78 FR 60023 - Endangered and Threatened Wildlife and Plants; Proposed Threatened Status for the Rufa Red Knot...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-30

    ...We, the U.S. Fish and Wildlife Service, propose to list the rufa red knot (Calidris canutus rufa) as a threatened species under the Endangered Species Act of 1973, as amended (Act). If we finalize this rule as proposed, it would extend the Act's protections to this species. The effect of this regulation will be to add this species to the List of Endangered and Threatened Wildlife.

  18. Can a manager have a life and a career? International and multisource perspectives on work-life balance and career advancement potential.

    PubMed

    Lyness, Karen S; Judiesch, Michael K

    2008-07-01

    The present study was the first cross-national examination of whether managers who were perceived to be high in work-life balance were expected to be more or less likely to advance in their careers than were less balanced, more work-focused managers. Using self ratings, peer ratings, and supervisor ratings of 9,627 managers in 33 countries, the authors examined within-source and multisource relationships with multilevel analyses. The authors generally found that managers who were rated higher in work-life balance were rated higher in career advancement potential than were managers who were rated lower in work-life balance. However, national gender egalitarianism, measured with Project GLOBE scores, moderated relationships based on supervisor and self ratings, with stronger positive relationships in low egalitarian cultures. The authors also found 3-way interactions of work-life balance ratings, ratee gender, and gender egalitarianism in multisource analyses in which self balance ratings predicted supervisor and peer ratings of advancement potential. Work-life balance ratings were positively related to advancement potential ratings for women in high egalitarian cultures and men in low gender egalitarian cultures, but relationships were nonsignificant for men in high egalitarian cultures and women in low egalitarian cultures.

  19. Accidental and potentially life-threatening finding: pulsatile mass of the hypopharynx.

    PubMed

    Ferreira, Joana Maria Soares; Coimbra, Edite; Almeida, António Faria; Condé, Artur

    2018-04-18

    Anatomical variations of the cervical part of the internal carotid artery (ICA) are not rare in the general population. They are usually asymptomatic and more common in the elderly. We report the case of a 70-year-old Caucasian woman who was referred to our department due to chronic cough. We performed a flexible nasofibrolaryngoscopy that demonstrated the presence of a pulsatile mass in the hypopharynx. After performing a cervical contrast-enhanced CT, the mass turned out to be an aberrant variation of the cervical part of the ICA. This case is intended to alert otolaryngologists, anaesthesiologists, radiologists and surgeons for this accidental finding and the possible consequences for the patient if not diagnosed and properly oriented. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Role of Physical Therapy Intervention in Patients With Life-Threatening Illnesses.

    PubMed

    Putt, Kaitlyn; Faville, Kelli Anne; Lewis, David; McAllister, Kevin; Pietro, Maria; Radwan, Ahmed

    2017-03-01

    Physical therapy encompasses the skilled treatment and care for patients across the life span through a multitude of different practice settings. This includes caring for individuals within end-of-life or palliative care settings. The goal of treatment in this stage of care is to relieve physical, social, psychological, and spiritual suffering in order to improve overall quality of life in patients with terminal illnesses. There has been limited research conducted to investigate the utilization of physical therapy interventions in palliative care settings. The purpose of this study was to contribute to the current research involving physical therapy and end-of-life care in terms of its efficacy, value, and how this value is perceived by patients and their caregivers. This was completed by independently screening and reviewing the studies that were published between the years 1994 and 2014 and related to this topic. The databases and journals searched included CINAHL, PUBMED, MEDLINE, Cochrane, PEDro, the Journal of Palliative Care, the American Journal of Hospice and Palliative Medicine, and Google Scholar. Thirteen qualitative articles were selected which met all inclusion criteria and discussed the role of physical therapy intervention in the palliative care setting. Methodological quality of articles were assessed using the QASP, scale and their findings were summarized and presented in table format. These articles support the utilization of physical therapy in palliative care settings and emphasizes the impact of physical therapy on improving patients' physical, social, and emotional well-being.

  1. Outcome of pregnancy complicated by threatened abortion.

    PubMed

    Dongol, A; Mool, S; Tiwari, P

    2011-01-01

    Threatened abortion is the most common complication in the first half of pregnancy. Most of these pregnancies continue to term with or without treatment. Spontaneous abortion occurs in less than 30% of these women. Threatened abortion had been shown to be associated with increased incidence of antepartum haemorrhage, preterm labour and intra uterine growth retardation. This study was to asses the outcome of threatened abortion following treatment. This prospective study was carried out in Dhulikhel Hospital - Kathmandu University Hospital from January 2009 till May 2010. Total 70 cases of threatened abortion were selected, managed with complete bed rest till 48 hrs of cessation of bleeding, folic acid supplementation, uterine sedative, and hormonal treatment till 28 weeks of gestation. Ultrasonogram was performed for diagnosis and to detect the presence of subchorionic hematoma. Patients were followed up until spontaneous abortion or up to delivery of the fetus. The measures used for the analysis were maternal age, parity, gestational age at the time of presentation, previous abortions, presence of subchorionic hematoma, complete abortion, continuation of pregnancy, antepartum hemorrhage, intrauterine growth retardation and intrauterine death of fetus. Out of 70 cases subchorionic haematoma was found in 30 (42.9%) cases. There were 12 (17.1%) patients who spontaneously aborted after diagnosis of threatened abortion during hospital stay, 5 (7.1%) aborted on subsequent visits while 53 (75.8%) continued pregnancy till term. Among those who continued pregnancy intrauterine growth retardation was seen in 7 (13.2%), antepartum hemorrhage in 4 (7.5%), preterm premature rupture of membrane in 3 (5.66%) and IUD in 3 (5.66%). Spontaneous abortion was found more in cases with subchorionic hematoma of size more than 20 cm2. In cases of threatened abortion with or without the presence of subchorionic hematoma, prognostic outcome is better following treatment with bed rest

  2. Vision-Threatening Behcet's Disease: Severity of Ocular Involvement Predictors

    PubMed Central

    Hussein, Mohammed A.; Dahab, Ahmed A.

    2018-01-01

    Purpose To examine and spot systemic findings commonly associated with a serious form of ocular Behcet's disease. This could potentially help ophthalmologists categorize their patients based on future risk and plan treatment accordingly. Subjects and Methods The data of 249 patients with Behcet's disease were examined thoroughly. Correlations between systemic and ocular findings were recorded. Patients were further subgrouped by the authors as having a vision-threatening form of the disease or not. Regression analysis was done to spot predictors for a vision-threatening form of the disease. Results The presence of systemic vasculitis and oral and genital ulcers in a patient with Behcet's disease was found to be associated with a milder form of ocular affection or none at all and vice versa. Certain correlations between findings were also found. Conclusion Certain findings in Behcet's disease may act as predictors for the severity of ocular affection. Directing our attention to these factors by the internist and ophthalmologist can help plan the frequency of follow-up as well as the aggressiveness of treatment in patients with Behcet's disease. PMID:29854430

  3. An introduction to adaptive management for threatened and endangered species

    USGS Publications Warehouse

    Runge, Michael C.

    2011-01-01

    Management of threatened and endangered species would seem to be a perfect context for adaptive management. Many of the decisions are recurrent and plagued by uncertainty, exactly the conditions that warrant an adaptive approach. But although the potential of adaptive management in these settings has been extolled, there are limited applications in practice. The impediments to practical implementation are manifold and include semantic confusion, institutional inertia, misperceptions about the suitability and utility, and a lack of guiding examples. In this special section of the Journal of Fish and Wildlife Management, we hope to reinvigorate the appropriate application of adaptive management for threatened and endangered species by framing such management in a decision-analytical context, clarifying misperceptions, classifying the types of decisions that might be amenable to an adaptive approach, and providing three fully developed case studies. In this overview paper, I define terms, review the past application of adaptive management, challenge perceived hurdles, and set the stage for the case studies which follow.

  4. Threatened, endangered, and vulnerable species of terrestrial vertebrates in the Rocky Mountain Region

    Treesearch

    Deborah M. Finch

    1991-01-01

    This report describes the current status of 67 threatened, endangered, and vulnerable wildlife species in the Rocky Mountain Region of the U.S. Forest Service. Known or potential reasons for population declines and species susceptibility are identified; and distributions, habitats, specialized needs, and perceived threats of individual species are discusses.

  5. The feasibility of ethnodrama as intervention to highlight late-life potential for nursing students and older adults.

    PubMed

    Eaton, Jacqueline

    2015-01-01

    One barrier to the expansion of geriatric health care providers is the limited desire of nursing students to work with older adults. The purpose of this study is to evaluate the feasibility of using ethnodrama as an intervention to highlight late-life potential. Twelve baccalaureate nursing students were paired with 12 residents of an assisted living facility to complete transformative learning activities focused on the topic of late-life potential culminating in a performance of an ethnodrama developed from these data. Transcripts of initial student meetings, self-reflections, the performance, postperformance discussion, and open-ended survey questions were analyzed using in vivo and pattern coding. Older adult participants recognized and emphasized positive late-life potential, whereas students explored potential throughout the life span and reflected on its meaning in their own lives. Increasing discussion about late-life potential may alter the stigma associated with aging.

  6. The biogeography of globally threatened seabirds and island conservation opportunities.

    PubMed

    Spatz, Dena R; Newton, Kelly M; Heinz, Reina; Tershy, Bernie; Holmes, Nick D; Butchart, Stuart H M; Croll, Donald A

    2014-10-01

    Seabirds are the most threatened group of marine animals; 29% of species are at some risk of extinction. Significant threats to seabirds occur on islands where they breed, but in many cases, effective island conservation can mitigate these threats. To guide island-based seabird conservation actions, we identified all islands with extant or extirpated populations of the 98 globally threatened seabird species, as recognized on the International Union for Conservation of Nature Red List, and quantified the presence of threatening invasive species, protected areas, and human populations. We matched these results with island attributes to highlight feasible island conservation opportunities. We identified 1362 threatened breeding seabird populations on 968 islands. On 803 (83%) of these islands, we identified threatening invasive species (20%), incomplete protected area coverage (23%), or both (40%). Most islands with threatened seabirds are amenable to island-wide conservation action because they are small (57% were <1 km(2) ), uninhabited (74%), and occur in high- or middle-income countries (96%). Collectively these attributes make islands with threatened seabirds a rare opportunity for effective conservation at scale. © 2014 Society for Conservation Biology.

  7. List identifies threatened ecosystems

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2012-09-01

    The International Union for Conservation of Nature (IUCN) announced on 9 September that it will develop a new Red List of Ecosystems that will identify which ecosystems are vulnerable or endangered. The list, which is modeled on the group's Red List of Threatened Species™, could help to guide conservation activities and influence policy processes such as the Convention on Biological Diversity, according to the group. “We will assess the status of marine, terrestrial, freshwater, and subterranean ecosystems at local, regional, and global levels,” stated Jon Paul Rodriguez, leader of IUCN's Ecosystems Red List Thematic Group. “The assessment can then form the basis for concerted implementation action so that we can manage them sustainably if their risk of collapse is low or restore them if they are threatened and then monitor their recovery.”

  8. Expanding Hematoma's Life-Threatening Neck and Face Emergency Management of Ballistic Injuries.

    PubMed

    Shuker, Sabri T

    2016-07-01

    This article aims to bring attention to the morbidity and fatality of hemorrhage, how expanding hematoma and air compromise neck/face N/F injuries and present challenges. Large neck vessel ballistic injuries may lead to hemorrhage and expanding hematoma, resulting in airway compromise, due to injuries to the internal and/or external carotid arteries, internal jugular veins "internal carotid artery, external carotid artery, internal jugular vein," and the external carotid artery deep branches. This also leads to injuries to the cervical fascial layers (barriers of deep spaces) that facilitate pooling blood and hematoma into compartmental and large potential space which effects the pharynx, larynx, esophagus, and trachea.The expanding hematomas distort neck anatomical landmarks so "no neck zones" classifications are applicable. As the spectrum of injuries continues to evolve, the clinical characterization needs a new categorization based on compartmental hematoma and potential space anatomical location like retropharyngeal, parapharyngeal, sublingual, submandibular spaces, retrobulbar, and cheek compartment space hematomas.Presence of symptoms and location of the hematoma generally dictate what type of procedure is needed and how urgently it needs to be appropriately performed.Two unusual patients of pseudoaneurysms facial artery injuries with extravasation of blood producing a pulsating hematoma are referred to. Another patient considers large internal carotid artery injuries pseudoaneurysms revealed in angiography.The immediate management of life-saving patients requires aggressive airway maintenance at the scene, conscious victim will often obtain a posture that clears his airway and the semiconscious or unconscious put him in prone position. Air compromise may need emergency intubation, large bore cannula cricothyroidotomy, cricothyrotomy and at medical facilities tracheostomy.

  9. Effects of life-history requirements on the distribution of a threatened reptile.

    PubMed

    Thompson, Denise M; Ligon, Day B; Patton, Jason C; Papeş, Monica

    2017-04-01

    Survival and reproduction are the two primary life-history traits essential for species' persistence; however, the environmental conditions that support each of these traits may not be the same. Despite this, reproductive requirements are seldom considered when estimating species' potential distributions. We sought to examine potentially limiting environmental factors influencing the distribution of an oviparous reptile of conservation concern with respect to the species' survival and reproduction and to assess the implications of the species' predicted climatic constraints on current conservation practices. We used ecological niche modeling to predict the probability of environmental suitability for the alligator snapping turtle (Macrochelys temminckii). We built an annual climate model to examine survival and a nesting climate model to examine reproduction. We combined incubation temperature requirements, products of modeled soil temperature data, and our estimated distributions to determine whether embryonic development constrained the northern distribution of the species. Low annual precipitation constrained the western distribution of alligator snapping turtles, whereas the northern distribution was constrained by thermal requirements during embryonic development. Only a portion of the geographic range predicted to have a high probability of suitability for alligator snapping turtle survival was estimated to be capable of supporting successful embryonic development. Historic occurrence records suggest adult alligator snapping turtles can survive in regions with colder climes than those associated with consistent and successful production of offspring. Estimated egg-incubation requirements indicated that current reintroductions at the northern edge of the species' range are within reproductively viable environmental conditions. Our results highlight the importance of considering survival and reproduction when estimating species' ecological niches, implicating

  10. Successful silicon stent for life-threatening tracheal wall laceration.

    PubMed

    Yamamoto, Shinichi; Endo, Shunsuke; Endo, Tetsuya; Mitsuda, Sayaka

    2013-01-01

    We report an 86-year-old woman with a large tracheal laceration caused by tracheal intubation at cardiopulmonary arrest who underwent a successful stent procedure. Tracheal laceration developed in the membranous portion longitudinally 6 cm in length to 2 cm above the carina. Following 9 days' tracheal intubation, a Y-shaped silicon stent was inserted over the lacerated trachea. Four months after the stenting procedure, we removed the Y-shaped silicon stent from the healed membranous wall. The patient returned to daily life without requiring thoracotomy.

  11. The density dilemma: limitations on juvenile production in threatened salmon populations

    USGS Publications Warehouse

    Walters, Annika W.; Copeland, Timothy; Venditti, David A.

    2013-01-01

    Density-dependent processes have repeatedly been shown to have a central role in salmonid population dynamics, but are often assumed to be negligible for populations at low abundances relative to historical records. Density dependence has been observed in overall spring/summer Snake River Chinook salmon Oncorhynchus tshawytscha production, but it is not clear how patterns observed at the aggregate level relate to individual populations within the basin. We used a Bayesian hierarchical modelling approach to explore the degree of density dependence in juvenile production for nine Idaho populations. Our results indicate that density dependence is ubiquitous, although its strength varies between populations. We also investigated the processes driving the population-level pattern and found density-dependent growth and mortality present for both common life-history strategies, but no evidence of density-dependent movement. Overwinter mortality, spatial clustering of redds and limited resource availability were identified as potentially important limiting factors contributing to density dependence. The ubiquity of density dependence for these threatened populations is alarming as stability at present low abundance levels suggests recovery may be difficult without major changes. We conclude that density dependence at the population level is common and must be considered in demographic analysis and management.

  12. Globally threatened vertebrates on islands with invasive species

    PubMed Central

    Spatz, Dena R.; Zilliacus, Kelly M.; Holmes, Nick D.; Butchart, Stuart H. M.; Genovesi, Piero; Ceballos, Gerardo; Tershy, Bernie R.; Croll, Donald A.

    2017-01-01

    Global biodiversity loss is disproportionately rapid on islands, where invasive species are a major driver of extinctions. To inform conservation planning aimed at preventing extinctions, we identify the distribution and biogeographic patterns of highly threatened terrestrial vertebrates (classified by the International Union for Conservation of Nature) and invasive vertebrates on ~465,000 islands worldwide by conducting a comprehensive literature review and interviews with more than 500 experts. We found that 1189 highly threatened vertebrate species (319 amphibians, 282 reptiles, 296 birds, and 292 mammals) breed on 1288 islands. These taxa represent only 5% of Earth’s terrestrial vertebrates and 41% of all highly threatened terrestrial vertebrates, which occur in <1% of islands worldwide. Information about invasive vertebrates was available for 1030 islands (80% of islands with highly threatened vertebrates). Invasive vertebrates were absent from 24% of these islands, where biosecurity to prevent invasions is a critical management tool. On the 76% of islands where invasive vertebrates were present, management could benefit 39% of Earth’s highly threatened vertebrates. Invasive mammals occurred in 97% of these islands, with Rattus sp. as the most common invasive vertebrate (78%; 609 islands). Our results provide an important baseline for identifying islands for invasive species eradication and other island conservation actions that reduce biodiversity loss. PMID:29075662

  13. Globally threatened vertebrates on islands with invasive species.

    PubMed

    Spatz, Dena R; Zilliacus, Kelly M; Holmes, Nick D; Butchart, Stuart H M; Genovesi, Piero; Ceballos, Gerardo; Tershy, Bernie R; Croll, Donald A

    2017-10-01

    Global biodiversity loss is disproportionately rapid on islands, where invasive species are a major driver of extinctions. To inform conservation planning aimed at preventing extinctions, we identify the distribution and biogeographic patterns of highly threatened terrestrial vertebrates (classified by the International Union for Conservation of Nature) and invasive vertebrates on ~465,000 islands worldwide by conducting a comprehensive literature review and interviews with more than 500 experts. We found that 1189 highly threatened vertebrate species (319 amphibians, 282 reptiles, 296 birds, and 292 mammals) breed on 1288 islands. These taxa represent only 5% of Earth's terrestrial vertebrates and 41% of all highly threatened terrestrial vertebrates, which occur in <1% of islands worldwide. Information about invasive vertebrates was available for 1030 islands (80% of islands with highly threatened vertebrates). Invasive vertebrates were absent from 24% of these islands, where biosecurity to prevent invasions is a critical management tool. On the 76% of islands where invasive vertebrates were present, management could benefit 39% of Earth's highly threatened vertebrates. Invasive mammals occurred in 97% of these islands, with Rattus sp. as the most common invasive vertebrate (78%; 609 islands). Our results provide an important baseline for identifying islands for invasive species eradication and other island conservation actions that reduce biodiversity loss.

  14. The search for life on Europa: limiting environmental factors, potential habitats, and Earth analogues.

    PubMed

    Marion, Giles M; Fritsen, Christian H; Eicken, Hajo; Payne, Meredith C

    2003-01-01

    The putative ocean of Europa has focused considerable attention on the potential habitats for life on Europa. By generally clement Earth standards, these Europan habitats are likely to be extreme environments. The objectives of this paper were to examine: (1) the limits for biological activity on Earth with respect to temperature, salinity, acidity, desiccation, radiation, pressure, and time; (2) potential habitats for life on Europa; and (3) Earth analogues and their limitations for Europa. Based on empirical evidence, the limits for biological activity on Earth are: (1) the temperature range is from 253 to 394 K; (2) the salinity range is a(H2O) = 0.6-1.0; (3) the desiccation range is from 60% to 100% relative humidity; (4) the acidity range is from pH 0 to 13; (5) microbes such as Deinococcus are roughly 4,000 times more resistant to ionizing radiation than humans; (6) the range for hydrostatic pressure is from 0 to 1,100 bars; and (7) the maximum time for organisms to survive in the dormant state may be as long as 250 million years. The potential habitats for life on Europa are the ice layer, the brine ocean, and the seafloor environment. The dual stresses of lethal radiation and low temperatures on or near the icy surface of Europa preclude the possibility of biological activity anywhere near the surface. Only at the base of the ice layer could one expect to find the suitable temperatures and liquid water that are necessary for life. An ice layer turnover time of 10 million years is probably rapid enough for preserving in the surface ice layers dormant life forms originating from the ocean. Model simulations demonstrate that hypothetical oceans could exist on Europa that are too cold for biological activity (T < 253 K). These simulations also demonstrate that salinities are high, which would restrict life to extreme halophiles. An acidic ocean (if present) could also potentially limit life. Pressure, per se, is unlikely to directly limit life on Europa. But

  15. Life-threatening complications of ibogaine: three case reports.

    PubMed

    Paling, F P; Andrews, L M; Valk, G D; Blom, H J

    2012-11-01

    Ibogaine is a naturally occurring psychoactive alkaloid extracted from the roots of the Tabernanthe iboga plant, which in alternative medicine is used to treat drug dependency. However, this upcoming, online advocated therapy can be dangerous due to its potentially lethal adverse effects. We present three cases in which toxic side effects were noted. We used the Naranjo scale to estimate the probability of a causal relationship between these effects and ibogaine. Findings in these three cases are suggestive of a causal relationship between the use of ibogaine and serious respiratory and cardiac problems (including lengthening of the QT interval). In our opinion it is of great importance that clinicians are aware of these potentially serious side effects and realise that widespread online marketing practices will give many more people access to ibogaine.

  16. 40 CFR 230.30 - Threatened and endangered species.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... consultation with the Secretary of the Interior occurs under section 7 of the Endangered Species Act, the... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Threatened and endangered species. 230... Impacts on Biological Characteristics of the Aquatic Ecosystem § 230.30 Threatened and endangered species...

  17. 40 CFR 230.30 - Threatened and endangered species.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... consultation with the Secretary of the Interior occurs under section 7 of the Endangered Species Act, the... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Threatened and endangered species. 230... Impacts on Biological Characteristics of the Aquatic Ecosystem § 230.30 Threatened and endangered species...

  18. 40 CFR 230.30 - Threatened and endangered species.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... consultation with the Secretary of the Interior occurs under section 7 of the Endangered Species Act, the... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Threatened and endangered species. 230... Impacts on Biological Characteristics of the Aquatic Ecosystem § 230.30 Threatened and endangered species...

  19. 40 CFR 230.30 - Threatened and endangered species.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... consultation with the Secretary of the Interior occurs under section 7 of the Endangered Species Act, the... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Threatened and endangered species. 230... Impacts on Biological Characteristics of the Aquatic Ecosystem § 230.30 Threatened and endangered species...

  20. Life-threatening urethral hemorrhage after placement of a Foley catheter in a patient with uroseptic disseminated intravascular coagulation due to chronic urinary retention induced by untreated benign prostatic hyperplasia.

    PubMed

    Ikegami, Yukihiro; Yoshida, Keisuke; Imaizumi, Tsuyoshi; Isosu, Tsuyoshi; Kurosawa, Shin; Murakawa, Masahiro

    2016-10-01

    A 77-year-old man with severe septic disseminated intravascular coagulation following urinary infection was transported to our hospital. He had developed urinary retention induced by untreated prostatic hyperplasia. Immediate drainage with a Foley catheter was successfully carried out, but the hematuria progressed to life-threatening hemorrhage. Complete hemostasis was impossible by surgical treatment because the tissue around the prostatic urethra was very fragile and hemorrhagic. Organized treatments (continuous hemodiafiltration combined with polymyxin-B immobilized fiber column hemoperfusion and systemic treatment with antibiotics and coagulation factors) were commenced soon after the operation. The patient eventually recovered from the septic disseminated intravascular coagulation. This case report illustrates the risk of placement of Foley catheters in patients with severe septic disseminated intravascular coagulation.

  1. Mineral-organic interfacial processes: potential roles in the origins of life.

    PubMed

    Cleaves, H James; Michalkova Scott, Andrea; Hill, Frances C; Leszczynski, Jerzy; Sahai, Nita; Hazen, Robert

    2012-08-21

    Life is believed to have originated on Earth ∼4.4-3.5 Ga ago, via processes in which organic compounds supplied by the environment self-organized, in some geochemical environmental niches, into systems capable of replication with hereditary mutation. This process is generally supposed to have occurred in an aqueous environment and, likely, in the presence of minerals. Mineral surfaces present rich opportunities for heterogeneous catalysis and concentration which may have significantly altered and directed the process of prebiotic organic complexification leading to life. We review here general concepts in prebiotic mineral-organic interfacial processes, as well as recent advances in the study of mineral surface-organic interactions of potential relevance to understanding the origin of life.

  2. High proportion of cactus species threatened with extinction.

    PubMed

    Goettsch, Bárbara; Hilton-Taylor, Craig; Cruz-Piñón, Gabriela; Duffy, James P; Frances, Anne; Hernández, Héctor M; Inger, Richard; Pollock, Caroline; Schipper, Jan; Superina, Mariella; Taylor, Nigel P; Tognelli, Marcelo; Abba, Agustín M; Arias, Salvador; Arreola-Nava, Hilda J; Baker, Marc A; Bárcenas, Rolando T; Barrios, Duniel; Braun, Pierre; Butterworth, Charles A; Búrquez, Alberto; Caceres, Fátima; Chazaro-Basañez, Miguel; Corral-Díaz, Rafael; Del Valle Perea, Mario; Demaio, Pablo H; Duarte de Barros, Williams A; Durán, Rafael; Yancas, Luis Faúndez; Felger, Richard S; Fitz-Maurice, Betty; Fitz-Maurice, Walter A; Gann, George; Gómez-Hinostrosa, Carlos; Gonzales-Torres, Luis R; Patrick Griffith, M; Guerrero, Pablo C; Hammel, Barry; Heil, Kenneth D; Hernández-Oria, José Guadalupe; Hoffmann, Michael; Ishihara, Mario Ishiki; Kiesling, Roberto; Larocca, João; León-de la Luz, José Luis; Loaiza S, Christian R; Lowry, Martin; Machado, Marlon C; Majure, Lucas C; Ávalos, José Guadalupe Martínez; Martorell, Carlos; Maschinski, Joyce; Méndez, Eduardo; Mittermeier, Russell A; Nassar, Jafet M; Negrón-Ortiz, Vivian; Oakley, Luis J; Ortega-Baes, Pablo; Ferreira, Ana Beatriz Pin; Pinkava, Donald J; Porter, J Mark; Puente-Martinez, Raul; Gamarra, José Roque; Pérez, Patricio Saldivia; Martínez, Emiliano Sánchez; Smith, Martin; Manuel Sotomayor M Del C, J; Stuart, Simon N; Muñoz, José Luis Tapia; Terrazas, Teresa; Terry, Martin; Trevisson, Marcelo; Valverde, Teresa; Van Devender, Thomas R; Véliz-Pérez, Mario Esteban; Walter, Helmut E; Wyatt, Sarah A; Zappi, Daniela; Alejandro Zavala-Hurtado, J; Gaston, Kevin J

    2015-10-05

    A high proportion of plant species is predicted to be threatened with extinction in the near future. However, the threat status of only a small number has been evaluated compared with key animal groups, rendering the magnitude and nature of the risks plants face unclear. Here we report the results of a global species assessment for the largest plant taxon evaluated to date under the International Union for Conservation of Nature (IUCN) Red List Categories and Criteria, the iconic Cactaceae (cacti). We show that cacti are among the most threatened taxonomic groups assessed to date, with 31% of the 1,478 evaluated species threatened, demonstrating the high anthropogenic pressures on biodiversity in arid lands. The distribution of threatened species and the predominant threatening processes and drivers are different to those described for other taxa. The most significant threat processes comprise land conversion to agriculture and aquaculture, collection as biological resources, and residential and commercial development. The dominant drivers of extinction risk are the unscrupulous collection of live plants and seeds for horticultural trade and private ornamental collections, smallholder livestock ranching and smallholder annual agriculture. Our findings demonstrate that global species assessments are readily achievable for major groups of plants with relatively moderate resources, and highlight different conservation priorities and actions to those derived from species assessments of key animal groups.

  3. Limitations of Routine Verification of Nasogastric Tube Insertion Using X-Ray and Auscultation: Two Case Reports of Life-Threatening Complications.

    PubMed

    Nejo, Takahide; Oya, Soichi; Tsukasa, Tsuchiya; Yamaguchi, Naomi; Matsui, Toru

    2016-12-01

    Several bedside approaches used in combination with thoracoabdominal X-ray are widely used to avoid severe complications that have been reported during nasogastric tube management. Although confirmation by X-ray is considered the gold standard, it is not yet perfect. We present 2 cases of rare complications in which the routine verification methods could not detect all the complications related to the nasogastric tube placement. Case 1 was a 17-year-old male who presented with a brain tumor and repeatedly required nasogastric tube placement. Despite normal auscultatory and X-ray findings, the patient's condition deteriorated rapidly after resuming the enteral nutrition (EN). Computed tomography images showed the presence of hepatic portal venous gas (HPVG). Urgent upper gastrointestinal endoscopy showed esophagogastric submucosal tunneling of the tube that required an emergency open total gastrectomy. Case 2 was a 76-year-old man with long-term EN after stroke. While the last auscultatory verification was normal, he suddenly developed extensive HPVG due to gastric mucosal injury following EN, which resulted in progressive intestinal necrosis, general peritonitis, and death. These 2 cases indicated that routine verification methods consisting of auscultation and X-ray may not be completely reliable, and the awareness of the limitations of these methods should be reaffirmed because expeditious examinations and necessary interventions are critical in preventing life-threatening complications.

  4. Bacterial vaginosis in threatened preterm, preterm and term labour.

    PubMed

    Chawanpaiboon, Saifon; Pimol, Kanjana

    2010-12-01

    To present the prevalence of bacterial vaginosis in threatened preterm, preterm, and term labor and results after treatment. Forty-four, 50, and 56 pregnant women with threatened preterm, preterm, and term labor respectively were participated. Bacterial vaginosis was diagnosed by Amsel's criteria. Treatment by metronidazole or clindamycin was used. A case record form recorded maternal age, obstetric history, gestational age at admission and delivery, examination data, the route of delivery, and the newborn birth weight and conditions. The patients in threatened preterm labor group had significantly positive bacterial vaginosis when compared to those in the term labor group. Prevalence of bacterial vaginosis in threatened preterm, preterm, and term labor were presented The prevalence of bacterial vaginosis in both preterm labor groups was higher than in the term labor group.

  5. Arguing over Life and Death

    ERIC Educational Resources Information Center

    Nageotte, Nichole; Buck, Gayle; Kirk, Holly

    2018-01-01

    Imagine saving just one of the 23,000 species threatened with extinction. Students studying endangered species in a general life science course faced the decision of which species to save as a summative assignment in a unit on scientific explanation and argumentation. They used the claim, evidence, and reasoning (CER) framework in which students…

  6. The life instinct.

    PubMed

    Abel-Hirsch, Nicola

    2010-10-01

    In psychoanalytic writing an oversimplified interpretation of Freud's concept of the life and death instincts sometimes colours the presentation. Roughly, there is an implication that the life instinct is 'good' and the death instinct 'bad'. Freud however is clear that: "Neither of these instincts is any less essential than the other; the phenomena of life arise from the concurrent or mutually opposing action of both"(1933b, p. 209). In this paper I look in detail at the characteristics of the life instinct as conceptualized by Freud, and draw on Bion's work 'on linking' to elaborate Freud's view that binding is the life instinct's key characteristic. I suggest that there are pathological forms of both the life and death instinct if defused (separated off) from the other, and I explore a pathological variation of the life instinct in which binding is without the negation, rest, limit or end provided by the 'opposing action' of the death instinct. I consider an instance of the kind that any analyst might meet clinically, in which an inhibited patient experiences severe anxiety that life-giving connections threaten to proliferate indiscriminately and to an overwhelming intensity and size. Copyright © 2010 Institute of Psychoanalysis.

  7. Life-threatening false alarm rejection in ICU: using the rule-based and multi-channel information fusion method.

    PubMed

    Liu, Chengyu; Zhao, Lina; Tang, Hong; Li, Qiao; Wei, Shoushui; Li, Jianqing

    2016-08-01

    False alarm (FA) rates as high as 86% have been reported in intensive care unit monitors. High FA rates decrease quality of care by slowing staff response times while increasing patient burdens and stresses. In this study, we proposed a rule-based and multi-channel information fusion method for accurately classifying the true or false alarms for five life-threatening arrhythmias: asystole (ASY), extreme bradycardia (EBR), extreme tachycardia (ETC), ventricular tachycardia (VTA) and ventricular flutter/fibrillation (VFB). The proposed method consisted of five steps: (1) signal pre-processing, (2) feature detection and validation, (3) true/false alarm determination for each channel, (4) 'real-time' true/false alarm determination and (5) 'retrospective' true/false alarm determination (if needed). Up to four signal channels, that is, two electrocardiogram signals, one arterial blood pressure and/or one photoplethysmogram signal were included in the analysis. Two events were set for the method validation: event 1 for 'real-time' and event 2 for 'retrospective' alarm classification. The results showed that 100% true positive ratio (i.e. sensitivity) on the training set were obtained for ASY, EBR, ETC and VFB types, and 94% for VTA type, accompanied by the corresponding true negative ratio (i.e. specificity) results of 93%, 81%, 78%, 85% and 50% respectively, resulting in the score values of 96.50, 90.70, 88.89, 92.31 and 64.90, as well as with a final score of 80.57 for event 1 and 79.12 for event 2. For the test set, the proposed method obtained the score of 88.73 for ASY, 77.78 for EBR, 89.92 for ETC, 67.74 for VFB and 61.04 for VTA types, with the final score of 71.68 for event 1 and 75.91 for event 2.

  8. Trends in a life threatening condition: morbid obesity in dutch, Turkish and Moroccan children in The Netherlands.

    PubMed

    van Dommelen, Paula; Schönbeck, Yvonne; van Buuren, Stef; HiraSing, Remy A

    2014-01-01

    Morbid obesity can be a life threatening condition. The aim of our study is to assess the trend in morbid obesity in The Netherlands among children of Dutch origin since 1980, and among children of Turkish and Moroccan origin since 1997. Cross-sectional height and weight data of children of Dutch, Turkish and Moroccan origin aged 2-18 years were selected from three national Dutch Growth Studies performed in 1980, 1997 and 2009 (n = 54,814). Extended international (IOTF) cut-offs in childhood were used to define morbid obesity (obesity class II and III combined). The morbidity index for overweight was calculated as the prevalence of morbid obesity divided by the prevalence of overweight. Our study showed that the prevalence of morbid obesity in children of Dutch origin was 0.59% in boys and 0.53% in girls in 2009. Significant upward trends occurred since 1980 and 1997. The prevalence was three to four fold higher in Turkish children compared to Dutch children. The Turkish children also had an upward trend since 1997, but this was only statistically significant in boys. The prevalence of morbid obesity in Moroccan children was two to three fold higher than in Dutch children, but it remained almost stable between 1997 and 2009. The Dutch and Turkish children showed an upward trend in morbidity index for overweight since respectively 1980 and 1997, while the Moroccan children showed a downward trend since 1997. In 2009, children of low educated parents had the highest prevalence rates of morbid obesity; 1.06% in Dutch, 2.11% in Turkish and 1.41% in Moroccan children. An upward trend of morbid obesity in Dutch and Turkish children in The Netherlands occurred. Monitoring and reducing the prevalence of childhood morbid obesity is of high importance for these children, health care and the community.

  9. 76 FR 6754 - Endangered and Threatened Species; Extension of Public Comment Period on Proposed Threatened...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-08

    ... proposed rule to list the Arctic (Phoca hispida hispida), Okhotsk (Phoca hispida ochotensis), Baltic (Phoca... rule to list the Arctic, Okhotsk, Baltic, and Ladoga subspecies of the ringed seal as threatened under...

  10. Investigating evolutionary constraints on the detection of threatening stimuli in preschool children.

    PubMed

    Zsido, Andras N; Deak, Anita; Losonci, Adrienn; Stecina, Diana; Arato, Akos; Bernath, Laszlo

    2018-04-01

    Numerous objects and animals could be threatening, and thus, children learn to avoid them early. Spiders and syringes are among the most common targets of fears and phobias of the modern word. However, they are of different origins: while the former is evolutionary relevant, the latter is not. We sought to investigate the underlying mechanisms that make the quick detection of such stimuli possible and enable the impulse to avoid them in the future. The respective categories of threatening and non-threatening targets were similar in shape, while low-level visual features were controlled. Our results showed that children found threatening cues faster, irrespective of the evolutionary age of the cues. However, they detected non-threatening evolutionary targets faster than non-evolutionary ones. We suggest that the underlying mechanism may be different: general feature detection can account for finding evolutionary threatening cues quickly, while specific features detection is more appropriate for modern threatening stimuli. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Street Life: Aggravated and Sexual Assaults among Homeless and Runaway Adolescents.

    ERIC Educational Resources Information Center

    Terrell, Nathanial Eugene

    1997-01-01

    Examines aggravated and sexual assaults among 240 runaway and homeless adolescents (RHAs) in Des Moines (Iowa). Results suggest RHAs are at risk of life-threatening situations on the streets due to aggressive and abusive parents. Additionally, street life situations have significant impacts on the probability that RHAs will be victims of…

  12. Sea-level rise: Destruction of threatened and endangered species habitat in South Carolina

    NASA Astrophysics Data System (ADS)

    Daniels, Richard C.; White, Tammy W.; Chapman, Kimberly K.

    1993-05-01

    Concern for the environment has increased over the past century, and the US Congress has responded to this concern by passing legislation designed to protect the nation’s ecological biodiversity. This legislation, culminating with the Endangered Species Act of 1973, has been instrumental in defining methods for identifying and protecting endangered or threatened species and their habitats. Current legislation, however, assumes that the range of a protected species will stay constant over time. This assumption may no longer be valid, as the unprecedented increase in the number and concentration of greenhouse gases in the atmosphere has the potential to cause a global warming of 1.0-4.5°C and a sea-level rise (SLR) of 31-150 cm by the year 2100. Changes in climate of this magnitude are capable of causing shifts in the population structure and range of most animal species. This article examines the effects that SLR may have on the habitats of endangered and threatened species at three scales. At the regional scale 52 endangered or threatened plant and animal species were found to reside within 3 m of mean sea level in the coastal stages of the US Southeast. At the state level, the habitats of nine endangered or threatened animals that may be at risk from future SLR were identified. At the local level, a microscale analysis was conducted in the Cape Romain National Wildlife Refuge, South Carolina, USA, on the adverse effects that SLR may have on the habitats of the American alligator, brown pelican, loggerhead sea turtle, and wood stork.

  13. Potential Mechanisms Underlying Inflammation-Enhanced Aminoglycoside-Induced Cochleotoxicity

    PubMed Central

    Jiang, Meiyan; Taghizadeh, Farshid; Steyger, Peter S.

    2017-01-01

    Aminoglycoside antibiotics remain widely used for urgent clinical treatment of life-threatening infections, despite the well-recognized risk of permanent hearing loss, i.e., cochleotoxicity. Recent studies show that aminoglycoside-induced cochleotoxicity is exacerbated by bacteriogenic-induced inflammation. This implies that those with severe bacterial infections (that induce systemic inflammation), and are treated with bactericidal aminoglycosides are at greater risk of drug-induced hearing loss than previously recognized. Incorporating this novel comorbid factor into cochleotoxicity risk prediction models will better predict which individuals are more predisposed to drug-induced hearing loss. Here, we review the cellular and/or signaling mechanisms by which host-mediated inflammatory responses to infection could enhance the trafficking of systemically administered aminoglycosides into the cochlea to enhance the degree of cochleotoxicity over that in healthy preclinical models. Once verified, these mechanisms will be potential targets for novel pharmacotherapeutics that reduce the risk of drug-induced hearing loss (and acute kidney damage) without compromising the life-saving bactericidal efficacy of aminoglycosides. PMID:29209174

  14. The Empty Nest Syndrome: Ways to Enhance Quality of Life

    ERIC Educational Resources Information Center

    Chen, Dianbing; Yang, Xinxiao; Aagard, Steve Dale

    2012-01-01

    Empty nest syndrome occurs as a result of urbanization and loosened relationships among family members. It may threaten the life quality of older adults and stability of society as a whole. This survey was designed to investigate the situation and factors that influence the life quality of a sample of older adults in a western state. Thirty-five…

  15. Ocean acidification compromises recruitment success of the threatened Caribbean coral Acropora palmata

    PubMed Central

    Albright, Rebecca; Mason, Benjamin; Miller, Margaret; Langdon, Chris

    2010-01-01

    Ocean acidification (OA) refers to the ongoing decline in oceanic pH resulting from the uptake of atmospheric CO2. Mounting experimental evidence suggests that OA will have negative consequences for a variety of marine organisms. Whereas the effect of OA on the calcification of adult reef corals is increasingly well documented, effects on early life history stages are largely unknown. Coral recruitment, which necessitates successful fertilization, larval settlement, and postsettlement growth and survivorship, is critical to the persistence and resilience of coral reefs. To determine whether OA threatens successful sexual recruitment of reef-building corals, we tested fertilization, settlement, and postsettlement growth of Acropora palmata at pCO2 levels that represent average ambient conditions during coral spawning (∼400 μatm) and the range of pCO2 increases that are expected to occur in this century [∼560 μatm (mid-CO2) and ∼800 μatm (high-CO2)]. Fertilization, settlement, and growth were all negatively impacted by increasing pCO2, and impairment of fertilization was exacerbated at lower sperm concentrations. The cumulative impact of OA on fertilization and settlement success is an estimated 52% and 73% reduction in the number of larval settlers on the reef under pCO2 conditions projected for the middle and the end of this century, respectively. Additional declines of 39% (mid-CO2) and 50% (high-CO2) were observed in postsettlement linear extension rates relative to controls. These results suggest that OA has the potential to impact multiple, sequential early life history stages, thereby severely compromising sexual recruitment and the ability of coral reefs to recover from disturbance. PMID:21059900

  16. Ocean acidification compromises recruitment success of the threatened Caribbean coral Acropora palmata.

    PubMed

    Albright, Rebecca; Mason, Benjamin; Miller, Margaret; Langdon, Chris

    2010-11-23

    Ocean acidification (OA) refers to the ongoing decline in oceanic pH resulting from the uptake of atmospheric CO(2). Mounting experimental evidence suggests that OA will have negative consequences for a variety of marine organisms. Whereas the effect of OA on the calcification of adult reef corals is increasingly well documented, effects on early life history stages are largely unknown. Coral recruitment, which necessitates successful fertilization, larval settlement, and postsettlement growth and survivorship, is critical to the persistence and resilience of coral reefs. To determine whether OA threatens successful sexual recruitment of reef-building corals, we tested fertilization, settlement, and postsettlement growth of Acropora palmata at pCO(2) levels that represent average ambient conditions during coral spawning (∼400 μatm) and the range of pCO(2) increases that are expected to occur in this century [∼560 μatm (mid-CO(2)) and ∼800 μatm (high-CO(2))]. Fertilization, settlement, and growth were all negatively impacted by increasing pCO(2), and impairment of fertilization was exacerbated at lower sperm concentrations. The cumulative impact of OA on fertilization and settlement success is an estimated 52% and 73% reduction in the number of larval settlers on the reef under pCO(2) conditions projected for the middle and the end of this century, respectively. Additional declines of 39% (mid-CO(2)) and 50% (high-CO(2)) were observed in postsettlement linear extension rates relative to controls. These results suggest that OA has the potential to impact multiple, sequential early life history stages, thereby severely compromising sexual recruitment and the ability of coral reefs to recover from disturbance.

  17. The outcome of pregnancy after threatened abortion.

    PubMed

    Hertz, J B; Heisterberg, L

    1985-01-01

    A prospectively collected group of 93 pregnancies complicated by threatened abortion was carefully monitored throughout pregnancy, during birth and in the perinatal period, and any deviation from a completely uneventful course was registered. Comparison was made with a selected group of 282 non-risk pregnant women. A significant association was found between threatened abortion and the overall number of complications in the second half of pregnancy requiring medical intervention and/or admission to hospital, impending pre-term birth requiring betamimetics, pre-term birth, retention of the placenta, birth weight below 2000 g, light-for-dates infants in case of pre-term birth or birth weight below 2000 g, and hyperbilirubinemia in infants with birth weight below 2000 g. The incidences of perinatal mortality and congenital malformations did not differ significantly from those of the control group. Pregnancies complicated by threatened abortion constitute a risk group requiring careful obstetric and perinatal supervision and follow-up.

  18. Plasmodium knowlesi malaria in humans is widely distributed and potentially life-threatening

    PubMed Central

    Cox-Singh, Janet; Davis, Timothy M. E.; Lee, Kim-Sung; Shamsul, Sunita S. G.; Matusop, Asmad; Ratnam, Shanmuga; Rahman, Hasan A.; Conway, David J; Singh, Balbir

    2008-01-01

    Background Until recently, Plasmodium knowlesi malaria in humans was misdiagnosed as P. malariae. The present objectives were to determine the geographic distribution of P. knowlesi in the human population in Malaysia and to investigate four suspected fatal cases. Methods Sensitive and specific nested-PCR was used to identify all Plasmodium species present in blood from i) 960 patients with malaria hospitalized in Sarawak, Malaysian Borneo from 2001-2006, ii) 54 P. malariae archival blood-films from 15 districts in Sabah, Malaysian Borneo (2003–2005) and four districts in Pahang, Peninsular Malaysia (2004–2005), and iii) suspected knowlesi fatalities. In the four latter cases, available clinical and laboratory data were reviewed. Results P. knowlesi DNA was detected in 266 of 960 (27·7%) of the samples from Sarawak hospitals, 41 of 49 (83·7%) from Sabah and all 5 from Pahang. Only P. knowlesi DNA was detected in archival blood films from the 4 fatal cases. All were hyperparasitemic and developed marked hepatorenal dysfunction. Conclusions Human infections with P. knowlesi, commonly misidentified as the more benign P. malariae, are widely distributed across Malaysian Borneo and extend to Peninsular Malaysia. Because P. knowlesi replicates every 24 hours, rapid diagnosis and prompt effective treatment are essential. In the absence of a specific routine diagnostic test for knowlesi malaria, we recommend that patients in, or who have travelled to, South-east Asia who are ill with a ‘P. malariae’ hyperparasitemia diagnosis by microscopy should receive intensive management as appropriate for severe falciparum malaria. PMID:18171245

  19. Treatment of severe life threatening hypocalcemia with recombinant human teriparatide in patients with postoperative hypoparathyroidism - a case series.

    PubMed

    Andrysiak-Mamos, Elżbieta; Żochowska, Ewa; Kaźmierczyk-Puchalska, Agnieszka; Popow, Michał; Kaczmarska-Turek, Dorota; Pachucki, Janusz; Bednarczuk, Tomasz; Syrenicz, Anhelli

    2016-01-01

    Hypocalcaemia is a common postoperative complication, both after the resection of parathyroid adenoma associated with primary hyperparathyroidism and after total thyroidectomy due to thyroid cancer or nodular goitre. For a few years, in patients with postoperative hypoparathyroidism and severe hypocalcaemia, who cannot discontinue intravenous calcium preparations even with the use of high vitamin D doses, attempts have been made to add recombinant human parathormone (rhPTH) to the treatment schedule. In this work, for the first time in Poland, we demonstrate the potential use of teriparatide for the treatment of severe hypocalcaemia based on three different cases of postoperative hypoparathyroidism. Case 1. Female (52) with postoperative hypoparathyroidism, after total thyroidectomy and the removal of lower left parathyroid gland due to hyperparathyroidism, several weeks after the surgery still required intravenous calcium infusions because of tetany symptoms. Just one month of teriparatide treatment at 20 μg/0.08 mL given in daily subcutaneous injections proved sufficient to control calcium levels with oral calcium and vitamin D preparations during the next few days until total resolution of hypocalcaemia symptoms and the achievement and maintenance of laboratory normocalcaemia in the following weeks. Female (33) with hypoparathyroidism following total thyroidectomy in 1996 because of papillary thyroid cancer, with congenital tubulopathy associated with renal loss of calcium and magnesium, and the symptoms of tetany recurring since the day of surgery, requiring intravenous calcium administration every 2-3 days. Currently, the patient has been hospitalised because of venous port infection, the only venous access, which made intravenous therapy impossible. Because of the life-threatening condition of the patient, bridging teriparatide treatment was prepared (20 μg/0.08 mL). Complete resolution of clinical symptoms of hypocalcaemia was obtained with teriparatide

  20. Effects of invasive knapweed (Centaurea stoebe subsp. micranthos) on a threatened native thistle (Cirsium pitcheri) vary with environment and life stage

    USDA-ARS?s Scientific Manuscript database

    Although invasive plants can threaten rare plants, more direct evidence on the type and magnitude of their effects on demographic parameters is needed. To determine whether Eurasian spotted knapweed, Centaurea maculosa, affected seedling emergence and establishment, juvenile survival or flowering pr...

  1. Life threatening illness in popular movies-a first descriptive analysis.

    PubMed

    Drukarczyk, Laura; Klein, Carsten; Ostgathe, Christoph; Stiel, Stephanie

    2014-01-01

    In the last two decades, public attention towards illness, dying and death has evolved. In particular, advance care planning, living wills, end-of-life care, and autonomy are increasingly discussed. How this change in public awareness has influenced the presentation of dying and death in cinema needs clarification. Over a one year period, November 2011 until October 2012, a systematic search was conducted to identify movies dealing with incurable diseases produced in 1991-2010 35 movies could be identified and were analyzed in detail and investigated the presentation of illness and death. The number of movies focusing on terminal illness, dying, and death has increased since 1991. The total number of movies that made the yearly German Federal Film Board (FFA) hit list and included a focus on terminal illness, dying, and death increased from 1991 (1 movie) to 2011 (6 movies). The gender of the main characters suffering from terminal illness was distributed equally; three movies portrayed terminally ill children. More than one third of the terminally ill characters died in hospital. The terms "palliative" or "hospice care" were not mentioned once in any films. The number of movies dealing with terminal illness continues to increase and a considerable audience has shown interest in these films. Due to a limited true-to-life performance in the films, a presentation closer to reality could be a major public educational resource.

  2. Assessing pesticide risks to threatened and endangered species using population models: Findings and recommendations from a CropLife America Science Forum.

    PubMed

    Forbes, V E; Brain, R; Edwards, D; Galic, N; Hall, T; Honegger, J; Meyer, C; Moore, D R J; Nacci, D; Pastorok, R; Preuss, T G; Railsback, S F; Salice, C; Sibly, R M; Tenhumberg, B; Thorbek, P; Wang, M

    2015-07-01

    This brief communication reports on the main findings and recommendations from the 2014 Science Forum organized by CropLife America. The aim of the Forum was to gain a better understanding of the current status of population models and how they could be used in ecological risk assessments for threatened and endangered species potentially exposed to pesticides in the United States. The Forum panelists' recommendations are intended to assist the relevant government agencies with implementation of population modeling in future endangered species risk assessments for pesticides. The Forum included keynote presentations that provided an overview of current practices, highlighted the findings of a recent National Academy of Sciences report and its implications, reviewed the main categories of existing population models and the types of risk expressions that can be produced as model outputs, and provided examples of how population models are currently being used in different legislative contexts. The panel concluded that models developed for listed species assessments should provide quantitative risk estimates, incorporate realistic variability in environmental and demographic factors, integrate complex patterns of exposure and effects, and use baseline conditions that include present factors that have caused the species to be listed (e.g., habitat loss, invasive species) or have resulted in positive management action. Furthermore, the panel advocates for the formation of a multipartite advisory committee to provide best available knowledge and guidance related to model implementation and use, to address such needs as more systematic collection, digitization, and dissemination of data for listed species; consideration of the newest developments in good modeling practice; comprehensive review of existing population models and their applicability for listed species assessments; and development of case studies using a few well-tested models for particular species to

  3. 76 FR 9733 - Endangered and Threatened Species; Proposed Threatened Status for Subspecies of the Ringed Seal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-22

    ..., we, NMFS, published a proposed rule to list the Arctic (Phoca hispida hispida), Okhotsk (Phoca... the Arctic, Okhotsk, Baltic, and Ladoga subspecies of the ringed seal as threatened under the ESA...

  4. 76 FR 14882 - Endangered and Threatened Species; Proposed Threatened Status for Subspecies of the Ringed Seal

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-18

    ... rule to list the Arctic (Phoca hispida hispida), Okhotsk (Phoca hispida ochotensis), Baltic (Phoca... rule to list the Arctic, Okhotsk, Baltic, and Ladoga subspecies of the ringed seal as threatened under...

  5. Stigma by Prejudice Transfer: Racism Threatens White Women and Sexism Threatens Men of Color.

    PubMed

    Sanchez, Diana T; Chaney, Kimberly E; Manuel, Sara K; Wilton, Leigh S; Remedios, Jessica D

    2017-04-01

    In the current research, we posited the stigma-by-prejudice-transfer effect, which proposes that stigmatized group members (e.g., White women) are threatened by prejudice that is directed at other stigmatized group members (e.g., African Americans) because they believe that prejudice has monolithic qualities. While most stigma researchers assume that there is a direct correspondence between the attitude of prejudiced individuals and the targets (i.e., sexism affects women, racism affects racial minorities), the five studies reported here demonstrate that White women can be threatened by racism (Study 1, 3, 4, and 5) and men of color by sexism (Study 2). Robust to perceptions of liking and the order in which measures were administered, results showed that prejudice transfers between racism and sexism were driven by the presumed social dominance orientation of the prejudiced individual. In addition, important downstream consequences, such as the increased likelihood of anticipated stigma, expectations of unfair treatment, and the attribution of negative feedback to sexism, appeared for stigmatized individuals.

  6. 77 FR 16553 - Endangered and Threatened Species Permit Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ... (Dendroica chrysoparia) within Texas. Permit TE-66055A Applicant: The Navajo Nation dba The Navajo Nation... endangered wildlife species, 50 CFR 17.32 for threatened wildlife species, 50 CFR 17.62 for endangered plant species, and 50 CFR 17.72 for threatened plant species. Applications Available for Review and Comment We...

  7. 78 FR 53157 - Endangered and Threatened Species Permit Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-28

    ... endangered wildlife species, 50 CFR 17.32 for threatened wildlife species, 50 CFR 17.62 for endangered plant species, and 50 CFR 17.72 for threatened plant species. Applications Available for Review and Comment We... following animal species and seed collection for the following plant species in Arizona: California condor...

  8. Assessing predation risk to threatened fauna from their prevalence in predator scats: dingoes and rodents in arid Australia.

    PubMed

    Allen, Benjamin L; Leung, Luke K-P

    2012-01-01

    The prevalence of threatened species in predator scats has often been used to gauge the risks that predators pose to threatened species, with the infrequent occurrence of a given species often considered indicative of negligible predation risks. In this study, data from 4087 dingo (Canis lupus dingo and hybrids) scats were assessed alongside additional information on predator and prey distribution, dingo control effort and predation rates to evaluate whether or not the observed frequency of threatened species in dingo scats warrants more detailed investigation of dingo predation risks to them. Three small rodents (dusky hopping-mice Notomys fuscus; fawn hopping-mice Notomys cervinus; plains mice Pseudomys australis) were the only threatened species detected in <8% of dingo scats from any given site, suggesting that dingoes might not threaten them. However, consideration of dingo control effort revealed that plains mice distribution has largely retracted to the area where dingoes have been most heavily subjected to lethal control. Assessing the hypothetical predation rates of dingoes on dusky hopping-mice revealed that dingo predation alone has the potential to depopulate local hopping-mice populations within a few months. It was concluded that the occurrence of a given prey species in predator scats may be indicative of what the predator ate under the prevailing conditions, but in isolation, such data can have a poor ability to inform predation risk assessments. Some populations of threatened fauna assumed to derive a benefit from the presence of dingoes may instead be susceptible to dingo-induced declines under certain conditions.

  9. 77 FR 59959 - Endangered and Threatened Species Permit Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-01

    ... endangered wildlife species, 50 CFR 17.32 for threatened wildlife species, 50 CFR 17.62 for endangered plant species, and 50 CFR 17.72 for threatened plant species. Applications Available for Review and Comment We... requests a new permit for research and recovery purposes to breed and capitvely hold Big Bend gambusia...

  10. Sequencing the fungal tree of life

    Treesearch

    F. Martin; D. Cullen; D. Hibbett; A. Pisabarro; J.W. Spatafora; S.E. Baker; I.V. Grigoriev

    2011-01-01

    Terrestrial ecosystems host a complex array of interacting communities, with thousands of species of animals, plants, fungi and bacteria. In soils, this complex web of life is responsible for the cycling of carbon (C), for water and nutrients, for soil quality and for plant nutrition and health. To predict future changes of these threatened ecosystems and to fully...

  11. 76 FR 57943 - Endangered and Threatened Wildlife and Plants; Revising the List of Endangered and Threatened...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-19

    ...; Revising the List of Endangered and Threatened Wildlife for the Gray Wolf (Canis lupus) in the Eastern... the listing of the Minnesota population of gray wolves (Canis lupus) under the Endangered Species Act...

  12. Endangered and Threatened Species at Kennedy Space Center Merritt Island National Wildlife Refuge

    NASA Technical Reports Server (NTRS)

    Galdolfi, Catherine

    2010-01-01

    Throughout my internship, I assisted with the long-term monitoring of the Florida Scrub- Jay (Aphelocoma coerulescens), a threatened species endemic to Florida. The Florida Scrub Jay diet consists of insects and small vertebrates throughout most of the year; however, during the winter their primary diet is acorns because the insect population is low. Furthermore, the Florida Scrub-Jay is a habitat specialist that lives in a disappearing plant community called the scrub, which consists of sand live oak, myrtle oak and chapman oak. The Florida Scrub-Jay is considered threatened because its numbers are decreasing primarily due to the loss of habitat that it needs to survive. Scrub habitat is highly desirable for human development because it is high, dry, and sandy. Periodic controlled burns maintain the scrub in a low, open condition favored by Scrub-Jays. Florida Scrub-Jays build their nests approximately 3-5 feet (approximately 1.5 m) above the ground in shrubby oaks (Breininger 153), mate for life and are cooperative breeders; which means that the young jays remain in their natal territory for at least a year to help their parents defend their territory, feed the young, and mob predators. (Breininger 152). I assisted in conducting monthly censuses at long-term monitoring sites and a juvenile in July survey to determine reproductive success for the year. In addition, to Scrub-Jay monitoring, I also had the opportunity to assist with some long term monitoring of ecosystem recovery. Scrub is a fire maintained system. Fire maintains the structure of scrub necessary for many of the threatened species that reside in the scrub habitat.

  13. Map of Life - A Dashboard for Monitoring Planetary Species Distributions

    NASA Astrophysics Data System (ADS)

    Jetz, W.

    2016-12-01

    Geographic information about biodiversity is vital for understanding the many services nature provides and their potential changes, yet remains unreliable and often insufficient. By integrating a wide range of knowledge about species distributions and their dynamics over time, Map of Life supports global biodiversity education, monitoring, research and decision-making. Built on a scalable web platform geared for large biodiversity and environmental data, Map of Life endeavors provides species range information globally and species lists for any area. With data and technology provided by NASA and Google Earth Engine, tools under development use remote sensing-based environmental layers to enable on-the-fly predictions of species distributions, range changes, and early warning signals for threatened species. The ultimate vision is a globally connected, collaborative knowledge- and tool-base for regional and local biodiversity decision-making, education, monitoring, and projection. For currently available tools, more information and to follow progress, go to MOL.org.

  14. The common cold: potential for future prevention or cure.

    PubMed

    Passioti, Maria; Maggina, Paraskevi; Megremis, Spyridon; Papadopoulos, Nikolaos G

    2014-02-01

    The common cold is the most frequent, although generally mild, human disease. Human Rhinoviruses are the prevalent causative agents, but other viruses are also implicated. Being so common, viral colds, have significant implications on public health and quality of life, but may also be life-threatening for vulnerable groups of patients. Specific diagnosis and treatment of the common cold still remain unmet needs. Molecular diagnostic techniques allow specific detection of known pathogens as well as the identification of newly emerging viruses. Although a number of medications or natural treatments have been shown to have some effect, either on the number or on the severity of common colds, no single agent is considerably effective. Virus-specific management remains in most cases a challenging potential as many factors have to be taken into account, including the diversity of the viral genomes, the heterogeneity of affected individuals, as well as the complexity of this long standing host-virus relationship.

  15. [Critical incidents and quality of life among rescue workers].

    PubMed

    Prati, G; Pietrantoni, L

    2009-01-01

    Fire-fighters, paramedics and civil protection volunteers routinely confront potentially traumatic events in the course of their jobs. The frequency of exposure to critical incidents and the relationship between critical incident exposure and quality of life (Professional Quality of Life Scale, PROQOL, Stamm, 2005) A sample of 586 Italian emergency workers. The data indicated that the most frequent critical incidents were incidents involving multiple casualties (65% three or more times), prolonged extrication of trapped victim with life-threatening injuries (64% three or more times), verbal or physical threat by public while on duty (41% three or more times), and victims known to fire-emergency worker (40% three or more times). Infrequent events included serious line of duty injury to self (76% never) and colleagues and line of duty risk of injury or death to self (53% never) and colleagues (47% never). Emergency health workers were more exposed to critical incidents in comparison to fire-fighters. Result from non-parametric correlation analyses indicated that the more infrequent events showed the strong association with compassion fatigue and burnout while failed mission after extensive effort was the event most strongly associated with most associated with compassion satisfaction.

  16. Potentially traumatic events and serious life stressors are prospectively associated with frequency of doctor visits and overnight hospital visits.

    PubMed

    Gawronski, Katerina A B; Kim, Eric S; Miller, Laura E

    2014-08-01

    Cumulative lifetime exposure to potentially traumatic events and serious life stressors has been linked with both mental and physical health problems; however, less is known about the association between exposure to potentially traumatic events and serious life stressors with health care use. We investigated whether a higher number of potentially traumatic events and serious life stressors were prospectively associated with an increased number of doctor visits and nights spent in the hospital. Participants were drawn from the Health and Retirement Study, a prospective and nationally representative study of adults aged 50+ in the United States (n=7168). We analyzed the data using a generalized linear model with a gamma distribution and log link. A higher number of potentially traumatic events and serious life stressors were associated with an increased number of doctor visits and nights spent in the hospital. On a 10-point scale, each additional potentially traumatic event or serious life stressor was associated with an 8% increase in doctor visits after controlling for sociodemographic factors (RR=1.08, 95% CI=1.06-1.11; p<.001). Each additional potentially traumatic event or serious life stressor was also associated with an 18% increase in the number of nights spent in the hospital after controlling for sociodemographic factors (RR=1.18, 95% CI=1.10-1.27; p<.001). Exposure to potentially traumatic events and serious life stressors is associated with increased doctor visits and nights spent in the hospital, which may have important implications for the current standard of care. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Magnetic Resonance Imaging as a Predictor of Survival Free of Life-Threatening Arrhythmias and Transplantation in Cardiac Sarcoidosis.

    PubMed

    Ekström, Kaj; Lehtonen, Jukka; Hänninen, Helena; Kandolin, Riina; Kivistö, Sari; Kupari, Markku

    2016-05-02

    Cardiac magnetic resonance imaging has a key role in today's diagnosis of cardiac sarcoidosis. We set out to investigate whether cardiac magnetic resonance imaging also helps predict outcome in cardiac sarcoidosis. Our work involved 59 patients with cardiac sarcoidosis (38 female, mean age 46±10 years) seen at our hospital since February 2004 and followed up after contrast-enhanced cardiac magnetic resonance imaging. The extent of myocardial late gadolinium enhancement (measured as percentage of left ventricular mass), the volumes and ejection fractions of the left and right ventricles, and the thickness of the basal interventricular septum were determined and analyzed for prognostic significance. By April 2015, 23 patients had reached the study's end point, consisting of a composite of cardiac death (n=3), cardiac transplantation (n=1), and occurrence of life-threatening ventricular tachyarrhythmias (n=19; ventricular fibrillation in 5 and sustained ventricular tachycardia in 14 patients). In univariate analysis, myocardial extent of late gadolinium enhancement predicted event-free survival, as did scar-like thinning (<4 mm) of the basal interventricular septum and the ejection fraction of the right ventricle (P<0.05 for all). In multivariate Cox regression analysis, extent of late gadolinium enhancement was the only independent predictor of outcome events on cardiac magnetic resonance imaging, with a hazard ratio of 2.22 per tertile (95% CI 1.07-4.59). An extent of late gadolinium enhancement >22% (third tertile) had positive and negative predictive values for serious cardiac events of 75% and 76%, respectively. Findings on cardiac magnetic resonance imaging and the extent of myocardial late gadolinium enhancement in particular help predict serious cardiac events in cardiac sarcoidosis. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  18. 77 FR 20774 - Endangered and Threatened Species; Proposed Threatened Status for Distinct Population Segments of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-06

    ... the Bearded Seal AGENCY: National Marine Fisheries Service (NMFS), National Oceanic and Atmospheric... the bearded seal (Erignathus barbatus) under the Endangered Species Act, as amended (ESA). This notice... bearded seals as threatened (75 FR 77496). On December 13, 2011, in consideration of substantial...

  19. Biological Assessment of the Continued Operation of Los Alamos National Laboratory on Federally Listed Threatened and Endangered Species

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

    Hansen, Leslie A.

    2006-09-19

    This biological assessment considers the effects of continuing to operate Los Alamos National Laboratory on Federally listed threatened or endangered species, based on current and future operations identified in the 2006 Site-wide Environmental Impact Statement for the Continued Operation of Los Alamos National Laboratory (SWEIS; DOE In Prep.). We reviewed 40 projects analyzed in the SWEIS as well as two aspects on ongoing operations to determine if these actions had the potential to affect Federally listed species. Eighteen projects that had not already received U.S. Fish and Wildlife Service (USFWS) consultation and concurrence, as well as the two aspects ofmore » ongoing operations, ecological risk from legacy contaminants and the Outfall Reduction Project, were determined to have the potential to affect threatened or endangered species. Cumulative impacts were also analyzed.« less

  20. 77 FR 32130 - Endangered and Threatened Wildlife and Plants; Recovery Permit Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-31

    ...-FF06E00000] Endangered and Threatened Wildlife and Plants; Recovery Permit Applications AGENCY: Fish and... wildlife species, 50 CFR 17.32 for threatened wildlife species, 50 CFR 17.62 for endangered plant species, and 50 CFR 17.72 for threatened plant species. Applications Available for Review and Comment We invite...

  1. 76 FR 80960 - Endangered and Threatened Wildlife and Plants; Recovery Permit Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-27

    ...-FF06E00000] Endangered and Threatened Wildlife and Plants; Recovery Permit Applications AGENCY: Fish and... endangered wildlife species, 50 CFR 17.32 for threatened wildlife species, 50 CFR 17.62 for endangered plant species, and 50 CFR 17.72 for threatened plant species. Applications Available for Review and Comment We...

  2. 78 FR 48899 - Endangered and Threatened Wildlife and Plants; Recovery Permit Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-12

    ...-FF06E00000] Endangered and Threatened Wildlife and Plants; Recovery Permit Applications AGENCY: Fish and....32 for threatened wildlife species, 50 CFR 17.62 for endangered plant species, and 50 CFR 17.72 for threatened plant species. Applications Available for Review and Comment We invite local, State, and Federal...

  3. Self-esteem and life satisfaction in adolescents-gender and age as potential moderators.

    PubMed

    Moksnes, Unni K; Espnes, Geir A

    2013-12-01

    The present paper investigated gender differences on life satisfaction and self-esteem as well as the association between self-esteem and life satisfaction in Norwegian adolescents aged 13-18 years. The potential moderating role of gender and age in the relation between self-esteem and life satisfaction was also investigated. A total of 1,239 adolescents from public elementary and secondary schools in mid-Norway participated in the school-based survey study. Mean score differences on the variables used in the study were tested using t tests. Hierarchical multiple regression analysis was used to evaluate the association between self-esteem and life satisfaction, controlled for gender, age, stress, subjective health, and chronic health conditions. The results showed that boys scored higher than girls on both self-esteem and life satisfaction. Self-esteem was positively associated with life satisfaction, explaining 24 % of the variance. However, no interaction effect of gender × self-esteem or age × self-esteem was found in relation to life satisfaction. The results give support for that boys report higher self-esteem and life satisfaction than girls. Self-esteem has a positive role in association with adolescents' life satisfaction, and this relationship is equally strong for both genders and across age.

  4. Land Use Explains the Distribution of Threatened New World Amphibians Better than Climate

    PubMed Central

    Brum, Fernanda Thiesen; Gonçalves, Larissa Oliveira; Cappelatti, Laura; Carlucci, Marcos Bergmann; Debastiani, Vanderlei Júlio; Salengue, Elisa Viana; dos Santos Seger, Guilherme Dubal; Both, Camila; Bernardo-Silva, Jorge Sebastião; Loyola, Rafael Dias; da Silva Duarte, Leandro

    2013-01-01

    Background We evaluated the direct and indirect influence of climate, land use, phylogenetic structure, species richness and endemism on the distribution of New World threatened amphibians. Methodology/Principal Findings We used the WWF’s New World ecoregions, the WWFs amphibian distributional data and the IUCN Red List Categories to obtain the number of threatened species per ecoregion. We analyzed three different scenarios urgent, moderate, and the most inclusive scenario. Using path analysis we evaluated the direct and indirect effects of climate, type of land use, phylogenetic structure, richness and endemism on the number of threatened amphibians in New World ecoregions. In all scenarios we found strong support for direct influences of endemism, the cover of villages and species richness on the number of threatened species in each ecoregion. The proportion of wild area had indirect effects in the moderate and the most inclusive scenario. Phylogenetic composition was important in determining the species richness and endemism in each ecoregion. Climate variables had complex and indirect effects on the number of threatened species. Conclusion/Significance Land use has a more direct influence than climate in determining the distribution of New World threatened amphibians. Independently of the scenario analyzed, the main variables influencing the distribution of threatened amphibians were consistent, with endemism having the largest magnitude path coefficient. The importance of phylogenetic composition could indicate that some clades may be more threatened than others, and their presence increases the number of threatened species. Our results highlight the importance of man-made land transformation, which is a local variable, as a critical factor underlying the distribution of threatened amphibians at a biogeographic scale. PMID:23637764

  5. Abnormal brain activation during threatening face processing in schizophrenia: A meta-analysis of functional neuroimaging studies.

    PubMed

    Dong, Debo; Wang, Yulin; Jia, Xiaoyan; Li, Yingjia; Chang, Xuebin; Vandekerckhove, Marie; Luo, Cheng; Yao, Dezhong

    2017-11-15

    Impairment of face perception in schizophrenia is a core aspect of social cognitive dysfunction. This impairment is particularly marked in threatening face processing. Identifying reliable neural correlates of the impairment of threatening face processing is crucial for targeting more effective treatments. However, neuroimaging studies have not yet obtained robust conclusions. Through comprehensive literature search, twenty-one whole brain datasets were included in this meta-analysis. Using seed-based d-Mapping, in this voxel-based meta-analysis, we aimed to: 1) establish the most consistent brain dysfunctions related to threating face processing in schizophrenia; 2) address task-type heterogeneity in this impairment; 3) explore the effect of potential demographic or clinical moderator variables on this impairment. Main meta-analysis indicated that patients with chronic schizophrenia demonstrated attenuated activations in limbic emotional system along with compensatory over-activation in medial prefrontal cortex (MPFC) during threatening faces processing. Sub-task analyses revealed under-activations in right amygdala and left fusiform gyrus in both implicit and explicit tasks. The remaining clusters were found to be differently involved in different types of tasks. Moreover, meta-regression analyses showed brain abnormalities in schizophrenia were partly modulated by age, gender, medication and severity of symptoms. Our results highlighted breakdowns in limbic-MPFC circuit in schizophrenia, suggesting general inability to coordinate and contextualize salient threat stimuli. These findings provide potential targets for neurotherapeutic and pharmacological interventions for schizophrenia. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Frequent life-threatening laryngeal attacks in two Croatian families with hereditary angioedema due to C1 inhibitor deficiency harbouring a novel frameshift mutation in SERPING1.

    PubMed

    Karadža-Lapić, Ljerka; Korošec, Peter; Šilar, Mira; Košnik, Mitja; Cikojević, Draško; Lozić, Bernarda; Rijavec, Matija

    2016-11-01

    Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) is a rare autosomal dominant disease caused by mutations in the SERPING1 gene. It can affect many regions in the body, but potentially life-threatening laryngeal oedemas are of concern. Twenty-three subjects from two families were recruited for clinical data evaluation and molecular analysis at General Hospital Šibenik, Croatia. Decreased levels of C1 inhibitor were detected in 12 adult patients and three young asymptomatic persons. The same novel deletion of two nucleotides on exon 3 (c.74_75delAT) was identified in all of them. A history of laryngeal oedema was present in 10 patients (83%), and all patients reported laryngeal attacks at least once a year. The delay in diagnosis decreased noticeably from the first to the last generation. We identified a novel causative mutation in SERPING1 in several affected members of two apparently unrelated families with a high frequency of laryngeal oedema. Molecular analysis of large C1-INH-HAE families will provide new insights on the genotype-phenotype relationship. Key messages Hereditary angioedema due to C1 inhibitor deficiency is a rare autosomal dominant disease caused by mutations in the SERPING1 gene, and laryngeal oedema is of concern because it can cause death by asphyxiation. A novel causative mutation in SERPING1, a deletion of two nucleotides on exon 3 (c.74_75delAT), was identified in several affected members of two apparently unrelated families with a high frequency of laryngeal oedema. Molecular analysis of large C1-INH-HAE families will provide new insights on the genotype-phenotype relationship because it appears that the mutation type may affect disease severity.

  7. Early pregnancy factor as a marker for assessing embryonic viability in threatened and missed abortions.

    PubMed

    Shahani, S K; Moniz, C L; Bordekar, A D; Gupta, S M; Naik, K

    1994-01-01

    It is now well recognized that the presence of early pregnancy factor (EPF) can signify the occurrence of fertilization, continuation of pregnancy and the existence of a viable embryo. With this in view, a study was undertaken to observe the potential of EPF as a marker in assessing embryo viability in cases complicated with vaginal bleeding during early pregnancy. The results indicated that the sensitivity of EPF as a marker in predicting threatened or missed abortion was 78.9% and the specificity 95.6%. The positive predictive value was observed to be 93.8% and the negative predictive value 84.6%. Our studies have shown that since EPF is present in viable but absent in non-viable pregnancies, it could be a useful marker of prognostic value in threatened abortions.

  8. Sex Hormone Metabolism and Threatened Abortion

    PubMed Central

    Xu, Qianhua; Chen, Juan; Wei, Zhaolian; Brandon, Ted; Zava, David; Shi, Yuenian Eric; Cao, Yunxia

    2017-01-01

    Background The aim of this study was to evaluate changes in sex hormone metabolism in patients with threatened miscarriage. Material/Method We recruited 73 women in early pregnancy (6–8 weeks of gestation) and divided them into the following 2 groups based on whether they had vaginal bleeding: group A (n=34), the threatened abortion group; and group B (n=39), the normal pregnancy group. Human chorionic gonadotrophin (hCG), estradiol (E2), progesterone (P4), and testosterone (T) serum levels were tested and sex hormone metabolites in the urine were detected using gas chromatography-triple quadrupole mass spectrometry (GC-MS/MS). As the control, data for sex hormones and their metabolites were obtained in normal women of childbearing age without pregnancy (group C: n=23). Results E2 and T serum levels were lower in women with threatened miscarriage (group A). Estrone (E1), E2, estriol (E3), 16α-hydroxyestrone (16α-OHE1), 4-methoxyestrone (4-MeOE1), 2-hydroxyestradiol (2-OHE2), and 4-methoxyestradiol (4-MeOE2) levels were significantly lower in group A (P=0.001, 0.003, 0.009, 0.001, 0.012, 0.032, and 0.047, respectively.). Urine levels of dehydroepiandrosterone (DHEA), androstenedione (A2), and the metabolite of (A2) were also significantly lower in group A (P=0.007, 0.009, and 0.011, respectively). The 2-OHE1/E1, 4-OHE1/E1, 2-MeOE1/E1, and 2-MeOE2/E2 ratios were lower in group B, whereas the 2-OHE2/E2, 4-OHE2/E2, and 4-MeOE2/E2 ratios were dramatically lower in all pregnant women (groups A and B) than in group C. Conclusions Deficiency in DHEA and abnormal levels of sex hormone metabolites may cause a reduction in the activity of estrogens in women with threatened abortion. These alterations may result in bleeding during the first trimester of pregnancy. PMID:29056745

  9. Stamina in later life.

    PubMed

    Colerick, E J

    1985-01-01

    Patterns of aging raise a number of important questions concerning the paths to successful adaptation. What gives some older individuals their staying power in the face of misfortune? What causes others to function less effectively when stressed, to resist change? Clearly, the margin of safety, the degree of elasticity and resilience varies across individuals in the later years. This study focuses on event histories and current behavior of 62 elderly men and women (Phase I) and reports by their confidants (N = 62; Phase II). A central proposition, that stamina in later life depends, in part, on the appraisal of previous events involving loss is investigated using a model that incorporates aspects of earlier life, cognitive appraisal and clinically judged dimensions of stamina in old age. Multivariate (particularly path analytic) techniques are used to test the links between variable foci. Results suggest that antecedents of stamina involve the interaction of social resources and cognitive orientations. Specifically, stamina in later life is contingent, for the most part, on a triumphant, positive outlook during periods of adversity. Elderly so oriented are also those with robust health histories and marked educational accomplishments. Conversely, persons who view situations involving loss as threatening, overwhelming and potentially defeating experience no such outcome; low levels of stamina mark their later years. Interestingly, quality childhood ties matter for stamina in old age only by increasing the likelihood of perceptions of a supportive environment during hard times. The findings corroborate the general pattern of research documenting the importance of cognitive orientations in adaptive processes.

  10. Palliative and end of life care in solid organ transplantation.

    PubMed

    Wentlandt, K; Weiss, A; O'Connor, E; Kaya, E

    2017-12-01

    Palliative care is an interprofessional approach that focuses on quality of life of patients who are facing life-threatening illness. Palliative care is consistently associated with improvements in advance care planning, patient and caregiver satisfaction, quality of life, symptom burden, and lower healthcare utilization. Most transplant patients have advanced chronic disease, significant symptom burden, and mortality awaiting transplant. Transplantation introduces new risks including perioperative death, organ rejection, infection, renal insufficiency, and malignancy. Numerous publications over the last decade identify that palliative care is well-suited to support these patients and their caregivers, yet access to palliative care and research within this population are lacking. This review describes palliative care and summarizes existing research supporting palliative intervention in advanced organ failure and transplant populations. A proposed model to provide palliative care in parallel with disease-directed therapy in a transplant program has the potential to improve symptom burden, quality of life, and healthcare utilization. Further studies are needed to elucidate specific benefits of palliative care for this population. In addition, there is a tremendous need for education, specifically for clinicians, patients, and families, to improve understanding of palliative care and its benefits for patients with advanced disease. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  11. Conservation genomics of threatened animal species.

    PubMed

    Steiner, Cynthia C; Putnam, Andrea S; Hoeck, Paquita E A; Ryder, Oliver A

    2013-01-01

    The genomics era has opened up exciting possibilities in the field of conservation biology by enabling genomic analyses of threatened species that previously were limited to model organisms. Next-generation sequencing (NGS) and the collection of genome-wide data allow for more robust studies of the demographic history of populations and adaptive variation associated with fitness and local adaptation. Genomic analyses can also advance management efforts for threatened wild and captive populations by identifying loci contributing to inbreeding depression and disease susceptibility, and predicting fitness consequences of introgression. However, the development of genomic tools in wild species still carries multiple challenges, particularly those associated with computational and sampling constraints. This review provides an overview of the most significant applications of NGS and the implications and limitations of genomic studies in conservation.

  12. Hawaiian Duck's Future Threatened by Feral Mallards

    USGS Publications Warehouse

    Uyehara, Kimberly J.; Engilis, Andrew; Reynolds, Michelle

    2007-01-01

    Nearly 70 percent of Hawaii's native bird species are found nowhere else on Earth, and many of these species are declining or in danger of extinction. Although the Hawaiian Islands were once home to a remarkable diversity of waterfowl, only three species remain-the Hawaiian Goose (Nene), Laysan Duck, and Hawaiian Duck (Koloa maoli)-all Federally endangered. The Koloa maoli is the only Hawaiian bird threatened by 'genetic extinction' from hybridization with an invasive species-feral Mallard ducks. U.S. Geological Survey (USGS) biologists in Hawaii are working to find the causes of bird endangerment and ways to prevent extinction of the Koloa maoli and other threatened birds.

  13. 76 FR 77465 - Endangered and Threatened Species; Proposed Threatened Status for Distinct Population Segments of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ... Population Segments of the Bearded Seal AGENCY: National Marine Fisheries Service (NMFS), National Oceanic... population segments (DPS) of the bearded seal (Erignathus barbatus) as threatened species under the... spotted seals (Phoca largha) under the ESA (73 FR 16617). On May 28, 2008, we received a petition from the...

  14. OVERVIEW OF THE DRAFT METHODOLOGY FOR CONDUCTING BIOLOGICAL EVALUATIONS OF AQUATIC LIFE CRITERIA

    EPA Science Inventory

    This presentation will provide an overview of the draft methodology used in developing biological evaluations of aquatic life criteria specifically addressing aquatic and aquatic-dependent threatened and endangered species.

  15. Comparative ecological transcriptomics and the contribution of gene expression to the evolutionary potential of a threatened fish.

    PubMed

    Brauer, Chris J; Unmack, Peter J; Beheregaray, Luciano B

    2017-12-01

    Understanding whether small populations with low genetic diversity can respond to rapid environmental change via phenotypic plasticity is an outstanding research question in biology. RNA sequencing (RNA-seq) has recently provided the opportunity to examine variation in gene expression, a surrogate for phenotypic variation, in nonmodel species. We used a comparative RNA-seq approach to assess expression variation within and among adaptively divergent populations of a threatened freshwater fish, Nannoperca australis, found across a steep hydroclimatic gradient in the Murray-Darling Basin, Australia. These populations evolved under contrasting selective environments (e.g., dry/hot lowland; wet/cold upland) and represent opposite ends of the species' spectrum of genetic diversity and population size. We tested the hypothesis that environmental variation among isolated populations has driven the evolution of divergent expression at ecologically important genes using differential expression (DE) analysis and an anova-based comparative phylogenetic expression variance and evolution model framework based on 27,425 de novo assembled transcripts. Additionally, we tested whether gene expression variance within populations was correlated with levels of standing genetic diversity. We identified 290 DE candidate transcripts, 33 transcripts with evidence for high expression plasticity, and 50 candidates for divergent selection on gene expression after accounting for phylogenetic structure. Variance in gene expression appeared unrelated to levels of genetic diversity. Functional annotation of the candidate transcripts revealed that variation in water quality is an important factor influencing expression variation for N. australis. Our findings suggest that gene expression variation can contribute to the evolutionary potential of small populations. © 2017 John Wiley & Sons Ltd.

  16. Mortality and potential years of life lost by road traffic injuries in Brazil, 2013

    PubMed Central

    Andrade, Silvânia Suely Caribé de Araújo; de Mello-Jorge, Maria Helena Prado

    2016-01-01

    ABSTRACT OBJECTIVE To estimate the potential years of life lost by road traffic injuries three years after the beginning of the Decade of Action for Traffic Safety. METHODS We analyzed the data of the Sistema de Informações sobre Mortalidade (SIM – Mortality Information System) related to road traffic injuries, in 2013. We estimated the crude and standardized mortality rates for Brazil and geographic regions. We calculated, for the Country, the proportional mortality according to age groups, education level, race/skin color, and type or quality of the victim while user of the public highway. We estimated the potential years of life lost according to sex. RESULTS The mortality rate in 2013 was of 21.0 deaths per 100,000 inhabitants for the Country. The Midwest region presented the highest rate (29.9 deaths per 100,000 inhabitants). Most of the deaths by road traffic injuries took place with males (34.9 deaths per 100,000 males). More than half of the people who have died because of road traffic injuries were of black race/skin color, young adults (24.2%), individuals with low schooling (24.0%), and motorcyclists (28.5%). The mortality rate in the triennium 2011-2013 decreased 4.1%, but increased among motorcyclists. Across the Country, more than a million of potential years of life were lost, in 2013, because of road traffic injuries, especially in the age group of 20 to 29 years. CONCLUSIONS The impact of the high mortality rate is of over a million of potential years of life lost by road traffic injuries, especially among adults in productive age (early mortality), in only one year, representing extreme social cost arising from a cause of death that could be prevented. Despite the reduction of mortality by road traffic injuries from 2011 to 2013, the mortality rates increased among motorcyclists. PMID:27706375

  17. Methods for Assessing the Impact of Fog Oil Smoke on Availability, Palatability, & Food Quality of Relevant Life Stages of Insects for Threatened and Endangered Species

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

    Driver, Crystal J.; Strenge, Dennis L.; Su, Yin-Fong

    2007-04-01

    A methodology for quantifying population dynamics and food source value of insect fauna in areas subjected to fog oil smoke was developed. Our approach employed an environmentally controlled re-circulating wind tunnel outfitted with a high-heat vaporization and re-condensation fog oil generator that has been shown to produce aerosols of comparable chemistry and droplet-size distribution as those of field releases of the smoke. This method provides reproducible exposures of insects under realistic climatic and environmental conditions to fog oil aerosols that duplicate chemical and droplet-size characteristics of field releases of the smoke. The responses measured take into account reduction in foodmore » sources due to death and to changes in availability of relevant life stages of insects that form the prey base for the listed Threatened and Endangered Species. The influence of key environmental factors, wind speed and canopy structure on these responses were characterized. Data generated using this method was used to develop response functions related to particle size, concentration, wind speed, and canopy structure that will allow military personnel to assess and manage impacts to endangered species from fog oil smoke used in military training.« less

  18. Potentially Stressful Life Events and Emotional Closeness between Grandparents and Adult Grandchildren

    ERIC Educational Resources Information Center

    Wood, Suzanne; Liossis, Poppy

    2007-01-01

    The purpose of this study is to explore the variation in emotional closeness in the adult grandchild and grandparent relationship in relation to the occurrence of potentially stressful life events in childhood. A sample of university students (N = 119) completed a questionnaire measuring elements of intergenerational solidarity. Comparisons were…

  19. 76 FR 63322 - Endangered and Threatened Species Permit Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-12

    ...We, the U.S. Fish and Wildlife Service, invite the public to comment on the following applications to conduct certain activities with endangered or threatened species. The Endangered Species Act of 1973, as amended (Act), prohibits activities with endangered and threatened species unless a Federal permit allows such activities. The Act and the National Environmental Policy Act also require that we invite public comment before issuing these permits.

  20. Adverse life events and health: a population study in Hong Kong.

    PubMed

    Karatzias, Thanos; Yan, Elsie; Jowett, Sally

    2015-02-01

    Although the effects of adverse life events on mental health have been well documented in the literature, there has never been a population based study that investigated systematically the association between history of adverse life events and physical health (objective and subjective) in adults. Cross-sectional, face-to-face household population based survey of adults (18+) in Hong Kong (N=1147). Participants were asked if they had a diagnosis of six health conditions including hypertension, heart disease, arthritis, diabetes, eyesight degeneration, and hearing loss. They were also asked if they had experienced five adverse life events including death of a partner or spouse, abuse, natural disaster, life threatening illness or injury, and family disruption. Interviews also included the Short-Form 12 Health Survey (SFHS-12) and the short version of the Centre for Epidemiologic Studies Depression Scale (CES-D). Overall, results indicate that specific adverse life events may be associated with specific health conditions. However, all tested life events were associated with subjective physical and mental health. Death of partner or parent and life threatening illness or injury were found to have the strongest association with physical health problems. A dose-response relationship between adverse life events and physical health in general was evident but more so for heart disease and eyesight degeneration. Considering the high prevalence of traumatic events and how common the conditions associated with such events are in the general population, screening for adverse life events as part of comprehensive assessment will allow a deeper understanding of patients' needs. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. 77 FR 22604 - Endangered and Threatened Wildlife and Plants; Recovery Permit Application[s

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-16

    ...-FF06E00000] Endangered and Threatened Wildlife and Plants; Recovery Permit Application[s] AGENCY: Fish and..., 50 CFR 17.32 for threatened wildlife species, 50 CFR 17.62 for endangered plant species, and 50 CFR 17.72 for threatened plant species. Applications Available for Review and Comment We invite local...

  2. Combining geodiversity with climate and topography to account for threatened species richness.

    PubMed

    Tukiainen, Helena; Bailey, Joseph J; Field, Richard; Kangas, Katja; Hjort, Jan

    2017-04-01

    Understanding threatened species diversity is important for long-term conservation planning. Geodiversity-the diversity of Earth surface materials, forms, and processes-may be a useful biodiversity surrogate for conservation and have conservation value itself. Geodiversity and species richness relationships have been demonstrated; establishing whether geodiversity relates to threatened species' diversity and distribution pattern is a logical next step for conservation. We used 4 geodiversity variables (rock-type and soil-type richness, geomorphological diversity, and hydrological feature diversity) and 4 climatic and topographic variables to model threatened species diversity across 31 of Finland's national parks. We also analyzed rarity-weighted richness (a measure of site complementarity) of threatened vascular plants, fungi, bryophytes, and all species combined. Our 1-km 2 resolution data set included 271 threatened species from 16 major taxa. We modeled threatened species richness (raw and rarity weighted) with boosted regression trees. Climatic variables, especially the annual temperature sum above 5 °C, dominated our models, which is consistent with the critical role of temperature in this boreal environment. Geodiversity added significant explanatory power. High geodiversity values were consistently associated with high threatened species richness across taxa. The combined effect of geodiversity variables was even more pronounced in the rarity-weighted richness analyses (except for fungi) than in those for species richness. Geodiversity measures correlated most strongly with species richness (raw and rarity weighted) of threatened vascular plants and bryophytes and were weakest for molluscs, lichens, and mammals. Although simple measures of topography improve biodiversity modeling, our results suggest that geodiversity data relating to geology, landforms, and hydrology are also worth including. This reinforces recent arguments that conserving nature's stage

  3. The Transition from Earth-Centred Biology to Cosmic Life

    NASA Astrophysics Data System (ADS)

    Wickramasinghe, N. Chandra; Tokoro, Gensuke; Wainwright, Milton

    A paradigm shift with potentially profound implications has been taking place over the past 3 decades. The convergence of research in diverse disciplines points to life being a cosmic phenomenon. A near-infinite information content of life appears to have evolved on a cosmological scale -- over vast distances, and enormous spans of time. It appears highly unlikely that life could have emerged from chemicals in "some warm little pond" on the Earth; in contrast we maintain that every species of life on the Earth, including Homo sapiens, is in essence the result of an assembly of cosmologically derived viral genes. The ingress of such genes that continues to the present day led to their accommodation within the genomes of evolving lineages, sifted according to the "natural processes of selection", a mechanism first enunciated by Patrick Matthews and later used by Darwin. The evidence for this point of view has now grown to the point where we believe, it will soon need to be accepted by the majority of the scientific community. This is particularly critical, since we suggest that new diseases capable of threatening Man's existence could arrive to Earth from space. Moreover, we need to understand that we must live in harmony with the Earth and its ever-changing biosphere if we are to coexist with it.

  4. 75 FR 57431 - Listing Endangered and Threatened Wildlife and Plants; 90-Day Finding on a Petition to List...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ... segment is discrete and significant (i.e., it is a DPS), its evaluation for endangered or threatened... discrete if: (1) it is markedly separated from other populations of the same taxon as a consequence of... examples of potential considerations indicating significance, including: (1) persistence of the discrete...

  5. Health Promotion Using Life Skills Education Approach for Adolescents in Schools--Development of a Model

    ERIC Educational Resources Information Center

    Bharath, Srikala; Kumar, K. V. Kishore

    2008-01-01

    Life Skills Education (LSE) is a novel promotional program that teaches generic life skills through participatory learning methods of games, debates, role-plays, and group discussion. Conceptual understanding and practicing of the skills occurs through experiential learning in a non-threatening setting. Such initiatives provide the adolescent with…

  6. [Dignity of human life: euthanasia and suicide].

    PubMed

    Niebrój, Lesław

    2005-07-01

    Euthanasia is commonly considered as a form of suicide. The study aims to explore if such a presumption could be justified. Philosophical analysis of concepts of "human being", "human person", "biological life" and "life of human person", undertaken in this article, proved that the effective cause of suicide is obviously different from such a cause of euthanasia. Suicide aims to destruct life of a human person which is considered deprived of its dignity. Euthanasia's effective cause is to protect the dignity of such a life which is threatened by low quality of biological life caused both by the disease as well as by the applied treatment even if palliative only. On the basis of these considerations the main conclusion is drawn: suicide and euthanasia having different moral (material) subjects should be also ethically evaluated in a different way.

  7. Values, animal symbolism, and human-animal relationships associated to two threatened felids in Mapuche and Chilean local narratives.

    PubMed

    Herrmann, Thora M; Schüttler, Elke; Benavides, Pelayo; Gálvez, Nicolas; Söhn, Lisa; Palomo, Nadja

    2013-06-13

    The Chilean temperate rainforest has been subjected to dramatic fragmentation for agriculture and forestry exploitation. Carnivore species are particularly affected by fragmentation and the resulting resource use conflicts with humans. This study aimed at understanding values and human-animal relationships with negatively perceived threatened carnivores through the disclosure of local stories and Mapuche traditional folktales. Our mixed approach comprised the qualitative analysis of 112 stories on the kodkod cat (Leopardus guigna) and the puma (Puma concolor) collected by students (9-14 years) from 28 schools in the Araucania region within their family contexts, 10 qualitative in-depth interviews with indigenous Mapuche people, 35 traditional Mapuche legends, and the significance of naming found in ethnographic collections. We revealed a quasi-extinction of traditional tales in the current knowledge pool about pumas and kodkods, local anecdotes, however, were present in significant numbers. Values associated to both felids were manifold, ranging from negativistic to positive values. While pumas played an important role in people's spirituality, negative mythological connotations persisted in kodkod stories. Four prominent relationships were derived: (1) Both felids represent threats to livestock, pumas even to life, (2) both felids are symbols for upcoming negative events, (3) pumas are spiritual creatures, and (4) kodkods are threatened by humans. Recommendations are provided for stimulating new ways of perceiving unpopular and threatened carnivores among those who live in vicinity to them.

  8. [Case report of live threatening complications due to self insertion of foreign body into the vagina for masturbation purpose].

    PubMed

    Kuzaka, Bolesław; Kobryń, Andrzej; Niemierko, Maciej; Czaplicki, Maciej

    2009-01-01

    Authors have reported a case report of life threatening complications due to insertion of foreign bodies into the vagina, because of masturbation purpose. In this case subsequently came to perforation of the urinary bladder by the huge calculus that developed over the foreign body, and next to the peritoneum with development peritonitis and acute renal insufficiency with the need of dialysotherapy. After a number of surgical operations, the patient with a definitive percutaneous nephrostomy was discharged.

  9. Fertile fathoms: Deep reproductive refugia for threatened shallow corals

    PubMed Central

    Holstein, Daniel M.; Smith, Tyler B.; Gyory, Joanna; Paris, Claire B.

    2015-01-01

    The persistence of natural metapopulations may depend on subpopulations that exist at the edges of species ranges, removed from anthropogenic stress. Mesophotic coral ecosystems (30–150 m) are buffered from disturbance by depth and distance, and are potentially massive reservoirs of coral diversity and fecundity; yet we know little about the reproductive capabilities of their constituent species and the potential for these marginal environments to influence patterns of coral reef persistence. We investigated the reproductive performance of the threatened depth-generalist coral Orbicella faveolata over the extent of its vertical range to assess mesophotic contributions to regional larval pools. Over equal habitat area, mesophotic coral populations were found to produce over an order of magnitude more eggs than nearby shallow populations. Positive changes with depth in both population abundance and polyp fecundity contributed to this discrepancy. Relative larval pool contributions of deeper living corals will likely increase as shallow habitats further degrade due to climate change and local habitat degradation. This is a compelling example of the potential for marginal habitat to be critical to metapopulation persistence as reproductive refugia. PMID:26196243

  10. Impact of CNG Crisis on Student's Academic Life

    ERIC Educational Resources Information Center

    Azeem, Kiran; Nadeem, Wajiha; Zia, Afsa; Shehzad, Shiza; Anwar, Zara

    2017-01-01

    The goal of this study is to determine the impact of Compressed Natural Gas (CNG) crisis on Student's Academic Life of Karachi Pakistan. This research helps in observing the behavior of students and their educational progress includes depression and anxiety, rate of absenteeism and undesirable results in exams threatens due to CNG crisis and…

  11. 78 FR 60766 - Endangered and Threatened Wildlife and Plants; Threatened Species Status for Spring Pygmy Sunfish

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-02

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service 50 CFR Part 17 [Docket No. FWS-R4-ES-2012... Pygmy Sunfish AGENCY: Fish and Wildlife Service, Interior. ACTION: Final rule. SUMMARY: We, the U.S. Fish and Wildlife Service (Service), determine threatened species status under the Endangered Species...

  12. The Potential Role of Aerobic Exercise to Modulate Cardiotoxicity of Molecularly Targeted Cancer Therapeutics

    PubMed Central

    Lakoski, Susan; Mackey, John R.; Douglas, Pamela S.; Haykowsky, Mark J.; Jones, Lee W.

    2013-01-01

    Molecularly targeted therapeutics (MTT) are the future of cancer systemic therapy. They have already moved from palliative therapy for advanced solid malignancies into the setting of curative-intent treatment for early-stage disease. Cardiotoxicity is a frequent and potentially serious adverse complication of some targeted therapies, leading to a broad range of potentially life-threatening complications, therapy discontinuation, and poor quality of life. Low-cost pleiotropic interventions are therefore urgently required to effectively prevent and/or treat MTT-induced cardiotoxicity. Aerobic exercise therapy has the unique capacity to modulate, without toxicity, multiple gene expression pathways in several organ systems, including a plethora of cardiac-specific molecular and cell-signaling pathways implicated in MTT-induced cardiac toxicity. In this review, we examine the molecular signaling of antiangiogenic and HER2-directed therapies that may underpin cardiac toxicity and the hypothesized molecular mechanisms underlying the cardioprotective properties of aerobic exercise. It is hoped that this knowledge can be used to maximize the benefits of small molecule inhibitors, while minimizing cardiac damage in patients with solid malignancies. PMID:23335619

  13. My Kite Will Fly: Improving Communication and Understanding in Young Children When a Mother Is Diagnosed with Life-Threatening Gynecological Cancer.

    PubMed

    Holland, Cynthia; Hocking, Alison; Joubert, Lynette; McDermott, Fiona; Niski, Marcus D; Thomson Salo, Frances; Quinn, Michael A

    2018-01-01

    The My Kite Will Fly (MKWF) research program is built on the well-documented need for effective clinical communication tools and therapeutic interventions where a child's mother is diagnosed with life-threatening gynecological cancer. The Dignity Model and Child-Centered approach were two key study foundations in this pilot cohort. Quantitative survey and qualitative semistructured methods were employed to gather data from patient families at three distinct phases: Diagnosis, Treatment, and Palliative care. Participants were identified from patient groups at The Royal Women's Hospital and Peter MacCallum Cancer Center, Melbourne, Australia. A purposive sample (n = 36 children) (24 girls and 12 boys aged between 3 and 12 years) drawn from 19 families completed structured art therapy workbook activities. The principal researcher and a specialist educational assistant undertook cross-case thematic analysis of all interviews and children's drawings. Five central themes were profiled in six illustrative case studies. Interviews with all families (n = 19) showed 86.1% positive evaluation of the MKWF workbook template at diagnosis. During treatments, 66.6% of parents reported better understanding of the chemotherapy process and better communication with younger family members. At palliative care, 97.3% of families reported stabilization of family routines and improved illness coping. Exit interviews with six children and surviving parents (n = 4) showed that the program substantially prepared them for parental bereavement. Results from this pilot cohort confirm the importance of enhanced parent-child communication and stabilized family routines. Current results provide an important platform for future evaluative research among larger patient-family populations across multisite oncology settings.

  14. Embolization of a Hemorrhoid Following 18 Hours of Life-Threatening Bleeding

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

    Berczi, Viktor, E-mail: berczi@hotmail.com; Gopalan, Deepa; Cleveland, Trevor J

    2008-01-15

    Hemorrhoids usually do not pose diagnostic difficulties and they rarely cause massive bleeding. We report a case of massive rectal bleeding over 18 h needing 22 U blood transfusion treated by superselective transcatheter coil embolization 12 h following operative treatment performed in a different hospital. Diagnostic angiography with a view to superselective embolization, following failure of sigmoidoscopy to localize and treat the cause of hemorrhage, might act as a life-saving treatment in massive rectal bleeding, obviating the need for repeated endoscopy or emergency surgery.

  15. Effects of early-life malnutrition on neurodevelopment and neuropsychiatric disorders and the potential mechanisms.

    PubMed

    Yan, Xintian; Zhao, Xinzhi; Li, Juxue; He, Lin; Xu, Mingqing

    2018-04-20

    Lines of evidence have demonstrated that early-life malnutrition is highly correlated with neurodevelopment and adulthood neuropsychiatric disorders, while some findings are conflicting with each other. In addition, the biological mechanisms are less investigated. We systematically reviewed the evidence linking early-life nutrition status with neurodevelopment and clinical observations in human and animal models. We summarized the effects of special nutritious on neuropsychiatric disorders and explored the underlying potential mechanisms. The further understanding of the biological regulation of early-life nutritional status on neurodevelopment might shed light on precision nutrition at an integrative systems biology framework. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. 76 FR 53379 - Endangered and Threatened Wildlife and Plants; Revising the List of Endangered and Threatened...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ...; Revising the List of Endangered and Threatened Wildlife for the Gray Wolf (Canis lupus) in the Eastern...), published a proposed rule to reevaluate the listing of the Minnesota population of gray wolves (Canis lupus... lupus lycaon should be elevated to the full species C. lycaon. We proposed to identify the Minnesota...

  17. When Safe Oral Feeding Is Threatened: End-of-Life Options and Decisions

    ERIC Educational Resources Information Center

    Groher, Michael E.; Groher, Tammy Peutz

    2012-01-01

    Managing one's dysphagia at the end-of-life is challenging for the patient and the medical care team. Decisions surrounding oral feeding safety and the use of artificially administered hydration and nutrition require the medical care team to provide its best advice, taking into consideration the patient's health-related goals and the impact the…

  18. 'End of life could be on any ward really': A qualitative study of hospital volunteers' end-of-life care training needs and learning preferences.

    PubMed

    Brighton, Lisa Jane; Koffman, Jonathan; Robinson, Vicky; Khan, Shaheen A; George, Rob; Burman, Rachel; Selman, Lucy Ellen

    2017-10-01

    Over half of all deaths in Europe occur in hospital, a location associated with many complaints. Initiatives to improve inpatient end-of-life care are therefore a priority. In England, over 78,000 volunteers provide a potentially cost-effective resource to hospitals. Many work with people who are dying and their families, yet little is known about their training in end-of-life care. To explore hospital volunteers' end-of-life care training needs and learning preferences, and the acceptability of training evaluation methods. Qualitative focus groups. Volunteers from a large teaching hospital were purposively sampled. Five focus groups were conducted with 25 hospital volunteers (aged 19-80 years). Four themes emerged as follows: preparation for the volunteering role, training needs, training preferences and evaluation preferences. Many described encounters with patients with life-threatening illness and their families. Perceived training needs in end-of-life care included communication skills, grief and bereavement, spiritual diversity, common symptoms, and self-care. Volunteers valued learning from peers and end-of-life care specialists using interactive teaching methods including real-case examples and role plays. A chance to 'refresh' training at a later date was suggested to enhance learning. Evaluation through self-reports or observations were acceptable, but ratings by patients, families and staff were thought to be pragmatically unsuitable owing to sporadic contact with each. Gaps in end-of-life care training for hospital volunteers indicate scope to maximise on this resource. This evidence will inform development of training and evaluations which could better enable volunteers to make positive, cost-effective contributions to end-of-life care in hospitals.

  19. Arrhythmogenicity of weight-loss supplements marketed on the Internet.

    PubMed

    Nazeri, Alireza; Massumi, Ali; Wilson, James M; Frank, Christopher M; Bensler, Michael; Cheng, Jie; Saeed, Mohammad; Rasekh, Abdi; Razavi, Mehdi

    2009-05-01

    We examined nonprescription weight-loss supplements marketed on the Internet for ingredients with potential arrhythmogenic and life-threatening cardiac adverse effects. We aimed to define the risks of life-threatening cardiac adverse effects that are associated with weight-loss supplements marketed on the Internet. We entered the key words "weight-loss supplements" and "diet pills" into three popular Internet search engines. The top four nonoverlapping hits from each search engine were purchased. After receipt, the products and their ingredient lists were inspected, and Medline and the Natural Medicines Comprehensive Database were searched for reports of significant associations between each ingredient and various key words for life-threatening cardiac adverse effects. All supplements had the list of ingredients on the label. We identified 60 different ingredients (7.25 +/- 4.66 per supplement; range 1-21). Eleven ingredients representing eight different substances (because multiple names were used for some substances) were each associated with two or more reports of life-threatening cardiac complications or death. Eight of the 12 products contained one or more such ingredients, but none of these eight products had warnings about life-threatening cardiac adverse effects on the Web pages, on the labels, or in the package inserts. One product contained ma huang (Chinese ephedra), even though the marketing of ephedra-containing products is banned in the United States. The Internet provides easy access to weight-loss supplements, several of which contain ingredients with potentially life-threatening adverse effects. There is a need for increased public education and awareness regarding such weight-loss products.

  20. Sensitive maintenance: a cognitive process underlying individual differences in memory for threatening information.

    PubMed

    Peters, Jan H; Hock, Michael; Krohne, Heinz Walter

    2012-01-01

    Dispositional styles of coping with threat influence memory for threatening information. In particular, sensitizers excel over repressors in their memory for threatening information after long retention intervals, but not after short ones. We therefore suggested that sensitizers, but not repressors, employ active maintenance processes during the retention interval to selectively retain threatening material. Sensitive maintenance was studied in 2 experiments in which participants were briefly exposed to threatening and nonthreatening pictures (Experiment 1, N = 128) or words (Experiment 2, N = 145). Following, we administered unannounced recognition tests before and after an intervening task that generated either high or low cognitive load, assuming that high cognitive load would impede sensitizers' memory maintenance of threatening material. Supporting our hypotheses, the same pattern of results was obtained in both experiments: Under low cognitive load, sensitizers forgot less threat material than repressors did; no such differences were observed under high cognitive load.

  1. 77 FR 73827 - Endangered and Threatened Wildlife and Plants; Listing the Lesser Prairie-Chicken as a Threatened...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-11

    ... commercial, recreational, scientific, or educational purposes; (C) disease or predation; (D) the inadequacy... amended (Act) (16 U.S.C. 1531 et seq.), which are: (a) The present or threatened destruction, modification..., scientific, or educational purposes; (c) Disease or predation; (d) The inadequacy of existing regulatory...

  2. Longevity in Slovenia: Past and potential gains in life expectancy by age and causes of death.

    PubMed

    Lotrič Dolinar, Aleša; Došenović Bonča, Petra; Sambt, Jože

    2017-06-01

    In Slovenia, longevity is increasing rapidly. From 1997 to 2014, life expectancy at birth increased by 7 and 5 years for men and women, respectively. This paper explores how this gain in life expectancy at birth can be attributed to reduced mortality from five major groups of causes of death by 5-year age groups. It also estimates potential future gains in life expectancy at birth. The importance of the five major causes of death was analysed by cause-elimination life tables. The total elimination of individual causes of death and a partial hypothetical adjustment of mortality to Spanish levels were analysed, along with age and cause decomposition (Pollard). During the 1997-2014 period, the increase in life expectancy at birth was due to lower mortality from circulatory diseases (ages above 60, both genders), as well as from lower mortality from neoplasms (ages above 50 years) and external causes (between 20 and 50 years) for men. However, considering the potential future gains in life expectancy at birth, by far the strongest effect can be attributed to lower mortality due to circulatory diseases for both genders. If Spanish mortality rates were reached, life expectancy at birth would increase by more than 2 years, again mainly because of lower mortality from circulatory diseases in very old ages. Life expectancy analyses can improve evidence-based decision-making and allocation of resources among different prevention programmes and measures for more effective disease management that can also reduce the economic burden of chronic diseases.

  3. 76 FR 30757 - Endangered and Threatened Wildlife and Plants; Listing the Salmon-Crested Cockatoo as Threatened...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-26

    ...We, the U.S. Fish and Wildlife Service, determine threatened status for the salmon-crested cockatoo (Cacatua moluccensis) under the Endangered Species Act of 1973, as amended (Act). This final rule implements the Federal protections provided by the Act for this species. We are also publishing a special rule for the species.

  4. Investigation into potential transmission sources of Giardia duodenalis in a threatened marsupial (Petrogale penicillata).

    PubMed

    Vermeulen, Elke T; Ashworth, Deborah L; Eldridge, Mark D B; Power, Michelle L

    2015-07-01

    Assemblages of the protozoan parasite Giardia duodenalis common in humans and domestic species are increasingly identified in wildlife species, raising concern about the spill-over of pathogens from humans and domestic animals into wildlife. Here, the identity and prevalence of G. duodenalis in populations of a threatened marsupial, the brush-tailed rock-wallaby (Petrogale penicillata), was investigated. Identification of G. duodenalis isolates, across three loci (18S rRNA, β-giardin and gdh), from rock-wallaby fecal samples (n = 318) identified an overall detection rate of 6.3%. No significant difference in G. duodenalis detection was found among captive, wild and supplemented populations. Isolates were assigned to the zoonotic assemblages A and B at 18S rRNA, with sub-assemblages AI and BIV identified at the β-giardin and gdh loci, respectively. Assemblages AI and BIV have previously been identified in human clinical cases, but also in domestic animals and wildlife. The identification of these assemblages in brush-tailed rock-wallabies suggests there are transmission routes of G. duodenalis from humans or other animals to Australian wildlife, both in captivity and in the wild. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Volatile Constituents from Baccharis spp. L. (Asteraceae): Chemical Support for the Conservation of Threatened Species in Uruguay.

    PubMed

    Minteguiaga, Manuel; González, Andrés; Cassel, Eduardo; Umpierrez, Noelia; Fariña, Laura; Dellacassa, Eduardo

    2018-05-01

    Chemical bioprospecting is an important tool for generating knowledge regarding local human-threatened floras and for conservation management. For Baccharis L. (Asteraceae), several volatile components have been reported for Brazil, Argentina, Bolivia, and Chile as a result of bioprospection, but not for Uruguayan flora, which is composed of more than 50 native species. In this work, through collection of aerial parts of different species and volatile simultaneous-distillation extraction and gas chromatography-mass spectrometry analyses, twelve native species of Baccharis were studied (B. articulata, B. cultrata, B. genistifolia, B. gibertii, B. gnaphalioides, B. ochracea, B. phyteumoides, B. punctulata, B. crispa, B. dracunculifolia, B. linearifolia subsp. linearifolia, and B. spicata). A detailed analysis of the male and female volatile composition was conducted for the last four species. The profiles of B. cultrata, B. genistifolia, B. gibertii, and B. gnaphalioides are reported for the first time. Because half of the species analyzed in this work are in Uruguay and are threatened or potentially threatened by human economic activities, the importance of their conservation as natural, sustainable resources is highlighted. © 2018 Wiley-VHCA AG, Zurich, Switzerland.

  6. Life-Threatening Opioid Toxicity

    DTIC Science & Technology

    1987-01-01

    mu recep- Fentanyl (Sublimaze) tor has been determined to mediate analgesia Propoxyphene (Darvon) and ventilatory depre.;sion. Furthermore, it Pure...following opioid overdose . The reduction in ventilation is accompanied by Opioids produce their major effect on the a decreased chemosensitivity to...opiates a o d F Diphenoxylate (active ingredient in Lomotil)a mperidline overdose . Fuithermore, ven- rpxhe (avnmepedinePropoxyphene Darvon) titatory

  7. Issues in life support and human factors in crew rescue from the ISS

    NASA Technical Reports Server (NTRS)

    Smart, K.

    2001-01-01

    The design and development of crew emergency response systems, particularly to provide an unplanned emergency return to Earth, requires an understanding of crew performance challenges in space. The combined effects of psychological and physiological adaptation during long-duration missions will have a significant effect on crew performance in the unpredictable and potentially life-threatening conditions of an emergency return to Earth. It is therefore important that the systems to be developed for emergency egress address these challenges through an integrated program to produce optimum productivity and safety in times of utmost stress. Fundamental to the success of the CRV is the Environmental Control and Life Support System (ECLSS), which provides the necessary conditions for the crew to survive their return mission in a shirtsleeve environment. This article will discuss the many issues in the design of an ECLSS system for CRV and place it in the context of the human performance challenges of the mission.

  8. Potential years lost and life expectancy in adults with newly diagnosed epilepsy.

    PubMed

    Granbichler, Claudia A; Zimmermann, Georg; Oberaigner, Willi; Kuchukhidze, Giorgi; Ndayisaba, Jean-Pierre; Taylor, Alexandra; Luef, Gerhard; Bathke, Arne C; Trinka, Eugen

    2017-11-01

    Studies using relative measures, such as standardized mortality ratios, have shown that patients with epilepsy have an increased mortality. Reports on more direct and absolute measure such as life expectancy are sparse. We report potential years lost and how life expectancy has changed over 40 years in a cohort of patients with newly diagnosed epilepsy. We analyzed life expectancy in a cohort of adult patients diagnosed with definite epilepsy between 1970 and 2010. Those with brain tumor as cause of epilepsy were excluded. By retrospective probabilistic record linkage, living or death status was derived from the national death registry. We estimated life expectancy by a Weibull regression model using gender, age at diagnosis, epilepsy etiology, and year of diagnosis as covariates at time of epilepsy diagnosis, and 5, 10, 15, and 20 years after diagnosis. Results were compared to the general population, and 95% confidence intervals are given. There were 249 deaths (105 women, age at death 19.0-104.0 years) in 1,112 patients (11,978.4 person-years, 474 women, 638 men). A substantial decrease in life expectancy was observed for only a few subgroups, strongly depending on epilepsy etiology and time of diagnosis: time of life lost was highest in patients with symptomatic epilepsy diagnosed between 1970 and 1980; the impact declined with increasing time from diagnosis. Over half of the analyzed subgroups did not differ significantly from the general population. This effect was reversed in the later decades, and life expectancy was prolonged in some subgroups, reaching a maximum in those with newly diagnosed idiopathic and cryptogenic epilepsy between 2001 and 2010. Life expectancy is reduced in symptomatic epilepsies. However, in other subgroups, a prolonged life expectancy was found, which has not been reported previously. Reasons may be manifold and call for further study. © 2017 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International

  9. This person is saying bad things about you: The influence of physically and socially threatening context information on the processing of inherently neutral faces.

    PubMed

    Klein, Fabian; Iffland, Benjamin; Schindler, Sebastian; Wabnitz, Pascal; Neuner, Frank

    2015-12-01

    Recent studies have shown that the perceptual processing of human faces is affected by context information, such as previous experiences and information about the person represented by the face. The present study investigated the impact of verbally presented information about the person that varied with respect to affect (neutral, physically threatening, socially threatening) and reference (self-referred, other-referred) on the processing of faces with an inherently neutral expression. Stimuli were presented in a randomized presentation paradigm. Event-related potential (ERP) analysis demonstrated a modulation of the evoked potentials by reference at the EPN (early posterior negativity) and LPP (late positive potential) stage and an enhancing effect of affective valence on the LPP (700-1000 ms) with socially threatening context information leading to the most pronounced LPP amplitudes. We also found an interaction between reference and valence with self-related neutral context information leading to more pronounced LPP than other related neutral context information. Our results indicate an impact of self-reference on early, presumably automatic processing stages and also a strong impact of valence on later stages. Using a randomized presentation paradigm, this study confirms that context information affects the visual processing of faces, ruling out possible confounding factors such as facial configuration or conditional learning effects.

  10. Threatening auditory hallucinations and Cotard syndrome in Parkinson disease.

    PubMed

    Factor, Stewart A; Molho, Eric S

    2004-01-01

    Psychotic symptoms are commonly reported in patients with Parkinson disease (PD). In particular, patients experience nonthreatening visual hallucinations that can occur with insight (so called hallucinosis) or without. Auditory hallucinations are uncommon, and schizophrenialike symptoms such as pejorative and threatening auditory hallucinations and delusions that are persecutory, referential, somatic, religious, or grandiose have rarely been reported. The authors present 2 PD patients who experienced threatening auditory hallucinations, without visual hallucinations, and schizophrenialike delusions with detailed description of the clinical phenomenology including 1 patient with Cotard syndrome.

  11. 77 FR 76706 - Endangered and Threatened Species; Threatened Status for the Arctic, Okhotsk, and Baltic...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-28

    ...We, NMFS, issue a final determination to list the Arctic (Phoca hispida hispida), Okhotsk (Phoca hispida ochotensis), and Baltic (Phoca hispida botnica) subspecies of the ringed seal (Phoca hispida) as threatened and the Ladoga (Phoca hispida ladogensis) subspecies of the ringed seal as endangered under the Endangered Species Act (ESA). We will propose to designate critical habitat for the Arctic ringed seal in a future rulemaking. To assist us in this effort, we solicit information that may be relevant to the designation of critical habitat for Arctic ringed seals. In light of public comments and upon further review, we are withdrawing the proposed ESA section 4(d) protective regulations for threatened subspecies of the ringed seal because we have determined that such regulations are not necessary or advisable for the conservation of the Arctic, Okhotsk, or Baltic subspecies of the ringed seal at this time. Given their current population sizes, the long-term nature of the primary threat to these subspecies (habitat alteration stemming from climate change), and the existing protections under the Marine Mammal Protection Act, it is unlikely that the proposed protective regulations would provide appreciable conservation benefits.

  12. Evaluation of Retention of Knowledge and Skills Imparted to First-Year Medical Students through Basic Life Support Training

    ERIC Educational Resources Information Center

    Pande, Sushma; Pande, Santosh; Parate, Vrushali; Pande, Sanket; Sukhsohale, Neelam

    2014-01-01

    Poor awareness among medical graduates about basic life support (BLS) is a matter of great concern. The presence of a trained rescuer is the key determinant of ultimate survival from life-threatening emergencies. To achieve this goal, early exposure to such life-saving skills is the right decision to foster these skills for medical students, which…

  13. Which activities threaten independent living of elderly when becoming problematic: inspiration for meaningful service robot functionality.

    PubMed

    Bedaf, Sandra; Gelderblom, Gert Jan; Syrdal, Dag Sverre; Lehmann, Hagen; Michel, Hervé; Hewson, David; Amirabdollahian, Farshid; Dautenhahn, Kerstin; de Witte, Luc

    2014-11-01

    In light of the increasing elderly population and the growing demand for home care, the potential of robot support is given increasing attention. In this paper, an inventory of activities was made that threaten independent living of elderly when becoming problematic. Results will guide the further development of an existing service robot, the Care-O-bot®. A systematic literature search of PubMed was performed, focused on the risk factors for institutionalization. Additionally, focus group sessions were conducted in the Netherlands, United Kingdom and France. In these focus group sessions, problematic activities threatening the independence of elderly people were discussed. Three separate target groups were included in the focus group sessions: (1) elderly persons (n = 41), (2) formal caregivers (n = 40) and (3) informal caregivers (n = 32). Activities within the International Classification of Functioning domains mobility, self-care, and interpersonal interaction and relationships were found to be the most problematic. A distinct set of daily activities was identified that may threaten independent living, but no single activity could be selected as the main activity causing a loss of independence as it is often a combination of problematic activities that is person-specific. Supporting the problematic activities need not involve a robotic solution.

  14. Potential for DNA-based identification of Great Lakes fauna: match and mismatch between taxa inventories and DNA barcode libraries.

    PubMed

    Trebitz, Anett S; Hoffman, Joel C; Grant, George W; Billehus, Tyler M; Pilgrim, Erik M

    2015-07-22

    DNA-based identification of mixed-organism samples offers the potential to greatly reduce the need for resource-intensive morphological identification, which would be of value both to bioassessment and non-native species monitoring. The ability to assign species identities to DNA sequences found depends on the availability of comprehensive DNA reference libraries. Here, we compile inventories for aquatic metazoans extant in or threatening to invade the Laurentian Great Lakes and examine the availability of reference mitochondrial COI DNA sequences (barcodes) in the Barcode of Life Data System for them. We found barcode libraries largely complete for extant and threatening-to-invade vertebrates (100% of reptile, 99% of fish, and 92% of amphibian species had barcodes). In contrast, barcode libraries remain poorly developed for precisely those organisms where morphological identification is most challenging; 46% of extant invertebrates lacked reference barcodes with rates especially high among rotifers, oligochaetes, and mites. Lack of species-level identification for many aquatic invertebrates also is a barrier to matching DNA sequences with physical specimens. Attaining the potential for DNA-based identification of mixed-organism samples covering the breadth of aquatic fauna requires a concerted effort to build supporting barcode libraries and voucher collections.

  15. Potential for DNA-based identification of Great Lakes fauna: match and mismatch between taxa inventories and DNA barcode libraries

    NASA Astrophysics Data System (ADS)

    Trebitz, Anett S.; Hoffman, Joel C.; Grant, George W.; Billehus, Tyler M.; Pilgrim, Erik M.

    2015-07-01

    DNA-based identification of mixed-organism samples offers the potential to greatly reduce the need for resource-intensive morphological identification, which would be of value both to bioassessment and non-native species monitoring. The ability to assign species identities to DNA sequences found depends on the availability of comprehensive DNA reference libraries. Here, we compile inventories for aquatic metazoans extant in or threatening to invade the Laurentian Great Lakes and examine the availability of reference mitochondrial COI DNA sequences (barcodes) in the Barcode of Life Data System for them. We found barcode libraries largely complete for extant and threatening-to-invade vertebrates (100% of reptile, 99% of fish, and 92% of amphibian species had barcodes). In contrast, barcode libraries remain poorly developed for precisely those organisms where morphological identification is most challenging; 46% of extant invertebrates lacked reference barcodes with rates especially high among rotifers, oligochaetes, and mites. Lack of species-level identification for many aquatic invertebrates also is a barrier to matching DNA sequences with physical specimens. Attaining the potential for DNA-based identification of mixed-organism samples covering the breadth of aquatic fauna requires a concerted effort to build supporting barcode libraries and voucher collections.

  16. The biogeography of threatened insular iguanas and opportunities for invasive vertebrate management

    USGS Publications Warehouse

    Tershy, Bernie R.; Newton, Kelly M.; Spatz, Dena R.; Swinnerton, Kirsty; Iverson, John B.; Fisher, Robert N.; Harlow, Peter S.; Holmes, Nick D.; Croll, Donald A.; Iverson, J.B.; Grant, T. D.; Knapp, C. R.; Pasachnik, S. A.

    2016-01-01

    Iguanas are a particularly threatened group of reptiles, with 61% of species at risk of extinction. Primary threats to iguanas include habitat loss, direct and indirect impacts by invasive vertebrates, overexploitation, and human disturbance. As conspicuous, charismatic vertebrates, iguanas also represent excellent flagships for biodiversity conservation. To assist planning for invasive vertebrate management and thus benefit threatened iguana recovery, we identified all islands with known extant or extirpated populations of Critically Endangered and Endangered insular iguana taxa as recognized by the International Union for Conservation of Nature (IUCN) Red List of Threatened Species. For each island, we determined total area, sovereignty, the presence of invasive alien vertebrates, and human population. For the 23 taxa of threatened insular iguanas we identified 230 populations, of which iguanas were extant on 185 islands and extirpated from 45 islands. Twenty-one iguana taxa (91% of all threatened insular iguana taxa) occurred on at least one island with invasive vertebrates present; 16 taxa had 100% of their population(s) on islands with invasive vertebrates present. Rodents, cats, ungulates, and dogs were the most common invasive vertebrates. We discuss biosecurity, eradication, and control of invasive vertebrates to benefit iguana recovery: (1) on islands already free of invasive vertebrates; (2) on islands with high iguana endemicity; and (3) for species and subspecies with small total populations occurring across multiple small islands. Our analyses provide an important first step toward understanding how invasive vertebrate management can be planned effectively to benefit threatened insular iguanas.

  17. ‘End of life could be on any ward really’: A qualitative study of hospital volunteers’ end-of-life care training needs and learning preferences

    PubMed Central

    Brighton, Lisa Jane; Koffman, Jonathan; Robinson, Vicky; Khan, Shaheen A; George, Rob; Burman, Rachel; Selman, Lucy Ellen

    2017-01-01

    Background: Over half of all deaths in Europe occur in hospital, a location associated with many complaints. Initiatives to improve inpatient end-of-life care are therefore a priority. In England, over 78,000 volunteers provide a potentially cost-effective resource to hospitals. Many work with people who are dying and their families, yet little is known about their training in end-of-life care. Aims: To explore hospital volunteers’ end-of-life care training needs and learning preferences, and the acceptability of training evaluation methods. Design: Qualitative focus groups. Setting/participants: Volunteers from a large teaching hospital were purposively sampled. Results: Five focus groups were conducted with 25 hospital volunteers (aged 19–80 years). Four themes emerged as follows: preparation for the volunteering role, training needs, training preferences and evaluation preferences. Many described encounters with patients with life-threatening illness and their families. Perceived training needs in end-of-life care included communication skills, grief and bereavement, spiritual diversity, common symptoms, and self-care. Volunteers valued learning from peers and end-of-life care specialists using interactive teaching methods including real-case examples and role plays. A chance to ‘refresh’ training at a later date was suggested to enhance learning. Evaluation through self-reports or observations were acceptable, but ratings by patients, families and staff were thought to be pragmatically unsuitable owing to sporadic contact with each. Conclusion: Gaps in end-of-life care training for hospital volunteers indicate scope to maximise on this resource. This evidence will inform development of training and evaluations which could better enable volunteers to make positive, cost-effective contributions to end-of-life care in hospitals. PMID:28056642

  18. Coping with the Stress of Potential Lay-Off and Worksite Re-Organization: A Test of the Buffering Hypothesis.

    ERIC Educational Resources Information Center

    Weinberg, Richard B.

    Two major classes of environmental stressors have been examined in life stress research: major life events and minor everyday hassles. To compare these two classes of stressors along with two stressful life events (threatened job loss and reorganization of the work setting), and to investigate the buffering effect of coping responses on…

  19. The Perceived Value of Maths and Academic Self-Efficacy in the Appraisal of Fear Appeals Used Prior to a High-Stakes Test as Threatening or Challenging

    ERIC Educational Resources Information Center

    Putwain, David William; Symes, Wendy

    2014-01-01

    Previous work has examined how messages communicated to students prior to high-stakes exams, that emphasise the importance of avoiding failure for subsequent life trajectory, may be appraised as threatening. In two studies, we extended this work to examine how students may also appraise such messages as challenging or disregard them as being of…

  20. 75 FR 17153 - Endangered and Threatened Wildlife and Plants; 5-Year Status Review of Roseate Tern

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-05

    ...] Endangered and Threatened Wildlife and Plants; 5-Year Status Review of Roseate Tern AGENCY: Fish and Wildlife... threatened or endangered on the Lists of Endangered and Threatened Wildlife and Plants is accurate. The prior... and threatened wildlife and plant species in the Code of Federal Regulations (CFR) at 50 CFR 17.11...

  1. Values, animal symbolism, and human-animal relationships associated to two threatened felids in Mapuche and Chilean local narratives

    PubMed Central

    2013-01-01

    Background The Chilean temperate rainforest has been subjected to dramatic fragmentation for agriculture and forestry exploitation. Carnivore species are particularly affected by fragmentation and the resulting resource use conflicts with humans. This study aimed at understanding values and human-animal relationships with negatively perceived threatened carnivores through the disclosure of local stories and Mapuche traditional folktales. Methods Our mixed approach comprised the qualitative analysis of 112 stories on the kodkod cat (Leopardus guigna) and the puma (Puma concolor) collected by students (9-14 years) from 28 schools in the Araucania region within their family contexts, 10 qualitative in-depth interviews with indigenous Mapuche people, 35 traditional Mapuche legends, and the significance of naming found in ethnographic collections. Results We revealed a quasi-extinction of traditional tales in the current knowledge pool about pumas and kodkods, local anecdotes, however, were present in significant numbers. Values associated to both felids were manifold, ranging from negativistic to positive values. While pumas played an important role in people’s spirituality, negative mythological connotations persisted in kodkod stories. Four prominent relationships were derived: (1) Both felids represent threats to livestock, pumas even to life, (2) both felids are symbols for upcoming negative events, (3) pumas are spiritual creatures, and (4) kodkods are threatened by humans. Recommendations are provided for stimulating new ways of perceiving unpopular and threatened carnivores among those who live in vicinity to them. PMID:23764186

  2. Determinants of bird conservation-action implementation and associated population trends of threatened species.

    PubMed

    Luther, David A; Brooks, Thomas M; Butchart, Stuart H M; Hayward, Matt W; Kester, Marieke E; Lamoreux, John; Upgren, Amy

    2016-12-01

    Conservation actions, such as habitat protection, attempt to halt the loss of threatened species and help their populations recover. The efficiency and the effectiveness of actions have been examined individually. However, conservation actions generally occur simultaneously, so the full suite of implemented conservation actions should be assessed. We used the conservation actions underway for all threatened and near-threatened birds of the world (International Union for Conservation of Nature Red List of Threatened Species) to assess which biological (related to taxonomy and ecology) and anthropogenic (related to geoeconomics) factors were associated with the implementation of different classes of conservation actions. We also assessed which conservation actions were associated with population increases in the species targeted. Extinction-risk category was the strongest single predictor of the type of conservation actions implemented, followed by landmass type (continent, oceanic island, etc.) and generation length. Species targeted by invasive nonnative species control or eradication programs, ex situ conservation, international legislation, reintroduction, or education, and awareness-raising activities were more likely to have increasing populations. These results illustrate the importance of developing a predictive science of conservation actions and the relative benefits of each class of implemented conservation action for threatened and near-threatened birds worldwide. © 2016 Society for Conservation Biology.

  3. Physical Therapy in Palliative Care: From Symptom Control to Quality of Life: A Critical Review

    PubMed Central

    Kumar, Senthil P; Jim, Anand

    2010-01-01

    Physiotherapy is concerned with identifying and maximizing movement potential, within the spheres of promotion, prevention, treatment and rehabilitation. Physical therapists practice in a broad range of inpatient, outpatient, and community-based settings such as hospice and palliative care centers where as part of a multidisciplinary team of care, they address the physical and functional dimensions of the patients’ suffering. Physiotherapy treatment methods like therapeutic exercise, electrical modalities, thermal modalities, actinotherapy, mechanical modalities, manual physical therapy and assistive devices are useful for a range of life-threatening and life-limiting conditions like cancer and cancer-associated conditions; HIV; neurodegenerative disorders like amyotrophic lateral sclerosis, multiple sclerosis; respiratory disorders like idiopathic pulmonary fibrosis; and altered mental states. The professional armamentarium is still expanding with inclusion of other miscellaneous techniques which were also proven to be effective in improving quality of life in these patients. Considering the scope of physiotherapy in India, and in palliative care, professionals in a multidisciplinary palliative care team need to understand and mutually involve toward policy changes to successfully implement physical therapeutic palliative care delivery. PMID:21218003

  4. EARLY LIFE STAGE TOXICITY OF COPPER TO ENDANGERED AND SURROGATE FISH SPECIES

    EPA Science Inventory

    Water quality criteria (WQC) for the protection of aquatic life have not explicitly considered the degree of protection afforded to aquatic species listed as endangered or threatened under the U.S. Endangered Species Act (listed species) . Most WQCs are based primarily on respon...

  5. Venus' Spectral Signatures and the Potential for Life in the Clouds.

    PubMed

    Limaye, Sanjay S; Mogul, Rakesh; Smith, David J; Ansari, Arif H; Słowik, Grzegorz P; Vaishampayan, Parag

    2018-03-30

    The lower cloud layer of Venus (47.5-50.5 km) is an exceptional target for exploration due to the favorable conditions for microbial life, including moderate temperatures and pressures (∼60°C and 1 atm), and the presence of micron-sized sulfuric acid aerosols. Nearly a century after the ultraviolet (UV) contrasts of Venus' cloud layer were discovered with Earth-based photographs, the substances and mechanisms responsible for the changes in Venus' contrasts and albedo are still unknown. While current models include sulfur dioxide and iron chloride as the UV absorbers, the temporal and spatial changes in contrasts, and albedo, between 330 and 500 nm, remain to be fully explained. Within this context, we present a discussion regarding the potential for microorganisms to survive in Venus' lower clouds and contribute to the observed bulk spectra. In this article, we provide an overview of relevant Venus observations, compare the spectral and physical properties of Venus' clouds to terrestrial biological materials, review the potential for an iron- and sulfur-centered metabolism in the clouds, discuss conceivable mechanisms of transport from the surface toward a more habitable zone in the clouds, and identify spectral and biological experiments that could measure the habitability of Venus' clouds and terrestrial analogues. Together, our lines of reasoning suggest that particles in Venus' lower clouds contain sufficient mass balance to harbor microorganisms, water, and solutes, and potentially sufficient biomass to be detected by optical methods. As such, the comparisons presented in this article warrant further investigations into the prospect of biosignatures in Venus' clouds. Key Words: Venus-Clouds-Life-Habitability-Microorganism-Albedo-Spectroscopy-Biosignatures-Aerosol-Sulfuric Acid. Astrobiology 18, xxx-xxx.

  6. [Life risk and nature of SAMU: users' perspectives and implications for nursing].

    PubMed

    Veronese, Andréa Márian; de Oliveira, Dora Lúcia Leidens Corrêa; Nast, Karoline

    2012-12-01

    The article is part of a qualitative study analisys developed in 2009 aiming at investigating the demand of emergency calls to the Emergency Mobile Attendance Service/Porto Alegre (SAMU) that classifies it as non-pertinent. The information was gathered from 16 semi-structured interviews with the subjects of that demand by utilizing as a methodological guideline the Grounded Theory. The article approaches the content of the sub-category "Entering into conflict with SAMU regulation in the evaluation of life-threatening", by focusing the divergences between the regulation and the users' perception about the operation of the service and the meaning of "life-threatening", factors implied in the construction of the non-pertinent demand. The importance of Nursing within this scenery is in its competence to perform education actions about first aid and to participate in projects among sectors which are able to intervene in situations that generate vulnerability.

  7. 50 CFR 222.103 - Federal/state cooperation in the conservation of endangered and threatened species.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... conservation of endangered and threatened species. 222.103 Section 222.103 Wildlife and Fisheries NATIONAL... MAMMALS GENERAL ENDANGERED AND THREATENED MARINE SPECIES Introduction and General Provisions § 222.103 Federal/state cooperation in the conservation of endangered and threatened species. (a) Application for...

  8. 50 CFR 222.103 - Federal/state cooperation in the conservation of endangered and threatened species.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... conservation of endangered and threatened species. 222.103 Section 222.103 Wildlife and Fisheries NATIONAL... MAMMALS GENERAL ENDANGERED AND THREATENED MARINE SPECIES Introduction and General Provisions § 222.103 Federal/state cooperation in the conservation of endangered and threatened species. (a) Application for...

  9. 50 CFR 222.103 - Federal/state cooperation in the conservation of endangered and threatened species.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... conservation of endangered and threatened species. 222.103 Section 222.103 Wildlife and Fisheries NATIONAL... MAMMALS GENERAL ENDANGERED AND THREATENED MARINE SPECIES Introduction and General Provisions § 222.103 Federal/state cooperation in the conservation of endangered and threatened species. (a) Application for...

  10. 50 CFR 222.103 - Federal/state cooperation in the conservation of endangered and threatened species.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... conservation of endangered and threatened species. 222.103 Section 222.103 Wildlife and Fisheries NATIONAL... MAMMALS GENERAL ENDANGERED AND THREATENED MARINE SPECIES Introduction and General Provisions § 222.103 Federal/state cooperation in the conservation of endangered and threatened species. (a) Application for...

  11. Acetazolamide-related life-threatening hypophosphatemia in a glaucoma patient.

    PubMed

    Hu, Ching-Yun; Lee, Bor-Jen; Cheng, Hsiang-Fan; Wang, Chen-Yu

    2015-01-01

    Acetazolamide-related hypophosphatemia leading to cardiac arrest is extremely rare. Herein we report a 78-year-old female glaucoma patient who developed general weakness and acute respiratory failure, followed by cardiac arrest 1 day after taking acetazolamide. The patient was successfully weaned from the ventilator after correction of hypophosphatemia and fully recovered. As acetazolamide was shown to have the potential to cause a lethal side effect in stable glaucoma, the risk of hypophosphatemia should be kept in mind by ophthalmologists. An examination of serum metabolic panels may be indicated in patients at risk of hypophosphatemia.

  12. Endangered and Threatened Marine Species :: NOAA Fisheries

    Science.gov Websites

    these species, about 675 are foreign species, found only in areas outside of the U.S. and our waters. We have jurisdiction over 161 endangered and threatened marine species, including 65 foreign species. We

  13. Hemorrhagic Shock as a Sequela of Splenic Rupture in a Patient with Infectious Mononucleosis: Focus on the Potential Role of Salicylates

    PubMed Central

    Bouliaris, Konstantinos; Karangelis, Dimos; Daskalopoulos, Marios; Spanos, Konstantinos; Fanariotis, Michael; Giaglaras, Anargyros

    2012-01-01

    Despite the fact that the vast majority of splenic ruptures are traumatic, infectious mononucleosis has been incriminated as a major predisposing factor that affects the integrity of the spleen, thus causing atraumatic ruptures and life-threatening hemorrhages. Herein we present a case of a 23-year-old Caucasian male who underwent an emergency laparotomy for acute abdomen and hemorrhagic shock, caused by spontaneous splenic rupture secondary to infectious mononucleosis. The potential role of salicylates in the development of a hemorrhagic complication in a patient with infectious mononucleosis is discussed. PMID:22431933

  14. Hemorrhagic shock as a sequela of splenic rupture in a patient with infectious mononucleosis: focus on the potential role of salicylates.

    PubMed

    Bouliaris, Konstantinos; Karangelis, Dimos; Daskalopoulos, Marios; Spanos, Konstantinos; Fanariotis, Michael; Giaglaras, Anargyros

    2012-01-01

    Despite the fact that the vast majority of splenic ruptures are traumatic, infectious mononucleosis has been incriminated as a major predisposing factor that affects the integrity of the spleen, thus causing atraumatic ruptures and life-threatening hemorrhages. Herein we present a case of a 23-year-old Caucasian male who underwent an emergency laparotomy for acute abdomen and hemorrhagic shock, caused by spontaneous splenic rupture secondary to infectious mononucleosis. The potential role of salicylates in the development of a hemorrhagic complication in a patient with infectious mononucleosis is discussed.

  15. Reversing Maladaptive Plasticity to Cure Autonomic Dysreflexia after Spinal Cord Injury

    DTIC Science & Technology

    2015-10-01

    Autonomic dysreflexia (AD) is a potential life threatening condition characterized as episodic vascular hypertension (often with bradycardia) that develops...subject, purpose and scope of the research. Autonomic dysreflexia (AD) is a life threatening condition of episodic vascular hypertension (often...months post-injury. Prevention (e.g., regular bladder/bowel care) and anti- hypertensive medications are currently the best way to “manage” AD

  16. Risk factors and biomarkers of life-threatening cancers

    PubMed Central

    Autier, Philippe

    2015-01-01

    There is growing evidence that risk factors for cancer occurrence and for cancer death are not necessarily the same. Knowledge of cancer aggressiveness risk factors (CARF) may help in identifying subjects at high risk of developing a potentially deadly cancer (and not just any cancer). The availability of CARFs may have positive consequences for health policies, medical practice, and the search for biomarkers. For instance, cancer chemoprevention and cancer screening of subjects with CARFs would probably be more ethical and cost-effective than recommending chemoprevention and screening to entire segments of the population. Also, the harmful consequences of chemoprevention and of screening would be reduced while effectiveness would be optimised. We present examples of CARF already in use (e.g. mutations of the breast cancer (BRCA) gene), of promising avenues for the discovery of biomarkers thanks to the investigation of CARFs (e.g. breast radiological density and systemic inflammation), and of biomarkers commonly used that are not real CARFs (e.g. certain mammography images, prostate-specific antigen (PSA) concentration, nevus number). PMID:26635900

  17. 78 FR 41499 - Endangered and Threatened Wildlife and Plants; Threatened Status for the Northern Mexican...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-10

    ...We, the U.S. Fish and Wildlife Service (Service), propose to list the northern Mexican gartersnake (Thamnophis eques megalops) and narrow-headed gartersnake (Thamnophis rufipunctatus) as threatened species under the Endangered Species Act of 1973, as amended (Act). If we finalize this rule as proposed, it would extend the Act's protections to these species. The effect of this regulation is to conserve northern Mexican and narrow-headed gartersnakes under the Act.

  18. 78 FR 77152 - Endangered and Threatened Wildlife and Plants; Recovery Permit Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-20

    ...-FF01E00000] Endangered and Threatened Wildlife and Plants; Recovery Permit Applications AGENCY: Fish and... endangered plant species, and 50 CFR 17.72 for threatened plant species. Applications Available for Review..., monitor habitat restoration, collect, captive rear and breed, and reintroduce) the Taylor's checkerspot...

  19. Potentially disruptive life events: what are the immediate impacts on chronic disease management? A case-crossover analysis.

    PubMed

    Lauffenburger, Julie C; Gagne, Joshua J; Song, Zirui; Brill, Gregory; Choudhry, Niteesh K

    2016-08-04

    To explore the association between unexpected potentially disruptive life events in a patient or family member that may challenge an individual's ability to take medications as prescribed and the discontinuation of evidence-based medications for common, chronic conditions. Understanding the relationship between medication adherence and life stressors, especially those that can be identified using administrative data, may help identify patients at risk of non-adherence. Observational self-controlled case-crossover design. Individuals in a nationally representative US commercial health insurance database. Adult individuals who initiated an oral hypoglycaemic, antihypertensive and/or statin and subsequently stopped the medication for ≥90 days. Potentially disruptive life events among patients and their family members measured in the 30 days just before the medication was discontinued ('hazard period') compared with the 30 days before this period ('control period'). These events included personal injury, hospitalisation, emergency room visits, changes in insurance coverage, acute stress or acute anxiety. Among the 326 519 patients meeting study criteria who discontinued their chronic disease medications, 88 896 (27.2%) experienced at least one potentially disruptive life event. Newly experiencing an injury (OR: 1.26, 95% CI 1.12 to 1.42), an emergency room visit (OR: 1.19, 95% CI 1.13 to 1.26) and acute stress (OR: 1.19, 95% CI 1.08 to 1.31) were associated with discontinuation. Life events among patients' family members did not appear to be associated with medication discontinuation or occurred less frequently just prior to discontinuation. Potentially disruptive life events among individuals identified using routinely collected claims data are associated with discontinuation of chronic disease medications. Awareness of these events may help providers or payers identify patients at risk of non-adherence to maximise patient outcomes. Published by the BMJ

  20. Potential life-threatening events in schools involving rescue inhalers, epinephrine autoinjectors, and glucagon delivery devices: reports from school nurses.

    PubMed

    Allen, Katherine; Henselman, Kimbra; Laird, Brian; Quiñones, Ana; Reutzel, Thomas

    2012-02-01

    The purpose of this research is to use the reports of school nurses to facilitate the understanding of how schools experience and manage asthmatic, anaphylactic, and diabetic emergencies by quantitative and qualitative analysis of online surveys. E-mails with a link to SurveyMonkey® were sent to all U.S. members of the National Association of School Nurses (13,695). Subjects were asked to describe their self-reported knowledge, opinions, practices, and experiences with such emergencies and the devices used to manage them. Regarding the frequency of emergencies in a given school year, the medians were 8 for asthma, 0 for anaphylaxis, and 10 for hypoglycemia. Twenty-two, five, and one subjects, respectively, reported that events like these resulted in deaths during their careers as school nurses. These diseases create substantial potential for emergencies in schools, and the schools represented by these nurses appear to be somewhat, but not ideally, equipped to handle such crises.

  1. Educating Gerontologists for Cultural Proficiency in End-of-Life Care Practice

    ERIC Educational Resources Information Center

    Stein, Gary L.; Sherman, Patricia A.; Bullock, Karen

    2009-01-01

    An educational program was developed to train practitioners to provide care for patients and families that are responsive to cultural concerns. The aim was to increase knowledge and improve attitudes toward providing culturally proficient and culturally sensitive care for patients and families facing life-threatening illnesses. The program…

  2. Potential impact of seawater uranium extraction on marine life

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

    Park, Jiyeon; Jeters, Robert T.; Kuo, Li-Jung

    A variety of adsorbent materials have been developed to extract uranium from seawater as an alternative traditional terrestrial mining. A large-scale deployment of these adsorbents would be necessary to recover useful quantities of uranium and this raises a number of concerns regarding potential impacts on the surrounding marine environment. Two concerns are whether or not the adsorbent materials are toxic and any potentially harmful effects that may result from depleting uranium or vanadium (also highly concentrated by the adsorbents) from the local environment. To test the potential toxicity of the adsorbent with or without bound metals, Microtox assays were usedmore » to test both direct contact toxicity and the toxicity of any leachate in the seawater. The Microtox assay was chosen because it the detection of non-specific mechanisms of toxicity. Toxicity was not observed with leachates from any of 68 adsorbent materials that were tested, but direct contact with some adsorbents at very high adsorbent con-centrations exhibited toxicity. These concentrations are, however, very unlikely to be seen in the actual marine deployment. Adsor-bents that accumulated uranium and trace metals were also tested for toxicity, and no toxic effect was observed. Biofouling on the adsorbents and in columns or flumes containing the adsorbents also indicates that the adsorbents are not toxic and that there may not be an obvious deleterious effect resulting from removing uranium and vanadium from seawater. An extensive literature search was also performed to examine the potential impact of uranium and vanadium extraction from seawater on marine life using the Pacific Northwest National Laboratory’s (PNNL’s) document analysis tool, IN-SPIRE™. Although other potential environmental effects must also be considered, results from both the Microtox assay and the literature search provide preliminary evidence that uranium extraction from seawater could be performed with minimal

  3. Serious Illness, Injury, and Death in Child Protection and Preparation for End-of-Life Situations among Child Welfare Services Workers

    ERIC Educational Resources Information Center

    Csikai, Ellen L.; Herrin, Charlotte; Tang, Maggie; Church, Wesley T., II

    2008-01-01

    A mailed survey of child welfare workers in one southern state assessed various aspects of encounters with end-of-life situations in practice. Findings revealed that child deaths, children with life-threatening or life-limiting illnesses, and parental deaths were most commonly encountered and that coworkers were relied on for support. Many had no…

  4. When to stop managing or surveying cryptic threatened species

    PubMed Central

    Chadès, Iadine; McDonald-Madden, Eve; McCarthy, Michael A.; Wintle, Brendan; Linkie, Matthew; Possingham, Hugh P.

    2008-01-01

    Threatened species become increasingly difficult to detect as their populations decline. Managers of such cryptic threatened species face several dilemmas: if they are not sure the species is present, should they continue to manage for that species or invest the limited resources in surveying? We find optimal solutions to this problem using a Partially Observable Markov Decision Process and rules of thumb derived from an analytical approximation. We discover that managing a protected area for a cryptic threatened species can be optimal even if we are not sure the species is present. The more threatened and valuable the species is, relative to the costs of management, the more likely we are to manage this species without determining its continued persistence by using surveys. If a species remains unseen, our belief in the persistence of the species declines to a point where the optimal strategy is to shift resources from saving the species to surveying for it. Finally, when surveys lead to a sufficiently low belief that the species is extant, we surrender resources to other conservation actions. We illustrate our findings with a case study using parameters based on the critically endangered Sumatran tiger (Panthera tigris sumatrae), and we generate rules of thumb on how to allocate conservation effort for any cryptic species. Using Partially Observable Markov Decision Processes in conservation science, we determine the conditions under which it is better to abandon management for that species because our belief that it continues to exist is too low. PMID:18779594

  5. When to stop managing or surveying cryptic threatened species.

    PubMed

    Chadès, Iadine; McDonald-Madden, Eve; McCarthy, Michael A; Wintle, Brendan; Linkie, Matthew; Possingham, Hugh P

    2008-09-16

    Threatened species become increasingly difficult to detect as their populations decline. Managers of such cryptic threatened species face several dilemmas: if they are not sure the species is present, should they continue to manage for that species or invest the limited resources in surveying? We find optimal solutions to this problem using a Partially Observable Markov Decision Process and rules of thumb derived from an analytical approximation. We discover that managing a protected area for a cryptic threatened species can be optimal even if we are not sure the species is present. The more threatened and valuable the species is, relative to the costs of management, the more likely we are to manage this species without determining its continued persistence by using surveys. If a species remains unseen, our belief in the persistence of the species declines to a point where the optimal strategy is to shift resources from saving the species to surveying for it. Finally, when surveys lead to a sufficiently low belief that the species is extant, we surrender resources to other conservation actions. We illustrate our findings with a case study using parameters based on the critically endangered Sumatran tiger (Panthera tigris sumatrae), and we generate rules of thumb on how to allocate conservation effort for any cryptic species. Using Partially Observable Markov Decision Processes in conservation science, we determine the conditions under which it is better to abandon management for that species because our belief that it continues to exist is too low.

  6. The Dubai Community Psychiatric Survey. IV. Life events, chronic difficulties and psychiatric morbidity.

    PubMed

    Bebbington, P; Hamdi, E; Ghubash, R

    1998-10-01

    The relationship between life events, chronic social difficulties and psychiatric morbidity was investigated in 297 women selected at random as part of the Dubai Community Psychiatric Survey. The PSE-ID-CATEGO system was used to identify psychiatric cases, based on an Index of Definition level of 5 or more. Life events in the 6-month period prior to illness or interview were elicited through the Life Events and Difficulties Schedule. Chronic difficulties were explored through direct questioning based on a list of possible problems. The study demonstrates a significant excess of marked and moderately threatening life events in acute cases of psychiatric disorder (50%) compared to chronic cases (16.7%) and non-cases (27.9%). The association was particularly marked for events in the 3-month period before the onset. Around 33% of psychiatric morbidity may be attributed to marked and moderately threatening life events. Rates for mild events were similar in the three groups of subjects. Subjects experiencing chronic social difficulties included a significantly higher proportion of cases (33.3%) than those who did not experience such difficulties (9.1%). The effect of chronic social difficulties was more pronounced than, and independent of, the effects of life events. There were no interactions between life events and vulnerability factors in their effect on psychiatric morbidity, although numbers were small. The results suggest that the overall influence of life events and chronic difficulties on psychiatric morbidity is commensurate with that in Western societies, despite the different coping traditions of Islam.

  7. [Psychiatric comorbidities and quality of life in adult individuals with high potential: Relationships with self-esteem].

    PubMed

    Lancon, Christophe; Martinelli, Marion; Michel, Pierre; Debals, Matthias; Auquier, Pascal; Guedj, Eric; Boyer, Laurent

    2015-05-01

    The objectives of this study were: 1) to describe the psychiatric comorbidities in adult individuals with high potential; 2) to assess self-esteem and quality of life in comparison with general population; 3) to study the relationships between intelligent quotient (IQ), self-esteem, psychiatric comorbidities and quality of life. This cross-sectional study was conducted in the psychiatric department of a public university hospital (Marseille, France). An outpatient hospital service has been specifically opened to test intelligence since 2012. During a period of six months, it was proposed to all the major individuals with high intellectual potential to receive a psychiatric evaluation using the Mini International Neuropsychiatric Interview (MINI) and to complete self-report questionnaires assessing depression (Beck scale), anxiety (STAI), self-esteem (Rosenberg scale) and quality of life (SF-36). Relationships between IQ, self-esteem, psychiatric comorbidities and quality of life were analyzed using a Bayesian path analysis. Twenty-eight subjects were included, 8 had an IQ between 115 and 130, and 20 had an IQ>130. Fifty-seven percent of individuals had generalized anxiety, 21.4% a current major depressive episode, and 75% a past major depressive episode. Subjects had a low self-esteem and quality of life levels significantly lower than those in the French general population. Subjects with higher self-esteem levels had more depressive (β=0.726, P<0.001) and anxiety (β=0.335, P<0.001) disorders, associated with lower quality of life levels (β=-0.447, P<0.001 and β=-0.276, P=0.012), suggesting that self-esteem was defensive and inadequate. Our study found a high frequency of psychiatric disorders associated with low levels of self-esteem and quality of life. A psychological treatment focusing on self-esteem may have a beneficial effect on anxiety, depression and quality of life. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Self-affirmation enhances attentional bias toward threatening components of a persuasive message.

    PubMed

    Klein, William M P; Harris, Peter R

    2009-12-01

    We explored whether self-affirmation enhances attentional bias toward threatening elements of a persuasive message. Female alcohol consumers read an article linking alcohol to breast cancer and were then exposed supraliminally to threat and nonthreat words from the article (as well as threat and nonthreat words that did not appear in the article). Among moderately heavy drinkers who were not self-affirmed, there emerged an attentional bias away from the threatening words in the article-a result suggesting an avoidant response. However, among moderately heavy drinkers who were self-affirmed, there was a bias toward the threatening words. No attentional biases appeared for threat words not in the message, which suggested that the effect was threat specific. Moreover, no attentional biases were found among the heaviest drinkers. Self-affirmation may facilitate targeted implicit processing of threatening messages, although the effects could attenuate among individuals engaging in high levels of the behavior featured in the message.

  9. Cryptosporidiosis as threatening health problem: A review

    PubMed Central

    Rossle, Nurul Fariza; Latif, Baha

    2013-01-01

    The protozoa under the genus Cryptosporidium is a zoonotic apicomplexan obligate intracellular parasite. Cryptosporidiosis, the term used to designate infection caused by Cryptosporidium sp., is considered as one of the most common food and waterborne diseases with worldwide spread, acting as a common cause of diarrhoea in animals and man. In immunocompetent individuals, Cryptosporidium typically induces self-limiting diarrhoea, which may resolve on its own after 2-3 d. However, cryptosporidiosis may turn life-threatening and subsequently lead to death in small children, the elderly and immunocompromised person, especially in AIDS patient. The diagnosis for Cryptosporidium infection is usually carried out through examination of stool for the presence of oocysts which measured 4-6 µm with spherical appearance. Morphometric identification is often difficult because of the diminutive size and obscure internal structure of the protozoa. Often, the identification of Cryptosporidium is realised through the combination of methods incorporating data from morphometrics, molecular techniques, and host specificity. However, limitations to some of these techniques still exist whether because of cost, duration, expertise, or reliability. Drugs combination is implemented in treatment of cryptosporidiosis. The efficiency of paromomycin, an aminocyclitol antibiotic isolated from Streptomyces, can be effective when combined use with protease inhibitors or recombinant IL-12. Since there is no drug that achieves the complete removal of Cryptosporidium from the host, supportive therapy was preferred in both human and domestic animals.

  10. Threatened and Endangered Species: Tour Packet.

    ERIC Educational Resources Information Center

    Coats, Victoria; Samia, Cory

    This resource unit contains a teacher information packet and a middle school student activity packet to be used in creating a threatened and endangered species unit. The packet of student activities is designed to help maximize a field trip to the zoo and build on students' zoo experience in the classroom. The teacher information packet covers the…

  11. Threatened preterm labor is a risk factor for impaired cognitive development in early childhood.

    PubMed

    Paules, Cristina; Pueyo, Victoria; Martí, Elena; de Vilchez, Susana; Burd, Irina; Calvo, Pilar; Oros, Daniel

    2017-02-01

    Threatened preterm labor is a leading cause of hospital admission during pregnancy. Patients with an episode of threatened preterm labor who deliver at term are considered to have false preterm labor. However, threatened preterm labor has been proposed as a pathologic insult that is not always sufficient to induce irreversible spontaneous preterm birth but that could alter the normal course of pregnancy. The aim of this study was to evaluate threatened preterm labor during pregnancy as a risk factor of neurodevelopmental deficits of children at 2 years of age. Two-year-old children who were born late preterm (n=22) or at term after threatened preterm labor (n=23) were compared with at-term control children (n=42). Neurodevelopment was evaluated at a corrected age of 24-29 months with the use of the Merrill-Palmer-Revised Scales of Development. Children who were born at term after threatened preterm labor had lower scores than control children on global cognitive index (95.4 vs 104.2; P=.011), cognition (95.1 vs 103.1; P=.021), fine motor (95.2 vs 103.4; P=.003), gross motor (84.7 vs 99.8; P=.001), memory (92.9 vs 100.4; P=.015), receptive language (93.9 vs 102.9; P=.03), speed of processing (105.7 vs 113.3; P=.011), and visual motor coordination (98.8 vs 106.7; P=.003) subtests. Children born at term after threatened preterm labor had an increased risk of mild neurodevelopmental delay compared with control children (odds ratio for global cognitive index, 2.06; 95% confidence interval, 1.09-3.88; P=.033). There were no significant differences in any cognitive domain between children who were born late preterm and children who were born at term after threatened preterm labor. Threatened preterm labor is a risk factor for impaired cognitive development at 2 years of age, even if birth occurred at term. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Pregnancy Outcome in Women with Threatened Miscarriage: a Year Study

    PubMed Central

    Ahmed, Salah Roshdy; El-Sammani, Mohamed El-Khatem; Al-Sheeha, Muneera Al-Alaziz; Aitallah, Abdou Saeed; Jabin Khan, Farhat; Ahmed, Salah Roshdy

    2012-01-01

    Introduction: Patients with threatened miscarriage associated with adverse pregnancy outcomes because of associated pregnancy and labor complications. Objectives: To evaluate the effect of threatened miscarriage on early and late pregnancy outcome. Methods: A retrospective case–controlled study was performed on 89 women with threatened miscarriage (study group) at Maternity and Children Hospital Buraidah, KSA from January 2010 to December 2010. They were matched for age and parity to 45 cases (control group) attending route antenatal clinic at the same time. Data recorded included, demographic characteristics and detailed pregnancy outcome and ultrasound finding including gestational age, cardiac activity and subchorionic hematoma. Results: The overall adverse pregnancy outcome was significantly higher in the studied cases compared to the control group (p=015).The miscarriage rate was significantly higher in study group compared to the controls group, (16.9%vs 2.2%, p=0000). Preterm delivery, babies with low birth weight and premature rupture of membranes were significantly higher in the miscarriage group compared to the controls group, (15.7% vs 2.2%, p=0.001), (15.7% vs 2.2%), p=0.001) and (6.7%) vs 4.45), p=0.016). There were no significant differences in other pregnancy outcomes. Conclusion: threatened miscarriage is associated with increased incidence of adverse pregnancy outcome. The risk is specially increased in premature rupture of the membranes, preterm delivery and neonatal birth weight. PMID:23678307

  13. 77 FR 74202 - Endangered and Threatened Wildlife and Plants; Recovery Permit Application

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... biological samples, breed in captivity, reintroduce, relocate, remove from the wild, kill, and, for plant...-FF06E00000] Endangered and Threatened Wildlife and Plants; Recovery Permit Application AGENCY: Fish and... endangered wildlife species, 50 CFR 17.32 for threatened wildlife species, 50 CFR 17.62 for endangered plant...

  14. 50 CFR 17.8 - Import exemption for threatened, CITES Appendix-II wildlife.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 50 Wildlife and Fisheries 2 2014-10-01 2014-10-01 false Import exemption for threatened, CITES Appendix-II wildlife. 17.8 Section 17.8 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., EXPORTATION, AND IMPORTATION OF WILDLIFE AND PLANTS (CONTINUED) ENDANGERED AND THREATENED WILDLIFE AND PLANTS...

  15. 50 CFR 17.8 - Import exemption for threatened, CITES Appendix-II wildlife.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 50 Wildlife and Fisheries 2 2012-10-01 2012-10-01 false Import exemption for threatened, CITES Appendix-II wildlife. 17.8 Section 17.8 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., EXPORTATION, AND IMPORTATION OF WILDLIFE AND PLANTS (CONTINUED) ENDANGERED AND THREATENED WILDLIFE AND PLANTS...

  16. 50 CFR 17.8 - Import exemption for threatened, CITES Appendix-II wildlife.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 2 2011-10-01 2011-10-01 false Import exemption for threatened, CITES Appendix-II wildlife. 17.8 Section 17.8 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., EXPORTATION, AND IMPORTATION OF WILDLIFE AND PLANTS (CONTINUED) ENDANGERED AND THREATENED WILDLIFE AND PLANTS...

  17. 50 CFR 17.8 - Import exemption for threatened, CITES Appendix-II wildlife.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 2 2010-10-01 2010-10-01 false Import exemption for threatened, CITES Appendix-II wildlife. 17.8 Section 17.8 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., EXPORTATION, AND IMPORTATION OF WILDLIFE AND PLANTS (CONTINUED) ENDANGERED AND THREATENED WILDLIFE AND PLANTS...

  18. 50 CFR 17.8 - Import exemption for threatened, CITES Appendix-II wildlife.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 50 Wildlife and Fisheries 2 2013-10-01 2013-10-01 false Import exemption for threatened, CITES Appendix-II wildlife. 17.8 Section 17.8 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE..., EXPORTATION, AND IMPORTATION OF WILDLIFE AND PLANTS (CONTINUED) ENDANGERED AND THREATENED WILDLIFE AND PLANTS...

  19. Habitat degradation is threatening reef replenishment by making fish fearless.

    PubMed

    Lönnstedt, Oona M; McCormick, Mark I; Chivers, Douglas P; Ferrari, Maud C O

    2014-09-01

    Habitat degradation is one of the 'Big Five' drivers of biodiversity loss. However, the mechanisms responsible for this progressive loss of biodiversity are poorly understood. In marine ecosystems, corals play the role of ecosystem engineers, providing essential habitat for hundreds of thousands of species and hence their health is crucial to the stability of the whole ecosystem. Climate change is causing coral bleaching and degradation, and while this has been known for a while, little do we know about the cascading consequences of these events on the complex interrelationships between predators and their prey. The goal of our study was to investigate, under completely natural conditions, the effect of coral degradation on predator-prey interactions. Settlement stage ambon damselfish (Pomacentrus amboinensis), a common tropical fish, were released on patches of healthy or dead corals, and their behaviours in situ were measured, along with their response to injured conspecific cues, a common risk indicator. This study also explored the effect of habitat degradation on natural levels of mortality at a critical life-history transition. We found that juveniles in dead corals displayed risk-prone behaviours, sitting further away and higher up on the reef patch, and failed to respond to predation cues, compared to those on live coral patches. In addition, in situ survival experiments over 48 h indicated that juveniles on dead coral habitats had a 75% increase in predation-related mortality, compared to fish released on live, healthy coral habitats. Our results provide the first of many potential mechanisms through which habitat degradation can impact the relationship between prey and predators in the coral reef ecosystem. As the proportion of dead coral increases, the recruitment and replenishment of coral reef fishes will be threatened, and so will the level of diversity in these biodiversity hot spots. © 2014 The Authors. Journal of Animal Ecology © 2014 British

  20. Megacity pumping and preferential flow threaten groundwater quality

    PubMed Central

    Khan, Mahfuzur R.; Koneshloo, Mohammad; Knappett, Peter S. K.; Ahmed, Kazi M.; Bostick, Benjamin C.; Mailloux, Brian J.; Mozumder, Rajib H.; Zahid, Anwar; Harvey, Charles F.; van Geen, Alexander; Michael, Holly A.

    2016-01-01

    Many of the world's megacities depend on groundwater from geologically complex aquifers that are over-exploited and threatened by contamination. Here, using the example of Dhaka, Bangladesh, we illustrate how interactions between aquifer heterogeneity and groundwater exploitation jeopardize groundwater resources regionally. Groundwater pumping in Dhaka has caused large-scale drawdown that extends into outlying areas where arsenic-contaminated shallow groundwater is pervasive and has potential to migrate downward. We evaluate the vulnerability of deep, low-arsenic groundwater with groundwater models that incorporate geostatistical simulations of aquifer heterogeneity. Simulations show that preferential flow through stratigraphy typical of fluvio-deltaic aquifers could contaminate deep (>150 m) groundwater within a decade, nearly a century faster than predicted through homogeneous models calibrated to the same data. The most critical fast flowpaths cannot be predicted by simplified models or identified by standard measurements. Such complex vulnerability beyond city limits could become a limiting factor for megacity groundwater supplies in aquifers worldwide. PMID:27673729

  1. Nodulation in Dimorphandra wilsonii Rizz. (Caesalpinioideae), a Threatened Species Native to the Brazilian Cerrado

    PubMed Central

    Fonseca, Márcia Bacelar; Peix, Alvaro; de Faria, Sergio Miana; Mateos, Pedro F.; Rivera, Lina P.; Simões-Araujo, Jean L.; França, Marcel Giovanni Costa; dos Santos Isaias, Rosy Mary; Cruz, Cristina; Velázquez, Encarna; Scotti, Maria Rita; Sprent, Janet I.; James, Euan K.

    2012-01-01

    The threatened caesalpinioid legume Dimorphandra wilsonii, which is native to the Cerrado biome in Brazil, was examined for its nodulation and N2-fixing ability, and was compared with another, less-threatened species, D. jorgei. Nodulation and potential N2 fixation was shown on seedlings that had been inoculated singly with five bradyrhizobial isolates from mature D. wilsonii nodules. The infection of D. wilsonii by two of these strains (Dw10.1, Dw12.5) was followed in detail using light and transmission electron microscopy, and was compared with that of D. jorgei by Bradyrhizobium strain SEMIA6099. The roots of D. wilsonii were infected via small transient root hairs at 42 d after inoculation (dai), and nodules were sufficiently mature at 63 dai to express nitrogenase protein. Similar infection and nodule developmental processes were observed in D. jorgei. The bacteroids in mature Dimorphandra nodules were enclosed in plant cell wall material containing a homogalacturonan (pectic) epitope that was recognized by the monoclonal antibody JIM5. Analysis of sequences of their rrs (16S rRNA) genes and their ITS regions showed that the five D. wilsonii strains, although related to SEMIA6099, may constitute five undescribed species of genus Bradyrhizobium, whilst their nodD and nifH gene sequences showed that they formed clearly separated branches from other rhizobial strains. This is the first study to describe in full the N2-fixing symbiotic interaction between defined rhizobial strains and legumes in the sub-family Caesalpinioideae. This information will hopefully assist in the conservation of the threatened species D. wilsonii. PMID:23185349

  2. The Dominant Robot: Threatening Robots Cause Psychological Reactance, Especially When They Have Incongruent Goals

    NASA Astrophysics Data System (ADS)

    Roubroeks, M. A. J.; Ham, J. R. C.; Midden, C. J. H.

    Persuasive technology can take the form of a social agent that persuades people to change behavior or attitudes. However, like any persuasive technology, persuasive social agents might trigger psychological reactance, which can lead to restoration behavior. The current study investigated whether interacting with a persuasive robot can cause psychological reactance. Additionally, we investigated whether goal congruency plays a role in psychological reactance. Participants programmed a washing machine while a robot gave threatening advice. Confirming expectations, participants experienced more psychological reactance when receiving high-threatening advice compared to low-threatening advice. Moreover, when the robot gave high-threatening advice and expressed an incongruent goal, participants reported the highest level of psychological reactance (on an anger measure). Finally, high-threatening advice led to more restoration, and this relationship was partially mediated by psychological reactance. Overall, results imply that under certain circumstances persuasive technology can trigger opposite effects, especially when people have incongruent goal intentions.

  3. Health-related quality of life in fibromyalgia and refractory angina pectoris: a comparison between two chronic non-malignant pain disorders.

    PubMed

    Andréll, Paulin; Schultz, Tomas; Mannerkorpi, Kaisa; Nordeman, Lena; Börjesson, Mats; Mannheimer, Clas

    2014-04-01

    To compare health-related quality of life in 2 different populations with chronic pain: patients with fibromyalgia and patients with refractory angina pectoris. Previous separate studies have indicated that these patient groups report different impacts of pain on health-related quality of life. The Short-Form 36 was used to assess health- related quality of life. In order to adjust for age and gender differences between the groups, both patient groups were compared with age- and gender-matched normative controls. The difference in health-related quality of life between the 2 patient groups was assessed by transforming the Short-Form 36 subscale scores to a z-score. The patients with fibromyalgia (n = 203) reported poorer health-related quality of life in all the subscale scores of Short-Form 36 (p < 0.05-0.0001) than the patients with refractory angina (n = 146) when both groups were compared with their corresponding normal population (z-score). Patients with fibromyalgia experience greater impairment in health-related quality of life compared with the normal population than do patients with refractory angina pectoris, despite the fact that the latter have a potentially life-threatening disease. The great impairment in health- related quality of life in patients with fibromyalgia should be taken into consideration when planning rehabilitation.

  4. Intraspecific morphological and genetic variation of common species predicts ranges of threatened ones

    PubMed Central

    Fuller, Trevon L.; Thomassen, Henri A.; Peralvo, Manuel; Buermann, Wolfgang; Milá, Borja; Kieswetter, Charles M.; Jarrín-V, Pablo; Devitt, Susan E. Cameron; Mason, Eliza; Schweizer, Rena M.; Schlunegger, Jasmin; Chan, Janice; Wang, Ophelia; Schneider, Christopher J.; Pollinger, John P.; Saatchi, Sassan; Graham, Catherine H.; Wayne, Robert K.; Smith, Thomas B.

    2013-01-01

    Predicting where threatened species occur is useful for making informed conservation decisions. However, because they are usually rare, surveying threatened species is often expensive and time intensive. Here, we show how regions where common species exhibit high genetic and morphological divergence among populations can be used to predict the occurrence of species of conservation concern. Intraspecific variation of common species of birds, bats and frogs from Ecuador were found to be a significantly better predictor for the occurrence of threatened species than suites of environmental variables or the occurrence of amphibians and birds. Fully 93 per cent of the threatened species analysed had their range adequately represented by the geographical distribution of the morphological and genetic variation found in seven common species. Both higher numbers of threatened species and greater genetic and morphological variation of common species occurred along elevation gradients. Higher levels of intraspecific divergence may be the result of disruptive selection and/or introgression along gradients. We suggest that collecting data on genetic and morphological variation in common species can be a cost effective tool for conservation planning, and that future biodiversity inventories include surveying genetic and morphological data of common species whenever feasible. PMID:23595273

  5. Gravitational Potential: Real-life Results

    DTIC Science & Technology

    2016-01-01

    the surface and thus locations of larger g correspond to smaller h. However, that would not happen in real life . If the earth were covered with water...spherical nonrotating planet of mass M and radius R. The density of the planet can vary radi- ally, but assume it does not vary in the angular

  6. Effects of Climate Change, Urban Development, and Threatened and Endangered Species Management on Army Training Capabilities: Firing Ranges

    DTIC Science & Technology

    2016-01-01

    Climate Assessment for Army Enterprise Planning Effects of Climate Change , Urban Development, and... Climate Assessment for Army Enterprise Planning ERDC/CERL TR-16-29 January 2016 Effects of Climate Change , Urban Development, and Threatened and...due to climate change factors. The effects of climate change on DoD in- stallations is increasing in significance and has the potential to impact

  7. Possible role of gamma ray bursts on life extinction in the universe.

    PubMed

    Piran, Tsvi; Jimenez, Raul

    2014-12-05

    As a copious source of gamma rays, a nearby galactic gamma ray burst (GRB) can be a threat to life. Using recent determinations of the rate of GRBs, their luminosity function, and properties of their host galaxies, we estimate the probability that a life-threatening (lethal) GRB would take place. Amongst the different kinds of GRBs, long ones are most dangerous. There is a very good chance (but no certainty) that at least one lethal GRB took place during the past 5 gigayears close enough to Earth as to significantly damage life. There is a 50% chance that such a lethal GRB took place during the last 500×10^{6}  years, causing one of the major mass extinction events. Assuming that a similar level of radiation would be lethal to life on other exoplanets hosting life, we explore the potential effects of GRBs to life elsewhere in the Galaxy and the Universe. We find that the probability of a lethal GRB is much larger in the inner Milky Way (95% within a radius of 4 kpc from the galactic center), making it inhospitable to life. Only at the outskirts of the Milky Way, at more than 10 kpc from the galactic center, does this probability drop below 50%. When considering the Universe as a whole, the safest environments for life (similar to the one on Earth) are the lowest density regions in the outskirts of large galaxies, and life can exist in only ≈10% of galaxies. Remarkably, a cosmological constant is essential for such systems to exist. Furthermore, because of both the higher GRB rate and galaxies being smaller, life as it exists on Earth could not take place at z>0.5. Early life forms must have been much more resilient to radiation.

  8. Risk Factors Analysis and Death Prediction in Some Life-Threatening Ailments Using Chi-Square Case-Based Reasoning (χ2 CBR) Model.

    PubMed

    Adeniyi, D A; Wei, Z; Yang, Y

    2018-01-30

    A wealth of data are available within the health care system, however, effective analysis tools for exploring the hidden patterns in these datasets are lacking. To alleviate this limitation, this paper proposes a simple but promising hybrid predictive model by suitably combining the Chi-square distance measurement with case-based reasoning technique. The study presents the realization of an automated risk calculator and death prediction in some life-threatening ailments using Chi-square case-based reasoning (χ 2 CBR) model. The proposed predictive engine is capable of reducing runtime and speeds up execution process through the use of critical χ 2 distribution value. This work also showcases the development of a novel feature selection method referred to as frequent item based rule (FIBR) method. This FIBR method is used for selecting the best feature for the proposed χ 2 CBR model at the preprocessing stage of the predictive procedures. The implementation of the proposed risk calculator is achieved through the use of an in-house developed PHP program experimented with XAMP/Apache HTTP server as hosting server. The process of data acquisition and case-based development is implemented using the MySQL application. Performance comparison between our system, the NBY, the ED-KNN, the ANN, the SVM, the Random Forest and the traditional CBR techniques shows that the quality of predictions produced by our system outperformed the baseline methods studied. The result of our experiment shows that the precision rate and predictive quality of our system in most cases are equal to or greater than 70%. Our result also shows that the proposed system executes faster than the baseline methods studied. Therefore, the proposed risk calculator is capable of providing useful, consistent, faster, accurate and efficient risk level prediction to both the patients and the physicians at any time, online and on a real-time basis.

  9. 78 FR 76638 - Endangered and Threatened Wildlife and Plants; Recovery Permit Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-18

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R6-ES-2013-N256; FXES11130600000D2-123-FF06E00000] Endangered and Threatened Wildlife and Plants; Recovery Permit Applications AGENCY: Fish and... wildlife species, 50 CFR 17.62 for endangered plant species, and 50 CFR 17.72 for threatened plant species...

  10. 78 FR 29150 - Endangered and Threatened Wildlife and Plants; Recovery Permit Applications

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-17

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R6-ES-2013-N107; FXES11130600000D2-123-FF06E00000] Endangered and Threatened Wildlife and Plants; Recovery Permit Applications AGENCY: Fish and... wildlife species, 50 CFR 17.62 for endangered plant species, and 50 CFR 17.72 for threatened plant species...

  11. There's that scary picture: attention bias to threatening scenes in Williams syndrome.

    PubMed

    Dodd, Helen F; Porter, Melanie A

    2011-01-01

    There is increasing evidence that Williams syndrome (WS) is associated with elevated anxiety that is non-social in nature, including generalised anxiety and fears. To date very little research has examined the cognitive processes associated with this anxiety. In the present research, attentional bias for non-social threatening images in WS was examined using a dot-probe paradigm. Participants were 16 individuals with WS aged between 13 and 34 years and two groups of typically developing controls matched to the WS group on chronological age and attentional control ability, respectively. The WS group exhibited a significant attention bias towards threatening images. In contrast, no bias was found for group matched on attentional control and a slight bias away from threat was found in the chronological age matched group. The results are contrasted with recent findings suggesting that individuals with WS do not show an attention bias for threatening faces and discussed in relation to neuroimaging research showing elevated amygdala activation in response to threatening non-social scenes in WS. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. 77 FR 60207 - Endangered and Threatened Wildlife and Plants; Proposed Threatened Status for Coral Pink Sand...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-02

    ...We, the U.S. Fish and Wildlife Service (Service) propose to list the Coral Pink Sand Dunes tiger beetle, Cicindela albissima, as a threatened species under the Endangered Species Act of 1973, as amended (Act); and propose to designate critical habitat for the species. In total, approximately 921 hectares (2,276 acres) are being proposed for designation as critical habitat. The proposed critical habitat is located in Kane County, Utah.

  13. [Surgical therapy of life-threatening tachycardic cardiac arrhythmias in children].

    PubMed

    Frank, G; Schmid, C; Baumgart, D; Lowes, D; Klein, H; Kallfelz, H C

    1989-05-01

    Surgical techniques for tachyarrhythmias refractory to medical treatment are used with increasing frequency. Among 211 patients undergoing antiarrhythmic surgery 10 children (2 to 14 years old) were operated by electrophysiologically directed procedures. 7 patients suffered from WPW syndrome, 2 from focal atrial tachycardias and 1 from recurrent ventricular tachycardia following the repair of Fallot's tetralogy. In all cases preoperative electrophysiologic study and intraoperative mapping preceded operative ablation. Surgical treatment consisted of interruption of the bundle of Kent (3 right-sided, 2 left-sided, 3 septal), ablation of the atrial focus (1 right-sided, 1 left-sided) and right ventricular outflow tract incision. In 7 operations cryo-techniques were added. 2 children with WPW syndrome had two interventions because of tachycardia recurrences due to multiple accessory pathways. In 1 case a VVI-pacemaker was implanted postoperatively due to complete atrioventricular block. Another 2 children with prolonged postoperative bradycardia received a pacemaker prophylactically. Only the child with previous tetralogy of Fallot is still under antiarrhythmic medication while all other children are free of tachycardiac episodes. Our data confirm the efficacy of surgical treatment of tachyarrhythmias in children thereby abolishing the need for life-long antiarrhythmic medication.

  14. 7 CFR 624.4 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... occurrence that could cause significant damage to property or threaten human life in the near future. (e)(1...) Exigency means those situations that demand immediate action to avoid potential loss of life or property..., cause new damages or the potential loss of life if action to remedy the situation is not taken...

  15. 7 CFR 624.4 - Definitions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... occurrence that could cause significant damage to property or threaten human life in the near future. (e)(1...) Exigency means those situations that demand immediate action to avoid potential loss of life or property..., cause new damages or the potential loss of life if action to remedy the situation is not taken...

  16. Fetal growth and perinatal outcome of pregnancies continuing after threatened abortion.

    PubMed

    Das, A G; Gopalan, S; Dhaliwal, L K

    1996-05-01

    The present study was conducted with the aim to find out the effect of threatened abortion in the current pregnancy on the subsequent perinatal outcome and follow the growth pattern of the fetuses of such complicated pregnancies. The study group consisted of 55 women with threatened abortion and 55 women with normal pregnancies formed the control group. Most of the patients presented at 6-12 weeks' gestation. The fetal growth was monitored by both clinical as well as ultrasound (USG) parameters. The mean growth rates were almost identical throughout gestation. The mean values of each parameter of the study group were found lying with 95% confidence limit values of their control group. The apparent increased incidence of low lying placenta in early pregnancy probably contributed to threatened abortion. There was no significant difference in preterm delivery, low birth-weight and overall perinatal outcome.

  17. Clinical potentials of human pluripotent stem cells in lung diseases

    PubMed Central

    2014-01-01

    Lung possesses very limited regenerative capacity. Failure to maintain homeostasis of lung epithelial cell populations has been implicated in the development of many life-threatening pulmonary diseases leading to substantial morbidity and mortality worldwide, and currently there is no known cure for these end-stage pulmonary diseases. Embryonic stem cells (ESCs) and somatic cell-derived induced pluripotent stem cells (iPSCs) possess unlimited self-renewal capacity and great potential to differentiate to various cell types of three embryonic germ layers (ectodermal, mesodermal, and endodermal). Therapeutic use of human ESC/iPSC-derived lung progenitor cells for regeneration of injured or diseased lungs will have an enormous clinical impact. This article provides an overview of recent advances in research on pluripotent stem cells in lung tissue regeneration and discusses technical challenges that must be overcome for their clinical applications in the future. PMID:24995122

  18. Challenged but not threatened: Managing health in advanced age.

    PubMed

    Wiles, Janine; Miskelly, Philippa; Stewart, Oneroa; Kerse, Ngaire; Rolleston, Anna; Gott, Merryn

    2018-06-20

    In this paper we reflect on discussions with people of advanced age in Āotearoa New Zealand, and draw on theoretical frameworks of resilience and place in old age, to explore insights about the ways older people maintain quality of life and health. Twenty community-dwelling people of advanced age (85+) were recruited in 2015-16 from a large multidisciplinary longitudinal study of advanced age. These twenty participated in interviews about health in advanced age, impact of illnesses, interactions with clinicians, access to information, support for managing health, and perceptions of primary care, medications, and other forms of assistance. We use a positioning theory framework drawing on thematic and narrative analysis to understand the dynamic ways people in advanced age position themselves and the ways they age well through speech acts and storylines. People in advanced age saw themselves as challenged, rather than threatened, by adversities, and positioned themselves as able to draw on a lifetime of experience and resourcefulness and collaborations with supporters to deal with challenges. Key strategies include downplaying illness and resisting biomedical discourses of complexity, positioning embodied selves as having agency, and creative adaptation in the face of loss. People in advanced age exhibit resilience, maintaining wellbeing, autonomy and good physical and mental quality of life even while living with challenges such as functional decline and multi-morbidities. These findings have significance for supporters of older people, emphasising the need to move away from a narrow focus on problems to working together WITH people in advanced age to offer a more holistic approach that encourages and enhances adaptation and flexibility, rather than rigid and counterproductive coping patterns. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Challenging authority during a life-threatening crisis: the effect of operating theatre hierarchy.

    PubMed

    Sydor, D T; Bould, M D; Naik, V N; Burjorjee, J; Arzola, C; Hayter, M; Friedman, Z

    2013-03-01

    Effective operating theatre (OT) communication is important for team function and patient safety. Status asymmetry between team members may contribute to communication breakdown and threaten patient safety. We investigated how hierarchy in the OT team influences an anaesthesia trainee's ability to challenge an unethical decision by a consultant anaesthetist in a simulated crisis scenario. We prospectively randomized 49 postgraduate year (PGY) 2-5 anaesthesia trainees at two academic hospitals to participate in a videotaped simulated crisis scenario with a simulated OT team practicing either a hierarchical team structure (Group H) or a non-hierarchical team structure (Group NH). The scenario allowed trainees several opportunities to challenge their consultant anaesthetist when administering blood to a Jehovah's Witness. Three independent, blinded raters scored the performances using a modified advocacy-inquiry score (AIS). The primary outcome was the comparison of the best-response AIS between Groups H vs NH. Secondary outcomes included the comparison of best AIS by PGY and the percentage in each group that checked and administered blood. The AIS did not differ between the groups (P=0.832) but significantly improved from PGY2 to PGY5 (P=0.026). The rates of checking blood (92% vs 76%, P=0.082) and administering blood (62% vs 57%, P=0.721) were high in both groups but not significantly different between the groups. This study did not show a significant effect of OT team hierarchical structure on trainee's ability to challenge authority; however, the results are concerning. The challenges were suboptimal in quality and there was an alarming high rate of blood checking and administration in both groups. This may reflect lack of training in appropriately and effectively challenging authority within the formal curriculum with implications for patient safety.

  20. Implications of Extreme Life Span in Clonal Organisms: Millenary Clones in Meadows of the Threatened Seagrass Posidonia oceanica

    PubMed Central

    Arnaud-Haond, Sophie; Duarte, Carlos M.; Diaz-Almela, Elena; Marbà, Núria; Sintes, Tomas; Serrão, Ester A.

    2012-01-01

    The maximum size and age that clonal organisms can reach remains poorly known, although we do know that the largest natural clones can extend over hundreds or thousands of metres and potentially live for centuries. We made a review of findings to date, which reveal that the maximum clone age and size estimates reported in the literature are typically limited by the scale of sampling, and may grossly underestimate the maximum age and size of clonal organisms. A case study presented here shows the occurrence of clones of slow-growing marine angiosperm Posidonia oceanica at spatial scales ranging from metres to hundreds of kilometres, using microsatellites on 1544 sampling units from a total of 40 locations across the Mediterranean Sea. This analysis revealed the presence, with a prevalence of 3.5 to 8.9%, of very large clones spreading over one to several (up to 15) kilometres at the different locations. Using estimates from field studies and models of the clonal growth of P. oceanica, we estimated these large clones to be hundreds to thousands of years old, suggesting the evolution of general purpose genotypes with large phenotypic plasticity in this species. These results, obtained combining genetics, demography and model-based calculations, question present knowledge and understanding of the spreading capacity and life span of plant clones. These findings call for further research on these life history traits associated with clonality, considering their possible ecological and evolutionary implications. PMID:22312426

  1. An Unusual Case of Alternating Ventricular Morphology on the 12-Lead Electrocardiogram.

    PubMed

    Sammon, Maura; Dawood, Alveena; Beaudoin, Scott; Harrigan, Richard A

    2017-03-01

    One of the principal tasks of an emergency physician is identifying potentially life-threatening conditions in the undifferentiated patient; cardiac dysrhythmia is an example of such a condition. A systematic approach to a patient with atypical dysrhythmia enables proper identification of such-life threatening conditions. We describe a 31-year-old man presenting to the emergency department with an undifferentiated dysrhythmia after naloxone reversal of an opiate overdose. A systematic approach to the electrocardiogram led to the rare diagnosis of Wolff-Parkinson-White (WPW) alternans. We review the differential diagnosis of this dysrhythmia and the initial evaluation of a patient with the WPW pattern present on their electrocardiogram. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be prepared to use a systematic approach to an undifferentiated dysrhythmia to identify potentially life-threatening conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. 78 FR 57076 - Endangered and Threatened Wildlife and Plants; Endangered Status for the Neosho Mucket and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-17

    ...-0031; 4500030113] RIN 1018-AX73 Endangered and Threatened Wildlife and Plants; Endangered Status for... requires that we identify species of wildlife and plants that are endangered or threatened based on the... they should be added to the Federal Lists of Endangered and Threatened Wildlife and Plants. The listing...

  3. The potential role of adult stem cells in the management of the rheumatic diseases

    PubMed Central

    Franceschetti, Tiziana; De Bari, Cosimo

    2017-01-01

    Adult stem cells are considered as appealing therapeutic candidates for inflammatory and degenerative musculoskeletal diseases. A large body of preclinical research has contributed to describing their immune-modulating properties and regenerative potential. Additionally, increasing evidence suggests that stem cell differentiation and function are disrupted in the pathogenesis of rheumatic diseases. Clinical studies have been limited, for the most part, to the application of adult stem cell-based treatments on small numbers of patients or as a ‘salvage’ therapy in life-threatening disease cases. Nevertheless, these preliminary studies indicate that adult stem cells are promising tools for the long-term treatment of rheumatic diseases. This review highlights recent knowledge acquired in the fields of hematopoietic and mesenchymal stem cell therapy for the management of systemic sclerosis (SSc), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and osteoarthritis (OA) and the potential mechanisms mediating their function. PMID:28717403

  4. Attentional Modulation of Somatosensory Processing During the Anticipation of Movements Accompanying Pain: An Event-Related Potential Study.

    PubMed

    Clauwaert, Amanda; Torta, Diana M; Danneels, Lieven; Van Damme, Stefaan

    2018-02-01

    Attending to pain-relevant information is crucial to protect us from physical harm. Behavioral studies have already suggested that during anticipation of pain somatosensory input at the body location under threat is prioritized. However, research using daily life cues for pain, especially movements, is lacking. Furthermore, to our knowledge, no studies have investigated cortical processing associated with somatosensory processing during threatened movements. The current study aims to investigate whether movements accompanying pain automatically steer attention toward somatosensory input at the threatened location, affecting somatosensory evoked potentials (SEPs). Healthy volunteers were cued to perform movements with the left or the right hand, and one of these movements could be accompanied by pain on the moving hand. During movement anticipation, a task-irrelevant tactile stimulus was presented to the threatened or pain-free hand to evoke SEPs. During anticipation of movements accompanying pain, the N120 component was increased for tactile stimuli at the threatened relative to the hand without pain. Moreover, the P200 SEP was enhanced during anticipation of movements accompanying pain relative to movements without pain, irrespective of which hand was stimulated. These findings show that the anticipation of pain-accompanying movements may affect the processing of somatosensory input, and that this is likely to be driven by attentional processes. This study shows that the anticipation of pain-related movements automatically biases attention toward stimuli at a pain-related location, measured according to SEPs. The present study provides important new insights in the interplay between pain and attention, and its consequences at the cortical level. Copyright © 2017 The American Pain Society. Published by Elsevier Inc. All rights reserved.

  5. Addressing the Misuse Potential of Life Science Research-Perspectives From a Bottom-Up Initiative in Switzerland.

    PubMed

    Oeschger, Franziska M; Jenal, Ursula

    2018-01-01

    Codes of conduct have received wide attention as a bottom-up approach to foster responsibility for dual use aspects of life science research within the scientific community. In Switzerland, a series of discussion sessions led by the Swiss Academy of Sciences with over 40 representatives of most Swiss academic life science research institutions has revealed that while a formal code of conduct was considered too restrictive, a bottom-up approach toward awareness raising and education and demonstrating scientists' responsibility toward society was highly welcomed. Consequently, an informational brochure on "Misuse potential and biosecurity in life sciences research" was developed to provide material for further discussions and education.

  6. Methods, systems and devices for detecting threatening objects and for classifying magnetic data

    DOEpatents

    Kotter, Dale K [Shelley, ID; Roybal, Lyle G [Idaho Falls, ID; Rohrbaugh, David T [Idaho Falls, ID; Spencer, David F [Idaho Falls, ID

    2012-01-24

    A method for detecting threatening objects in a security screening system. The method includes a step of classifying unique features of magnetic data as representing a threatening object. Another step includes acquiring magnetic data. Another step includes determining if the acquired magnetic data comprises a unique feature.

  7. Leishmune vaccine: the newest tool for prevention and control of canine visceral leishmaniosis and its potential as a transmission-blocking vaccine.

    PubMed

    Dantas-Torres, Filipe

    2006-10-10

    Canine visceral leishmaniosis is a life-threatening disease caused by Leishmania infantum. For quite some time, specialists in leishmaniosis have tried to develop more affordable and effective control measures against this disease. In this search, the first vaccine against canine visceral leishmaniosis was recently licensed in Brazil. In the light of recent research, the Leishmune vaccine might be seen as the newest tool for prevention and control of canine visceral leishmaniosis. Moreover, the potential of the Leishmune as a transmission-blocking vaccine has recently been demonstrated, indicating its usefulness in the control of zoonotic visceral leishmaniosis.

  8. A potential gender bias in assessing quality of life - a standard gamble experiment among university students.

    PubMed

    Obaidi, Leath Al; Mahlich, Jörg

    2015-01-01

    There are several methodologies that can be used for evaluating patients' perception of their quality of life. Most commonly, utilities are directly elicited by means of either the time-trade-off or the standard-gamble method. In both methods, risk attitudes determine the quality of life values. Quality of life values among 31 Austrian undergraduate students were elicited by means of the standard gamble approach. The impact of several variables such as gender, side job, length of study, and living arrangements on the quality of life were identified using different types of regression techniques (ordinary least squares, generalized linear model, Betafit). Significant evidence was found that females are associated with a higher quality of life in all specifications of our estimations. The observed gender differences in quality of life can be attributed to a higher degree of risk aversion of women. A higher risk aversion leads to a higher valuation of given health states and a potential gender bias in health economic evaluations. This result could have implications for health policy planners when it comes to budget allocation decisions.

  9. Overstory treatment and planting season affect survival of replacement tree species in emerald ash borer threatened Fraxinus nigra forests in Minnesota, USA

    Treesearch

    Christopher E. Looney; Anthony W. D' Amato; Brian J. Palik; Robert A. Slesak

    2015-01-01

    Fraxinus nigra Marsh. (black ash) wetland forests in northern Minnesota, USA, are threatened by the invasive insect, emerald ash borer (Agrilus planipennis Fairmaire (EAB)). A potential management option is promoting regeneration of tree species that are not EAB hosts to maintain ecosystem functions. Using an operational-scale...

  10. Anti-addiction Drug Ibogaine Prolongs the Action Potential in Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes.

    PubMed

    Rubi, Lena; Eckert, Daniel; Boehm, Stefan; Hilber, Karlheinz; Koenig, Xaver

    2017-04-01

    Ibogaine is a plant alkaloid used as anti-addiction drug in dozens of alternative medicine clinics worldwide. Recently, alarming reports of life-threatening cardiac arrhythmias and cases of sudden death associated with the ingestion of ibogaine have accumulated. Using whole-cell patch clamp recordings, we assessed the effects of ibogaine and its main metabolite noribogaine on action potentials in human ventricular-like cardiomyocytes derived from induced pluripotent stem cells. Therapeutic concentrations of ibogaine and its long-lived active metabolite noribogaine significantly retarded action potential repolarization in human cardiomyocytes. These findings represent the first experimental proof that ibogaine application entails a cardiac arrhythmia risk for humans. In addition, they explain the clinically observed delayed incidence of cardiac adverse events several days after ibogaine intake. We conclude that therapeutic concentrations of ibogaine retard action potential repolarization in the human heart. This may give rise to a prolongation of the QT interval in the electrocardiogram and cardiac arrhythmias.

  11. The role of extracorporeal membrane oxygenation in patients after irreversible cardiac arrest as potential organ donors

    PubMed Central

    Puślecki, Mateusz; Zieliński, Marcin; Mandecki, Michał; Ligowski, Marcin; Stefaniak, Sebastian; Dąbrowski, Marek; Karczewski, Marek; Gąsiorowski, Łukasz; Sip, Maciej; Dąbrowska, Agata; Telec, Wojciech; Perek, Bartłomiej; Jemielity, Marek

    2017-01-01

    The number of people waiting for a kidney or liver transplant is growing systematically. Due to the latest advances in transplantation, persons after irreversible cardiac arrest and confirmation of death have become potential organ donors. It is estimated that they may increase the number of donations by more than 40%. However, without good organization and communication between pre-hospital care providers, emergency departments, intensive care units and transplantation units, it is almost impossible to save the organs of potential donors in good condition. Various systems, including extracorporeal membrane oxygenation (ECMO), supporting perfusion of organs for transplantation play a key role. In 2016 the “ECMO for Greater Poland” program was established. Although its main goal is to improve the survival rate of patients suffering from life-threatening cardiopulmonary conditions, one of its branches aims to increase the donation rate in patients with irreversible cardiac arrest. In this review, the role of ECMO in the latter group as the potential organ donors is presented. PMID:29354178

  12. The potential of planets orbiting red dwarf stars to support oxygenic photosynthesis and complex life

    NASA Astrophysics Data System (ADS)

    Gale, Joseph; Wandel, Amri

    2017-01-01

    We review the latest findings on extra-solar planets and their potential of having environmental conditions that could support Earth-like life. Focusing on planets orbiting red dwarf (RD) stars, the most abundant stellar type in the Milky Way, we show that including RDs as potential life supporting host stars could increase the probability of finding biotic planets by a factor of up to a thousand, and reduce the estimate of the distance to our nearest biotic neighbour by up to 10. We argue that binary and multiple star systems need to be taken into account when discussing habitability and the abundance of biotic exoplanets, in particular RDs in such systems. Early considerations indicated that conditions on RD planets would be inimical to life, as their habitable zones would be so close to the host star as to make planets tidally locked. This was thought to cause an erratic climate and expose life forms to flares of ionizing radiation. Recent calculations show that these negative factors are less severe than originally thought. It has also been argued that the lesser photon energy of the radiation of the relatively cool RDs would not suffice for oxygenic photosynthesis (OP) and other related energy expending reactions. Numerous authors suggest that OP on RD planets may evolve to utilize photons in the infrared. We however argue, by analogy to the evolution of OP and the environmental physiology and distribution of land-based vegetation on Earth, that the evolutionary pressure to utilize infrared radiation would be small. This is because vegetation on RD planets could enjoy continuous illumination of moderate intensity, containing a significant component of photosynthetic 400-700 nm radiation. We conclude that conditions for OP could exist on RD planets and consequently the evolution of complex life might be possible. Furthermore, the huge number and the long lifetime of RDs make it more likely to find planets with photosynthesis and life around RDs than around

  13. Life Expectancy and Years of Potential Life Lost After Acute Myocardial Infarction by Sex and Race: A Cohort-Based Study of Medicare Beneficiaries.

    PubMed

    Bucholz, Emily M; Normand, Sharon-Lise T; Wang, Yun; Ma, Shuangge; Lin, Haiqun; Krumholz, Harlan M

    2015-08-11

    Most studies of sex and race differences after acute myocardial infarction (AMI) have not taken into account differences in life expectancy in the general population. Years of potential life lost (YPLL) is a metric that takes into account the burden of disease and can be compared by sex and race. This study sought to determine sex and race differences in long-term survival after AMI using life expectancy and YPLL to account for differences in population-based life expectancy. Using data from the Cooperative Cardiovascular Project, a prospective cohort study of Medicare beneficiaries hospitalized for AMI between 1994 and 1995 (N = 146,743), we calculated life expectancy and YPLL using Cox proportional hazards regression with extrapolation using exponential models. Of the 146,743 patients with AMI, 48.1% were women and 6.4% were black; the average age was 75.9 years. Post-AMI life expectancy estimates were similar for men and women of the same race but lower for black patients than white patients. On average, women lost 10.5% (SE 0.3%) more of their expected life than men, and black patients lost 6.2% (SE 0.6%) more of their expected life than white patients. After adjustment, women still lost an average of 7.8% (0.3%) more of their expected life than men, but black race became associated with a survival advantage, suggesting that racial differences in YPLL were largely explained by differences in clinical presentation and treatment between black and white patients. Women and black patients lost more years of life after AMI, on average, than men and white patients, an effect that was not explained in women by clinical or treatment differences. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  14. "Evolution Canyon," a potential microscale monitor of global warming across life.

    PubMed

    Nevo, Eviatar

    2012-02-21

    Climatic change and stress is a major driving force of evolution. The effects of climate change on living organisms have been shown primarily on regional and global scales. Here I propose the "Evolution Canyon" (EC) microscale model as a potential life monitor of global warming in Israel and the rest of the world. The EC model reveals evolution in action at a microscale involving biodiversity divergence, adaptation, and incipient sympatric speciation across life from viruses and bacteria through fungi, plants, and animals. The EC consists of two abutting slopes separated, on average, by 200 m. The tropical, xeric, savannoid, "African" south-facing slope (AS = SFS) abuts the forested "European" north-facing slope (ES = NFS). The AS receives 200-800% higher solar radiation than the ES. The ES represents the south European forested maquis. The AS and ES exhibit drought and shade stress, respectively. Major adaptations on the AS are because of solar radiation, heat, and drought, whereas those on the ES relate to light stress and photosynthesis. Preliminary evidence suggests the extinction of some European species on the ES and AS. In Drosophila, a 10-fold higher migration was recorded in 2003 from the AS to ES. I advance some predictions that could be followed in diverse species in EC. The EC microclimatic model is optimal to track global warming at a microscale across life from viruses and bacteria to mammals in Israel, and in additional ECs across the planet.

  15. Mortality trends and years of potential life lost from gastric cancer in Mexico, 2000-2012.

    PubMed

    Sánchez-Barriga, J J

    2016-01-01

    In 2013 in Mexico, gastric cancer (GC) was the third leading cause of death from cancer in individuals 20 years of age or older. GC remains a public health problem in Mexico due to its high mortality and low survival rates, and the significantly lower quality of life of patients with this condition. The aims of this study were to determine mortality trends nationwide, by state and socioeconomic region, and to determine rates of age-adjusted years of potential life lost due to GC, by state and socioeconomic region, within the period of 2000-2012. Mortality records associated with GC for 2000-2012 were obtained from the National Health Information System of the Mexican Department of Health. Codes from the Tenth Revision of the International Classification of Diseases corresponding to the basic cause of death from GC were identified. Mortality and age-adjusted years of potential life lost rates, by state and socioeconomic region, were also calculated. In Mexico, 69,107 individuals died from GC within the time frame of 2000-2012. The age-adjusted mortality rate per 100,000 inhabitants decreased from 7.5 to 5.6. The male:female ratio was 1.15:1.0. Chiapas had the highest death rate from GC (9.2, 95% CI 8.2-10.3 [2000] and 8.2, 95% CI 7.3-9 [2012]), as well as regions 1, 2, and 5. Chiapas and socioeconomic region 1 had the highest rate of years of potential life lost. Using the world population age distribution as the standard, the age-adjusted mortality rate in Mexico per 100,000 inhabitants that died from GC decreased from 7.5 to 5.6 between 2000 and 2012. Chiapas and socioeconomic regions 1, 2, and 5 had the highest mortality from GC (Chiapas: 9.2, 95% CI 8.2-10.3 [2000] and 8.2, 95% CI 7.3-9 [2012], region 1: 5.5, 95% CI 5.2-5.9 [2000] and 5.3, 95% CI 4.9-5.7 [2012]; region 2: 5.3, 95% CI 5-5.6 [2000] and 5.4, 95% CI 5.1-5.8 [2012]; region 5: 6.1, 95% CI 5.6-6.6 [2000] and 4.6, 95% CI 4.2-5 [2012]). Chiapas and socioeconomic region 1 had the highest rate of years of

  16. Obstetric outcome in women with threatened miscarriage in the first trimester.

    PubMed

    Wijesiriwardana, Ajith; Bhattacharya, Sohinee; Shetty, Ashalatha; Smith, Norman; Bhattacharya, Siladitya

    2006-03-01

    To assess pregnancy outcomes in women with threatened miscarriage in the first trimester. This was a retrospective cohort study based on data extracted from the Aberdeen Maternity and Neonatal Databank. Cases included all primigravid women with first-trimester vaginal bleeding who delivered after 24 weeks of gestation between 1976 and 2004. The control group comprised all other women who had first pregnancies during the same period. Data were analyzed by univariate and multivariate statistical methods. Compared with the control group (n = 31,633), women with threatened miscarriage (n = 7,627) were more likely to have antepartum hemorrhage of unknown origin (odds ratio [OR] 1.83, 95% confidence interval [CI] 1.73-2.01). Elective cesarean (OR 1.30, 95% CI 1.14-1.48) and manual removal of placenta (OR 1.40, 95% CI 1.21-1.62) were performed more frequently in these women, who also had a higher risk of preterm delivery (OR 1.56, 95% CI 1.43-1.71) and malpresentation (OR 1.26, 95% CI 1.13-1.40). Threatened miscarriage in the first trimester is required in 112, 112, 17, 85, 32 patients, respectively, for each additional case of manual removal of placenta, elective cesarean, antepartum hemorrhage of unknown origin, malpresentation, and preterm delivery. Pregnancies complicated by threatened miscarriage are at a slightly higher risk of obstetric complications and interventions. II-2.

  17. The Immunologic Basis for Severe Neonatal Herpes Disease and Potential Strategies for Therapeutic Intervention

    PubMed Central

    Gantt, Soren; Muller, William J.

    2013-01-01

    Herpes simplex viruses types 1 and 2 (HSV-1 and HSV-2) infect a large proportion of the world's population. Infection is life-long and can cause periodic mucocutaneous symptoms, but it only rarely causes life-threatening disease among immunocompetent children and adults. However, when HSV infection occurs during the neonatal period, viral replication is poorly controlled and a large proportion of infants die or develop disability even with optimal antiviral therapy. Increasingly, specific differences are being elucidated between the immune system of newborns and those of older children and adults, which predispose to severe infections and reflect the transition from fetal to postnatal life. Studies in healthy individuals of different ages, individuals with primary or acquired immunodeficiencies, and animal models have contributed to our understanding of the mechanisms that control HSV infection and how these may be impaired during the neonatal period. This paper outlines our current understanding of innate and adaptive immunity to HSV infection, immunologic differences in early infancy that may account for the manifestations of neonatal HSV infection, and the potential of interventions to augment neonatal immune protection against HSV disease. PMID:23606868

  18. Approaching threatening stimuli cause an expansion of defensive peripersonal space.

    PubMed

    Bufacchi, R J

    2017-10-01

    When sudden environmental stimuli signaling threat occur in the portion of space surrounding the body (defensive peripersonal space), defensive responses are enhanced. Recently Bisio et al. (Bisio A, Garbarini F, Biggio M, Fossataro C, Ruggeri P, Bove M. J Neurosci 37: 2415-2424, 2017) showed that a marker of defensive peripersonal space, the defensive hand-blink reflex, is modulated by the motion of the eliciting threatening stimulus. These results can be parsimoniously explained by the continuous monitoring of environmental threats, resulting in an expansion of defensive peripersonal space when threatening stimuli approach. Copyright © 2017 the American Physiological Society.

  19. Clinically Relevant Pharmacological Strategies That Reverse MDMA-Induced Brain Hyperthermia Potentiated by Social Interaction.

    PubMed

    Kiyatkin, Eugene A; Ren, Suelynn; Wakabayashi, Ken T; Baumann, Michael H; Shaham, Yavin

    2016-01-01

    MDMA-induced hyperthermia is highly variable, unpredictable, and greatly potentiated by the social and environmental conditions of recreational drug use. Current strategies to treat pathological MDMA-induced hyperthermia in humans are palliative and marginally effective, and there are no specific pharmacological treatments to counteract this potentially life-threatening condition. Here, we tested the efficacy of mixed adrenoceptor blockers carvedilol and labetalol, and the atypical antipsychotic clozapine, in reversing MDMA-induced brain and body hyperthermia. We injected rats with a moderate non-toxic dose of MDMA (9 mg/kg) during social interaction, and we administered potential treatment drugs after the development of robust hyperthermia (>2.5 °C), thus mimicking the clinical situation of acute MDMA intoxication. Brain temperature was our primary focus, but we also simultaneously recorded temperatures from the deep temporal muscle and skin, allowing us to determine the basic physiological mechanisms of the treatment drug action. Carvedilol was modestly effective in attenuating MDMA-induced hyperthermia by moderately inhibiting skin vasoconstriction, and labetalol was ineffective. In contrast, clozapine induced a marked and immediate reversal of MDMA-induced hyperthermia via inhibition of brain metabolic activation and blockade of skin vasoconstriction. Our findings suggest that clozapine, and related centrally acting drugs, might be highly effective for reversing MDMA-induced brain and body hyperthermia in emergency clinical situations, with possible life-saving results.

  20. Clinically Relevant Pharmacological Strategies That Reverse MDMA-Induced Brain Hyperthermia Potentiated by Social Interaction

    PubMed Central

    Kiyatkin, Eugene A; Ren, Suelynn; Wakabayashi, Ken T; Baumann, Michael H; Shaham, Yavin

    2016-01-01

    MDMA-induced hyperthermia is highly variable, unpredictable, and greatly potentiated by the social and environmental conditions of recreational drug use. Current strategies to treat pathological MDMA-induced hyperthermia in humans are palliative and marginally effective, and there are no specific pharmacological treatments to counteract this potentially life-threatening condition. Here, we tested the efficacy of mixed adrenoceptor blockers carvedilol and labetalol, and the atypical antipsychotic clozapine, in reversing MDMA-induced brain and body hyperthermia. We injected rats with a moderate non-toxic dose of MDMA (9 mg/kg) during social interaction, and we administered potential treatment drugs after the development of robust hyperthermia (>2.5 °C), thus mimicking the clinical situation of acute MDMA intoxication. Brain temperature was our primary focus, but we also simultaneously recorded temperatures from the deep temporal muscle and skin, allowing us to determine the basic physiological mechanisms of the treatment drug action. Carvedilol was modestly effective in attenuating MDMA-induced hyperthermia by moderately inhibiting skin vasoconstriction, and labetalol was ineffective. In contrast, clozapine induced a marked and immediate reversal of MDMA-induced hyperthermia via inhibition of brain metabolic activation and blockade of skin vasoconstriction. Our findings suggest that clozapine, and related centrally acting drugs, might be highly effective for reversing MDMA-induced brain and body hyperthermia in emergency clinical situations, with possible life-saving results. PMID:26105141

  1. Atmospheric Nitrogen Deposition Threatens Biodiversity: Development of Novel Mitigation Policies in California

    NASA Astrophysics Data System (ADS)

    Weiss, S. B.

    2011-12-01

    Atmospheric nitrogen deposition threatens biodiversity in many parts of the world. In California, 20% of the land surface receives > 5 kg-N ha-1 year-1, with hotspots receiving > 50 kg-N ha-1 year-1. Documented impacts of N-deposition include increased growth of annual grass and other invasives in coastal sage scrub, serpentine grasslands, vernal pools, and deserts, altered nutrient cycling and fuel accumulation of montane forests, enhanced fire cycles, nitrate leaching into surface and groundwater, and eutrophication of montane lakes such as Lake Tahoe. 40% of listed threatened and endangered plants are exposed to > 5 kg-N ha-1 year-1, and N-deposition is arguably a greater immediate threat to biodiversity than is climate change. Appropriate policy responses are lagging, because the magnitude of N-deposition impacts on biodiversity is poorly known in the broader conservation/regulatory community and the general public. Policies to decrease emissions and deposition are clearly the ultimate solution on a decadal time scale. In the interim, habitat management is critical to preventing extinction of many species. This presentation reviews recent policies and regulatory actions in California that address N-deposition impacts on biodiversity. The immediate and long-term needs for invasive weed management are overwhelming and require long-term endowment funding. Mitigation requirements under the US Endangered Species Act have been used to secure land and management resources. The on-going story of the threatened Bay checkerspot butterfly, from the first precedent setting mitigation in 2001 through a regional Habitat Conservation Plan (HCP), illustrates the development of these novel policies based on science, regulatory authority, grassroots activism, public education, habitat restoration, and legal actions. The 50-year HCP will ultimately result in a network of conserved lands with management endowments. Eventually N-deposition may be reduced below critical loads

  2. The Life Threatened Child and the Life Enhancing Clown: Towards a Model of Therapeutic Clowning

    PubMed Central

    Gryski, Camilla

    2008-01-01

    In the last decade, there has been a rapid growth in the presence of clowns in hospitals, particularly in pediatric settings. The proliferation of clowns in health care settings has resulted in varying levels of professionalism and accountability. For this reason, there is a need to examine various forms of clowning, in particular therapeutic clowning in pediatric settings. The purpose of this article is to address what therapeutic clowning is and to describe the extent to which it can provide a complementary form of health care. In an attempt to apply theory to practice, the article will draw upon the experiences of a therapeutic clown within a pediatric setting while providing a historical and theoretical account of how clowns came to be in hospitals. Toward this end, a proposed model of therapeutic clowning will be offered which can be adapted for a variety of settings where children require specialized forms of play in order to enhance their coping, development and adjustment to life changes. Finally, current research on clowning in children's hospitals will be reviewed including a summary of findings from surveys administered at the Hospital for Sick Children. PMID:18317544

  3. 78 FR 7907 - Endangered and Threatened Wildlife and Plants; Removing the Island Night Lizard From the Federal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-04

    ...We, the U.S. Fish and Wildlife Service (Service), propose to remove the island night lizard (Xantusia riversiana) from the Federal List of Endangered and Threatened Wildlife. This action is based on a review of the best available scientific and commercial information, which indicates that the species no longer meets the definition of endangered species or threatened species under the Endangered Species Act of 1973, as amended (Act). This proposed rule, if made final, would remove the island night lizard as a threatened species from the List of Endangered and Threatened Wildlife. This document also constitutes our 12-month finding on a petition to remove the island night lizard from the Federal List of Endangered and Threatened Wildlife.

  4. Mapping hotspots of threatened species traded in bushmeat markets in the Cross-Sanaga rivers region.

    PubMed

    Fa, John E; Farfán, Miguel Angel; Marquez, Ana Luz; Duarte, Jesús; Nackoney, Janet; Hall, Amy; Dupain, Jef; Seymour, Sarah; Johnson, Paul J; MacDonald, David W; Vargas, J Mario

    2014-02-01

    Bushmeat markets exist in many countries in West and Central Africa, and data on species sold can be used to detect patterns of wildlife trade in a region. We surveyed 89 markets within the Cross-Sanaga rivers region, West Africa. In each market, we counted the number of carcasses of each taxon sold. During a 6-month period (7594 market days), 44 mammal species were traded. Thirteen species were on the International Union for Conservation of Nature (IUCN) Red List or protected under national legislation, and at least 1 threatened species was traded in 88 of the 89 markets. We used these data to identify market groups that traded similar species assemblages. Using cluster analyses, we detected 8 market groups that were also geographically distinct. Market groups differed in the diversity of species, evenness of species, and dominant, prevalent, and characteristic species traded. We mapped the distribution of number of threatened species traded across the study region. Most threatened species were sold in markets nearest 2 national parks, Korup National Park in Cameroon and Cross River in Nigeria. To assess whether the threatened-species trade hotspots coincided with the known ranges of these species, we mapped the overlap of all threatened species traded. Markets selling more threatened species overlapped with those regions that had higher numbers of these. Our study can provide wildlife managers in the region with better tools to discern zones within which to focus policing efforts and reduce threats to species that are threatened by the bushmeat trade. © 2013 Society for Conservation Biology.

  5. 7 CFR 650.22 - Rare, threatened, and endangered species of plants and animals.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Rare, threatened, and endangered species of plants and... Related Environmental Concerns § 650.22 Rare, threatened, and endangered species of plants and animals. (a) Background. (1) A variety of plant and animal species of the United States are so reduced in numbers that...

  6. Repair of the threatened feminine identity: experience of women with cervical cancer undergoing fertility preservation surgery.

    PubMed

    Komatsu, Hiroko; Yagasaki, Kaori; Shoda, Rie; Chung, Younghui; Iwata, Takashi; Sugiyama, Juri; Fujii, Takuma

    2014-01-01

    Fertility preservation is important for women of reproductive age with cervical cancer. The underlying reasons behind suboptimal reproductive results after successful fertility-preserving surgery have not yet been fully revealed. The objective of this study was to explore the experience of fertility preservation with radical trachelectomy from the perspective of women with cervical cancer. We conducted interviews with women with cervical cancer who underwent radical trachelectomy using a Grounded Theory methodology with a theoretical framework of symbolic interactionism. Our findings articulate a process in which feminine identity is first threatened by a diagnosis of cancer, then repaired by fertility preservation with radical trachelectomy, and finally reconstructed after the surgery, through interactions with self, others, and external events in women with cervical cancer. Feeling incomplete as a woman because of the loss of the uterus was a critical factor in the women's feeling that their feminine identity was threatened. Thus, fertility preservation was significant for these women. The meaning of fertility preservation varied among the women, and their life perspectives were therefore distinct after the surgery. Women with cervical cancer who undergo radical trachelectomy experience an identity transformation process, and child bearing is not the only expected outcome of fertility preservation. Nurses should coordinate care through the cancer trajectory. Understanding the identity transformation process helps nurses to assess patients' needs and provide appropriate individual care.

  7. When some is actually all: scalar inferences in face-threatening contexts.

    PubMed

    Bonnefon, Jean-François; Feeney, Aidan; Villejoubert, Gaëlle

    2009-08-01

    Accounts of the scalar inference from 'some X-ed' to 'not all X-ed' are central to the debate between contemporary theories of conversational pragmatics. An important contribution to this debate is to identify contexts that decrease the endorsement rate of the inference. We suggest that the inference is endorsed less often in face-threatening contexts, i.e., when X implies a loss of face for the listener. This claim is successfully tested in Experiment 1. Experiment 2 rules out a possible confound between face-threatening contexts and lower-bound contexts. Experiment 3 shows that whilst saying 'some X-ed' when one knew for a fact that all X-ed is always perceived as an underinformative utterance, it is also seen as a nice and polite thing to do when X threatens the face of the listener. These findings are considered from the perspective of Relevance Theory as well as that of the Generalized Conversational Inference approach.

  8. The Potential of Wetlands in Reducing Storm Surge

    DTIC Science & Technology

    2010-01-01

    threatened by erosion and damage due to storm waves, wind, and surge. The risk of damage and loss of life is exacerbated by many factors, including coastal...obtained when attempting to correlate hurricane translation speed, surge hydrograph at the coast, and surge elevations inland. However, a trend was...greater surface roughness. In addition to reducing wind speeds, the models eliminate the wind stress in forested wetlands which inhibit wind from

  9. Potential of derived lunar volatiles for life support

    NASA Technical Reports Server (NTRS)

    Bula, R. J.; Wittenberg, L. J.; Tibbitts, T. W.; Kulcinski, G. L.

    1992-01-01

    The lunar regolith contains small quantities of solar wind implanted volatile compounds that have vital, basic uses for maintaining life support systems of lunar or space settlements. Recent proposals to utilize the helium-3 isotope (He-3) derived from the lunar regolith as a fuel for fusion reactors would result in the availability of large quantities of other lunar volatile compounds. The quantities obtained would provide the annual life support replacement requirements of 1150 to 23,000 inhabitants per ton of He-3 recovered, depending on the volatile compound. Utilization of the lunar volatile compounds for life support depends on the costs, in terms of materials and energy, associated with their extraction from the lunar regolith as compared to the delivery costs of these compounds from Earth resources. Considering today's conservative estimated transportation costs ($10,000 dollars per kilogram) and regolith mining costs ($5 dollars per ton), the life support replacement requirements could be more economically supplied by recovering the lunar volatile compounds than transporting these materials from Earth resources, even before He-3 will be utilized as a fusion fuel. In addition, availability of lunar volatile compounds could have a significant cost impact on maintaining the life support systems of the space station and a Mars base.

  10. 78 FR 42540 - Endangered and Threatened Species; Permits

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-16

    ...-FF06E00000] Endangered and Threatened Species; Permits AGENCY: Fish and Wildlife Service, Interior. ACTION... permits to conduct certain activities with endangered species under the authority of the Endangered Species Act, as amended (Act). FOR FURTHER INFORMATION CONTACT: Kathy Konishi, Permit Coordinator...

  11. Exploring the Quality of Life of People in North Eastern and Southern Thailand

    ERIC Educational Resources Information Center

    Jongudomkarn, Darunee; Camfield, Laura

    2006-01-01

    The assumption that development brings not only material prosperity but also a better overall quality of life lies at the heart of the development project. Against this, critics assert that development can undermine social cohesion and threaten cultural integrity. Rarely, however, is the impact of development on well-being rigourously analysed…

  12. The relationship between cognitive function and life space: the potential role of personal control beliefs.

    PubMed

    Sartori, Andrea C; Wadley, Virginia G; Clay, Olivio J; Parisi, Jeanine M; Rebok, George W; Crowe, Michael

    2012-06-01

    We examined the relationship of cognitive and functional measures with life space (a measure of spatial mobility examining extent of movement within a person's environment) in older adults, and investigated the potential moderating role of personal control beliefs. Internal control beliefs reflect feelings of competence and personal agency, while attributions of external control imply a more dependent or passive point of view. Participants were 2,737 adults from the ACTIVE study, with a mean age of 74 years. Females comprised 76% of the sample, with good minority representation (27% African American). In multiple regression models controlling for demographic factors, cognitive domains of memory, reasoning, and processing speed were significantly associated with life space (p < .001 for each), and reasoning ability appeared most predictive (B = .117). Measures of everyday function also showed significant associations with life space, independent from the traditional cognitive measures. Interactions between cognitive function and control beliefs were tested, and external control beliefs moderated the relationship between memory and life space, with the combination of high objective memory and low external control beliefs yielding the highest life space (t = -2.07; p = .039). In conclusion, older adults with better cognitive function have a larger overall life space. Performance-based measures of everyday function may also be useful in assessing the functional outcome of life space. Additionally, subjective external control beliefs may moderate the relationship between objective cognitive function and life space. Future studies examining the relationships between these factors longitudinally appear worthwhile to further elucidate the interrelationships of cognitive function, control beliefs, and life space. PsycINFO Database Record (c) 2012 APA, all rights reserved

  13. 77 FR 68789 - Establishing a List of Qualifying Pathogens That Have the Potential To Pose a Serious Threat to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-16

    ... or life-threatening infections caused by bacteria or fungi. For an application for a drug that is...) multi-drug resistant [G]ram[- ]negative bacteria, including Acinetobacter, Klebsiella, Pseudomonas, and...

  14. Agriculture in the climate change negotiations; ensuring that food production is not threatened.

    PubMed

    Muldowney, J; Mounsey, J; Kinsella, L

    2013-06-01

    With the human population predicted to reach nine billion by 2050, demand for food is predicted to more than double over this time period, a trend which will lead to increased greenhouse gas (GHG) emissions from agriculture. Furthermore, expansion in food production is predicted to occur primarily in the developing world, where adaptation to climate change may be more difficult and opportunities to mitigate emissions limited. In the establishment of the United Nations Framework Convention on Climate Change (UNFCCC), 'ensuring that food production is not threatened' is explicitly mentioned in the objective of the Convention. However, the focus of negotiations under the Convention has largely been on reducing GHG emissions from energy, and industrial activities and realizing the potential of forestry as a carbon sink. There has been little attention by the UNFCCC to address the challenges and opportunities for the agriculture sector. Since 2006, concerted efforts have been made to raise the prominence of agriculture within the negotiations. The most recent The Intergovernmental Panel on Climate Change report and 'The Emissions Gap Report' by the UNEP highlighted the significant mitigation potential of agriculture, which can help contribute towards keeping global temperature rises below the 2°C limit agreed in Cancun. Agriculture has to be a part of the solution to address climate change, but this will also require a focus on how agriculture systems can adapt to climate change in order to continue to increase food output. However, to effectively realize this potential, systematic and dedicated discussion and decisions within the UNFCCC are needed. UNFCCC discussions on a specific agriculture agenda item started in 2012, but are currently inconclusive. However, Parties are generally in agreement on the importance of agriculture in contributing to food security and employment as well as the need to improve understanding of agriculture and how it can contribute to

  15. Potential responses to climate change in organisms with complex life histories: evolution and plasticity in Pacific salmon.

    PubMed

    Crozier, L G; Hendry, A P; Lawson, P W; Quinn, T P; Mantua, N J; Battin, J; Shaw, R G; Huey, R B

    2008-05-01

    Salmon life histories are finely tuned to local environmental conditions, which are intimately linked to climate. We summarize the likely impacts of climate change on the physical environment of salmon in the Pacific Northwest and discuss the potential evolutionary consequences of these changes, with particular reference to Columbia River Basin spring/summer Chinook (Oncorhynchus tshawytscha) and sockeye (Oncorhynchus nerka) salmon. We discuss the possible evolutionary responses in migration and spawning date egg and juvenile growth and development rates, thermal tolerance, and disease resistance. We know little about ocean migration pathways, so cannot confidently suggest the potential changes in this life stage. Climate change might produce conflicting selection pressures in different life stages, which will interact with plastic (i.e. nongenetic) changes in various ways. To clarify these interactions, we present a conceptual model of how changing environmental conditions shift phenotypic optima and, through plastic responses, phenotype distributions, affecting the force of selection. Our predictions are tentative because we lack data on the strength of selection, heritability, and ecological and genetic linkages among many of the traits discussed here. Despite the challenges involved in experimental manipulation of species with complex life histories, such research is essential for full appreciation of the biological effects of climate change.

  16. Potential responses to climate change in organisms with complex life histories: evolution and plasticity in Pacific salmon

    PubMed Central

    Crozier, L G; Hendry, A P; Lawson, P W; Quinn, T P; Mantua, N J; Battin, J; Shaw, R G; Huey, R B

    2008-01-01

    Salmon life histories are finely tuned to local environmental conditions, which are intimately linked to climate. We summarize the likely impacts of climate change on the physical environment of salmon in the Pacific Northwest and discuss the potential evolutionary consequences of these changes, with particular reference to Columbia River Basin spring/summer Chinook (Oncorhynchus tshawytscha) and sockeye (Oncorhynchus nerka) salmon. We discuss the possible evolutionary responses in migration and spawning date egg and juvenile growth and development rates, thermal tolerance, and disease resistance. We know little about ocean migration pathways, so cannot confidently suggest the potential changes in this life stage. Climate change might produce conflicting selection pressures in different life stages, which will interact with plastic (i.e. nongenetic) changes in various ways. To clarify these interactions, we present a conceptual model of how changing environmental conditions shift phenotypic optima and, through plastic responses, phenotype distributions, affecting the force of selection. Our predictions are tentative because we lack data on the strength of selection, heritability, and ecological and genetic linkages among many of the traits discussed here. Despite the challenges involved in experimental manipulation of species with complex life histories, such research is essential for full appreciation of the biological effects of climate change. PMID:25567630

  17. Threatening social context facilitates pain-related fear learning.

    PubMed

    Karos, Kai; Meulders, Ann; Vlaeyen, Johan W S

    2015-03-01

    This study investigated the effects of a threatening and a safe social context on learning pain-related fear, a key factor in the development and maintenance of chronic pain. We measured self-reported pain intensity, pain expectancy, pain-related fear (verbal ratings and eyeblink startle responses), and behavioral measures of avoidance (movement-onset latency and duration) using an established differential voluntary movement fear conditioning paradigm. Participants (N = 42) performed different movements with a joystick: during fear acquisition, movement in one direction (CS+) was followed by a painful stimulus (pain-US) whereas movement in another direction (CS-) was not. For participants in the threat group, an angry face was continuously presented in the background during the task, whereas in the safe group, a happy face was presented. During the extinction phase the pain-US was omitted. As compared to the safe social context, a threatening social context led to increased contextual fear and facilitated differentiation between CS+ and CS- movements regarding self-reported pain expectancy, fear of pain, eyeblink startle responses, and movement-onset latency. In contrast, self-reported pain intensity was not affected by social context. These data support the modulation of pain-related fear by social context. A threatening social context leads to stronger acquisition of (pain-related) fear and simultaneous contextual fear but does not affect pain intensity ratings. This knowledge may aid in the prevention of chronic pain and anxiety disorders and shows that social context might modulate pain-related fear without immediately affecting pain intensity itself. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

  18. [The role of complementary examinations and home monitoring in patient at risk from apparent life threatening event, apneas and sudden infant death syndrome].

    PubMed

    Martínez Monseny, A; Bobillo Pérez, S; Martínez Planas, A; García García, J J

    2015-08-01

    Home apnea monitors detect abnormalities in cardiac and respiratory frequency, but their use in the diagnosis of respiratory -related sleep disturbances in children has not been demonstrated, as was originally thought. To describe the type of patients being monitored, for how long and their outcome. A retrospective descriptive study was conducted on patients with controlled home cardiorespiratory monitoring from October 2008 to September 2012 in the Outpatient department of a Maternity tertiary hospital. During the study period 88 patients were included, 58% of them were male, with a median age of 15.5 days, and followed up for a period of 4.7 months. The reason for monitoring was in a 20.5% due to a history of sudden death without finding underlying pathology in 20.5%, 25% due to apnea of prematurity, 20.5% due to apparent life-threatening event, and 14.8% due to choking. Other causes accounted for 19.3% (apnea/hypopnea, desaturation and periodic breathing). Of these last three groups, pathological events were observed in 50% of them: reflux disease (9), apnea of prematurity (2), neurological causes (3), and apnea of unknown cause (10). Suspected infant apnea is a cause for consultation that creates a great deal of concern to the family and the pediatrician. Home monitoring is useful in detecting changes in cardiac and respiratory frequency, but is necessary to limit its indications and ensure proper monitoring of these patients, avoiding the abuse of other tests or treatments. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  19. 75 FR 15454 - Endangered and Threatened Wildlife and Plants; 5-Year Status Reviews of 14 Southwestern Species

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-29

    ...] Endangered and Threatened Wildlife and Plants; 5-Year Status Reviews of 14 Southwestern Species AGENCY: Fish... that our classification of each species on the Lists of Endangered and Threatened Wildlife and Plants... Wildlife and Plants (50 CFR 17.12), or reclassified from endangered to threatened (downlisted), or from...

  20. Threatened fish and fishers along the Brazilian Atlantic Forest Coast.

    PubMed

    Begossi, Alpina; Salivonchyk, Svetlana; Hallwass, Gustavo; Hanazaki, Natalia; Lopes, Priscila F M; Silvano, Renato A M

    2017-12-01

    Small-scale fisheries of the Brazilian Atlantic Forest Coast (BAFC) depend on fish resources for food and income. Thus, if the catch diminishes or if fish species that are a target for fishers are overexploited or impacted, this could affect fishers' livelihoods. The exclusion of threatened fish species from the catch is believed to be a threat to small-scale fisheries, which is likely to be the case along the BAFC. Many fish species are currently listed as threatened or vulnerable, whereas there is not enough biological information available to determine the status of the majority of the other species. Failure to protect the BAFC biodiversity might negatively impact fishers' income and the regional economy of local small-scale fisheries. We collected data from 1986 to 2009 through 347 interviews and 24-h food recall surveys at seven southeastern coastal sites of the Atlantic Forest. We show that important species of consumed fish are currently threatened: of the 65 species mentioned by fishers as the most consumed fishes, 33% are decreasing and 54% have an unknown status. Thus, biological and ecological data for BAFC marine species are urgently needed, along with co-management, to promote fish conservation.