[BASIC PRINCIPLES AND METHODS TO THE USE IMMUNOMODULATING PREPARATIONS IN CLINICAL PRACTICE: CLASSIFICATION, INDICATIONS AND CONTRAINDICATIONS].

PubMed

Sepiashvili, R

2015-06-01

This paper is devoted to one of the most pressing issues in modern clinical medicine, the problem of immunomodulators and immunotropic therapy. The materials presented are the logical sequel of the papers published by Revaz I. Sepiashvili in 2001-2015. In these articles, the author proposed the first classification of immunotropic preparations, a brief historical background and chronological emergence of the concept of therapies, as well as definition of immunomodulators. This paper presents an updated classification of immunomodulatory drugs which is valid for January 2015. The paper also outlines basic principles for therapies that allow the clinician not only to select a proper immunomodulator but also to develop strategy and tactics in treatment of the patient, taking into account his/her individual characteristics and the need to use in clinical practice only officially registered immunotropic preparations.

Therapeutic perspectives in hypertension: novel means for renin-angiotensin-aldosterone system modulation and emerging device-based approaches.

PubMed

Unger, Thomas; Paulis, Ludovit; Sica, Domenic A

2011-11-01

The conventional antihypertensive therapies including renin-angiotensin-aldosterone system antagonists (converting enzyme inhibitors, receptor blockers, renin inhibitors, and mineralocorticoid receptor blockers), diuretics, β-blockers, and calcium channel blockers are variably successful in achieving the challenging target blood pressure values in hypertensive patients. Difficult to treat hypertension is still a commonly observed problem world-wide. A number of drugs are considered to be used as novel therapies for hypertension. Renalase supplementation, vasopeptidase inhibitors, endothelin antagonists, and especially aldosterone antagonists (aldosterone synthase inhibitors and novel selective mineralocorticoid receptor blockers) are considered an option in resistant hypertension. In addition, the aldosterone antagonists as well as (pro)renin receptor blockers or AT(2) receptor agonists might attenuate end-organ damage. This array of medications has now been complemented by a number of new approaches of non-pharmacological strategies including vaccination, genomic interference, controlled breathing, baroreflex activation, and probably most successfully renal denervation techniques. However, the progress on innovative therapies seems to be slow and the problem of resistant hypertension and proper blood pressure control appears to be still persisting. Therefore the regimens of currently available drugs are being fine-tuned, resulting in the establishment of several novel fixed-dose combinations including triple combinations with the aim to facilitate proper blood pressure control. It remains an exciting question which approach will confer the best blood pressure control and risk reduction in this tricky disease.

Management of cutaneous rosacea: emphasis on new medical therapies.

PubMed

Del Rosso, James Q

2014-10-01

Over the past decade, both basic science and clinical research have provided new information on pathophysiology and therapy that has led to advances in the management of rosacea. As rosacea is a very common facial skin disorder in adults of both genders and essentially all races and ethnicities, these advances can provide therapeutic benefit to many affected individuals around the world. This article provides a collective review of more recent information on the pathophysiology and clinical manifestations of rosacea, and discusses individual medical therapies based on PubMed literature searches on 'rosacea', 'rosacea therapies' and each therapy that are included in this article. The perspectives of the author on management of rosacea are also included. Newer therapies and treatment concepts received greater emphasis. Management of cutaneous rosacea involves patient education, integration of proper skin care, differentiation of visible manifestations and symptoms, selecting therapies that correlate with the manifestations that are to be treated, setting realistic patient expectations on anticipated degree and time course of response and designing an overall management plan that addresses needs of the individual patient. In many cases, a combination approach is needed, and due to the chronicity of the disease long-term management is often warranted.

Expanding choices in intranasal steroid therapy: summary of a roundtable meeting.

PubMed

Blaiss, Michael S; Benninger, Michael S; Fromer, Len; Gross, Gary; Mabry, Richard; Mahr, Todd; Marple, Bradley; Stoloff, Stuart

2006-01-01

Intranasal steroids (INSs) are recommended as first-line treatment for allergic rhinitis (AR) and a wealth of data exist supporting them as safe and effective. Our goal was to develop a consensus to help physicians choose between INSs by focusing on clinical profiles and patient preferences and providing expert advice on choosing the appropriate INS for each patient. Experts from specialties that manage patients with AR attended a roundtable meeting to discuss INS therapy. Besides comparisons with other pharmacologic agents, they examined the effects of INS on nasal anatomy, patient preferences for INS, and benefits of product selection based on patient profile. The literature on INSs in AR was reviewed, examining properties of the various drugs, delivery devices, formulations, and patient preference data. Nasal anatomy and physiology must be considered to optimize INS deposition in the nose. Teaching patients proper technique for using INS devices is important to prevent nasal injury and may help concentrate drug effect on affected tissues. INS therapies differ somewhat in biological properties and specific formulation; however, all are considered safe and effective treatment for AR. Patients exhibit different clinical profiles, which play a role in INS selection. Patients can clearly identify sensory characteristics of INS and therefore establish product preference. Patient preference also can guide physicians in choosing the appropriate agent for each patient. Control of AR requires a systematic approach to treatment selection and follow-up. Treatment selection should be matched with clinical profile and patient preferences.

SU-E-T-13: A Comparative Dosimetric Study On Radio-Dynamic Therapy for Pelvic Cancer Treatment: Strategies for Bone Marrow Dose and Volume Reduction

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

Li, C; Renmin Hospital of Wuhan University, Wuhan, Hubei Province; Wang, B

Purpose: Radio-dynamic therapy (RDT) is a potentially effective modality for local and systemic cancer treatment. Using RDT, the administration of a radio-sensitizer enhances the biological effect of high-energy photons. Although the sensitizer uptake ratio of tumor to normal tissue is normally high, one cannot simply neglect its effect on critical structures. In this study, we aim to explore planning strategies to improve bone marrow sparing without compromising the plan quality for RDT treatment of pelvic cancers. Methods: Ten cervical and ten prostate cancer patients who previously received radiotherapy at our institution were selected for this study. For each patient, ninemore » plans were created using the Varian Eclipse treatmentplanning-system (TPS) with 3D-CRT, IMRT, and VMAT delivery techniques containing various gantry angle combinations and optimization parameters (dose constraints to the bone marrow). To evaluate the plans for bone marrow sparing, the dose-volume parameters V5, V10, V15, V20, V30, and V40 for bone marrow were examined. Effective doseenhancement factors for the sensitizer were used to weigh the dose-volume histograms for various tissues from individual fractions. Results: The planning strategies had different impacts on bone marrow sparing for the cervical and prostate cases. For the cervical cases, provided the bone marrow constraints were properly set during optimization, the dose to bone marrow sparing was found to be comparable between different IMRT and VMAT plans regardless of the gantry angle selection. For the prostate cases, however, careful selection of gantry angles could dramatically improve the bone marrow sparing, although the dose distribution in bone marrow was clinically acceptable for all prostate plans that we created. Conclusion: For intensity-modulated RDT planning for cervical cancer, planners should set bone marrow constraints properly to avoid any adverse damage, while for prostate cancer one can carefully select gantry angles to improve bone marrow sparing when necessary.« less

Premenstrual Dysphoric Disorder: Contemporary Diagnosis and Management.

PubMed

Reid, Robert L; Soares, Claudio N

2018-02-01

Most ovulatory women experience premenstrual symptoms (premenstrual syndrome, molimina) which indicate impending menstruation and are of little clinical relevance because they do not affect quality of life. A few women, however, experience significant physical and/or psychological symptoms before menstruation that, if left untreated, would result in deterioration in functioning and relationships. The precise etiology remains elusive, although new theories are gaining support in pre-clinical and early clinical trials. Refined diagnostic criteria allow better discrimination of this condition from other psychiatric diagnoses and the selection of symptom appropriate therapies that afford relief for most women. Pharmacotherapies (particularly selective serotonin reuptake inhibitors and SNRIs) represent the first-line treatment for premenstrual dysphoric disorder and severe, mood-related premenstrual syndrome. Continuous combined oral contraceptives have limited evidence for usefulness in premenstrual dysphoric disorder, whereas medical ovarian suppression is often recommended for patients who fail to respond or cannot tolerate first-line treatments (e.g., selective serotonin reuptake inhibitors). The use of cognitive behavioural therapies is promising, but it remains limited by sparse data and restricted access to trained professionals. A proper diagnosis (particularly the distinction from other underlying psychiatric conditions) is crucial for the implementation of effective therapy and alleviation of this impairing condition. Copyright © 2018 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

Outcome measurement in clinical trials for Ulcerative Colitis: towards standardisation

PubMed Central

Cooney, Rachel M; Warren, Bryan F; Altman, Douglas G; Abreu, Maria T; Travis, Simon PL

2007-01-01

Clinical trials on novel drug therapies require clear criteria for patient selection and agreed definitions of disease remission. This principle has been successfully applied in the field of rheumatology where agreed disease scoring systems have allowed multi-centre collaborations and facilitated audit across treatment centres. Unfortunately in ulcerative colitis this consensus is lacking. Thirteen scoring systems have been developed but none have been properly validated. Most trials choose different endpoints and activity indices, making comparison of results from different trials extremely difficult. International consensus on endoscopic, clinical and histological scoring systems is essential as these are the key components used to determine entry criteria and outcome measurements in clinical trials on ulcerative colitis. With multiple new therapies under development, there is a pressing need for consensus to be reached. PMID:17592647

The Role of Aspirin in the Prevention of Cardiovascular Disease

PubMed Central

Ittaman, Sunitha V.; VanWormer, Jeffrey J.; Rezkalla, Shereif H.

2014-01-01

Aspirin therapy is well-accepted as an agent for the secondary prevention of cardiovascular events and current guidelines also define a role for aspirin in primary prevention. In this review, we describe the seminal trials of aspirin use in the context of current guidelines, discuss factors that may influence the effectiveness of aspirin therapy for cardiovascular disease prevention, and briefly examine patterns of use. The body of evidence supports a role for aspirin in both secondary and primary prevention of cardiovascular events in selected population groups, but practice patterns may be suboptimal. As a simple and inexpensive prophylactic measure for cardiovascular disease, aspirin use should be carefully considered in all at-risk adult patients, and further measures, including patient education, are necessary to ensure its proper use. PMID:24573704

A practical approach to the treatment of depression in patients with chronic kidney disease and end-stage renal disease.

PubMed

Hedayati, S Susan; Yalamanchili, Venkata; Finkelstein, Fredric O

2012-02-01

Depression is a common, under-recognized, and under-treated problem that is independently associated with increased morbidity and mortality in CKD patients. However, only a minority of CKD patients with depression are treated with antidepressant medications or nonpharmacologic therapy. Reasons for low treatment rates include a lack of properly controlled trials that support or refute efficacy and safety of various treatment regimens in CKD patients. The aim of this manuscript is to provide a comprehensive review of studies exploring depression treatment options in CKD. Observational studies as well as small trials suggest that certain serotonin-selective reuptake inhibitors may be safe to use in patients with advanced CKD and ESRD. These studies were limited by small sample sizes, lack of placebo control, and lack of formal assessment for depression diagnosis. Nonpharmacologic treatments were explored in selected ESRD samples. The most promising data were reported for frequent hemodialysis and cognitive behavioral therapy. Alternative proposed therapies include exercise training regimens, treatment of anxiety, and music therapy. Given the association of depression with cardiovascular events and mortality, and the excessive rates of cardiovascular death in CKD, it becomes imperative to not only investigate whether treatment of depression is efficacious, but also whether it would result in a reduction in morbidity and mortality in this patient population.

Therapeutic perspectives in hypertension: novel means for renin–angiotensin–aldosterone system modulation and emerging device-based approaches

PubMed Central

Unger, Thomas; Paulis, Ludovit; Sica, Domenic A.

2011-01-01

The conventional antihypertensive therapies including renin–angiotensin–aldosterone system antagonists (converting enzyme inhibitors, receptor blockers, renin inhibitors, and mineralocorticoid receptor blockers), diuretics, β-blockers, and calcium channel blockers are variably successful in achieving the challenging target blood pressure values in hypertensive patients. Difficult to treat hypertension is still a commonly observed problem world-wide. A number of drugs are considered to be used as novel therapies for hypertension. Renalase supplementation, vasopeptidase inhibitors, endothelin antagonists, and especially aldosterone antagonists (aldosterone synthase inhibitors and novel selective mineralocorticoid receptor blockers) are considered an option in resistant hypertension. In addition, the aldosterone antagonists as well as (pro)renin receptor blockers or AT2 receptor agonists might attenuate end-organ damage. This array of medications has now been complemented by a number of new approaches of non-pharmacological strategies including vaccination, genomic interference, controlled breathing, baroreflex activation, and probably most successfully renal denervation techniques. However, the progress on innovative therapies seems to be slow and the problem of resistant hypertension and proper blood pressure control appears to be still persisting. Therefore the regimens of currently available drugs are being fine-tuned, resulting in the establishment of several novel fixed-dose combinations including triple combinations with the aim to facilitate proper blood pressure control. It remains an exciting question which approach will confer the best blood pressure control and risk reduction in this tricky disease. PMID:21951628

42 CFR 482.56 - Condition of participation: Rehabilitation services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... offered. (1) The director of the services must have the necessary knowledge, experience, and capabilities to properly supervise and administer the services. (2) Physical therapy, occupational therapy, speech... provides rehabilitation, physical therapy, occupational therapy, audiology, or speech pathology services...

Endoscopic Vacuum-Assisted Closure Therapy in Patients with Anastomotic Leakage after Esophagectomy: A Single-Center Experience

PubMed Central

Noh, Soo Min; Lee, Jeong Hoon; Jung, Hwoon-Yong; AlGhamdi, Zeead; Kim, Hyeong Ryul; Kim, Yong-Hee

2018-01-01

Aim To study the efficacy of E-VAC therapy for patients with anastomotic leakage after esophagectomy. Methods Between January 2013 and April 2017, 12 patients underwent E-VAC therapy for the management of postoperative leakage. Their clinical features and endoscopic procedure details, therapy results, adverse events, and survival were investigated. Results All 12 patients were male and the median age was 57 years (interquartile range 51.5–62.8 years). The reasons for esophageal surgery were esophageal cancer (83.3%), gastrointestinal stromal tumor (8.3%), and esophageal diverticulum (8.3%). Prior to E-VAC therapy, 6 patients had undergone failed primary surgical repair and the median duration from esophagectomy to leakage discovery was 13.5 days (IQR 6–207 days). The median duration of E-VAC therapy was 25 days (IQR 13.5–34.8 days) and the average sponge exchange rate was 2.7 times during the treatment period. After E-VAC therapy, 8 patients (66.7%) had complete leakage closure, 3 (25%) had a decreased leakage size, and 1 (8.3%) was unchanged. The three patients with a decreased leakage size after E-VAC therapy were treated with endoscopic and conservative management without further surgery. Conclusion With proper patient selection, E-VAC therapy is a feasible and safe method for the treatment of anastomotic leakage after esophagectomy. PMID:29849581

Thyroid Lobectomy Is Associated with Excellent Clinical Outcomes in Properly Selected Differentiated Thyroid Cancer Patients with Primary Tumors Greater Than 1 cm

PubMed Central

Vaisman, Fernanda; Momesso, Denise; Bulzico, Daniel A.; Pessoa, Cencita H. C. N.; da Cruz, Manuel Domingos Gonçalves; Dias, Fernando; Corbo, Rossana; Vaisman, Mario; Tuttle, R. Michael

2013-01-01

Background and Objective. An individualized risk-based approach to the treatment of thyroid cancer is being extensively discussed in the recent literature. However, controversies about the ideal surgical approach remain an important issue with regard to the impact on prognosis and follow-up strategies. This study was designed to describe clinical outcomes in a cohort of low and intermediate risk thyroid cancer patients treated with thyroid lobectomy. Methods. Retrospective review of 70 patients who underwent lobectomy. Results. After a median follow-up of 11 years, 5 patients (5/70, 7.1%) recurred and 5 had a completion for benign lesions, while 60 patients (86%) continued to be observed without evidence for disease recurrence. Suspicious ultrasound findings were significantly more common in patients that had structural disease recurrence (100% versus 4.3%, P < 0.001). Furthermore, a rising suppressed Tg value over time was also associated with structural disease recurrence (80% versus 21.5%, P = 0.01). After additional therapy, 99% of the patients had no evidence of disease. Conclusions. Properly selected thyroid cancer patients can be treated with lobectomy with excellent clinical outcomes. PMID:24455413

Nosocomial Candidiasis: Antifungal Stewardship and the Importance of Rapid Diagnosis.

PubMed

Pfaller, Michael A; Castanheira, Mariana

2016-01-01

Candidemia and other forms of candidiasis are associated with considerable excess mortality and costs. Despite the addition of several new antifungal agents with improved spectrum and potency, the frequency of Candida infection and associated mortality have not decreased in the past two decades. The lack of rapid and sensitive diagnostic tests has led to considerable overuse of antifungal agents resulting in increased costs, selection pressure for resistance, unnecessary drug toxicity, and adverse drug interactions. Both the lack of timely diagnostic tests and emergence of antifungal resistance pose considerable problems for antifungal stewardship. Whereas antifungal stewardship with a focus on nosocomial candidiasis should be able to improve the administration of antifungal therapy in terms of drug selection, proper dose and duration, source control and de-escalation therapy, an important parameter, timeliness of antifungal therapy, remains a victim of slow and insensitive diagnostic tests. Fortunately, new proteomic and molecular diagnostic tools are improving the time to species identification and detection. In this review we will describe the potential impact that rapid diagnostic testing and antifungal stewardship can have on the management of nosocomial candidiasis. © The Author 2015. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Commander’s Emergency Response Program: A Model for Future Implementation

DTIC Science & Technology

2010-04-07

unintended Effects. The INVEST-E methodology serves as a tool for commanders and their designated practitioners to properly select projects, increasing...for commanders and their designated practitioners to properly select projects, increasing the effectiveness of CERP funds. 4 TABLE OF...and unintended Effects. The INVEST-E methodology serves as a tool for commanders and their designated practitioners to properly select projects

Non-Thermal Atmospheric Pressure Plasma Preferentially Induces Apoptosis in p53-Mutated Cancer Cells by Activating ROS Stress-Response Pathways

PubMed Central

Ma, Yonghao; Ha, Chang Seung; Hwang, Seok Won; Lee, Hae June; Kim, Gyoo Cheon; Lee, Kyo-Won; Song, Kiwon

2014-01-01

Non-thermal atmospheric pressure plasma (NTAPP) is an ionized gas at room temperature and has potential as a new apoptosis-promoting cancer therapy that acts by generating reactive oxygen species (ROS). However, it is imperative to determine its selectivity and standardize the components and composition of NTAPP. Here, we designed an NTAPP-generating apparatus combined with a He gas feeding system and demonstrated its high selectivity toward p53-mutated cancer cells. We first determined the proper conditions for NTAPP exposure to selectively induce apoptosis in cancer cells. The apoptotic effect of NTAPP was greater for p53-mutated cancer cells; artificial p53 expression in p53-negative HT29 cells decreased the pro-apoptotic effect of NTAPP. We also examined extra- and intracellular ROS levels in NTAPP-treated cells to deduce the mechanism of NTAPP action. While NTAPP-mediated increases in extracellular nitric oxide (NO) did not affect cell viability, intracellular ROS increased under NTAPP exposure and induced apoptotic cell death. This effect was dose-dependently reduced following treatment with ROS scavengers. NTAPP induced apoptosis even in doxorubicin-resistant cancer cell lines, demonstrating the feasibility of NTAPP as a potent cancer therapy. Collectively, these results strongly support the potential of NTAPP as a selective anticancer treatment, especially for p53-mutated cancer cells. PMID:24759730

Emerging analgesic drugs for Parkinson's disease.

PubMed

Perez-Lloret, Santiago; Rey, María Verónica; Dellapina, Estelle; Pellaprat, Jean; Brefel-Courbon, Christine; Rascol, Olivier

2012-06-01

Pain affects between 40 and 85% of Parkinson's disease (PD) patients. It is a frequently disabling and overlooked feature, which can significantly reduce health-related quality of life. Unfortunately, there are no universally recommended treatments for this condition. Evidence about the efficacy and safety of available analgesic treatments is summarized in this review. Potential targets for upcoming therapies are then discussed in light of what is currently known about the physiopathology of pain in PD. Protocols for efficacy and safety assessment of novel analgesic therapies are discussed. Finally, critical aspects of study protocol design such as patient selection or outcomes to be evaluated are discussed. Preliminary results indicate that duloxetine, cranial electrotherapy stimulation, rotigotine, subthalamic or pallidum nuclei stimulation or lesion or levodopa could be effective for treating pain in PD. Similarly, some case reports indicate that repetitive transcranial magnetic stimulation (rTMS) or apomorphine could be effective for relieving painful off-period dystonia. Clinical trials with rTMS or oxycodone/naloxone prolonged-release tablets for neuropathic pain or botulinum toxin for off-period dystonia are underway. Success of clinical trials about analgesic strategies in PD will depend on the selection of the right PD population to be treated, according to the type of pain, and the proper selection of study outcomes and follow-up of international recommendations.

Improved antimicrobial therapy with cationic tetra- and octa-substituted phthalocyanines

NASA Astrophysics Data System (ADS)

Angelov, I.; Mantareva, V.; Kussovski, V.; Woehrle, D.; Borisova, E.; Avramov, L.

2008-12-01

Photodynamic therapy (PDT) today is an innovative and not yet widespread light-drug initiated treatment that is based on the photoactive compound irradiated with proper light to produce oxygen species that are toxic to the pathogenic biological objects- bacteria, viruses, tumor cells. The obstacles that limited the efficacy of PDT concern to the selectivity and multi-drug resistance prolong time for cellular release and side effects of skin photosensitivity for commercial porphyrin originated photosensitizers (PS). Now there are very intensive investigations for introducing in practice a new, with a least side effects PSs for PDT. The usefulness of the more extended macromolecules structured with proper substituents refers not only to the improved optical properties like far-red and with intensive absorption and emission capacity, but mainly to the ability for selective delivery and adhesion to the target cells, such as bacteria or other pathogens. The present study focuses on the charge effect of photodynamic agent on the uptake capacity toward gram-negative bacteria cells and their further photoinactivation. The multi-drug resistant microorganism Aeromanas hydrophilla, which is causing diseases to fishes and humans, is treated. The new octa-cationic phthalocyanines are designed to compare PDT efficacy to the efficacy of tetra-substituted derivatives with the same functional peripheral substituents. The higher cellular accumulation to the bacteria cells as a result of the high number of positive charges of photosensitizer, leading to the better adhesion to the cellular membranes and improved photoinactivation of bacteria causing superficial and intraorgan infections. These results set a base of a rationale design of covalently octa-substituted phthalocyanines with positive charge for a successful treatment of microorganisms.

Current management of atopic dermatitis and interruption of the atopic march.

PubMed

Boguniewicz, Mark; Eichenfield, Lawrence F; Hultsch, Thomas

2003-12-01

Treatment of atopic dermatitis requires a comprehensive approach that includes evaluation of potential triggers and education of the patient and family regarding proper avoidance measures. Hydration of the skin and maintenance of an intact skin barrier remain integral to proper management. Although topical corticosteroids have been a mainstay of anti-inflammatory therapy, the newer topical calcineurin inhibitors offer advantages for treatment of this chronic, relapsing disease. Studies aimed at defining optimal combination therapy and early intervention might change the treatment paradigm for atopic dermatitis.

Endurance exercise intensity determination in the rehabilitation of coronary artery disease patients: a critical re-appraisal of current evidence.

PubMed

Hansen, Dominique; Stevens, An; Eijnde, Bert O; Dendale, Paul

2012-01-01

In the care of coronary artery disease (CAD) patients, the benefits of exercise therapy are generally established. Even though the selected endurance exercise intensity might affect medical safety, therapy adherence and effectiveness in the rehabilitation of CAD patients in how to determine endurance exercise intensity properly remains difficult. The aim of this review is to describe the available methods for endurance exercise intensity determination in the rehabilitation of CAD patients, accompanied with their (dis)advantages, validity and reproducibility. In general, endurance exercise intensity can objectively be determined in CAD patients by calculating a fraction of maximal exercise tolerance and/or determining ventilatory threshold after execution of a cardiopulmonary exercise test with ergospirometry. This can be translated to a corresponding training heart rate (HR) or workload. In the absence of ergospirometry equipment, target exercise HR can be calculated directly by different ways (fraction of maximal HR and/or Karvonen formula), and/or anaerobic threshold can be determined. However, the use of HR for determining exercise intensity during training sessions seems complicated, because many factors/conditions affect the HR. In this regard, proper standardization of the exercise sessions, as well as exercise testing, might be required to improve the accuracy of exercise intensity determination. Alternatively, subjective methods for the determination of endurance exercise intensity in CAD patients, such as the Borg ratings of perceived exertion and the talk test, have been developed. However, these methods lack proper validity and reliability to determine endurance exercise intensity in CAD patients. In conclusion, a practical and systematic approach for the determination of endurance exercise intensity in CAD patients is presented in this article.

A Review of the “Bolus Guide,” A New Insulin Bolus Dosing Support Tool Based on Selection of Carbohydrate Ranges

PubMed Central

Pańkowska, Ewa

2010-01-01

In this issue of Journal of Diabetes Science and Technology, Shapira and colleagues present new concepts of carbohydrate load estimation in intensive insulin therapy. By using a mathematical model, they attempt to establish how accurately carbohydrate food content should be maintained in order to keep postprandial blood glucose levels in the recommended range. Their mathematical formula, the “bolus guide” (BG), is verified by simulating prandial insulin dosing and responding to proper blood glucose levels. Different variants such as insulin sensitivity factor, insulin-to-carbohydrate ratio, and target blood glucose were taken into this formula in establishing the calculated proper insulin dose. The new approach presented here estimates the carbohydrate content by rearranging the carbohydrate load instead of the simple point estimation that the current bolus calculators (BCs) use. Computerized estimations show that the BG directives, as compared to a BC, result in more glucose levels above 200 mg/dl and thus indicate less hypoglycemia readings. PMID:20663454

Management of skeletal Class III malocclusion with face mask therapy and comprehensive orthodontic treatment.

PubMed

Muthukumar, Kirthika; Vijaykumar, N M; Sainath, M C

2016-01-01

Orthopedic correction of skeletal Class III malocclusion in a growing patient is crucial as it can circumvent future surgical procedures. Further, as surgery is done only at a later stage, early treatment helps to avoid the detrimental effects produced by the facial disfigurement on the patient's social life. This case report describes the treatment of a child aged 9 years 6 months who had a skeletal Class III malocclusion. The treatment plan involved the use of a reverse pull headgear (facemask) and multibracket appliance therapy resulting in successful correction of the malocclusion. The treatment results were highly satisfactory resulting in improved facial esthetics, a skeletal Class I with a Dental Class I molar and canine relationship, an ideal overjet and overbite. Thus, dentoalveolar camouflage, if done in properly selected cases, alleviates the need for surgical intervention. The patient is being monitored until the end of growth to ensure the stability of treatment results.

Patient-reported outcomes to support medical product labeling claims: FDA perspective.

PubMed

Patrick, Donald L; Burke, Laurie B; Powers, John H; Scott, Jane A; Rock, Edwin P; Dawisha, Sahar; O'Neill, Robert; Kennedy, Dianne L

2007-01-01

This article concerns development and use of patient-reported outcomes (PROs) in clinical trials to evaluate medical products. A PRO is any report coming directly from patients, without interpretation by physicians or others, about how they function or feel in relation to a health condition and its therapy. PRO instruments are used to measure these patient reports. PROs provide a unique perspective on medical therapy, because some effects of a health condition and its therapy are known only to patients. Properly developed and evaluated PRO instruments also have the potential to provide more sensitive and specific measurements of the effects of medical therapies, thereby increasing the efficiency of clinical trials that attempt to measure the meaningful treatment benefits of those therapies. Poorly developed and evaluated instruments may provide misleading conclusions or data that cannot be used to support product labeling claims. We review selected major challenges from Food and Drug Administration's perspective in using PRO instruments, measures, and end points to support treatment benefit claims in product labeling. These challenges highlight the need for sponsors to formulate desired labeling claim(s) prospectively, to acquire and document information needed to support these claim(s), and to identify existing instruments or develop new and more appropriate PRO instruments for evaluating treatment benefit in the defined population in which they will seek claims.

Balancing cardiovascular and gastrointestinal risks in patients with osteoarthritis receiving nonsteroidal anti‑inflammatory drugs. A summary of guidelines from an international expert group.

PubMed

Mosleh, Wassim; Farkouh, Michael E

2016-01-01

Over the past 2 decades, extensive research has assessed the use of traditional nonsteroidal anti‑inflammatory drugs (NSAIDs), and the newer cyclooxygenase‑2 (COX-2) inhibitor drugs, in the treatment of chronic pain syndromes. The proper use of NSAIDs has been the subject of significant debate, bringing together multidisciplinary researchers and clinicians to discuss the risks and benefits of these therapies. Current guidelines discussing the proper use of NSAIDs do not address the issue of the risks of COX‑2‑selective NSAIDs and nonselective NSAIDs for both the gastrointestinal (GI) and cardiovascular (CV) systems in patients on low‑dose aspirin. Accordingly, a multidisciplinary expert group was organized to review the current evidence with the aim of developing statements devoted to guide clinicians in making evidence‑based and individualized selections of NSAIDs. This review will discuss and summarize the most recent evidence on this topic to give an insight into the most effective and safest therapeutic options, thus preventing serious adverse CV and GI events. NSAIDs should be used cautiously and as infrequently as possible, with nonpharmacological approaches prescribed first. If the use of NSAIDs is required, the choice should balance the possible CV and GI risks.

Considerations for proper selection of dental cements.

PubMed

Simon, James F; Darnell, Laura A

2012-01-01

Selecting the proper cement for sufficient bond strength has become progressively complicated as the number of different materials for indirect restorations has increased. The success of any restoration is highly dependent on the proper cement being chosen and used. The function of the cement is not only to seal the restoration on the tooth but also, in some cases, to support the retention of the restoration. This ability to strengthen retention varies by the cement chosen by the clinician; therefore, careful consideration must precede cement selection.

[Neuroprotection with hypothermia in the newborn with hypoxic-ischaemic encephalopathy. Standard guidelines for its clinical application].

PubMed

Blanco, D; García-Alix, A; Valverde, E; Tenorio, V; Vento, M; Cabañas, F

2011-11-01

Standardisation of hypothermia as a treatment for perinatal hypoxic-ischaemic encephalopathy is supported by current scientific evidence. The following document was prepared by the authors on request of the Spanish Society of Neonatology and is intended to be a guide for the proper implementation of this therapy. We discuss the difficulties that may arise when moving from the strict framework of clinical trials to clinical daily care: early recognition of clinical encephalopathy, inclusion and exclusion criteria, hypothermia during transport, type of hypothermia (selective head or systemic cooling) and side effects of therapy. The availability of hypothermia therapy has changed the prognosis of children with hypoxic-ischaemic encephalopathy and our choices of therapeutic support. In this sense, it is especially important to be aware of the changes in the predictive value of the neurological examination and the electroencephalographic recording in cooled infants. In order to improve neuroprotection with hypothermia we need earlier recognition of to recognise earlier the infants that may benefit from cooling. Biomarkers of brain injury could help us in the selection of these patients. Every single infant treated with hypothermia must be included in a follow up program in order to assess neurodevelopmental outcome. Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

SAGITTARIUS STREAM THREE-DIMENSIONAL KINEMATICS FROM SLOAN DIGITAL SKY SURVEY STRIPE 82

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

Koposov, Sergey E.; Belokurov, Vasily; Evans, N. Wyn

2013-04-01

Using multi-epoch observations of the Stripe 82 region from the Sloan Digital Sky Survey (SDSS), we measure precise statistical proper motions of the stars in the Sagittarius (Sgr) stellar stream. The multi-band photometry and SDSS radial velocities allow us to efficiently select Sgr members and thus enhance the proper-motion precision to {approx}0.1 mas yr{sup -1}. We measure separately the proper motion of a photometrically selected sample of the main-sequence turn-off stars, as well as spectroscopically selected Sgr giants. The data allow us to determine the proper motion separately for the two Sgr streams in the south found in Koposov etmore » al. Together with the precise velocities from SDSS, our proper motions provide exquisite constraints of the three-dimensional motions of the stars in the Sgr streams.« less

Enhancing Cold Atmospheric Plasma Treatment Efficiency for Cancer Therapy

NASA Astrophysics Data System (ADS)

Cheng, Xiaoqian

To improve efficiency and safety of anti-cancer therapies the researchers and clinicians alike are prompted to develop targeted combined therapies that especially minimize damage to healthy tissues while eradicating the body of cancerous tissues. Previous research in cold atmospheric plasma (CAP) and cancer cell interaction has repeatedly proven that cold plasma induced cell death. In this study, we seek to integrate the medical application of CAP. We proposed and implemented 3 novel ideas to enhance efficacy and selectivity of cancer therapy. It is postulated that the reactive oxygen species (ROS) and reactive nitrogen species (RNS) play a major role in the CAP cancer therapy. We determined a mechanism of CAP therapy on glioblastoma cells (U87) through an understanding of the composition of CAP, including output voltage, treatment time, and gas flow-rate. We varied the characteristics of the cold plasma in order to obtain different major species (such as O, OH, N2+, and N2 lines). "plasma dosage" D ~ Q * V * t. is defined, where D is the entire "plasma dosage"; Q is the flow rate of feeding gas; V is output voltage; t is treatment time. The proper CAP dosage caused 3-fold cell death in the U87 cells compared to the normal human astrocytes E6/E7 cells. We demonstrated there is a synergy between AuNPS and CAP in cancer therapy. Specifically, the concentration of AuNPs plays an important role on plasma therapy. At an optimal concentration, gold nanoparticles can significantly induce U87 cell death up to a 30% overall increase compared to the control group with the same plasma dosage but no AuNPs applied. The ROS intensity of the corresponding conditions has a reversed trend compared to cell viability. This matches with the theory that intracellular ROS accumulation results in oxidative stress, which further changes the intracellular pathways, causing damage to the proteins, lipids and DNA. Our results show that this synergy has great potential in improving the efficiency of cancer therapy and reducing harm to normal cells. Finally, we propose a novel idea to combine static magnetic field (SMF) with CAP as a tool for cancer therapy. The breast cancer cells MDA-MB-231 showed a significant decrease in viability after direct plasma treatment with SMF (compared to only plasma treatment). In addition, cancer cells treated by the CAP-SMF-activated media (indirect treatment) also showed viability decrease but slightly weaker than the direct plasma-MF treatment. When treated by plasma with MF, mouse wild type dermal fibroblasts (WTDF) show no difference from the plasma treatment, both directly and indirectly. By integrating the use of MF and CAP, we are able to discover their advantages that are yet to be utilized. Although plasma can selectively kill cancer cells, long time exposure can still damage the normal cells around the tumor. This prompts researchers to seek for novel ideas in the designing of plasma treatment. This study provides the idea of combining the proper dosage of cold atmospheric plasma, AuNPs and MF in order to achieve the enhanced killing effect on cancer cells.

MOTION VERIFIED RED STARS (MoVeRS): A CATALOG OF PROPER MOTION SELECTED LOW-MASS STARS FROM WISE, SDSS, AND 2MASS

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

Theissen, Christopher A.; West, Andrew A.; Dhital, Saurav, E-mail: ctheisse@bu.edu

2016-02-15

We present a photometric catalog of 8,735,004 proper motion selected low-mass stars (KML-spectral types) within the Sloan Digital Sky Survey (SDSS) footprint, from the combined SDSS Data Release 10 (DR10), Two Micron All-Sky Survey (2MASS) point-source catalog (PSC), and Wide-field Infrared Survey Explorer (WISE) AllWISE catalog. Stars were selected using r − i, i − z, r − z, z − J, and z − W1 colors, and SDSS, WISE, and 2MASS astrometry was combined to compute proper motions. The resulting 3,518,150 stars were augmented with proper motions for 5,216,854 earlier type stars from the combined SDSS and United States Naval Observatory B1.0 catalog (USNO-B). We used SDSS+USNO-B proper motionsmore » to determine the best criteria for selecting a clean sample of stars. Only stars whose proper motions were greater than their 2σ uncertainty were included. Our Motion Verified Red Stars catalog is available through SDSS CasJobs and VizieR.« less

Practical aspects of inhaler use in the management of chronic obstructive pulmonary disease in the primary care setting.

PubMed

Yawn, Barbara P; Colice, Gene L; Hodder, Rick

2012-01-01

Sustained bronchodilation using inhaled medications in moderate to severe chronic obstructive pulmonary disease (COPD) grades 2 and 3 (Global Initiative for Chronic Obstructive Lung Disease guidelines) has been shown to have clinical benefits on long-term symptom control and quality of life, with possible additional benefits on disease progression and longevity. Aggressive diagnosis and treatment of symptomatic COPD is an integral and pivotal part of COPD management, which usually begins with primary care physicians. The current standard of care involves the use of one or more inhaled bronchodilators, and depending on COPD severity and phenotype, inhaled corticosteroids. There is a wide range of inhaler devices available for delivery of inhaled medications, but suboptimal inhaler use is a common problem that can limit the clinical effectiveness of inhaled therapies in the real-world setting. Patients' comorbidities, other physical or mental limitations, and the level of inhaler technique instruction may limit proper inhaler use. This paper presents information that can overcome barriers to proper inhaler use, including issues in device selection, steps in correct technique for various inhaler devices, and suggestions for assessing and monitoring inhaler techniques. Ensuring proper inhaler technique can maximize drug effectiveness and aid clinical management at all grades of COPD.

Practical aspects of inhaler use in the management of chronic obstructive pulmonary disease in the primary care setting

PubMed Central

Yawn, Barbara P; Colice, Gene L; Hodder, Rick

2012-01-01

Sustained bronchodilation using inhaled medications in moderate to severe chronic obstructive pulmonary disease (COPD) grades 2 and 3 (Global Initiative for Chronic Obstructive Lung Disease guidelines) has been shown to have clinical benefits on long-term symptom control and quality of life, with possible additional benefits on disease progression and longevity. Aggressive diagnosis and treatment of symptomatic COPD is an integral and pivotal part of COPD management, which usually begins with primary care physicians. The current standard of care involves the use of one or more inhaled bronchodilators, and depending on COPD severity and phenotype, inhaled corticosteroids. There is a wide range of inhaler devices available for delivery of inhaled medications, but suboptimal inhaler use is a common problem that can limit the clinical effectiveness of inhaled therapies in the real-world setting. Patients’ comorbidities, other physical or mental limitations, and the level of inhaler technique instruction may limit proper inhaler use. This paper presents information that can overcome barriers to proper inhaler use, including issues in device selection, steps in correct technique for various inhaler devices, and suggestions for assessing and monitoring inhaler techniques. Ensuring proper inhaler technique can maximize drug effectiveness and aid clinical management at all grades of COPD. PMID:22888221

Reducing the risk of burns during electroconvulsive therapy.

PubMed

2011-10-01

Poor contact between electroconvulsive therapy (ECT) electrodes and the skin can result in patient burns during ECT treatment. Proper site preparation and electrode application are essential to ensure adequate contact and to reduce the risk of burns.

Lasers in Melasma: A Review with Consensus Recommendations by Indian Pigmentary Expert Group.

PubMed

Sarkar, Rashmi; Aurangabadkar, Sanjeev; Salim, T; Das, Anupam; Shah, Swapnil; Majid, Imran; Singh, Mohan; Ravichandran, G; Godse, Kiran; Arsiwala, Shehnaz; Arya, Latika; Gokhale, Narendra; Sarma, Nilendu; Torsekar, R G; Sonthalia, Sidharth; Somani, V K

2017-01-01

Lasers have come up as the newest therapeutic modality in dermatological conditions including melasma. In this article, as a group of experts from Pigmentary Disorders Society in collaboration with South Asian Pigmentary Disorders Forum (SPF), we have tried to discuss the lasers which have been used in melasma and formulate simple consensus guidelines. Following thorough literature search, we have summarised the rationale of using the lasers and the supporting evidences have also been provided. It is clear that laser cannot be the first line treatment for melasma. However, it can be used as an adjuvant therapy in resistant cases, provided the selection of patient and counselling has been done properly.

Treatments for Tinnitus

PubMed Central

Noble, William

2008-01-01

The various forms of treatment for tinnitus that have been tested in properly controlled trials can be classified as pharmacological, acoustic-physical, and psychological. In clinical trials, no pharmacological agent has been shown to have lasting effect on the presence or severity of tinnitus, although there are promising signs in an animal model. Acoustic devices do not seem to influence tinnitus, although appropriately fitted hearing aids may slightly reduce its prominence. Of physical treatments, cortical implantation may hold some promise of being effective for tinnitus suppression in selected cases. A psychological treatment that has emerged as consistently beneficial is cognitive-behavior therapy in terms of affecting overall well-being and reducing level of tinnitus annoyance. PMID:18635586

Lasers in Melasma: A Review with Consensus Recommendations by Indian Pigmentary Expert Group

PubMed Central

Sarkar, Rashmi; Aurangabadkar, Sanjeev; Salim, T; Das, Anupam; Shah, Swapnil; Majid, Imran; Singh, Mohan; Ravichandran, G; Godse, Kiran; Arsiwala, Shehnaz; Arya, Latika; Gokhale, Narendra; Sarma, Nilendu; Torsekar, R G; Sonthalia, Sidharth; Somani, V K

2017-01-01

Lasers have come up as the newest therapeutic modality in dermatological conditions including melasma. In this article, as a group of experts from Pigmentary Disorders Society in collaboration with South Asian Pigmentary Disorders Forum (SPF), we have tried to discuss the lasers which have been used in melasma and formulate simple consensus guidelines. Following thorough literature search, we have summarised the rationale of using the lasers and the supporting evidences have also been provided. It is clear that laser cannot be the first line treatment for melasma. However, it can be used as an adjuvant therapy in resistant cases, provided the selection of patient and counselling has been done properly. PMID:29263531

Spinfoam cosmology with the proper vertex amplitude

NASA Astrophysics Data System (ADS)

Vilensky, Ilya

2017-11-01

The proper vertex amplitude is derived from the Engle-Pereira-Rovelli-Livine vertex by restricting to a single gravitational sector in order to achieve the correct semi-classical behaviour. We apply the proper vertex to calculate a cosmological transition amplitude that can be viewed as the Hartle-Hawking wavefunction. To perform this calculation we deduce the integral form of the proper vertex and use extended stationary phase methods to estimate the large-volume limit. We show that the resulting amplitude satisfies an operator constraint whose classical analogue is the Hamiltonian constraint of the Friedmann-Robertson-Walker cosmology. We find that the constraint dynamically selects the relevant family of coherent states and demonstrate a similar dynamic selection in standard quantum mechanics. We investigate the effects of dynamical selection on long-range correlations.

Efficacy, Safety, and Subject Satisfaction of a Specified Skin Care Regimen to Cleanse, Medicate, Moisturize, and Protect the Skin of Patients Under Treatment for Acne Vulgaris

PubMed Central

Del Rosso, James Q.; Gold, Michael; Rueda, Maria José; Brandt, Staci; Winkelman, Warren J.

2015-01-01

Optimal management of acne vulgaris requires incorporation of several components including patient education, selection of a rational therapeutic regimen, dedicated adherence with the program by the patient, and integration of proper skin care. Unfortunately, the latter component is often overlooked or not emphasized strongly enough to the patient. Proper skin care may reduce potential irritation that can be associated with topical acne medications and prevents the patient from unknowingly using skin care products that can actually sabotage their treatment. This article reviews the effectiveness, skin tolerability, safety, and patient satisfaction of an open label study in which a specified skin care regimen is used in combination with topical therapy. The study was designed to mirror “real world” management of facial acne vulgaris clinical practice. The skin care regimen used in this study included a brand foam wash and a brand moisturizer with SPF 30 photoprotection, both of which contain ingredients that are included to provide benefits for acne-prone and acne-affected skin. PMID:25610521

Engineering a prostate-specific membrane antigen-activated tumor endothelial cell prodrug for cancer therapy.

PubMed

Denmeade, Samuel R; Mhaka, Annastasiah M; Rosen, D Marc; Brennen, W Nathaniel; Dalrymple, Susan; Dach, Ingrid; Olesen, Claus; Gurel, Bora; Demarzo, Angelo M; Wilding, George; Carducci, Michael A; Dionne, Craig A; Møller, Jesper V; Nissen, Poul; Christensen, S Brøgger; Isaacs, John T

2012-06-27

Heterogeneous expression of drug target proteins within tumor sites is a major mechanism of resistance to anticancer therapies. We describe a strategy to selectively inhibit, within tumor sites, the function of a critical intracellular protein, the sarcoplasmic/endoplasmic reticulum calcium adenosine triphosphatase (SERCA) pump, whose proper function is required by all cell types for viability. To achieve targeted inhibition, we took advantage of the unique expression of the carboxypeptidase prostate-specific membrane antigen (PSMA) by tumor endothelial cells within the microenvironment of solid tumors. We generated a prodrug, G202, consisting of a PSMA-specific peptide coupled to an analog of the potent SERCA pump inhibitor thapsigargin. G202 produced substantial tumor regression against a panel of human cancer xenografts in vivo at doses that were minimally toxic to the host. On the basis of these data, a phase 1 dose-escalation clinical trial has been initiated with G202 in patients with advanced cancer.

Strategy Guideline. Proper Water Heater Selection

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

Hoeschele, M.; Springer, D.; German, A.

2015-04-09

This Strategy Guideline on proper water heater selection was developed by the Building America team Alliance for Residential Building Innovation to provide step-by-step procedures for evaluating preferred cost-effective options for energy efficient water heater alternatives based on local utility rates, climate, and anticipated loads.

Strategy Guideline: Proper Water Heater Selection

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

Hoeschele, M.; Springer, D.; German, A.

2015-04-01

This Strategy Guideline on proper water heater selection was developed by the Building America team Alliance for Residential Building Innovation to provide step-by-step procedures for evaluating preferred cost-effective options for energy efficient water heater alternatives based on local utility rates, climate, and anticipated loads.

Chapter 9. Mechanical plant control

Treesearch

Richard Stevens; Steven B. Monsen

2004-01-01

When planning a restoration or rehabilitation project, proper equipment selection should be a high priority. Equipment should be selected that is adapted to the treatment site, and that when properly used, will fulfill and add to the objectives of the treatment. Equipment should be economical and ecologically sound.

Subjective and objective assessment of patients' compression therapy skills as a predicator of ulcer recurrence.

PubMed

Mościcka, Paulina; Szewczyk, Maria T; Jawień, Arkadiusz; Cierzniakowska, Katarzyna; Cwajda-Białasik, Justyna

2016-07-01

To verify whether the subjectively and objectively assessed patient's skills in applying compression therapy constitute a predicting factor of venous ulcer recurrence. Systematic implementation of compression therapy by the patient is a core of prophylaxis for recurrent ulcers. Therefore, patient education constitutes a significant element of care. However, controversies remain if all individuals benefit equally from education. A retrospective analysis. The study included medical records of patients with venous ulcers (n = 351) treated between 2001 and 2011 at the Clinic for Chronic Wounds at Bydgoszcz Clinical Hospital. We compared two groups of patients, (1) with at least one episode of recurrent ulcer during the five-year observation period, and (2) without recurrences throughout the analysed period in terms of their theoretical skills and knowledge on compression therapy recorded at baseline and after one month. Very good self-assessment of a patient's compression therapy skills and weak assessment of these skills by a nurse proved significant risk factors for recurrence of the ulcers on univariate analysis. The significance of these variables as independent risk factors for recurrent ulcers has been also confirmed on multivariate analysis, which also took into account other clinical parameters. Building up proper compression therapy skills among the patients should be the key element of a properly construed nurse-based prophylactic program, as it is the most significant modifiable risk factor for recurrent ulcers. Although the development of compression skills is undeniably important, also other factors should be considered, e.g. surgical correction of superficial reflux. Instruction on compression therapy should be conducted by properly trained nursing personnel - the nurses should have received both content and psychological training. The compression therapy training should contain practical instruction with guided exercises and in-depth objective assessment of the effects of the training. © 2016 John Wiley & Sons Ltd.

Metronomic chemotherapy for non-metastatic triple negative breast cancer: Selection is the key

PubMed Central

Rabanal, Connie; Ruiz, Rossana; Neciosup, Silvia; Gomez, Henry

2017-01-01

Triple negative breast cancer (TNBC) accounts for 15%-20% of all breast cancer, and is still defined as what it is not. Currently, TNBC is the only type of breast cancer for which there are no approved targeted therapies and maximum tolerated dose chemotherapy with taxanes and anthracycline-containing regimens is still the standard of care in both the neoadjuvant and adjuvant settings. In the last years, metronomic chemotherapy (MC) is being explored as an alternative to improve outcomes in TNBC. In the neoadjuvant setting, purely metronomic and hybrid approaches have been developed with the objective of increasing complete pathologic response (pCR) and prolonging disease free survival. These regimens proved to be very effective achieving pCR rates between 47%-60%, but at the cost of great toxicity. In the adjuvant setting, MC is used to intensify adjuvant chemotherapy and, more promisingly, as maintenance therapy for high-risk patients, especially those with no pCR after neoadjuvant chemotherapy. Considering the dismal prognosis of TNBC, any strategy that potentially improves outcomes, specially being the oral agents broadly available and inexpensive, should be considered and certainly warrants further exploration. Finally, the benefit of MC needs to be validated in properly designed clinical trials were the selection of the population is the key. PMID:29291168

Graphene-augmented nanofiber scaffolds demonstrate new features in cells behaviour

NASA Astrophysics Data System (ADS)

Kazantseva, Jekaterina; Ivanov, Roman; Gasik, Michael; Neuman, Toomas; Hussainova, Irina

2016-07-01

Three-dimensional (3D) customized scaffolds capable to mimic a native extracellular matrix open new frontiers in cells manipulation and advanced therapy. The major challenge is in a proper substrate for in vitro models on engineered scaffolds, capable to modulate cells differentiation. Here for the first time we demonstrate novel design and functionality of the 3D porous scaffolds of aligned, self-assembled ceramic nanofibers of ultra-high anisotropy ratio (~107), augmented into graphene shells. This unique hybrid nano-network allows an exceptional combination of selective guidance stimuli of stem cells differentiation, immune reactions variations, and local immobilization of cancer cells, which was not available before. The scaffolds were shown to be able to direct human mesenchymal stem cells (important for stimulation of neuronal and muscle cells) preferential orientation, to suppress major inflammatory factors, and to localize cancer cells; all without additions of specific culture media. The selective downregulation of specific cytokines is anticipated as a new tool for understanding of human immune system and ways of treatment of associated diseases. The effects observed are self-regulated by cells only, without side effects, usually arising from use of external factors. New scaffolds may open new horizons for stem cells fate control such as towards axons and neurites regeneration (Alzheimer’s disease) as well as cancer therapy development.

[Companion diagnostics in the era of personalized medicine--chairmen's introductory remarks].

PubMed

Fukutsuka, Katsuhiro; Takubo, Takayuki

2014-04-01

Personalized medicine is a medical model that proposes the customization of treatment for individual patients. In this model, diagnostic tests are essential for selecting safer and more efficacious treatments. The term "companion diagnostics" has been used to describe these tests, whereby molecular assays that measure the levels of proteins or specific gene mutations are used to provide a specific therapy for an individual by stratifying the disease status, selecting the proper medication, and tailoring dosages. Examples of companion diagnostics in the field of cancer medicine for molecular targeted therapy include tests for the ALK-fusion gene in non-small cell lung cancer and expression of CCR4 in adult T-cell leukemia. For breast cancer, the expression of HER2 protein is evaluated by immunohistochemistry (IHC), and gene amplification of HER2 is tested by fluorescence in situ hybridization (FISH); both tests consist of pre-analysis, analysis, and post-analysis processes that require quality control to ensure the reliability of the results. This symposium includes: 1) future aspects of companion diagnostics addressing many of the problems that must be overcome, 2) companion diagnostics using FISH focusing on HER2 amplification and ALK alteration, 3) newly developed diagnostic tests using tumor specimens and cell-free DNA in serum, and 4) CCR4 expression detected by IHC and flow cytometry.

Mental Health Service Career Ladder

DTIC Science & Technology

1994-01-01

suicide risk patients 54 H315 Adjust or inspect refrigerators for proper temperatures 54 1372 Participate in rehashes of therapy sessions 53 H320...included biofeedback (paragraph 13c), electroconvulsive therapy (ECT) (paragraph 13h), and combat/disaster casualty management (paragraph 13m). Two other...focused on identifying marital and family counseling factors and determining the purpose and procedures for administering electroconvulsive therapy (ECT

Photodynamic therapy (PDT) utilizing PhotofrinR for treatment of early esophageal cancer

NASA Astrophysics Data System (ADS)

Overholt, Bergein F.; Panjehpour, Masoud; Teffeteller, Elmeria; Rose, S. Mark

1993-06-01

Four lesions of early carcinoma of the esophagus found during endoscopic biopsies in three patients were treated with photodynamic therapy. Follow-up biopsies over 9 - 24 months remain negative for carcinoma. Endoscopic ultrasonography is essential for proper staging and treatment planning for these patients. Photodynamic therapy may provide an alternative to surgical resection for early esophageal carcinoma or severe dysplasia in Barrett's esophagus.

Uses and abuses of multipliers in the stand prognosis model

Treesearch

David A. Hamilton

1994-01-01

Users of the Stand Prognosis Model may have difficulties in selecting the proper set of multipliers to simulate a desired effect or in determining the appropriate value to assign to selected multipliers. A series of examples describe impact of multipliers on simulated stand development. Guidelines for the proper use of multipliers are presented....

Fuels and Lubricants. Selecting and Storing.

ERIC Educational Resources Information Center

Parady, W. Harold; Colvin, Thomas S.

The manual presents basic information for the person who plans to operate or service tractors, trucks, industrial engines, and automobiles. It tells how to select the proper fuels and lubricants and how to store them properly. Although there are no prerequisites to the study of the text, a general knowledge of engines and mobile-type vehicles is…

Sodium benzoate for treatment of hepatic encephalopathy.

PubMed

Misel, Michael L; Gish, Robert G; Patton, Heather; Mendler, Michel

2013-04-01

Hepatic encephalopathy (HE) is a serious but usually reversible neuropsychiatric complication of cirrhosis, inborn errors of metabolism involving disorders of the urea cycle, and noncirrhotic portosystemic shunting that most commonly arises from a transjugular intrahepatic portosystemic shunting procedure. Symptoms can include alterations in cognitive function, neuromuscular activity, and consciousness, as well as sleep disorders and mood changes. HE is associated with significant morbidity and mortality and, if not properly treated, will lead to increased hospital admissions and healthcare costs. Although the standard therapies of lactulose and rifaximin (Xifaxan, Salix) are effective for most patients, these drugs may be associated with significant adverse effects and expense and, in some patients, inadequate therapeutic response. A need for adjunctive therapies exists. Drugs that target serum and tissue ammonia metabolism and elimination may be important adjuncts to drugs that reduce ammonia production and absorption from the gastrointestinal tract for patients with severe or persistent overt symptoms of HE. Sodium benzoate is an inexpensive adjunctive agent that can be used in addition to lactulose and rifaximin and may provide an option for some select patients with refractory HE who have failed to respond to standard therapies or who cannot afford them. Although sodium benzoate does not share the same adverse effect profiles of standard therapies for HE, its efficacy has not been well established. Given the significant dose-dependent sodium content of this therapy, it may not be appropriate for patients with significant fluid retention or kidney dysfunction.

Sodium Benzoate for Treatment of Hepatic Encephalopathy

PubMed Central

Misel, Michael L.; Patton, Heather; Mendler, Michel

2013-01-01

Hepatic encephalopathy (HE) is a serious but usually reversible neuropsychiatric complication of cirrhosis, inborn errors of metabolism involving disorders of the urea cycle, and noncirrhotic portosystemic shunting that most commonly arises from a transjugular intrahepatic portosystemic shunting procedure. Symptoms can include alterations in cognitive function, neuromuscular activity, and consciousness, as well as sleep disorders and mood changes. HE is associated with significant morbidity and mortality and, if not properly treated, will lead to increased hospital admissions and healthcare costs. Although the standard therapies of lactulose and rifaximin (Xifaxan, Salix) are effective for most patients, these drugs may be associated with significant adverse effects and expense and, in some patients, inadequate therapeutic response. A need for adjunctive therapies exists. Drugs that target serum and tissue ammonia metabolism and elimination may be important adjuncts to drugs that reduce ammonia production and absorption from the gastrointestinal tract for patients with severe or persistent overt symptoms of HE. Sodium benzoate is an inexpensive adjunctive agent that can be used in addition to lactulose and rifaximin and may provide an option for some select patients with refractory HE who have failed to respond to standard therapies or who cannot afford them. Although sodium benzoate does not share the same adverse effect profiles of standard therapies for HE, its efficacy has not been well established. Given the significant dose-dependent sodium content of this therapy, it may not be appropriate for patients with significant fluid retention or kidney dysfunction. PMID:24711766

42 CFR 456.705 - Prospective drug review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... potential for, or the occurrence of, an allergic reaction as a result of drug therapy. (7) Clinical abuse..., including their avoidance, and the action required if they occur; (v) Techniques for self-monitoring drug therapy; (vi) Proper storage; (vii) Prescription refill information; and (viii) Action to be taken in the...

Onychomycosis of Toenails and Post-hoc Analyses with Efinaconazole 10% Solution Once-daily Treatment: Impact of Disease Severity and Other Concomitant Associated Factors on Selection of Therapy and Therapeutic Outcomes.

PubMed

Del Rosso, James Q

2016-02-01

Topical treatment for toenail onychomycosis has been fraught with a long-standing reputation of poor efficaey, primarily due to physical properties of the nail unit that impede drug penetration. Newer topical agents have been formulated as Solution, which appear to provide better therapeutic response in properly selected patients. It is important to recognize the impact the effects that mitigating and concomitant factors can have on efficaey. These factors include disease severity, gender, presence of tinea pedis, and diabetes. This article reviews results achieved in Phase 3 pivotal studies with topical efinaconazole 10% Solution applied once daily for 48 weeks with a focus on how the aforementioned factors influenced therapeutic outcomes. It is important for clinicians treating patients for onychomycosis to evaluate severity, treat concomitant tinea pedis, address control of diabetes if present by encouraging involvement of the patient's primary care physician, and consider longer treatment courses when clinically relevant.

20 CFR 408.620 - What information do we consider in selecting the proper representative payee for you?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false What information do we consider in selecting the proper representative payee for you? 408.620 Section 408.620 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Representative Payment § 408.620 What...

20 CFR 408.620 - What information do we consider in selecting the proper representative payee for you?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false What information do we consider in selecting the proper representative payee for you? 408.620 Section 408.620 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Representative Payment § 408.620 What...

20 CFR 408.620 - What information do we consider in selecting the proper representative payee for you?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false What information do we consider in selecting the proper representative payee for you? 408.620 Section 408.620 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Representative Payment § 408.620 What...

20 CFR 408.620 - What information do we consider in selecting the proper representative payee for you?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false What information do we consider in selecting the proper representative payee for you? 408.620 Section 408.620 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Representative Payment § 408.620 What...

20 CFR 408.620 - What information do we consider in selecting the proper representative payee for you?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false What information do we consider in selecting the proper representative payee for you? 408.620 Section 408.620 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Representative Payment § 408.620 What...

Stromal androgen receptor roles in the development of normal prostate, benign prostate hyperplasia, and prostate cancer.

PubMed

Wen, Simeng; Chang, Hong-Chiang; Tian, Jing; Shang, Zhiqun; Niu, Yuanjie; Chang, Chawnshang

2015-02-01

The prostate is an androgen-sensitive organ that needs proper androgen/androgen receptor (AR) signals for normal development. The progression of prostate diseases, including benign prostate hyperplasia (BPH) and prostate cancer (PCa), also needs proper androgen/AR signals. Tissue recombination studies report that stromal, but not epithelial, AR plays more critical roles via the mesenchymal-epithelial interactions to influence the early process of prostate development. However, in BPH and PCa, much more attention has been focused on epithelial AR roles. However, accumulating evidence indicates that stromal AR is also irreplaceable and plays critical roles in prostate disease progression. Herein, we summarize the roles of stromal AR in the development of normal prostate, BPH, and PCa, with evidence from the recent results of in vitro cell line studies, tissue recombination experiments, and AR knockout animal models. Current evidence suggests that stromal AR may play positive roles to promote BPH and PCa progression, and targeting stromal AR selectively with AR degradation enhancer, ASC-J9, may allow development of better therapies with fewer adverse effects to battle BPH and PCa. Copyright © 2015 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

Antitumor Efficacy Testing in Rodents

PubMed Central

2008-01-01

The preclinical research and human clinical trials necessary for developing anticancer therapeutics are costly. One contributor to these costs is preclinical rodent efficacy studies, which, in addition to the costs associated with conducting them, often guide the selection of agents for clinical development. If inappropriate or inaccurate recommendations are made on the basis of these preclinical studies, then additional costs are incurred. In this commentary, I discuss the issues associated with preclinical rodent efficacy studies. These include the identification of proper preclinical efficacy models, the selection of appropriate experimental endpoints, and the correct statistical evaluation of the resulting data. I also describe important experimental design considerations, such as selecting the drug vehicle, optimizing the therapeutic treatment plan, properly powering the experiment by defining appropriate numbers of replicates in each treatment arm, and proper randomization. Improved preclinical selection criteria can aid in reducing unnecessary human studies, thus reducing the overall costs of anticancer drug development. PMID:18957675

Abnormal uterine bleeding in perimenopause.

PubMed

Goldstein, S R; Lumsden, M A

2017-10-01

Abnormal uterine bleeding is one of the commonest presenting complaints encountered in a gynecologist's office or primary-care setting. The wider availability of diagnostic tools has allowed prompt diagnosis and treatment of an increasing number of menstrual disorders in an office setting. This White Paper reviews the advantages and disadvantages of transvaginal ultrasound, blind endometrial sampling and diagnostic hysteroscopy. Once a proper diagnosis has been established, appropriate therapy may be embarked upon. Fortunately, only a minority of such patients will have premalignant or malignant disease. When bleeding is sufficient to cause severe anemia or even hypovolemia, prompt intervention is called for. In most of the cases, however, the abnormal uterine bleeding will be disquieting to the patient and significantly affect her 'quality of life'. Sometimes, reassurance and expectant management will be sufficient in such patients. Overall, however, in cases of benign disease, some intervention will be required. The use of oral contraceptive pills especially those with a short hormone-free interval, the insertion of the levonorgestrel intrauterine system, the incorporation of newer medical therapies including antifibrinolytic drugs and selective progesterone receptor modulators and minimally invasive treatments have made outpatient therapy increasingly effective. For others, operative hysteroscopy and endometrial ablation are proven therapeutic tools to provide both long- and short-term relief of abnormal uterine bleeding, thus avoiding, or deferring, hysterectomy.

Nerve damage related to implant dentistry: incidence, diagnosis, and management.

PubMed

Greenstein, Gary; Carpentieri, Joseph R; Cavallaro, John

2015-10-01

Proper patient selection and treatment planning with respect to dental implant placement can preclude nerve injuries. Nevertheless, procedures associated with implant insertion can inadvertently result in damage to branches of the trigeminal nerve. Nerve damage may be transient or permanent; this finding will depend on the cause and extent of the injury. Nerve wounding may result in anesthesia, paresthesia, or dysesthesia. The type of therapy to ameliorate the condition will be dictated by clinical and radiographic assessments. Treatment may include monitoring altered sensations to see if they subside, pharmacotherapy, implant removal, reverse-torquing an implant to decompress a nerve, combinations of the previous therapies, and/or referral to a microsurgeon for nerve repair. Patients manifesting altered sensations due to various injuries require different therapies. Transection of a nerve dictates immediate referral to a microsurgeon for evaluation. If a nerve is compressed by an implant or adjacent bone, the implant should be reverse-torqued away from the nerve or removed. When an implant is not close to a nerve, but the patient is symptomatic, the patient can be monitored and treated pharmacologically as long as symptoms improve or the implant can be removed. There are diverse opinions in the literature concerning how long an injured patient should be monitored before being referred to a microsurgeon.

The role of asymptomatic P. falciparum parasitaemia in the evolution of antimalarial drug resistance in areas of seasonal transmission.

PubMed

Babiker, Hamza A; Gadalla, Amal A H; Ranford-Cartwright, Lisa C

2013-01-01

In areas with seasonal transmission, proper management of acute malaria cases that arise in the transmission season can markedly reduce the disease burden. However, asymptomatic carriage of Plasmodium falciparum sustains a long-lasting reservoir in the transmission-free dry season that seeds cyclical malaria outbreaks. Clinical trials targeting asymptomatic parasitaemia in the dry season failed to interrupt the malaria epidemics that follow annual rains. These asymptomatic infections tend to carry multiple-clones, capable of producing gametocytes and infecting Anopheles mosquitoes. Different clones within an infection fluctuate consistently, indicative of interaction between clones during the long course of asymptomatic carriage. However, the therapy-free environment that prevails in the dry season dis-advantages the drug resistant lineages and favors the wild-type parasites. This review highlights some biological and epidemiological characteristics of asymptomatic parasitaemia and calls for consideration of policies to diminish parasite exposure to drugs "therapy-free" and allow natural selection to curb drug resistance in the above setting. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ethical issues in ocular genetics.

PubMed

Mezer, Eedy; Wygnanski-Jaffe, Tamara

2009-09-01

To review some of the major issues in ophthalmic genetics ethics: predictive testing, prenatal testing and abortion, gene therapy, confidentiality, payment for genetic testing, the duty to recontact patients and convey new information. Patients and families may perceive benefits even though genetic testing may be associated with adverse psychosocial outcomes. Most patients were in favor of prenatal diagnosis but opposed abortion. Patient selection as candidates for gene therapy should be based on the different clinical characteristics of each hereditary disease. The balance between the right of the patient for confidentiality and the best interest of family members or society is an ethical challenge. Most insurance companies will pay for genetic testing if the condition is hereditary. The duty to recontact patients when new medical information becomes available is still ethically controversial. The field of ocular genetics is ever growing involving complex medical, technical, financial and social issues. As a result, ethical issues are expected to become more common. Properly prepared medical professionals as well as unique counseling for participants and families may enable improved decision-making taking into consideration the needs of each individual.

Treatment strategies for dystonia

PubMed Central

Cloud, Leslie J; Jinnah, HA

2012-01-01

Importance of the field Dystonia is a neurological syndrome characterized by involuntary twisting movements and unnatural postures. It has many different manifestations and causes, and many different treatment options are available. These options include physical and occupational therapy, oral medications, intramuscular injection of botulinum toxins, and neurosurgical interventions. Areas covered in this review In this review, we first summarize the treatment options available, then we provide suggestions from our own experience for how these can be applied in different types of dystonia. In preparing this review article, an extensive literature search was undertaken using PubMed. Only selected references from 1970 to 2008 are cited. What the reader will gain This review is intended to provide the clinician with a practical guide to the treatment of dystonia. Take home message Treatment of dystonia begins with proper diagnosis and classification, followed by an appropriate search for underlying etiology, and an assessment of the functional impairment associated with the dystonia. The therapeutic approach, which is usually limited to symptomatic therapy, must then be tailored to the individual needs of the patient. PMID:20001425

Partial Gland Ablation for Prostate Cancer: Report of a Food and Drug Administration, American Urological Association, and Society of Urologic Oncology Public Workshop.

PubMed

Jarow, Jonathan P; Ahmed, Hashim U; Choyke, Peter L; Taneja, Samir S; Scardino, Peter T

2016-02-01

To summarize the discussion that took place at a public workshop, co-sponsored by the U.S. Food and Drug Administration, the American Urological Association, and Society of Urologic Oncology reviewing the current state of the art for partial gland ablation (PGA) for the management of patients with prostate cancer. The purpose of this workshop was to discuss potential indications, current available evidence, and designs for future trials to provide the evidence needed by patients and providers to decide how and when to use PGA. A workshop evaluating PGA for prostate cancer was held in New Orleans, Louisiana, in May 2015. Invited experts representing all stakeholders and attendees discussed the regulatory development of medical products, technology available, potential indications, and designs of trials to evaluate this modality of therapy. The panel presented the current information on the technologies available to perform PGA, the potential indications, and results of prior consensus conferences. Use of magnetic resonance imaging for patient selection, guide therapy, and follow-up was discussed. Designs of trials to assess PGA outcomes were discussed. The general consensus was that currently available technologies are capable of selective ablation with reasonable accuracy, but that criteria for patient selection remain debatable, and long-term cancer control remains to be established in properly designed and well-performed prospective clinical trials. Concerns include the potential for excessive, unnecessary use in patients with low-risk cancer and, conversely, that current diagnostic techniques may underestimate the extent and aggressiveness of some cancers, leading to inadequate treatment. Published by Elsevier Inc.

Cholangiocarcinoma

PubMed Central

Razumilava, Nataliya; Gores, Gregory J

2014-01-01

Cholangiocarcinoma represents a diverse group of epithelial cancers united by late diagnosis and poor outcomes. Specific diagnostic and therapeutic approaches are undertaken for cholangiocarcinomas of different anatomical locations (intrahepatic, perihilar, and distal). Mixed hepatocellular cholangiocarcinomas have emerged as a distinct subtype of primary liver cancer. Clinicians need to be aware of intrahepatic cholangiocarcinomas arising in cirrhosis and properly assess liver masses in this setting for cholangiocarcinoma. Management of biliary obstruction is obligatory in perihilar cholangiocarcinoma, and advanced cytological tests such as fluorescence in-situ hybridisation for aneusomy are helpful in the diagnosis. Liver transplantation is a curative option for selected patients with perihilar but not with intrahepatic or distal cholangiocarcinoma. International efforts of clinicians and scientists are helping to identify the genetic drivers of cholangiocarcinoma progression, which will unveil early diagnostic markers and direct development of individualised therapies. PMID:24581682

Surface-functionalized nanoparticles for biosensing and imaging-guided therapeutics

NASA Astrophysics Data System (ADS)

Jiang, Shan; Win, Khin Yin; Liu, Shuhua; Teng, Choon Peng; Zheng, Yuangang; Han, Ming-Yong

2013-03-01

In this article, the very recent progress of various functional inorganic nanomaterials is reviewed including their unique properties, surface functionalization strategies, and applications in biosensing and imaging-guided therapeutics. The proper surface functionalization renders them with stability, biocompatibility and functionality in physiological environments, and further enables their targeted use in bioapplications after bioconjugation via selective and specific recognition. The surface-functionalized nanoprobes using the most actively studied nanoparticles (i.e., gold nanoparticles, quantum dots, upconversion nanoparticles, and magnetic nanoparticles) make them an excellent platform for a wide range of bioapplications. With more efforts in recent years, they have been widely developed as labeling probes to detect various biological species such as proteins, nucleic acids and ions, and extensively employed as imaging probes to guide therapeutics such as drug/gene delivery and photothermal/photodynamic therapy.

Genetic characterization of the HIV-1 reservoir after Vacc-4x and romidepsin therapy in HIV-1 infected individuals.

PubMed

Winckelmann, Anni; Morcilla, Vincent; Shao, Wei; Schleimann, Mariane H; Højen, Jesper F; Schlub, Timothy E; Denton, Paul W; Østergaard, Lars; Søgaard, Ole S; Tolstrup, Martin; Palmer, Sarah

2018-05-11

Therapeutic HIV-1 immunization followed by latency reversal has been suggested as a strategy to eradicate HIV-1. Here we investigate the phylogenetic composition of the HIV-1 regions targeted by the therapeutic HIV-1 peptide vaccine Vacc-4x in participants in a clinical trial. Seventeen participants on suppressive antiretroviral therapy were vaccinated with six doses of Vacc-4x followed by three doses of romidepsin. Seven study participants were selected for sequencing analysis. All participants underwent an analytical treatment interruption. Single-genome/proviral sequencing of the p24-RT region was performed to genetically characterize proviral DNA, cell-associated (CA) RNA and outgrowth viruses during therapy as well as plasma HIV-1 RNA during an analytical treatment interruption. There were no changes in CA HIV-1 RNA (P = 0.83) and DNA (P = 0.09) diversity over the course of the study and no difference between CA HIV-1 RNA and DNA diversity (P = 0.32). Only one participant showed signs of potential vaccine-related selection in the rebounding plasma virus. In five of seven participants, we identified HLA-specific CTL epitopes containing non-silent mutations in 100% of the sequences. We detected no evidence of selective immune pressure reflected in proviral diversity or by occurrence of specific mutation in the vaccine-targeted epitopes. Pre-existing CTL epitope mutations may affect the potency of this therapeutic vaccine. This highlights the challenges of developing effective HIV-1 therapeutic vaccines.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.

Selecting the proper seed source

Treesearch

Robert Z. Callaham

1959-01-01

A forester faces many problems in selecting the proper seed source of ponderosa pine. He wants a seed source well adapted to all of the conditions of his planting site–one that can tolerate all of the extremes of heat, cold, and drought; that can resist the ravages of insects, diseases, and animals; that can produce the most of the desired product in the shortest time...

Chronic radiation-induced dermatitis: challenges and solutions.

PubMed

Spałek, Mateusz

2016-01-01

Chronic radiation dermatitis is a late side effect of skin irradiation, which may deteriorate patients' quality of life. There is a lack of precise data about its incidence; however, several risk factors may predispose to the development of this condition. It includes radiotherapy dose, fractionation, technique, concurrent systemic therapy, comorbidities, and personal and genetic factors. Chronic radiation dermatitis is mostly caused by the imbalance of proinflammatory and profibrotic cytokines. Clinical manifestation includes changes in skin appearance, wounds, ulcerations, necrosis, fibrosis, and secondary cancers. The most severe complication of irradiation is extensive radiation-induced fibrosis (RIF). RIF can manifest in many ways, such as skin induration and retraction, lymphedema or restriction of joint motion. Diagnosis of chronic radiation dermatitis is usually made by clinical examination. In case of unclear clinical manifestation, a biopsy and histopathological examination are recommended to exclude secondary malignancy. The most effective prophylaxis of chronic radiation dermatitis is the use of proper radiation therapy techniques to avoid unnecessary irradiation of healthy skin. Treatment of chronic radiation dermatitis is demanding. The majority of the interventions are based only on clinical practice. Telangiectasia may be treated with pulse dye laser therapy. Chronic postirradiation wounds need special dressings. In case of necrosis or severe ulceration, surgical intervention may be considered. Management of RIF should be complex. Available methods are rehabilitative care, pharmacotherapy, hyperbaric oxygen therapy, and laser therapy. Future challenges include the assessment of late skin toxicity in modern irradiation techniques. Special attention should be paid on genomics and radiomics that allow scientists and clinicians to select patients who are at risk of the development of chronic radiation dermatitis. Novel treatment methods and clinical trials are strongly needed to provide more efficacious therapies.

Proceedings from Duke resistant hypertension think tank.

PubMed

Vemulapalli, Sreekanth; Ard, Jamy; Bakris, George L; Bhatt, Deepak L; Brown, Alan S; Cushman, William C; Ferdinand, Keith C; Flack, John M; Fleg, Jerome L; Katzen, Barry T; Kostis, John B; Oparil, Suzanne; Patel, Chet B; Pepine, Carl J; Piña, Ileana L; Rocha-Singh, Krishna J; Townsend, Raymond R; Peterson, Eric D; Califf, Robert M; Patel, Manesh R

2014-06-01

To identify patients at increased risk for cardiovascular outcomes, apparent treatment resistant hypertension (aTRH) is defined as having a blood pressure (BP) above goal despite the use of ≥3 antihypertensive therapies of different classes at maximally tolerated doses, ideally including a diuretic. In light of growing scientific interest in the treatment of this group, a multistakeholder think tank was convened to discuss the current state of knowledge, improve the care of these patients, and identify appropriate study populations for future observational and randomized trials in the field. Although recent epidemiologic studies in selected populations estimate that the prevalence of aTRH is 10% to 15% of hypertensive patients, further large-scale observational studies will be needed to better elucidate risk factors. To spur the development of therapies for aTRH, the development of an "aTRH" label for pharmacologic and device therapies with a developmental pathway including treatment added to the use of existing therapies is favored. Although demonstration of adequate BP lowering should be sufficient to gain Food and Drug Administration approval for therapies targeting aTRH, assessment of improvement in quality of life and cardiovascular outcomes is also desirable and considered in Centers for Medicare and Medicaid Services coverage decisions. Device trials under the aTRH label will need uniform and consistent processes for defining appropriate patient populations as well as postapproval registries assessing both long-term safety and duration of responses. Finally, patients with aTRH are likely to benefit from evaluation by a hypertension team to assure proper patient identification, diagnostic work-up, and therapeutic management before consideration of advanced or novel therapies to lower BP. Copyright © 2014 Mosby, Inc. All rights reserved.

Modeling treatment couches in the Pinnacle treatment planning system: Especially important for arc therapy

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

Duggar, William Neil, E-mail: wduggar@umc.edu; Nguyen, Alex; Stanford, Jason

This study is to demonstrate the importance and a method of properly modeling the treatment couch for dose calculation in patient treatment using arc therapy. The 2 treatment couch tops—Aktina AK550 and Elekta iBEAM evo—of Elekta LINACs were scanned using Philips Brilliance Big Bore CT Simulator. Various parts of the couch tops were contoured, and their densities were measured and recorded on the Pinnacle treatment planning system (TPS) using the established computed tomography density table. These contours were saved as organ models to be placed beneath the patient during planning. Relative attenuation measurements were performed following procedures outlined by TG-176more » as well as absolute dose comparison of static fields of 10 × 10 cm{sup 2} that were delivered through the couch tops with that calculated in the TPS with the couch models. A total of 10 random arc therapy treatment plans (5 volumetric-modulated arc therapy [VMAT] and 5 stereotactic body radiation therapy [SBRT]), using 24 beams, were selected for this study. All selected plans were calculated with and without couch modeling. Each beam was evaluated using the Delta{sup 4} dosimetry system (Delta{sup 4}). The Student t-test was used to determine statistical significance. Independent reviews were exploited as per the Imaging and Radiation Oncology Core head and neck credentialing phantom. The selected plans were calculated on the actual patient anatomies with and without couch modeling to determine potential clinical effects. Large relative beam attenuations were noted dependent on which part of the couch top beams were passing through. Substantial improvements were also noted for static fields both calculated with the TPS and delivered physically when the couch models were included in the calculation. A statistically significant increase in agreement was noted for dose difference, distance to agreement, and γ-analysis with the Delta{sup 4} on VMAT and SBRT plans. A credentialing review showed improvement in treatment delivery after couch modeling with both thermoluminescent dosimeter doses and film analysis. Furthermore, analysis of treatment plans with and without using the couch model showed a statistically significant reduction in planning target volume coverage and increase in skin dose. In conclusion, ignoring the treatment couch, a common practice when generating a patient treatment plan, can overestimate the dose delivered especially for arc therapy. This work shows that explicitly modeling the couch during planning can meaningfully improve the agreement between calculated and measured dose distributions. Because of this project, we have implemented the couch models clinically across all treatment plans.« less

The Optical Gravitational Lensing Experiment. The Catalog of Stellar Proper Motions toward the Magellanic Clouds

NASA Astrophysics Data System (ADS)

Poleski, R.; Soszyński, I.; Udalski, A.; Szymański, M. K.; Kubiak, M.; Pietrzyński, G.; Wyrzykowski, Ł.; Ulaczyk, K.

2012-03-01

We present a catalog of over 6.2 million stars with measured proper motions. All these stars are observed in the direction of the Magellanic Clouds within the brightness range 12

Recent advances in mechanism-based chemotherapy drug-siRNA pairs in co-delivery systems for cancer: A review.

PubMed

Wang, Mingfang; Wang, Jinyu; Li, Bingcheng; Meng, Lingxin; Tian, Zhaoxing

2017-09-01

Co-delivery of chemotherapy drugs and siRNA for cancer therapy has achieved remarkable results according to synergistic/combined antitumor effects, and is recognized as a promising therapeutic modality. However, little attention has been paid to the extremely complex mechanisms of chemotherapy drug-siRNA pairs during co-delivery process. Proper selection of chemotherapy drug-siRNA pairs is beneficial for achieving desirable cancer therapeutic effects. Exploring the inherent principles during chemotherapy drug-siRNA pair selection for co-delivery would greatly enhanced therapeutic efficiency. To achieve ideal results, this article will systematically review current different mechanism-based chemotherapy drug-siRNA pairs for co-delivery in cancer treatment. Large-scale library screening of recent different chemotherapy drug-siRNA pairs for co-delivery would help to establish the chemotherapy drug-siRNA pair selection principle, which could pave the way for co-delivery of chemotherapy drugs and siRNA for cancer treatment in clinic. Following the inherent principle of chemotherapy drug-siRNA pair, more effective co-delivery vectors can be designed in the future. Copyright © 2017 Elsevier B.V. All rights reserved.

Physical medicine and rehabilitation in the elderly arthritic patient.

PubMed

Schutt, A H

1977-02-01

The basic conservative therapy programs for elderly patients with arthritis include adequate physical rest and mental relaxation, analgesics, aspirin, and physical rehabilitation consisting of occupational and physical therapy with a good home therapy program providing appropriate balance between rest and activity. Proper protection from trauma and overuse of the involved joints, and appropriate nutrition can afford optimal improvement in health status and general resistance. Proper orientation of the patient regarding the nature of his disease and treatment program usually is required to obtain his full cooperation. A kind, encouraging, and understanding approach is most helpful in the elderly patient. Physical rehabilitation can help to relieve pain, decrease edema and deformities, improve muscle weakness and incoordination, and increase stamina. Difficulties with gait, transfers, and self-care can be solved or improved. Physical medicine and rehabilitation measures are important components of the challenging treatment of patients of all age groups who are afflicted with severe arthritis. It is most important to tailor these components of the treatment program to the problem presented by geriatric arthritic patients.

The structure and function of the epidermal barrier in patients with atopic dermatitis – treatment options. Part two

PubMed Central

Czarnecka-Operacz, Magdalena; Adamski, Zygmunt

2018-01-01

Atopic dermatitis (AD) is a chronic and recurrent disease induced by underlying defects of the epidermal barrier and immunological disorders, typical of atopic diseases. The genetic and immunological mechanisms (outlined in the previous paper) affecting the dysfunction of the barrier are intensified by environmental factors, e.g. airborne and food allergens, infections and stress. For this reason, proper skin care, which prevents further damage and restores the epidermal barrier is of such importance in the field of AD therapy. Appropriate therapy is based on emollients which, coupled with anti-inflammatory and antipruritic treatment, should be used as the first-line therapy. The aim of the present paper is to outline the effects of the abovementioned factors on the dysfunction of the epidermal barrier as well as to emphasize the importance of proper atopic skin care in maintaining the integrity of the barrier and preventing exacerbation of the disease. PMID:29760610

Endo-periodontal lesion--endodontic approach.

PubMed

Jivoinovici, R; Suciu, I; Dimitriu, B; Perlea, P; Bartok, R; Malita, M; Ionescu, C

2014-01-01

Endo-perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The prognosis is good, with an adequate root canal treatment; it depends on the severity of the periodontal disease, appropriate healing time and the response to the treatment. A correct diagnosis is sometimes difficult; an accurate identification of the etiologic factors is important for an adequate treatment. Primary perio-endo lesion may heal after a proper disinfection and sealing of the endodontic system, the one-year follow-up radiograph showing bonny repair. Invasive periodontal procedures should be avoided at that moment. The microorganisms and by-products from the infected root canal may cross accessory and furcal canals and determine sinus tract and loss of attachment. In both clinical cases presented in this article, successful healing was obtained after a proper disinfection and sealing of the endodontic system.

An adaptive model order reduction by proper snapshot selection for nonlinear dynamical problems

NASA Astrophysics Data System (ADS)

Nigro, P. S. B.; Anndif, M.; Teixeira, Y.; Pimenta, P. M.; Wriggers, P.

2016-04-01

Model Order Reduction (MOR) methods are employed in many fields of Engineering in order to reduce the processing time of complex computational simulations. A usual approach to achieve this is the application of Galerkin projection to generate representative subspaces (reduced spaces). However, when strong nonlinearities in a dynamical system are present and this technique is employed several times along the simulation, it can be very inefficient. This work proposes a new adaptive strategy, which ensures low computational cost and small error to deal with this problem. This work also presents a new method to select snapshots named Proper Snapshot Selection (PSS). The objective of the PSS is to obtain a good balance between accuracy and computational cost by improving the adaptive strategy through a better snapshot selection in real time (online analysis). With this method, it is possible a substantial reduction of the subspace, keeping the quality of the model without the use of the Proper Orthogonal Decomposition (POD).

A bioinformatics approach for precision medicine off-label drug drug selection among triple negative breast cancer patients

PubMed Central

Cheng, Lijun; Schneider, Bryan P

2016-01-01

Background Cancer has been extensively characterized on the basis of genomics. The integration of genetic information about cancers with data on how the cancers respond to target based therapy to help to optimum cancer treatment. Objective The increasing usage of sequencing technology in cancer research and clinical practice has enormously advanced our understanding of cancer mechanisms. The cancer precision medicine is becoming a reality. Although off-label drug usage is a common practice in treating cancer, it suffers from the lack of knowledge base for proper cancer drug selections. This eminent need has become even more apparent considering the upcoming genomics data. Methods In this paper, a personalized medicine knowledge base is constructed by integrating various cancer drugs, drug-target database, and knowledge sources for the proper cancer drugs and their target selections. Based on the knowledge base, a bioinformatics approach for cancer drugs selection in precision medicine is developed. It integrates personal molecular profile data, including copy number variation, mutation, and gene expression. Results By analyzing the 85 triple negative breast cancer (TNBC) patient data in the Cancer Genome Altar, we have shown that 71.7% of the TNBC patients have FDA approved drug targets, and 51.7% of the patients have more than one drug target. Sixty-five drug targets are identified as TNBC treatment targets and 85 candidate drugs are recommended. Many existing TNBC candidate targets, such as Poly (ADP-Ribose) Polymerase 1 (PARP1), Cell division protein kinase 6 (CDK6), epidermal growth factor receptor, etc., were identified. On the other hand, we found some additional targets that are not yet fully investigated in the TNBC, such as Gamma-Glutamyl Hydrolase (GGH), Thymidylate Synthetase (TYMS), Protein Tyrosine Kinase 6 (PTK6), Topoisomerase (DNA) I, Mitochondrial (TOP1MT), Smoothened, Frizzled Class Receptor (SMO), etc. Our additional analysis of target and drug selection strategy is also fully supported by the drug screening data on TNBC cell lines in the Cancer Cell Line Encyclopedia. Conclusions The proposed bioinformatics approach lays a foundation for cancer precision medicine. It supplies much needed knowledge base for the off-label cancer drug usage in clinics. PMID:27107440

A Protocol-Based Decision for Choosing a Proper Surgical Treatment Option for Carotid Artery Stenosis.

PubMed

Jang, E-Wook; Chung, Joonho; Seo, Kwon-Duk; Suh, Sang Hyun; Kim, Yong Bae; Lee, Kyung-Yul

2015-06-01

There are two established surgical treatment options for carotid artery stenosis. Carotid endarterectomy (CEA) has been accepted as a gold standard for surgical treatment while carotid artery stenting (CAS) has recently become an alternative option. Each treatment option has advantages and disadvantages for the treatment outcomes. We propose a protocol for selection of a proper surgical treatment option for carotid artery stenosis. A total of 192 published articles on management of carotid artery stenosis were reviewed. Preoperatively considerable factors which had been repeatedly noted in those articles for the risk/benefits of CEA or CAS were selected. According to those factors, a protocol with four categories was established. CEA or CAS is indicated when the patient has a symptomatic stenosis ≥ 50%, or when the patient has an asymptomatic stenosis ≥ 80%. Each treatment option has absolute indications and favorable indications. Each absolute indication is scored with three points, and each favorable indication, one point. Based on the highest scores, a proper treatment option (CEA or CAS) is selected. We have been treating patients according to this protocol and evaluating the outcomes of our protocol-based decision because this protocol might be helpful in assessment of risk/benefit for selection of a proper surgical treatment option in patients with carotid artery stenosis.

Assessment of cortical auditory evoked potentials in children with specific language impairment.

PubMed

Włodarczyk, Elżbieta; Szkiełkowska, Agata; Pilka, Adam; Skarżyński, Henryk

2018-02-28

The proper course of speech development heavily influences the cognitive and personal development of children. It is a condition for achieving preschool and school successes - it facilitates socializing and expressing feelings and needs. Impairment of language and its development in children represents a major diagnostic and therapeutic challenge for physicians and therapists. Early diagnosis of coexisting deficits and starting the therapy influence the therapeutic success. One of the basic diagnostic tests for children suffering from specific language impairment (SLI) is audiometry, thus far referred to as a hearing test. Auditory processing is just as important as a proper hearing threshold. Therefore, diagnosis of central auditory disorder may be a valuable supplementation of diagnosis of language impairment. Early diagnosis and implementation of appropriate treatment may contribute to an effective language therapy.

Acupuncture therapy related cardiac injury.

PubMed

Li, Xue-feng; Wang, Xian

2013-12-01

Cardiac injury is the most serious adverse event in acupuncture therapy. The causes include needling chest points near the heart, the cardiac enlargement and pericardial effusion that will enlarge the projected area on the body surface and make the proper depth of needling shorter, and the incorrect needling method of the points. Therefore, acupuncture practitioners must be familiar with the points of the heart projected area on the chest and the correct needling methods in order to reduce the risk of acupuncture therapy related cardiac injury.

Principles of endodontic therapy.

PubMed

Lobprise, H B

1993-08-01

Endodontics is that branch of dentistry concerned with the treatment of damaged or diseased dental pulp. Veterinarians are now being asked to preserve tooth function and structure rather than to extract injured or diseased teeth. A variety of instruments are available that facilitate endodontic treatment. Endodontic treatment involves preparation (filing), sterilization, and obturation (filling) of the pulp cavity. Properly performed, endodontic therapy can effectively preserve dental structure and function. Complications of endodontic therapy will be discussed in "Problem Solving in Veterinary Endodontics" on page 165 in this issue.

Dystonia: Physical Therapy

MedlinePlus

... straight. Soft, sunken chairs and sofas do not foster proper alignment and may affect the position of ... dystonia, one should consider modifying the task to foster posture and muscle control. A person with trouble ...

Photomedicine and Stem Cells; The Janus face of photodynamic therapy (PDT) to kill cancer stem cells, and photobiomodulation (PBM) to stimulate normal stem cells

NASA Astrophysics Data System (ADS)

Abrahamse, Heidi; Hamblin, Michael R.

2017-12-01

Janus, the ancient Roman god depicted with two faces is an appropriate metaphor for light therapy. In the right photodynamic therapy conditions, light is able to kill nearly anything that is living such as cancers, microorganisms, parasites, and more. On the opposite face, light of the correct wavelength and proper dose (photobiomodulation) can heal, regenerate, protect, revitalize and restore any kind of dead, damaged, stressed, dying, degenerating cells, tissue, or organ system. This book discusses both sides of Janus' face in regards to light therapy.

Postoperative dysesthesia in minimally invasive transforaminal lumbar interbody fusion: a report of five cases.

PubMed

Wang, Honggang; Zhou, Yue; Zhang, Zhengfeng

2016-05-01

Minimally invasive transforaminal lumbar interbody fusion (misTLIF) can potentially lead to dorsal root ganglion (DRG) injury which may cause postoperative dysesthesia (POD). The purpose of retrospective study was to describe the uncommon complication of POD in misTLIF. Between January 2010 and December 2014, 539 patients were treated with misTLIF in investigator group. POD was defined as dysesthetic pain or burning dysesthesia at a proper DRG innervated region, whether spontaneous or evoked. Non-steroidal antiinflammatory drugs, central non-opioid analgesic agent, neuropathic pain drugs and/or intervertebral foramen block were selectively used to treat POD. There were five cases of POD (5/539, 0.9 %), which consisted of one patient in recurrent lumbar disc herniation (1/36, 3 %), one patient in far lateral lumbar disc herniation (1/34, 3 %), and 3 patients in lumbar spondylolisthesis (3/201, 1 %). Two DRG injury cases were confirmed by revision surgery. After the treatment by drugs administration plus DRG block, all patients presented pain relief with duration from 22 to 50 days. A gradual pain moving to distal end of a proper DRG innervated region was found as the beginning of end. Although POD is a unique and rare complication and maybe misdiagnosed as nerve root injury in misTLIF, combination drug therapy and DRG block have an effective result of pain relief. The appearance of a gradual pain moving to distal end of a proper DRG innervated region during recovery may be used as a sign for the good prognosis.

Electron backscattering simulation in Geant4

NASA Astrophysics Data System (ADS)

Dondero, Paolo; Mantero, Alfonso; Ivanchencko, Vladimir; Lotti, Simone; Mineo, Teresa; Fioretti, Valentina

2018-06-01

The backscattering of electrons is a key phenomenon in several physics applications which range from medical therapy to space including AREMBES, the new ESA simulation framework for radiation background effects. The importance of properly reproducing this complex interaction has grown considerably in the last years and the Geant4 Monte Carlo simulation toolkit, recently upgraded to the version 10.3, is able to comply with the AREMBES requirements in a wide energy range. In this study a validation of the electron Geant4 backscattering models is performed with respect to several experimental data. In addition a selection of the most recent validation results on the electron scattering processes is also presented. Results of our analysis show a good agreement between simulations and data from several experiments, confirming the Geant4 electron backscattering models to be robust and reliable up to a few tens of electronvolts.

Perioperative management of patients with cardiac implantable electronic devices.

PubMed

Poveda-Jaramillo, R; Castro-Arias, H D; Vallejo-Zarate, C; Ramos-Hurtado, L F

2017-05-01

The use of implantable cardiac devices in people of all ages is increasing, especially in the elderly population: patients with pacemakers, cardioverter-defibrillators or cardiac resynchronization therapy devices regularly present for surgery for non-cardiac causes. This review was made in order to collect and analyze the latest evidence for the proper management of implantable cardiac devices in the perioperative period. Through a detailed exploration of PubMed, Academic Search Complete (EBSCO), ClinicalKey, Cochrane (Ovid), the search software UpToDate, textbooks and patents freely available to the public on Google, we selected 33 monographs, which matched the objectives of this publication. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Beyond Gaussians: a study of single spot modeling for scanning proton dose calculation

PubMed Central

Li, Yupeng; Zhu, Ronald X.; Sahoo, Narayan; Anand, Aman; Zhang, Xiaodong

2013-01-01

Active spot scanning proton therapy is becoming increasingly adopted by proton therapy centers worldwide. Unlike passive-scattering proton therapy, active spot scanning proton therapy, especially intensity-modulated proton therapy, requires proper modeling of each scanning spot to ensure accurate computation of the total dose distribution contributed from a large number of spots. During commissioning of the spot scanning gantry at the Proton Therapy Center in Houston, it was observed that the long-range scattering protons in a medium may have been inadequately modeled for high-energy beams by a commercial treatment planning system, which could lead to incorrect prediction of field-size effects on dose output. In the present study, we developed a pencil-beam algorithm for scanning-proton dose calculation by focusing on properly modeling individual scanning spots. All modeling parameters required by the pencil-beam algorithm can be generated based solely on a few sets of measured data. We demonstrated that low-dose halos in single-spot profiles in the medium could be adequately modeled with the addition of a modified Cauchy-Lorentz distribution function to a double-Gaussian function. The field-size effects were accurately computed at all depths and field sizes for all energies, and good dose accuracy was also achieved for patient dose verification. The implementation of the proposed pencil beam algorithm also enabled us to study the importance of different modeling components and parameters at various beam energies. The results of this study may be helpful in improving dose calculation accuracy and simplifying beam commissioning and treatment planning processes for spot scanning proton therapy. PMID:22297324

Ventricular Fibrillation and Tachycardia detection from surface ECG using time-frequency representation images as input dataset for machine learning.

PubMed

Mjahad, A; Rosado-Muñoz, A; Bataller-Mompeán, M; Francés-Víllora, J V; Guerrero-Martínez, J F

2017-04-01

To safely select the proper therapy for Ventricullar Fibrillation (VF) is essential to distinct it correctly from Ventricular Tachycardia (VT) and other rhythms. Provided that the required therapy would not be the same, an erroneous detection might lead to serious injuries to the patient or even cause Ventricular Fibrillation (VF). The main novelty of this paper is the use of time-frequency (t-f) representation images as the direct input to the classifier. We hypothesize that this method allow to improve classification results as it allows to eliminate the typical feature selection and extraction stage, and its corresponding loss of information. The standard AHA and MIT-BIH databases were used for evaluation and comparison with other authors. Previous to t-f Pseudo Wigner-Ville (PWV) calculation, only a basic preprocessing for denoising and signal alignment is necessary. In order to check the validity of the method independently of the classifier, four different classifiers are used: Logistic Regression with L2 Regularization (L2 RLR), Adaptive Neural Network Classifier (ANNC), Support Vector Machine (SSVM), and Bagging classifier (BAGG). The main classification results for VF detection (including flutter episodes) are 95.56% sensitivity and 98.8% specificity, 88.80% sensitivity and 99.5% specificity for ventricular tachycardia (VT), 98.98% sensitivity and 97.7% specificity for normal sinus, and 96.87% sensitivity and 99.55% specificity for other rhythms. Results shows that using t-f data representations to feed classifiers provide superior performance values than the feature selection strategies used in previous works. It opens the door to be used in any other detection applications. Copyright © 2017 Elsevier B.V. All rights reserved.

[Pain, flare-ups and failures in root canal therapy].

PubMed

Moorer, W R

1989-10-01

In this overview the incidences and causes of pain, flare-ups and failures that occur after root canal therapy are discussed. Infection is considered the most important single, underlying determinant of the many factors that may cause pain and failures. Therefore, strict adherence to recognized therapeutic principles of shaping, disinfection and filling, in addition to proper aftercare, is of importance to diminish postoperative sequelae.

Ethical issues in growth hormone therapy.

PubMed

Lantos, J; Siegler, M; Cuttler, L

1989-02-17

Pediatricians face clinical and ethical dilemmas about therapy to augment growth in short children who do not meet classic criteria for growth hormone (GH) deficiency. Biologic norms of health are unhelpful because of the uncertain relationship between stature, GH secretion, health, and disease. Instead, we suggest that GH therapy be evaluated from the perspective of cultural norms. We compare GH therapy for short normal children with currently accepted therapies for non--life-threatening pediatric conditions such as well-child care, cosmetic therapy, treatment of psychological problems, and invasive outpatient therapy for chronic conditions. Based on this analysis, we argue that the burdens of therapy, the uncertainty about long-term risks and benefits, the unclear therapeutic end point, and the implications for child health policy place routine GH therapy for children without documented deficiency of GH secretion outside current pediatric ethical norms. Such therapy is properly administered within a comprehensive clinical research protocol.

How to select a proper early warning threshold to detect infectious disease outbreaks based on the China infectious disease automated alert and response system (CIDARS).

PubMed

Wang, Ruiping; Jiang, Yonggen; Michael, Engelgau; Zhao, Genming

2017-06-12

China Centre for Diseases Control and Prevention (CDC) developed the China Infectious Disease Automated Alert and Response System (CIDARS) in 2005. The CIDARS was used to strengthen infectious disease surveillance and aid in the early warning of outbreak. The CIDARS has been integrated into the routine outbreak monitoring efforts of the CDC at all levels in China. Early warning threshold is crucial for outbreak detection in the CIDARS, but CDCs at all level are currently using thresholds recommended by the China CDC, and these recommended thresholds have recognized limitations. Our study therefore seeks to explore an operational method to select the proper early warning threshold according to the epidemic features of local infectious diseases. The data used in this study were extracted from the web-based Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS), and data for infectious disease cases were organized by calendar week (1-52) and year (2009-2015) in Excel format; Px was calculated using a percentile-based moving window (moving window [5 week*5 year], x), where x represents one of 12 centiles (0.40, 0.45, 0.50….0.95). Outbreak signals for the 12 Px were calculated using the moving percentile method (MPM) based on data from the CIDARS. When the outbreak signals generated by the 'mean + 2SD' gold standard were in line with a Px generated outbreak signal for each week during the year of 2014, this Px was then defined as the proper threshold for the infectious disease. Finally, the performance of new selected thresholds for each infectious disease was evaluated by simulated outbreak signals based on 2015 data. Six infectious diseases were selected in this study (chickenpox, mumps, hand foot and mouth diseases (HFMD), scarlet fever, influenza and rubella). Proper thresholds for chickenpox (P75), mumps (P80), influenza (P75), rubella (P45), HFMD (P75), and scarlet fever (P80) were identified. The selected proper thresholds for these 6 infectious diseases could detect almost all simulated outbreaks within a shorter time period compared to thresholds recommended by the China CDC. It is beneficial to select the proper early warning threshold to detect infectious disease aberrations based on characteristics and epidemic features of local diseases in the CIDARS.

Recent Updates on Treatment of Ocular Microbial Infections by Stem Cell Therapy: A Review.

PubMed

Teh, Seoh Wei; Mok, Pooi Ling; Abd Rashid, Munirah; Bastion, Mae-Lynn Catherine; Ibrahim, Normala; Higuchi, Akon; Murugan, Kadarkarai; Mariappan, Rajan; Subbiah, Suresh Kumar

2018-02-13

Ocular microbial infection has emerged as a major public health crisis during the past two decades. A variety of causative agents can cause ocular microbial infections; which are characterized by persistent and destructive inflammation of the ocular tissue; progressive visual disturbance; and may result in loss of visual function in patients if early and effective treatments are not received. The conventional therapeutic approaches to treat vision impairment and blindness resulting from microbial infections involve antimicrobial therapy to eliminate the offending pathogens or in severe cases; by surgical methods and retinal prosthesis replacing of the infected area. In cases where there is concurrent inflammation, once infection is controlled, anti-inflammatory agents are indicated to reduce ocular damage from inflammation which ensues. Despite advances in medical research; progress in the control of ocular microbial infections remains slow. The varying level of ocular tissue recovery in individuals and the incomplete visual functional restoration indicate the chief limitations of current strategies. The development of a more extensive therapy is needed to help in healing to regain vision in patients. Stem cells are multipotent stromal cells that can give rise to a vast variety of cell types following proper differentiation protocol. Stem cell therapy shows promise in reducing inflammation and repairing tissue damage on the eye caused by microbial infections by its ability to modulate immune response and promote tissue regeneration. This article reviews a selected list of common infectious agents affecting the eye; which include fungi; viruses; parasites and bacteria with the aim of discussing the current antimicrobial treatments and the associated therapeutic challenges. We also provide recent updates of the advances in stem cells studies on sepsis therapy as a suggestion of optimum treatment regime for ocular microbial infections.

Preliminary efficacy and tolerability of chemohormonal therapy in metastatic hormone-naïve prostate cancer: The first real-life experience in Asia.

PubMed

Poon, Darren M C; Chan, Tim; Chan, Kuen; Chan, Michelle; Lee, Eric K C; Law, Kitty; Lam, Daisy

2018-04-16

A substantial survival benefit with chemohormonal therapy has been proven by the CHAARTED and STAMPEDE studies, and this clinical approach has emerged as the standard of care for patients with metastatic hormone-naïve prostate cancer (mHSPC). However, because its clinical efficacy and tolerability in Asian patients remains uncertain, this study aims to evaluate preliminary results of its use in Hong Kong. The clinical records of mHSPC patients treated with chemohormonal therapy from all six public oncology centers in Hong Kong between January 2015 and July 2016 were reviewed. Time to castration-resistant prostate cancer (CRPC), treatment-related complications, prostate-specific antigen (PSA) response and the time to PSA nadir were assessed. A total of 32 patients (median age, 66 years) were treated with chemohormonal therapy in the review period. After median follow-up time of 11.4 months, the median time to CRPC and time to PSA nadir were 19.5 months and 7 months, respectively. PSA response (>50% drop in PSA level from baseline) was achieved in all patients and the median maximal PSA response was 99.6%. The rates of grade 3 or 4 febrile neutropenia, neutropenia and anemia were 12.5%, 40.6% and 3.1%, respectively. Early efficacy with chemohormonal therapy in Asian mHSPC patients was comparable to the pivotal study and biochemical response is promising. The high frequency of hematologic toxicities in Asian patients highlights the importance of proper patient selection and pre-emptive use of granulocyte colony-stimulating factor. © 2018 The Authors. Asia-Pacific Journal of Clinical Oncology Published by John Wiley & Sons Australia, Ltd.

Recent Updates on Treatment of Ocular Microbial Infections by Stem Cell Therapy: A Review

PubMed Central

Teh, Seoh Wei; Mok, Pooi Ling; Abd Rashid, Munirah; Bastion, Mae-Lynn Catherine; Ibrahim, Normala; Higuchi, Akon; Murugan, Kadarkarai; Mariappan, Rajan

2018-01-01

Ocular microbial infection has emerged as a major public health crisis during the past two decades. A variety of causative agents can cause ocular microbial infections; which are characterized by persistent and destructive inflammation of the ocular tissue; progressive visual disturbance; and may result in loss of visual function in patients if early and effective treatments are not received. The conventional therapeutic approaches to treat vision impairment and blindness resulting from microbial infections involve antimicrobial therapy to eliminate the offending pathogens or in severe cases; by surgical methods and retinal prosthesis replacing of the infected area. In cases where there is concurrent inflammation, once infection is controlled, anti-inflammatory agents are indicated to reduce ocular damage from inflammation which ensues. Despite advances in medical research; progress in the control of ocular microbial infections remains slow. The varying level of ocular tissue recovery in individuals and the incomplete visual functional restoration indicate the chief limitations of current strategies. The development of a more extensive therapy is needed to help in healing to regain vision in patients. Stem cells are multipotent stromal cells that can give rise to a vast variety of cell types following proper differentiation protocol. Stem cell therapy shows promise in reducing inflammation and repairing tissue damage on the eye caused by microbial infections by its ability to modulate immune response and promote tissue regeneration. This article reviews a selected list of common infectious agents affecting the eye; which include fungi; viruses; parasites and bacteria with the aim of discussing the current antimicrobial treatments and the associated therapeutic challenges. We also provide recent updates of the advances in stem cells studies on sepsis therapy as a suggestion of optimum treatment regime for ocular microbial infections. PMID:29438279

Adjuvant endocrine therapy for premenopausal women with hormone-responsive breast cancer.

PubMed

Mathew, Aju; Davidson, Nancy E

2015-11-01

Multiple strategies for endocrine treatment of premenopausal women with hormone-responsive breast cancer have been assessed and results have been presented over the last two years. These include tamoxifen for 5-10 years (ATLAS and aTTom), tamoxifen for 5 years followed by aromatase inhibitor (AI) for 5 years for women who have become postmenopausal (MA-17); ovarian ablation (OA) by surgery (EBCTCG overview); ovarian function suppression (OFS) by LHRH agonist (LHRH agonist meta-analysis); or combinations of approaches including OFS plus tamoxifen or AI (SOFT, TEXT, ABCSG 12 and E3193). Many of these trials have taken place in the backdrop of (neo)adjuvant chemotherapy which can confound interpretation because such therapy can suppress ovarian function either transiently or permanently. Nonetheless these trials suggest in aggregate that 10 years of tamoxifen are better than 5 years and that a program of extended adjuvant therapy of tamoxifen for 5 years followed by aromatase inhibitor for 5 years is effective for suitable candidates. The SOFT and E3193 trials do not show a major advantage for use of OFS + tamoxifen compared to tamoxifen alone. The joint SOFT/TEXT analysis and ABCGS12 trials both suggest that outcomes can be excellent with the use of combined endocrine therapy alone in properly selected patients but give conflicting results with regard to potential benefits for OFS + AI compared with OFS + tamoxifen. Further work will be needed to ascertain long-term outcomes, identify factors that predict who will benefit from extended adjuvant endocrine therapy, and assess role of OFS by medical or surgical means. It is clear, however, that endocrine therapy is a critical part of the adjuvant regimen for most premenopausal women with hormone-responsive breast cancer, and a subset of these women with luminal A-type tumors can be safely treated with endocrine therapy alone. Copyright © 2015 Elsevier Ltd. All rights reserved.

The dancer's hip.

PubMed

Sammarco, G J

1983-11-01

Conditions that occur in the dancer's hip fall into the following categories: poor training; conditions that occur as the result of normal use; overuse syndromes, including tendinitis and myositis; and conditions referring pain to the hip. Dancers are highly motivated and goal oriented and often suppress symptoms for long periods, making diagnosis and treatment difficult. Observing the dancer at work and understanding his art are emphasized, and a practical guide to therapy is presented. Development of proper dance technique and a proper flexibility program can decrease the incidence of injuries.

Generalizing Evidence From Randomized Clinical Trials to Target Populations

PubMed Central

Cole, Stephen R.; Stuart, Elizabeth A.

2010-01-01

Properly planned and conducted randomized clinical trials remain susceptible to a lack of external validity. The authors illustrate a model-based method to standardize observed trial results to a specified target population using a seminal human immunodeficiency virus (HIV) treatment trial, and they provide Monte Carlo simulation evidence supporting the method. The example trial enrolled 1,156 HIV-infected adult men and women in the United States in 1996, randomly assigned 577 to a highly active antiretroviral therapy and 579 to a largely ineffective combination therapy, and followed participants for 52 weeks. The target population was US people infected with HIV in 2006, as estimated by the Centers for Disease Control and Prevention. Results from the trial apply, albeit muted by 12%, to the target population, under the assumption that the authors have measured and correctly modeled the determinants of selection that reflect heterogeneity in the treatment effect. In simulations with a heterogeneous treatment effect, a conventional intent-to-treat estimate was biased with poor confidence limit coverage, but the proposed estimate was largely unbiased with appropriate confidence limit coverage. The proposed method standardizes observed trial results to a specified target population and thereby provides information regarding the generalizability of trial results. PMID:20547574

VizieR Online Data Catalog: WD+dMs from the SUPERBLINK proper motion survey (Skinner+, 2017)

NASA Astrophysics Data System (ADS)

Skinner, J. N.; Morgan, D. P.; West, A. A.; Lepine, S.; Thorstensen, J. R.

2018-06-01

To select for nearby WD+dMs, we used the SUPERBLINK proper motion survey (Lepine et al. 2002, J/AJ/124/1190; Lepine & Shara 2005, Cat. I/298), an ongoing all-sky survey that identifies and characterizes stars with proper motions μ>40 mas/yr. For this study, we used the 2011 July version of SUPERBLINK, which listed 2270481 stars, and was estimated to be >90% complete to V=19.0. We selected WD+dMs based on a combination of V magnitudes derived from the DSS plates (see Lepine & Shara 2005, Cat. I/298), near-UV magnitudes from GALEX, and Ks magnitudes from 2MASS. Using the UV-optical-IR color selection outlined in Skinner et al. (2014AJ....148..115S), we selected targets for spectroscopic follow-up (see bottom panel of Figure 1). We acquired optical spectroscopy of 178 newly identified WD+dM candidates, with the Boller and Chivens CCD spectrograph (CCDS), using both the Hiltner 2.4 m and McGraw-Hill 1.3 m telescopes located at the MDM Observatory. (3 data files).

Endo-periodontal lesion – endodontic approach

PubMed Central

Jivoinovici, R; Suciu, I; Dimitriu, B; Perlea, P; Bartok, R; Malita, M; Ionescu, C

2014-01-01

Endo-perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The prognosis is good, with an adequate root canal treatment; it depends on the severity of the periodontal disease, appropriate healing time and the response to the treatment. A correct diagnosis is sometimes difficult; an accurate identification of the etiologic factors is important for an adequate treatment. Primary perio-endo lesion may heal after a proper disinfection and sealing of the endodontic system, the one-year follow-up radiograph showing bonny repair. Invasive periodontal procedures should be avoided at that moment. The microorganisms and by-products from the infected root canal may cross accessory and furcal canals and determine sinus tract and loss of attachment. In both clinical cases presented in this article, successful healing was obtained after a proper disinfection and sealing of the endodontic system. PMID:25713618

Utilizing Integrative Medicine in the U.S. Army Medical Department

DTIC Science & Technology

2012-05-15

This first group can be considered ―complementary‖ to traditional Western medicine (TWM6), such as diet and herbal therapy, or mind-body medicine, in...categorized as: nutritional medicine (including dietary supplements ), botanical medicine, lifestyle medicine, mind-body medicine, manual medicine, traditional...focus on the body and the psyche‘s ability to restore themselves, aided by measures such as proper diet, healing spices, herbal therapy, meditation

Electrotherapy: yesterday, today and tomorrow.

PubMed

Tiktinsky, R; Chen, L; Narayan, P

2010-07-01

The use of electrotherapy has been part of physical therapy treatment for the past few decades. There have been numerous modalities used such as TENS, interferential, diathermy, magnetic therapy, ultrasound, laser and surface electromyography to name a few. There has been an upsurge in the past decade of new and innovative modalities. There needs to be extensive research on each of these electrotherapy devices to determine the proper use of each device.

Application of neutron capture autoradiography to Boron Delivery seeking techniques for selective accumulation of boron compounds to tumor with intra-arterial administration of boron entrapped water-in-oil-in-water emulsion

NASA Astrophysics Data System (ADS)

Mikado, S.; Yanagie, H.; Yasuda, N.; Higashi, S.; Ikushima, I.; Mizumachi, R.; Murata, Y.; Morishita, Y.; Nishimura, R.; Shinohara, A.; Ogura, K.; Sugiyama, H.; Iikura, H.; Ando, H.; Ishimoto, M.; Takamoto, S.; Eriguchi, M.; Takahashi, H.; Kimura, M.

2009-06-01

It is necessary to accumulate the 10B atoms selectively to the tumor cells for effective Boron Neutron Capture Therapy (BNCT). In order to achieve an accurate measurement of 10B accumulations in the biological samples, we employed a technique of neutron capture autoradiography (NCAR) of sliced samples of tumor tissues using CR-39 plastic track detectors. The CR-39 track detectors attached with the biological samples were exposed to thermal neutrons in the thermal column of the JRR3 of Japan Atomic Energy Agency (JAEA). We obtained quantitative NCAR images of the samples for VX-2 tumor in rabbit liver after injection of 10BSH entrapped water-in-oil-in-water (WOW) emulsion by intra-arterial injection via proper hepatic artery. The 10B accumulations and distributions in VX-2 tumor and normal liver of rabbit were investigated by means of alpha-track density measurements. In this study, we showed the selective accumulation of 10B atoms in the VX-2 tumor by intra-arterial injection of 10B entrapped WOW emulsion until 3 days after injection by using digitized NCAR images (i.e. alpha-track mapping).

Designing effective drug and device development programs for hospitalized heart failure: A proposal for pretrial registries

PubMed Central

Greene, Stephen J.; Shah, Ami N.; Butler, Javed; Ambrosy, Andrew P.; Anker, Stefan D.; Chioncel, Ovidiu; Collins, Sean P.; Dinh, Wilfried; Dunnmon, Preston M.; Fonarow, Gregg C.; Lam, Carolyn S. P.; Mentz, Robert J.; Pieske, Burkert; Roessig, Lothar; Rosano, Giuseppe M. C.; Sato, Naoki; Vaduganathan, Muthiah; Gheorghiade, Mihai

2014-01-01

Recent international phase III clinical trials of novel therapies for hospitalized heart failure (HHF) have failed to improve the unacceptably high postdischarge event rate. These large studies have demonstrated notable geographic and site-specific variation in patient profiles and enrollment. Possible contributors to the lack of success in HHF outcome trials include challenges in selecting clinical sites capable of (1) providing adequate numbers of appropriately selected patients and (2) properly executing the study protocol. We propose a “pretrial registry” as a novel tool for improving the efficiency and quality of international HHF trials by focusing on the selection and cultivation of high-quality sites. A pretrial registry may help assess a site’s ability to achieve adequate enrollment of the target patient population, integrate protocol requirements into clinical workflow, and accomplish appropriate follow-up. Although such a process would be associated with additional upfront resource investment, this appropriation may be modest in comparison with the downstream costs associated with maintenance of poorly performing sites, failed clinical trials, and the global health and economic burden of HHF. This review is based on discussions between scientists, clinical trialists, and regulatory representatives regarding methods for improving international HHF trials that took place at the United States Food and Drug Administration on January 12th, 2012. PMID:25066552

A prospective randomised study of alginate-drenched low stretch bandages as an alternative to conventional lymphologic compression bandaging.

PubMed

Kasseroller, Renato G; Brenner, Erich

2010-03-01

Breast-cancer-related lymphoedema, either caused by the tumour itself or its therapy, can be found in approximately 24% of all patients. It results in disabilities, psychological distress and reduced quality of life. Therefore, proper therapy for this entity is very important. Guidelines recommend a therapy in two phases, an intensive phase I for 3 weeks for volume reduction and, between the cycles of phase I, a reduced phase II to maintain the result. During phase I therapy, manual lymphatic drainage often cannot be administered on weekends or holidays; only a reduced therapy, mainly by application of a more or less passive compression by bandaging, is administered. For this, conventional low-stretch bandages are hitherto being used. Several attempts have been made to overcome this disadvantage by either impregnating or covering the bandage with sticky or adhesive substances such as india rubber, elastomeres, polyacrylates, etc. Recently, new bandages are available, which are drenched with alginate that becomes semi-rigid after drying for approximately 6 h. It was the aim of this study to compare alginate bandaging to a conventional lymphologic-multilayered low-stretch bandaging with individual supportive lining as to their effect concerning their congestive capacity in exactly delimited time periods of reduced decongestive therapy as well as the patients' tolerance. From December 2007 until May 2008, 61 female patients with a one-sided lymphoedema of the axillary tributary region after axillar dissection who underwent a phase I complex decongestive therapy were prospectively selected for our investigation. On weekends, group A got the conventional low-stretch compressive bandaging, whereas group B got an alginate semi-rigid bandage. Arm volumes were measured before and after these bandages were applied. Additionally, the subjective sensations of the skin caused by the compression were measured by means of a five-level Likert scale. The initial volumes (V (0)) of the two groups (A, 2,939.0 ml +/- 569.182; B, 3,062.6 ml +/- 539.161) varied within the same magnitude, with somewhat smaller values in group A. The same was true for the final volumes (V (6)), measured at day 22 (A, 2,674.5 ml +/- 480.427; B, 2,740.1 ml +/- 503.593). During the weekends, the arm volumes re-increased (first weekend: A, 16.4 ml vs. B, 4.7 ml; second weekend: A, 14.2 ml vs. B, 2.7 ml; third weekend: A, 7.5 ml vs. B, 1.1 ml). A significantly smaller volume increase appeared in the alginate group during the weekends. There were no serious side effects in both groups. Concerning the patients' comfort, the values of the alginate group were clearly better than those of the conventionally bandaged group. Additionally, the volume changes in the alginate group revealed fewer fluctuations. As a summary, one can state that a good alternative to the conventional bandaging is available with the alginate bandages, bringing distinct advantages for the patients when administered properly.

Immune System

EPA Science Inventory

A properly functioning immune system is essential to good health. It defends the body against infectious agents and in some cases tumor cells. Individuals with immune deficiencies resulting from genetic defects, diseases (e.g., AIDS, leukemia), or drug therapies are more suscepti...

Ovulation induction: a mini review.

PubMed

Messinis, Ioannis E

2005-10-01

Ovulation induction is the method for treating anovulatory infertility. For patients with hypogonadotrophic hypogonadism, the treatment involves administration of both FSH and LH, while HCG is injected for follicle rupture. Pulsatile GnRH has the same effectiveness as gonadotrophins and the advantage of the low multiple pregnancy rate. In polycystic ovary syndrome (PCOS), the first treatment choice is clomiphene citrate. With this drug, in properly selected patients, the cumulative pregnancy rate approaches that of normal women. Low-dose protocols of FSH are the second line of treatment, effective in inducing monofollicular development. Laparoscopic ovarian drilling can be an alternative but not as a first choice treatment in clomiphene-resistant patients. Other treatments, such as pulsatile GnRH and GnRH agonists, are hardly used today in PCOS. However, in obese women with PCOS, weight loss and exercise should be recommended as the first line of therapy. Newer agents including aromatase inhibitors and insulin sensitizers, although promising, need further evaluation.

Consensus recommendations from the American acne & rosacea society on the management of rosacea, part 4: a status report on physical modalities and devices.

PubMed

Tanghetti, Emil; Del Rosso, James Q; Thiboutot, Diane; Gallo, Richard; Webster, Guy; Eichenfield, Lawrence F; Stein-Gold, Linda; Berson, Diane; Zaenglein, Andrea

2014-02-01

The fourth article in this 5-part series reviews physical modalities and devices used to treat cutaneous rosacea based on consensus recommendations from the American Acne & Rosacea Society (AARS) on the management of the common presentations of cutaneous rosacea. The major therapeutic uses of physical modalities and devices, especially laser and light-based systems, are for treatment of telangiectases and persistent facial erythema (background erythema). Phymas, especially rhinophyma, also are treated with physical modalities such as ablative lasers or surgical devices (eg, electrosurgical loop). Appropriately selected and properly used lasers and intense pulsed light (IPL) devices can successfully address specific clinical manifestations of rosacea that exhibit limited or no response to available medical therapies, such as telangiectases and background centrofacial erythema. Rosacea-associated symptoms also may improve. In most cases, treatment will need to be repeated intermittently to sustain improvement.

Hemodynamic monitoring in the critically ill.

PubMed

Voga, G

1995-06-01

Monitoring of vital functions is one of the most important and essential tools in the management of critically ill patients in the ICU. Today it is possible to detect and analyze a great variety of physiological signals by various noninvasive and invasive techniques. An intensivist should be able to select and perform the most appropriate monitoring method for the individual patient considering risk-benefit ratio of the particular monitoring technique and the need for immediate therapy, specific diagnosis, continuous monitoring and evaluation of morphology should be included. Despite rapid development of noninvasive monitoring techniques, invasive hemodynamic monitoring in still one of the most basic ICU procedures. It enables monitoring of pressures, flow and saturation, pressures in the systemic and pulmonary circulation, estimation of cardiac performance and judgment of the adequacy of the cardiocirculatory system. Carefully and correctly obtained information are basis for proper hemodynamic assessment which usually effects the therapeutic decisions.

Psychosocial interventions in bipolar disorder: a review.

PubMed

Lolich, María; Vázquez, Gustavo H; Alvarez, Lina M; Tamayo, Jorge M

2012-01-01

Multiple psychosocial interventions for bipolar disorder have been proposed in recent years. Therefore, we consider that a critical review of empirically validated models would be useful. A review of the literature was conducted in Medline/PubMed for articles published during 2000-2010 that respond to the combination of "bipolar disorder" with the following key words: "psychosocial intervention", "psychoeducational intervention" and "psychotherapy". Cognitive-behavioral, psychoeducational, systematic care models, interpersonal and family therapy interventions were found to be empirically validated. All of them reported significant improvements in therapeutic adherence and in the patients' functionality. Although there are currently several validated psychosocial interventions for treating bipolar disorder, their efficacy needs to be specified in relation to more precise variables such as clinical type, comorbid disorders, stages or duration of the disease. Taking into account these clinical features would enable a proper selection of the most adequate intervention according to the patient's specific characteristics.

Specifications of a continual reassessment method design for phase I trials of combined drugs†

PubMed Central

Wages, Nolan A.; Conaway, Mark R.

2013-01-01

In studies of combinations of agents in phase I oncology trials, the dose–toxicity relationship may not be monotone for all combinations, in which case the toxicity probabilities follow a partial order. The continual reassessment method for partial orders (PO-CRM) is a design for phase I trials of combinations that leans upon identifying possible complete orders associated with the partial order. This article addresses some practical design considerations not previously undertaken when describing the PO-CRM. We describe an approach in choosing a proper subset of possible orderings, formulated according to the known toxicity relationships within a matrix of combination therapies. Other design issues, such as working model selection and stopping rules, are also discussed. We demonstrate the practical ability of PO-CRM as a phase I design for combinations through its use in a recent trial designed at the University of Virginia Cancer Center. PMID:23729323

Postoperative dysesthesia in lumbar three-column resection osteotomies.

PubMed

Zhang, Zhengfeng; Wang, Honggang; Zheng, Wenjie

2016-08-01

Three-column lumbar spinal resection osteotomies including pedicle subtraction osteotomy (PSO), vertebral column resection (VCR), and total en bloc spondylectomy (TES) can potentially lead to dorsal root ganglion (DRG) injury which may cause postoperative dysesthesia (POD). The purpose of retrospective study was to describe the uncommon complication of POD in lumbar spinal resection osteotomies. Between January 2009 and December 2013, 64 patients were treated with lumbar three-column spinal resection osteotomies (PSO, n = 31; VCR, n = 29; TES, n = 4) in investigator group. POD was defined as dysesthetic pain or burning dysesthesia at a proper DRG innervated region, whether spontaneous or evoked. Non-steroidal antiinflammatory drugs, central none-opioid analgesic agent, neuropathic pain drugs and/or intervertebral foramen block were selectively used to treat POD. There were 5 cases of POD (5/64, 7.8 %), which consisted of 1 patient in PSO (1/31, 3.2 %), 3 patients in PVCR (3/29, 10.3 %), and 1 patient in TES (1/4, 25 %). After the treatment by drugs administration plus DRG block, all patients presented pain relief with duration from 8 to 38 days. A gradual pain moving to distal end of a proper DRG innervated region was found as the beginning of end. Although POD is a unique and rare complication and maybe misdiagnosed as nerve root injury in lumbar spinal resection osteotomies, combination drug therapy and DRG block have an effective result of pain relief. The appearance of a gradual pain moving to distal end of a proper DRG innervated region during recovering may be used as a sign for the good prognosis.

Limited-memory adaptive snapshot selection for proper orthogonal decomposition

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

Oxberry, Geoffrey M.; Kostova-Vassilevska, Tanya; Arrighi, Bill

2015-04-02

Reduced order models are useful for accelerating simulations in many-query contexts, such as optimization, uncertainty quantification, and sensitivity analysis. However, offline training of reduced order models can have prohibitively expensive memory and floating-point operation costs in high-performance computing applications, where memory per core is limited. To overcome this limitation for proper orthogonal decomposition, we propose a novel adaptive selection method for snapshots in time that limits offline training costs by selecting snapshots according an error control mechanism similar to that found in adaptive time-stepping ordinary differential equation solvers. The error estimator used in this work is related to theory boundingmore » the approximation error in time of proper orthogonal decomposition-based reduced order models, and memory usage is minimized by computing the singular value decomposition using a single-pass incremental algorithm. Results for a viscous Burgers’ test problem demonstrate convergence in the limit as the algorithm error tolerances go to zero; in this limit, the full order model is recovered to within discretization error. The resulting method can be used on supercomputers to generate proper orthogonal decomposition-based reduced order models, or as a subroutine within hyperreduction algorithms that require taking snapshots in time, or within greedy algorithms for sampling parameter space.« less

Nanotechnology and stem cell therapy for cardiovascular diseases: potential applications.

PubMed

La Francesca, Saverio

2012-01-01

The use of stem cell therapy for the treatment of cardiovascular diseases has generated significant interest in recent years. Limitations to the clinical application of this therapy center on issues of stem cell delivery, engraftment, and fate. Nanotechnology-based cell labeling and imaging techniques facilitate stem cell tracking and engraftment studies. Nanotechnology also brings exciting new opportunities to translational stem cell research as it enables the controlled engineering of nanoparticles and nanomaterials that can properly relate to the physical scale of cell-cell and cell-niche interactions. This review summarizes the most relevant potential applications of nanoscale technologies to the field of stem cell therapy for the treatment of cardiovascular diseases.

Forum for Injection Technique and Therapy Expert Recommendations, India: The Indian Recommendations for Best Practice in Insulin Injection Technique, 2017

PubMed Central

Tandon, Nikhil; Kalra, Sanjay; Balhara, Yatan Pal Singh; Baruah, Manash P.; Chadha, Manoj; Chandalia, Hemraj B.; Prasanna Kumar, K. M.; Madhu, S. V.; Mithal, Ambrish; Sahay, Rakesh; Shukla, Rishi; Sundaram, Annamalai; Unnikrishnan, Ambika G.; Saboo, Banshi; Gupta, Vandita; Chowdhury, Subhankar; Kesavadev, Jothydev; Wangnoo, Subhash K.

2017-01-01

Health-care professionals in India frequently manage injection or infusion therapies in persons with diabetes (PWD). Patients taking insulin should know the importance of proper needle size, correct injection process, complication avoidance, and all other aspects of injection technique from the first visit onward. To assist health-care practitioners in their clinical practice, Forum for Injection Technique and Therapy Expert Recommendations, India, has updated the practical advice and made it more comprehensive evidence-based best practice information. Adherence to these updated recommendations, learning, and translating them into clinical practice should lead to effective therapies, improved outcomes, and lower costs for PWD. PMID:28670547

Fecal Fat: The Test

MedlinePlus

... for Targeted Cancer Therapy Glucose Tests Gonorrhea Testing Gram Stain Growth Hormone Haptoglobin hCG Pregnancy hCG Tumor Marker ... can I vary it between 50 and 150 grams? You should ... has the proper stain and equipment. The quantitative test requires specialized equipment; ...

R.S.V.P. Teacher-Coordinator Handbook.

ERIC Educational Resources Information Center

1983

Alaska Teacher-Coordinators in the Rural Student Vocational Program (RSVP) should be familiar with activities necessary to insure proper selection of students and proper and meaningful work placement. In RSVP, students from outlying high schools travel to Anchorage, Fairbanks, or Juneau to participate in 2 weeks of work experience with cooperating…

Achieving a high seat belt use rate : a guide for selective traffic enforcement programs

DOT National Transportation Integrated Search

2001-04-01

When used properly, lap/shoulder belts reduce the risk of fatal injury to front-seat passenger car occupants by 45% and the risk of moderate-to-critical injury by 50%. Even greater risk reduction results when seat belts are used properly in light tru...

Proper Installation Improves Carpet Life.

ERIC Educational Resources Information Center

Grogan, Ralph

1998-01-01

Explains how proper carpet installation can add to carpet life; includes tips to consider before signing a carpet-installation purchasing agreement that can make the new carpet a better investment. Topics cover how color selection lengthens appearance life, the need for moisture testing, the importance of carpet seams in the purchasing process,…

5 CFR 550.808 - Prohibition against setting aside proper promotions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... promotions. 550.808 Section 550.808 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE... promotions. Nothing in section 5596 of title 5, United States Code, or this subpart shall be construed as authorizing the setting aside of an otherwise proper promotion by a selecting official from a group of...

The emergence and popularisation of autologous somatic cellular therapies in Australia: therapeutic innovation or regulatory failure?

PubMed

McLean, Alison K; Stewart, Cameron; Kerridge, Ian

2014-09-01

Private stem cell clinics throughout Australia are providing autologous stem cell therapies for a range of chronic and debilitating illnesses despite the lack of published literature to support the clinical application of these therapies. The Therapeutic Goods Administration has excluded autologous stem cell therapies from its regulatory domain leaving such therapies to be regulated by the same mechanisms that regulate research, such as the National Health and Medical Research Council Research Ethics Guidelines, and clinical practice, such as the Australian Health Practitioner Regulation Agency. However, the provision of these stem cell therapies does not follow the established pathways for legitimate medical advance--therapeutic innovation or research. The current regulatory framework is failing to achieve its aims of protecting vulnerable patients and ensuring the proper conduct of medical practitioners in the private stem cell industry.

A bioinformatics approach for precision medicine off-label drug drug selection among triple negative breast cancer patients.

PubMed

Cheng, Lijun; Schneider, Bryan P; Li, Lang

2016-07-01

Cancer has been extensively characterized on the basis of genomics. The integration of genetic information about cancers with data on how the cancers respond to target based therapy to help to optimum cancer treatment. The increasing usage of sequencing technology in cancer research and clinical practice has enormously advanced our understanding of cancer mechanisms. The cancer precision medicine is becoming a reality. Although off-label drug usage is a common practice in treating cancer, it suffers from the lack of knowledge base for proper cancer drug selections. This eminent need has become even more apparent considering the upcoming genomics data. In this paper, a personalized medicine knowledge base is constructed by integrating various cancer drugs, drug-target database, and knowledge sources for the proper cancer drugs and their target selections. Based on the knowledge base, a bioinformatics approach for cancer drugs selection in precision medicine is developed. It integrates personal molecular profile data, including copy number variation, mutation, and gene expression. By analyzing the 85 triple negative breast cancer (TNBC) patient data in the Cancer Genome Altar, we have shown that 71.7% of the TNBC patients have FDA approved drug targets, and 51.7% of the patients have more than one drug target. Sixty-five drug targets are identified as TNBC treatment targets and 85 candidate drugs are recommended. Many existing TNBC candidate targets, such as Poly (ADP-Ribose) Polymerase 1 (PARP1), Cell division protein kinase 6 (CDK6), epidermal growth factor receptor, etc., were identified. On the other hand, we found some additional targets that are not yet fully investigated in the TNBC, such as Gamma-Glutamyl Hydrolase (GGH), Thymidylate Synthetase (TYMS), Protein Tyrosine Kinase 6 (PTK6), Topoisomerase (DNA) I, Mitochondrial (TOP1MT), Smoothened, Frizzled Class Receptor (SMO), etc. Our additional analysis of target and drug selection strategy is also fully supported by the drug screening data on TNBC cell lines in the Cancer Cell Line Encyclopedia. The proposed bioinformatics approach lays a foundation for cancer precision medicine. It supplies much needed knowledge base for the off-label cancer drug usage in clinics. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A long term feed supplementation based on phosphate binders in Feline Chronic Kidney Disease.

PubMed

Biasibetti, E; Martello, E; Bigliati, M; Biasato, I; Cocca, T; Bruni, N; Capucchio, M T

2018-06-01

Chronic kidney disease (CKD) is a very common disorder in elderly cats. A proper renal diet represents the most efficient therapeutic intervention to improve survival and life quality in feline patients with 3 and 4 International Renal Interest Society (IRIS) stages. Twenty cats were selected in this study. Ten were administered the dietary supplementation for 360 days and the other ten, whose owners did not give consent for any supplemental therapies apart from the renal diet, were selected from a clinical database and used as control group. The present study is a long term study (360 days) aiming to evaluate the efficacy and palatability of a dietary supplementation containing calcium carbonate, calcium-lactate gluconate, chitosan and sodium bicarbonate in cats diagnosed with 3 and 4 IRIS stages of CKD. The owners were asked to fill in questionnaires to get information on the cat's appetite, the palatability of the given supplement, the presence of vomit and/or diarrhoea, general health and vitality. Hematochemical, biochemical and urinary analyses were performed on day 0, 30, 60, 90, 120, 150,180 and 360. GraphPad Prism® software was used to perform statistical analysis. Our study shows that the given dietary supplement reduced serum phosphorus and increased serum bicarbonate values in cats with CKD. In turn, this supplement could be used as a support therapy in cats with advanced CKD improving their clinical conditions without any adverse reaction. Finally, it is important to underline that all the animals completed the study and the owners reported a good palatability of the feed supplement.

Enhanced neuro-therapeutic potential of Wharton's Jelly-derived mesenchymal stem cells in comparison with bone marrow mesenchymal stem cells culture.

PubMed

Drela, Katarzyna; Lech, Wioletta; Figiel-Dabrowska, Anna; Zychowicz, Marzena; Mikula, Michał; Sarnowska, Anna; Domanska-Janik, Krystyna

2016-04-01

Substantial inconsistencies in mesenchymal stem (stromal) cell (MSC) therapy reported in early translational and clinical studies may indicate need for selection of the proper cell population for any particular therapeutic purpose. In the present study we have examined stromal stem cells derived either from umbilical cord Wharton's Jelly (WJ-MSC) or bone marrow (BM-MSC) of adult, healthy donors. The cells characterized in accordance with the International Society for Cellular Therapy (ISCT) indications as well as other phenotypic and functional parameters have been compared under strictly controlled culture conditions. WJ-MSC, in comparison with BM-MSC, exhibited a higher proliferation rate, a greater expansion capability being additionally stimulated under low-oxygen atmosphere, enhanced neurotrophic factors gene expression and spontaneous tendency toward a neural lineage differentiation commitment confirmed by protein and gene marker induction. Our data suggest that WJ-MSC may represent an example of immature-type "pre-MSC," where a substantial cellular component is embryonic-like, pluripotent derivatives with the default neural-like differentiation. These cells may contribute in different extents to nearly all classical MSC populations adversely correlated with the age of cell donors. Our data suggest that neuro-epithelial markers, like nestin, stage specific embryonic antigens-4 or α-smooth muscle actin expressions, may serve as useful indicators of MSC culture neuro-regeneration-associated potency. Copyright © 2016 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

The role of managed care in improving outcomes in epilepsy.

PubMed

Stern, John M

2011-07-01

The burden of epilepsy for patients and payers is large and onerous. The heterogeneous nature of the condition and the lack of diagnostic or treatment biomarkers present considerable clinical challenge. Despite expansion of the treatment armamentarium, selection of maximally appropriate therapy for individual patients remains a challenge, especially in those with treatment-refractory epilepsy. While numerous factors play a role in resolving these uncertainties, 3 key factors stand out. An overwhelming quantity of clinical data support the notion that the most effective therapies-measured by the ability to control seizures while minimizing adverse effects-are typically the most cost-effective. A second consideration is maximizing adherence to prescribed therapies, which has been an ongoing dilemma in the treatment of epilepsy because the condition occurs episodically. Poor adherence has a profound effect on treatment and costs, and several strategies for improving adherence have been identified. If properly observed, these can improve outcomes and lower expenditures. The third consideration is the monitoring of therapeutic response. This is essentially through ongoing care by the prescriber with careful assessment of seizures, patient satisfaction with treatment, dose-related adverse effects, and the subjective aspects of idiosyncratic toxicity; however, laboratory testing can also have a role. The resources needed to provide this monitoring vary across treatments. From a systemic point of view, engagement of all stakeholders-patients, payers, and physicians-in overseeing the effective and efficient use of healthcare resources will benefit all parties involved.

Screening, prevention, detection, and treatment of cancer therapy-induced bone loss in patients with breast cancer.

PubMed

Limburg, Connie E

2007-01-01

To identify protocols to screen, detect, prevent, and treat cancer therapy-induced bone loss resulting in osteoporosis in patients with breast cancer. Published books and articles. Normal bone remodeling is affected by hormonal stimulation. Breast cancer therapies target hormones that promote cancer cell growth. Chemotherapy regimens and hormone ablation may cause ovarian failure, resulting in decreased hormone levels. A decrease in hormones, in estrogen- and progesterone-positive and -negative patients, introduces an environment for decreased bone remodeling, which may result in thinning bone and osteoporosis. The acceleration of bone loss leading to osteoporosis can result in higher fracture rates among breast cancer survivors. With proper use of screening tools, patient education, and advice about lifestyle changes, all prior to cancer treatment, healthcare professionals may decrease or prevent bone loss in patients with breast cancer. Doing so minimizes healthcare costs and decreases morbidity and mortality rates in breast cancer survivors. As more individuals diagnosed with breast cancer are surviving for extended periods of time, oncology nurses are providing long-term follow-up care. Part of the care should include proper screening and patient education for healthier recovery and prevention of further healthcare complications as a result of cancer treatment.

Customizing inhaled therapy to meet the needs of COPD patients.

PubMed

Fromer, Leonard; Goodwin, Elizabeth; Walsh, John

2010-03-01

Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by airflow limitation resulting from emphysema and chronic bronchitis. Inhaled therapy is the major therapeutic approach for treating COPD. Multiple inhaler medications are available in the United States and are delivered by a variety of different devices: metered-dose inhalers, dry powdered inhalers, and nebulizers. Each inhaler device has unique requirements for use that must be correctly performed by the patient for successful drug delivery. Patients with COPD represent a medically diverse population, with each patient having distinct characteristics, such as lung function, comorbidities, cognitive functions, hand strength, and lifestyle. These characteristics impact the patient's ability to properly use specific inhaler devices and therefore affect adherence to therapy, therapeutic outcomes, and quality of life. It is estimated that between 28% to 68% of patients do not use metered-dose inhalers or dry powder inhalers correctly. Worsening symptoms or increased frequency of exacerbations may not always indicate disease progression but may indicate a patient's inability to use their inhaler device properly. This review discusses the patient- and device-specific factors to be considered when choosing an inhaled therapy, which will be concordant with the patient's medical needs, preferences, and lifestyle. The review also considers how the ideas underlying the patient-centered medical home model can be incorporated into the choice and use of inhaler device for a given patient with COPD to improve treatment outcomes.

Efficient preloading of the ventricles by a properly timed atrial contraction underlies stroke work improvement in the acute response to cardiac resynchronization therapy

PubMed Central

Hu, Yuxuan; Gurev, Viatcheslav; Constantino, Jason; Trayanova, Natalia

2013-01-01

Background The acute response to cardiac resynchronization therapy (CRT) has been shown to be due to three mechanisms: resynchronization of ventricular contraction, efficient preloading of the ventricles by a properly timed atrial contraction, and mitral regurgitation reduction. However, the contribution of each of the three mechanisms to the acute response of CRT, specifically stroke work improvement, has not been quantified. Objective The goal of this study was to use an MRI-based anatomically accurate 3D model of failing canine ventricular electromechanics to quantify the contribution of each of the three mechanisms to stroke work improvement and identify the predominant mechanisms. Methods An MRI-based electromechanical model of the failing canine ventricles assembled previously by our group was further developed and modified. Three different protocols were used to dissect the contribution of each of the three mechanisms to stroke work improvement. Results Resynchronization of ventricular contraction did not lead to significant stroke work improvement. Efficient preloading of the ventricles by a properly timed atrial contraction was the predominant mechanism underlying stroke work improvement. Stroke work improvement peaked at an intermediate AV delay, as it allowed ventricular filling by atrial contraction to occur at a low diastolic LV pressure but also provided adequate time for ventricular filling before ventricular contraction. Diminution of mitral regurgitation by CRT led to stroke work worsening instead of improvement. Conclusion Efficient preloading of the ventricles by a properly timed atrial contraction is responsible for significant stroke work improvement in the acute CRT response. PMID:23928177

Predictors of Cosmetic Outcome Following MammoSite Breast Brachytherapy: A Single-Institution Experience of 100 Patients With Two Years of Follow-Up

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

Dragun, Anthony E.; Harper, Jennifer L.; Jenrette, Joseph M.

2007-06-01

Purpose: To identify the factors that predict for excellent cosmesis in patients who receive MammoSite breast brachytherapy (MBT). Methods and Materials: One hundred patients with Stage 0, I, or II adenocarcinoma of the breast underwent adjuvant therapy using MBT. A dose of 34 Gy, delivered in 10 fractions twice daily, was prescribed to 1-cm depth using {sup 192}Ir high-dose-rate brachytherapy. Patients were assessed for acute toxicity on the day of therapy completion, 4 weeks after therapy, and at least every 3 months by radiation, surgical, and/or medical oncologists. All available data were reviewed for documentation of cosmesis and rated usingmore » the Harvard Scale. All patients had a minimum follow-up of 6 months (median = 24 months). Results: Of 100 patients treated, 90 had adequate data and follow-up. Cosmesis was excellent in 62 (68.9%), good in 19 (21.1%), fair in 8 (8.9%), and poor in 1 (1.1%) patient. Using stepwise logistic regression, the factors that predicted for excellent cosmesis were as follows: the absence vs. presence of infection (p = 0.017), and the absence vs. presence of acute skin toxicity (p = 0.026). There was a statistically significant association between acute skin toxicity (present vs. absent) and balloon-to-skin distance (<8 vs. >8 mm, p = 0.001). Factors that did not predict for cosmesis were age, balloon placement technique, balloon volume, catheter days in situ, subcutaneous toxicity, and chemotherapy or hormonal therapy. Conclusions: The acute and late-term toxicity profiles of MBT have been acceptable. Cosmetic outcome is improved by proper patient selection and infection prevention.« less

43 CFR 2625.1 - Selection and patenting of swamp lands.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 43 Public Lands: Interior 2 2014-10-01 2014-10-01 false Selection and patenting of swamp lands... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) STATE GRANTS Swamp-land Grants § 2625.1 Selection and patenting of swamp lands. (a) All lands properly selected and reported to...

43 CFR 2625.1 - Selection and patenting of swamp lands.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 2 2012-10-01 2012-10-01 false Selection and patenting of swamp lands... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) STATE GRANTS Swamp-land Grants § 2625.1 Selection and patenting of swamp lands. (a) All lands properly selected and reported to...

43 CFR 2625.1 - Selection and patenting of swamp lands.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 2 2011-10-01 2011-10-01 false Selection and patenting of swamp lands... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) STATE GRANTS Swamp-land Grants § 2625.1 Selection and patenting of swamp lands. (a) All lands properly selected and reported to...

43 CFR 2625.1 - Selection and patenting of swamp lands.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 43 Public Lands: Interior 2 2013-10-01 2013-10-01 false Selection and patenting of swamp lands... LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR LAND RESOURCE MANAGEMENT (2000) STATE GRANTS Swamp-land Grants § 2625.1 Selection and patenting of swamp lands. (a) All lands properly selected and reported to...

Carpet Specifiers Guide. Ultron, Advanced Generation Nylon Carpet Fiber.

ERIC Educational Resources Information Center

Monsanto Textiles Co., Atlanta, GA.

The purpose of this guide is to assist specifiers in properly specifying carpet made of Monsanto Ultron advanced generation nylon fiber. The guide describes a variety of conditions that should be considered in arriving at the proper selection and provides reference information and data, ranging from varying regulatory requirements, performance and…

Comparison of Selected Bale Moisture Measurements in a Commercial Gin

USDA-ARS?s Scientific Manuscript database

Proper measurement of bale moisture content (mc) is crucial to proper management of a cotton gin. One issue would be to avoid producing wet cotton, unacceptable for Commodity Credit Corporation Marketing Assistance Loan Program, which is defined to be a bale of cotton which is at or above 7.5% wet ...

VizieR Online Data Catalog: Robo-AO observed cool subdwarf companions (Ziegler+, 2015)

NASA Astrophysics Data System (ADS)

Ziegler, C.; Law, N. M.; Baranec, C.; Riddle, R. L.; Fuchs, J. T.

2017-09-01

We selected targets from the 564 spectral type F- through M-subdwarf candidates studied by Marshall (2007, J/AJ/134/778). These targets were selected from the New Luyten Two-Tenths catalog (NLTT; Luyten, 1979nlcs.book.....L; Luyten & Hughes 1980, Proper-Motion Survey with the Forty-Eight Inch Schmidt Telescope LV First Supplement to the NLTT Catalogue (Minneapolis, MN: Univ. Minnesota Press)) of high proper motion stars (>0.18 arcsec/yr) using a reduced proper motion diagram (RPM). Of the 552 subdwarfs confirmed by Marshall, a randomly selected sample of 348 G-, K-, and M-subdwarfs were observed by Robo-AO when available between other high priority surveys. We obtained high-angular-resolution images of the 348 subdwarfs during 32 separate nights of observations between 2012 September 3 and 2013 August 21 (UT). The observations were performed using the Robo-AO laser adaptive optics system (Riddle et al. 2012SPIE.8447E..2OR; Baranec et al. 2013, J. Visualized Exp. 72 e50021; 2014ApJ...790L...8B) mounted on the Palomar 60 inch telescope. (1 data file).

Bayesian SEM for Specification Search Problems in Testing Factorial Invariance.

PubMed

Shi, Dexin; Song, Hairong; Liao, Xiaolan; Terry, Robert; Snyder, Lori A

2017-01-01

Specification search problems refer to two important but under-addressed issues in testing for factorial invariance: how to select proper reference indicators and how to locate specific non-invariant parameters. In this study, we propose a two-step procedure to solve these issues. Step 1 is to identify a proper reference indicator using the Bayesian structural equation modeling approach. An item is selected if it is associated with the highest likelihood to be invariant across groups. Step 2 is to locate specific non-invariant parameters, given that a proper reference indicator has already been selected in Step 1. A series of simulation analyses show that the proposed method performs well under a variety of data conditions, and optimal performance is observed under conditions of large magnitude of non-invariance, low proportion of non-invariance, and large sample sizes. We also provide an empirical example to demonstrate the specific procedures to implement the proposed method in applied research. The importance and influences are discussed regarding the choices of informative priors with zero mean and small variances. Extensions and limitations are also pointed out.

Corrupting the DNA damage response: a critical role for Rad52 in tumor cell survival.

PubMed

Lieberman, Rachel; You, Ming

2017-07-15

The DNA damage response enables cells to survive, maintain genome integrity, and to safeguard the transmission of high-fidelity genetic information. Upon sensing DNA damage, cells respond by activating this multi-faceted DNA damage response leading to restoration of the cell, senescence, programmed cell death, or genomic instability if the cell survives without proper repair. However, unlike normal cells, cancer cells maintain a marked level of genomic instability. Because of this enhanced propensity to accumulate DNA damage, tumor cells rely on homologous recombination repair as a means of protection from the lethal effect of both spontaneous and therapy-induced double-strand breaks (DSBs) in DNA. Thus, modulation of DNA repair pathways have important consequences for genomic instability within tumor cell biology and viability maintenance under high genotoxic stress. Efforts are underway to manipulate specific components of the DNA damage response in order to selectively induce tumor cell death by augmenting genomic instability past a viable threshold. New evidence suggests that RAD52, a component of the homologous recombination pathway, is important for the maintenance of tumor genome integrity. This review highlights recent reports indicating that reducing homologous recombination through inhibition of RAD52 may represent an important focus for cancer therapy and the specific efforts that are already demonstrating potential.

COPD: A stepwise or a hit hard approach?

PubMed

Ferreira, A J; Reis, A; Marçal, N; Pinto, P; Bárbara, C

2016-01-01

Current guidelines differ slightly on the recommendations for treatment of Chronic Obstructive Pulmonary Disease (COPD) patients, and although there are some undisputed recommendations, there is still debate regarding the management of COPD. One of the hindrances to deciding which therapeutic approach to choose is late diagnosis or misdiagnosis of COPD. After a proper diagnosis is achieved and severity assessed, the choice between a stepwise or "hit hard" approach has to be made. For GOLD A patients the stepwise approach is recommended, whilst for B, C and D patients this remains debatable. Moreover, in patients for whom inhaled corticosteroids (ICS) are recommended, a step-up or "hit hard" approach with triple therapy will depend on the patient's characteristics and, for patients who are being over-treated with ICS, ICS withdrawal should be performed, in order to optimize therapy and reduce excessive medications. This paper discusses and proposes stepwise, "hit hard", step-up and ICS withdrawal therapeutic approaches for COPD patients based on their GOLD group. We conclude that all approaches have benefits, and only a careful patient selection will determine which approach is better, and which patients will benefit the most from each approach. Copyright © 2016 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

Targets for therapy in sarcomeric cardiomyopathies

PubMed Central

Tardiff, Jil C.; Carrier, Lucie; Bers, Donald M.; Poggesi, Corrado; Ferrantini, Cecilia; Coppini, Raffaele; Maier, Lars S.; Ashrafian, Houman; Huke, Sabine; van der Velden, Jolanda

2015-01-01

To date, no compounds or interventions exist that treat or prevent sarcomeric cardiomyopathies. Established therapies currently improve the outcome, but novel therapies may be able to more fundamentally affect the disease process and course. Investigations of the pathomechanisms are generating molecular insights that can be useful for the design of novel specific drugs suitable for clinical use. As perturbations in the heart are stage-specific, proper timing of drug treatment is essential to prevent initiation and progression of cardiac disease in mutation carrier individuals. In this review, we emphasize potential novel therapies which may prevent, delay, or even reverse hypertrophic cardiomyopathy caused by sarcomeric gene mutations. These include corrections of genetic defects, altered sarcomere function, perturbations in intracellular ion homeostasis, and impaired myocardial energetics. PMID:25634554

Multi-scale habitat selection modeling: A review and outlook

Treesearch

Kevin McGarigal; Ho Yi Wan; Kathy A. Zeller; Brad C. Timm; Samuel A. Cushman

2016-01-01

Scale is the lens that focuses ecological relationships. Organisms select habitat at multiple hierarchical levels and at different spatial and/or temporal scales within each level. Failure to properly address scale dependence can result in incorrect inferences in multi-scale habitat selection modeling studies.

RADIO RANGING DEVICE

DOEpatents

Nieset, R.T.

1961-05-16

A radio ranging device is described. It utilizes a super regenerative detector-oscillator in which echoes of transmitted pulses are received in proper phase to reduce noise energy at a selected range and also at multiples of the selected range.

Nonlinear Reduced-Order Simulation Using An Experimentally Guided Modal Basis

NASA Technical Reports Server (NTRS)

Rizzi, Stephen A.; Przekop, Adam

2012-01-01

A procedure is developed for using nonlinear experimental response data to guide the modal basis selection in a nonlinear reduced-order simulation. The procedure entails using nonlinear acceleration response data to first identify proper orthogonal modes. Special consideration is given to cases in which some of the desired response data is unavailable. Bases consisting of linear normal modes are then selected to best represent the experimentally determined transverse proper orthogonal modes and either experimentally determined inplane proper orthogonal modes or the special case of numerically computed in-plane companions. The bases are subsequently used in nonlinear modal reduction and dynamic response simulations. The experimental data used in this work is simulated to allow some practical considerations, such as the availability of in-plane response data and non-idealized test conditions, to be explored. Comparisons of the nonlinear reduced-order simulations are made with the surrogate experimental data to demonstrate the effectiveness of the approach.

When to consider transfusion therapy for patients with non-transfusion-dependent thalassaemia

PubMed Central

Taher, A T; Radwan, A; Viprakasit, V

2015-01-01

Non-transfusion-dependent thalassaemia (NTDT) refers to all thalassaemia disease phenotypes that do not require regular blood transfusions for survival. Thalassaemia disorders were traditionally concentrated along the tropical belt stretching from sub-Saharan Africa through the Mediterranean region and the Middle East to South and South-East Asia, but global migration has led to increased incidence in North America and Northern Europe. Transfusionists may be familiar with β-thalassaemia major because of the lifelong transfusions needed by these patients. Although patients with NTDT do not require regular transfusions for survival, they may require transfusions in some instances such as pregnancy, infection or growth failure. The complications associated with NTDT can be severe if not properly managed, and many are directly related to chronic anaemia. Awareness of NTDT is important, and this review will outline the factors that should be taken into consideration when deciding whether to initiate and properly plan for transfusion therapy in these patients in terms of transfusion interval and duration of treatment. PMID:25286743

How To Select and Plant a Tree.

ERIC Educational Resources Information Center

Fazio, James R., Ed.

1991-01-01

This bulletin furnishes information about selecting and planting trees. The tree selection process includes being aware of the physical characteristics of bare root seedlings, containerized seedlings, balled and burlapped, or potted trees and determining the proper size and root ball proportions. The section on tree planting discusses how to: (1)…

Use and prescription of antibiotics in primary health care settings in China.

PubMed

Wang, Jin; Wang, Pan; Wang, Xinghe; Zheng, Yingdong; Xiao, Yonghong

2014-12-01

Appropriate antibiotic use is a key strategy to control antibacterial resistance. The first step in achieving this is to identify the major problems in antibiotic prescription in health care facilities, especially in primary health care settings, which is where most patients receive medical care. To identify current patterns of antibiotic use and explore the reasons for inappropriate prescription in primary health care settings in China. A total of 48 primary health care facilities in China were randomly selected from 6 provinces at various levels of economic development. Data for the years 2009 through 2011 from 39 qualifying facilities (23 city and 16 rural primary health care centers) were analyzed retrospectively. The study sample consisted of prescription records for 7311 outpatient visits and 2888 inpatient hospitalizations. General health center information, drug usage, disease diagnoses, and antibiotic use by outpatients and inpatients were surveyed. Cases of inappropriate antibiotic prescription were identified. Most staff in the primary health care facilities had less than a college degree, and the medical staff consisted primarily of physician assistants, assistant pharmacists, nurses, and nursing assistants. The median (range) governmental contribution to each facility was 34.0% (3.6%-92.5%) of total revenue. The facilities prescribed a median (range) of 28 (8-111) types of antibiotics, including 34 (10-115) individual agents. Antibiotics were included in 52.9% of the outpatient visit prescription records: of these, only 39.4% were prescribed properly. Of the inpatients, 77.5% received antibiotic therapy: of these, only 24.6% were prescribed properly. Antibiotics were prescribed for 78.0% of colds and 93.5% of cases of acute bronchitis. Of the antibiotic prescriptions, 28.0% contained cephalosporins and 15.7% fluoroquinolones. A total of 55.0% of the antibiotic prescriptions were for antibiotic combination therapy with 2 or more agents. In nonsurgical inpatients in cities, the mean (SD) duration of antibiotic therapy was 10.1 (7.8) days. Of the surgical patients, 98.0% received antibiotics, with 63.8% of these prescriptions for prophylaxis. Antibiotics are frequently prescribed in Chinese primary health care facilities, and a large proportion of these prescriptions are inappropriate. Frequent and inappropriate use of antibiotics in primary health care settings in China is a serious problem that likely contributes to antimicrobial resistance worldwide.

Translational Application of Microfluidics and Bioprinting for Stem Cell-Based Cartilage Repair

PubMed Central

Mondadori, Carlotta; Mainardi, Valerio Luca; Talò, Giuseppe; Candrian, Christian; Święszkowski, Wojciech

2018-01-01

Cartilage defects can impair the most elementary daily activities and, if not properly treated, can lead to the complete loss of articular function. The limitations of standard treatments for cartilage repair have triggered the development of stem cell-based therapies. In this scenario, the development of efficient cell differentiation protocols and the design of proper biomaterial-based supports to deliver cells to the injury site need to be addressed through basic and applied research to fully exploit the potential of stem cells. Here, we discuss the use of microfluidics and bioprinting approaches for the translation of stem cell-based therapy for cartilage repair in clinics. In particular, we will focus on the optimization of hydrogel-based materials to mimic the articular cartilage triggered by their use as bioinks in 3D bioprinting applications, on the screening of biochemical and biophysical factors through microfluidic devices to enhance stem cell chondrogenesis, and on the use of microfluidic technology to generate implantable constructs with a complex geometry. Finally, we will describe some new bioprinting applications that pave the way to the clinical use of stem cell-based therapies, such as scaffold-free bioprinting and the development of a 3D handheld device for the in situ repair of cartilage defects. PMID:29535776

Research on orbit prediction for solar-based calibration proper satellite

NASA Astrophysics Data System (ADS)

Chen, Xuan; Qi, Wenwen; Xu, Peng

2018-03-01

Utilizing the mathematical model of the orbit mechanics, the orbit prediction is to forecast the space target's orbit information of a certain time based on the orbit of the initial moment. The proper satellite radiometric calibration and calibration orbit prediction process are introduced briefly. On the basis of the research of the calibration space position design method and the radiative transfer model, an orbit prediction method for proper satellite radiometric calibration is proposed to select the appropriate calibration arc for the remote sensor and to predict the orbit information of the proper satellite and the remote sensor. By analyzing the orbit constraint of the proper satellite calibration, the GF-1solar synchronous orbit is chose as the proper satellite orbit in order to simulate the calibration visible durance for different satellites to be calibrated. The results of simulation and analysis provide the basis for the improvement of the radiometric calibration accuracy of the satellite remote sensor, which lays the foundation for the high precision and high frequency radiometric calibration.

Selective deficit for people's names following left temporal damage: an impairment of domain-specific conceptual knowledge.

PubMed

Miceli, G; Capasso, R; Daniele, A; Esposito, T; Magarelli, M; Tomaiuolo, F

2000-09-01

As a consequence of a head trauma, APA presented with selective anomia for the names of familiar people, in the absence of comparable disorders for common names and other proper names. Face recognition was normal; and naming performance was unaffected by stimulus and response types. Selective proper name anomia was not due to effects of frequency of usage or of age of acquisition, or to selective memory/learning deficits for the names of people. Even though APA was able to provide at least some information on many celebrities whom she failed to name, she was clearly impaired in all tasks that required full conceptual information on the same people (but she performed flawlessly in similar tasks that involved common names). This pattern of performance indicates that in our subject the inability to name familiar persons results from damage to conceptual information. It is argued that detailed analyses of conceptual knowledge are necessary before it is concluded that a subject with proper name anomia suffers from a purely output disorder, as opposed to a conceptual disorder. The behaviour observed in APA is consistent with the domain-specific hypothesis of conceptual organisation (Caramazza & Shelton, 1998), and in this framework can be explained by assuming selective damage to knowledge of conspecifics. The anatomo-clinical correlates of our subject's disorder are discussed with reference to recent hypotheses on the neural structures representing knowledge of familiar people.

Endoscopic Criteria for Evaluating Tumor Stage after Preoperative Chemoradiation Therapy in Locally Advanced Rectal Cancer.

PubMed

Han, Kyung Su; Sohn, Dae Kyung; Kim, Dae Yong; Kim, Byung Chang; Hong, Chang Won; Chang, Hee Jin; Kim, Sun Young; Baek, Ji Yeon; Park, Sung Chan; Kim, Min Ju; Oh, Jae Hwan

2016-04-01

Local excision may be an another option for selected patients with markedly down-staged rectal cancer after preoperative chemoradiation therapy (CRT), and proper evaluation of post-CRT tumor stage (ypT) is essential prior to local excision of these tumors. This study was designed to determine the correlations between endoscopic findings and ypT of rectal cancer. In this study, 481 patients with locally advanced rectal cancer who underwent preoperative CRT followed by surgical resection between 2004 and 2013 at a single institution were evaluated retrospectively. Pathological good response (p-GR) was defined as ypT ≤ 1, and pathological minimal or no response (p-MR) as ypT ≥ 2. The patients were randomly classified according to two groups, a testing (n=193) and a validation (n=288) group. Endoscopic criteria were determined from endoscopic findings and ypT in the testing group and used in classifying patients in the validation group as achieving or not achieving p-GR. Based on findings in the testing group, the endoscopic criteria for p-GR included scarring, telangiectasia, and erythema, whereas criteria for p-MR included nodules, ulcers, strictures, and remnant tumors. In the validation group, the kappa statistic was 0.965 (p < 0.001), and the sensitivity, specificity, positive predictive value, and negative predictive value were 0.362, 0.963, 0.654, and 0.885, respectively. The endoscopic criteria presented are easily applicable for evaluation of ypT after preoperative CRT for rectal cancer. These criteria may be used for selection of patients for local excision of down-staged rectal tumors, because patients with p-MR could be easily ruled out.

Novel Mps1 Kinase Inhibitors with Potent Antitumor Activity.

PubMed

Wengner, Antje M; Siemeister, Gerhard; Koppitz, Marcus; Schulze, Volker; Kosemund, Dirk; Klar, Ulrich; Stoeckigt, Detlef; Neuhaus, Roland; Lienau, Philip; Bader, Benjamin; Prechtl, Stefan; Raschke, Marian; Frisk, Anna-Lena; von Ahsen, Oliver; Michels, Martin; Kreft, Bertolt; von Nussbaum, Franz; Brands, Michael; Mumberg, Dominik; Ziegelbauer, Karl

2016-04-01

Monopolar spindle 1 (Mps1) has been shown to function as the key kinase that activates the spindle assembly checkpoint (SAC) to secure proper distribution of chromosomes to daughter cells. Here, we report the structure and functional characterization of two novel selective Mps1 inhibitors, BAY 1161909 and BAY 1217389, derived from structurally distinct chemical classes. BAY 1161909 and BAY 1217389 inhibited Mps1 kinase activity with IC50 values below 10 nmol/L while showing an excellent selectivity profile. In cellular mechanistic assays, both Mps1 inhibitors abrogated nocodazole-induced SAC activity and induced premature exit from mitosis ("mitotic breakthrough"), resulting in multinuclearity and tumor cell death. Both compounds efficiently inhibited tumor cell proliferation in vitro (IC50 nmol/L range). In vivo, BAY 1161909 and BAY 1217389 achieved moderate efficacy in monotherapy in tumor xenograft studies. However, in line with its unique mode of action, when combined with paclitaxel, low doses of Mps1 inhibitor reduced paclitaxel-induced mitotic arrest by the weakening of SAC activity. As a result, combination therapy strongly improved efficacy over paclitaxel or Mps1 inhibitor monotreatment at the respective MTDs in a broad range of xenograft models, including those showing acquired or intrinsic paclitaxel resistance. Both Mps1 inhibitors showed good tolerability without adding toxicity to paclitaxel monotherapy. These preclinical findings validate the innovative concept of SAC abrogation for cancer therapy and justify clinical proof-of-concept studies evaluating the Mps1 inhibitors BAY 1161909 and BAY 1217389 in combination with antimitotic cancer drugs to enhance their efficacy and potentially overcome resistance. Mol Cancer Ther; 15(4); 583-92. ©2016 AACR. ©2016 American Association for Cancer Research.

Beam orientation optimization for intensity-modulated radiation therapy using mixed integer programming

NASA Astrophysics Data System (ADS)

Yang, Ruijie; Dai, Jianrong; Yang, Yong; Hu, Yimin

2006-08-01

The purpose of this study is to extend an algorithm proposed for beam orientation optimization in classical conformal radiotherapy to intensity-modulated radiation therapy (IMRT) and to evaluate the algorithm's performance in IMRT scenarios. In addition, the effect of the candidate pool of beam orientations, in terms of beam orientation resolution and starting orientation, on the optimized beam configuration, plan quality and optimization time is also explored. The algorithm is based on the technique of mixed integer linear programming in which binary and positive float variables are employed to represent candidates for beam orientation and beamlet weights in beam intensity maps. Both beam orientations and beam intensity maps are simultaneously optimized in the algorithm with a deterministic method. Several different clinical cases were used to test the algorithm and the results show that both target coverage and critical structures sparing were significantly improved for the plans with optimized beam orientations compared to those with equi-spaced beam orientations. The calculation time was less than an hour for the cases with 36 binary variables on a PC with a Pentium IV 2.66 GHz processor. It is also found that decreasing beam orientation resolution to 10° greatly reduced the size of the candidate pool of beam orientations without significant influence on the optimized beam configuration and plan quality, while selecting different starting orientations had large influence. Our study demonstrates that the algorithm can be applied to IMRT scenarios, and better beam orientation configurations can be obtained using this algorithm. Furthermore, the optimization efficiency can be greatly increased through proper selection of beam orientation resolution and starting beam orientation while guaranteeing the optimized beam configurations and plan quality.

Impact of Eliminating Anchor Items Flagged from Statistical Criteria on Test Score Classifications in Common Item Equating

ERIC Educational Resources Information Center

Karkee, Thakur; Choi, Seung

2005-01-01

Proper maintenance of a scale established in the baseline year would assure the accurate estimation of growth in subsequent years. Scale maintenance is especially important when the state performance standards must be preserved for future administrations. To ensure proper maintenance of a scale, the selection of anchor items and evaluation of…

Group therapy for selective mutism - a parents' and children's treatment group.

PubMed

Sharkey, Louise; Mc Nicholas, Fiona; Barry, Edwina; Begley, Maire; Ahern, Sinead

2008-12-01

To evaluate the feasibility and effectiveness of group therapy for children with selective mutism and their parents. Five children (mean age 6.1 years) with a diagnosis of selective mutism were administered group therapy over an 8-week period. Parents simultaneously attended a second group, aimed at providing education and advice on managing selective mutism in everyday situations, and in the school environment. At post-treatment, all children increased their level of confident speaking in school, clinic and community settings. Parents indicated a reduction in their own anxiety levels, from pre- to post-treatment on self-rating scales. Findings support the feasibility and effectiveness of group therapy for children with selective mutism and their parents.

Phytoremediation of landfill leachate using Populus

Treesearch

Jill A. Zalesny; Ronald S., Jr. Zalesny; Adam H. Wiese; Richard B. Hall; Bart Sexton

2006-01-01

Proper genotype selection is required for successful phytoremediation. We selected eight Populus clones (NC13460, NC14018, DM115, NC14104, NC14106, DN5, NM2, NM6) of four genomic groups after three cycles of phyto-recurrent selection for a field trial that began June 2005 at the Oneida County Landfill in Rhinelander, WI, USA.

Identification of reduced-order thermal therapy models using thermal MR images: theory and validation.

PubMed

Niu, Ran; Skliar, Mikhail

2012-07-01

In this paper, we develop and validate a method to identify computationally efficient site- and patient-specific models of ultrasound thermal therapies from MR thermal images. The models of the specific absorption rate of the transduced energy and the temperature response of the therapy target are identified in the reduced basis of proper orthogonal decomposition of thermal images, acquired in response to a mild thermal test excitation. The method permits dynamic reidentification of the treatment models during the therapy by recursively utilizing newly acquired images. Such adaptation is particularly important during high-temperature therapies, which are known to substantially and rapidly change tissue properties and blood perfusion. The developed theory was validated for the case of focused ultrasound heating of a tissue phantom. The experimental and computational results indicate that the developed approach produces accurate low-dimensional treatment models despite temporal and spatial noises in MR images and slow image acquisition rate.

Component Selection for Sterile Compounding.

PubMed

Dilzer, Richard H

2017-01-01

This article describes the factors to consider, as well as the process of proper component selection, for use in preparing compounded sterile preparations. Special emphasis is placed on individual chemical factors that may impact a preparation's accuracy and potency. Values reported in a typical certificate of analysis are discussed, including methods of identifying any required adjustments to a master formulation or compounding record during the compounding of sterile preparations. Proper screening of the certificate of analysis, the Safety Data Sheet, procedural documentation, and the filing of all certificates of conformance are crucial to the operation of a sterile compounding facility. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

Emerging science and therapies in non-small-cell lung cancer: targeting the MET pathway.

PubMed

Kris, Mark G; Arenberg, Douglas A; Herbst, Roy S; Riely, Gregory J

2014-11-01

During this enduring, learner-driven, interactive CME webseries, lung cancer specialists will address the science and targeted therapies for the MET pathway in non-small cell lung cancer. Over the past decade, research has evolved in the science of identifying targeted biological changes in DNA and individual cancer cells. Along with the advanced understanding of lung cancer mutations, has come the development of specific targeted therapies that improve patient outcomes. The first step in treating a patient with lung cancer is proper diagnosis and staging, applying to the principles of personalize medicine. Our current understanding of lung cancer is that of a collection of diseases individualized through specific mutations. This CME activity reviews the role of the pulmonologist and pathologist in proper tissue acquisition and analysis. This new era of personalized medicine and clinical research advances has changed the way clinicians evaluate and treat patients with lung cancer. The data on lung cancer cell mutations and newer targeted therapies have improved the progression free survival and quality of life of lung cancer patients. This CME activity is designed to present a practical overview of recent evidenced based data of MET targeted therapies for patients with lung cancer. As research continues to evolve, we continue to advance our understanding in the science of lung cancers involving the MET pathway. Evidenced based data supporting newer targeted therapeutics provides insight on applying treatment for optimal outcomes. This CME activity will focus on the individualized treatment strategies using practical decision making for patients with MET expression. This activity has been designed to meet the educational needs of medical oncologists, pathologists, radiation oncologists, surgeons, pulmonologists, internists, and other healthcare clinicians responsible for the care of patients with lung cancer. Online access:http://www.elseviercme.com/516/.

Footwear recommendations and patterns among orthopaedic foot and ankle surgeons: a survey.

PubMed

Farber, Daniel C; Knutsen, Elisa J

2013-12-01

Foot and ankle surgeons are in a unique position to educate patients about the importance of proper footwear. Neither their recommendations regarding shoe selection nor their own footwear patterns have previously been reported. A total of 866 members of the American Orthopaedic Foot & Ankle Society (AOFAS) were asked to complete a survey via the Internet. Topics included specific shoe brands recommended to patients, how attributes of footwear are communicated, and respondents' footwear habits. In all, 276 (32%) surgeons responded, and 64% recommended New Balance athletic shoes to patients; 26% did not recommend specific brands. It was found that 50% wear New Balance athletic shoes; 25% wear Nike. Rockport (27%) and SAS (27%) were the most recommended dress shoes. In all, 76% are familiar with AOFAS guidelines for proper shoe fit, but only 56% educated their patients about the guidelines; 43% do not consider what patients might think of their shoes when selecting what to wear in the clinical setting. Despite the multitude of different brands, several were commonly recommended. Respondents seem to be aware of the impact of their own shoe selection on patients' perspectives of footwear, but many do not consider themselves role models for proper footwear.

Synthesis and characterization of boron fenbufen and its F-18 labeled homolog for boron neutron capture therapy of COX-2 overexpressed cholangiocarcinoma.

PubMed

Yeh, Chun-Nan; Chang, Chi-Wei; Chung, Yi-Hsiu; Tien, Shi-Wei; Chen, Yong-Ren; Chen, Tsung-Wen; Huang, Ying-Cheng; Wang, Hsin-Ell; Chou, You-Cheng; Chen, Ming-Huang; Chiang, Kun-Chun; Huang, Wen-Sheng; Yu, Chung-Shan

2017-09-30

Boron neutron capture therapy (BNCT) is a binary therapy that employs neutron irradiation on the boron agents to release high-energy helium and alpha particles to kill cancer cells. An optimal response to BNCT depends critically on the time point of maximal 10 B accumulation and highest tumor to normal ratio (T/N) for performing the neutron irradiation. The aggressive cholangiocarcinoma (CCA) representing a liver cancer that overexpresses COX-2 enzyme is aimed to be targeted by COX-2 selective boron carrier, fenbufen boronopinacol (FBPin). Two main works were performed including: 1) chemical synthesis of FBPin as the boron carrier and 2) radiochemical labeling with F-18 to provide the radiofluoro congener, m-[ 18 F]fluorofenbufen ester boronopinacol (m-[ 18 F]FFBPin), to assess the binding affinity, cellular accumulation level and distribution profile in CCA rats. FBPin was prepared from bromofenbufen via 3 steps with 82% yield. The binding assay employed [ 18 F]FFBPin to compete FBPin for binding to COX-1 (IC 50 =0.91±0.68μM) and COX-2 (IC 50 =0.33±0.24μM). [ 18 F]FFBPin-derived 60-min dynamic PET scans predict the 10 B-accumulation of 0.8-1.2ppm in liver and 1.2-1.8ppm in tumor and tumor to normal ratio=1.38±0.12. BNCT was performed 40-55min post intravenous administration of FBPin (20-30mg) in the CCA rats. CCA rats treated with BNCT display more tumor reduction than that by NCT with respect of 2-[ 18 F]fluoro-2-deoxy glucose uptake in the tumor region of interest, 20.83±3.00% (n=12) vs. 12.83±3.79% (n=10), P=0.05. The visualizing agent [ 18 F]FFBPin resembles FBPin to generate the time-dependent boron concentration profile. Optimal neutron irradiation period is thus determinable for BNCT. A boron-substituted agent based on COX-2-binding features has been prepared. The moderate COX-2/COX-1 selectivity index of 2.78 allows a fair tumor selectivity index of 1.38 with a mild cardiovascular effect. The therapeutic effect from FBPin with BNCT warrants a proper COX-2 targeting of boron NSAIDs. Copyright © 2017. Published by Elsevier B.V.

Periodontal therapy.

PubMed

Niemiec, Brook A

2008-05-01

Periodontal disease is the most common disease in small animal patients. It not only creates severe localized infection, but it has been linked to numerous severe systemic maladies. Proper therapy of this disease process results in a significant increase in the overall health of the patient. The treatment of periodontal disease is currently evolving due to the acceptance of the specific plaque hypothesis of periodontal disease. These findings have led to the development of the "one-stage full-mouth disinfection" treatment as well as a vaccine against these organisms. However, the cornerstone of therapy is still meticulous plaque control. This control is achieved via a combination of regular dental prophylaxis and home care. With progressive disease, advanced periodontal surgery or extraction becomes necessary.

Disease-related social situation in family of children with chronic kidney disease--parents` assessment. A multicentre study.

PubMed

Kiliś-Pstrusińska, Katarzyna; Medyńska, Anna; Adamczyk, Piotr; Bałasz-Chmielewska, Irena; Grenda, Ryszard; Kluska-Jóźwiak, Agnieszka; Leszczyńska, Beata; Olszak-Szot, Ilona; Miklaszewska, Monika; Szczepańska, Maria; Tkaczyk, Marcin; Wasilewska, Anna; Zachwieja, Katarzyna; Zajączkowska, Maria; Ziółkowska, Helena; Zagożdżon, Ilona; Zwolińska, Danuta

2014-01-01

Chronic kidney disease (CKD) in children burdens life of patients and their families. Little is known about parents` assessment of families' social situation. However, the knowledge of the details of a patient's and his family's life standards might influence modification and optimization of applied therapy. Therefore, the main goal of the present study was to explore the selected elements of life situation of patients suffering with CKD as well as their parents, depending on the CKD stage and appropriate treatment. Cross-sectional national study was conducted. A total of 203 children with CKD and 388 their parent-proxies (196 women and 192 men) were enrolled into this study. Patient data and questionnaires filled by both parents, concerning social-demographic parameters and assessment of changes in families after CKD diagnosis in the child, were analysed. CKD children are being brought up in proper families whose financial situation is not good. Children need help in process of education. Perception of current situation differed between both parents in the change of the income source, taking care of CKD child, change in social relations and evaluating relations with medical staff. Parents do not obtain proper support from social workers. Families of CKD children require support in area of financial and educational help for school children. The discrepancies in evaluation of family situation between mothers and fathers of ill children might be the source of conflicts possibly resulting in worsening the outcome for CKD children.

The Spanish Society of Neurology's official clinical practice guidelines for epilepsy. Special considerations in epilepsy: comorbidities, women of childbearing age, and elderly patients.

PubMed

Mauri Llerda, J A; Suller Marti, A; de la Peña Mayor, P; Martínez Ferri, M; Poza Aldea, J J; Gomez Alonso, J; Mercadé Cerdá, J M

2015-10-01

The characteristics of some population groups (patients with comorbidities, women of childbearing age, the elderly) may limit epilepsy management. Antiepileptic treatment in these patients may require adjustments. We searched articles in Pubmed, clinical practice guidelines for epilepsy, and recommendations by the most relevant medical societies regarding epilepsy in special situations (patients with comorbidities, women of childbearing age, the elderly). Evidence and recommendations are classified according to the prognostic criteria of Oxford Centre of Evidence-Based Medicine (2001) and the European Federation of Neurological Societies (2004) for therapeutic interventions. Epilepsy treatment in special cases of comorbidities must be selected properly to improve efficacy with the fewest side effects. Adjusting antiepileptic medication and/or hormone therapy is necessary for proper seizure management in catamenial epilepsy. Exposure to antiepileptic drugs (AED) during pregnancy increases the risk of birth defects and may affect fetal growth and/or cognitive development. Postpartum breastfeeding is recommended, with monitoring for adverse effects if sedative AEDs are used. Finally, the elderly are prone to epilepsy, and diagnostic and treatment characteristics in this group differ from those of other age groups. Although therapeutic limitations may be more frequent in older patients due to comorbidities, they usually respond better to lower doses of AEDs than do other age groups. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

Irrigation in endodontic treatment.

PubMed

Basrani, Bettina

2011-01-01

The primary endodontic treatment goal is to optimize root canal disinfection and to prevent reinfection. Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal system. In this review of the literature, various irrigants and the interactions between irrigants are discussed and new delivery systems are introduced.

Implementation of an Undergraduate Nutritional Support Clerkship.

ERIC Educational Resources Information Center

Stennett, Douglass J.; And Others

1983-01-01

A 10-week, full-time elective nutritional support clerkship designed for fifth-year pharmacy students is described. The course refines the student's communication skills and develops the student's ability to properly prepare and adjust a nutritional therapy plan. A weekly student activity plan and student evaluation form are appended. (MSE)

Early arthroscopic release in stiff shoulder

PubMed Central

Sabat, Dhananjaya; Kumar, Vinod

2008-01-01

Purpose: To evaluate the results of early arthroscopic release in the patients of stiff shoulder Methods: Twenty patients of stiff shoulder, who had symptoms for at least three months and failed to improve with steroid injections and physical therapy of 6 weeks duration, underwent arthroscopic release. The average time between onset of symptoms and the time of surgery was 4 months and 2 weeks. The functional outcome was evaluated using ASES and Constant and Murley scoring systems. Results: All the patients showed significant improvement in the range of motion and relief of pain by end of three months following the procedure. At 12 months, mean improvement in ASES score is 38 points and Constant and Murley score is 4O.5 points. All patients returned to work by 3-5 months (average -4.5 months). Conclusion: Early arthroscopic release showed promising results with reliable increase in range of motion, early relief of symptoms and consequent early return to work. So it is highly recommended in properly selected patients. Level of evidence: Level IV PMID:20300309

Foot Structure in Boys with Down Syndrome.

PubMed

Puszczałowska-Lizis, Ewa; Nowak, Krzysztof; Omorczyk, Jarosław; Ambroży, Tadeusz; Bujas, Przemysław; Nosiadek, Leszek

2017-01-01

Down syndrome (DS) is associated with numerous developmental abnormalities, some of which cause dysfunctions of the posture and the locomotor system. The analysis of selected features of the foot structure in boys with DS versus their peers without developmental disorders is done. The podoscopic examination was performed on 30 boys with DS aged 14-15 years. A control group consisted of 30 age- and gender-matched peers without DS. The feet of boys with DS are flatter compared to their healthy peers. The hallux valgus angle is not the most important feature differentiating the shape of the foot in the boys with DS and their healthy peers. In terms of the V toe setting, healthy boys had poorer results. Specialized therapeutic treatment in individuals with DS should involve exercises to increase the muscle strength around the foot joints, enhancing the stabilization in the joints and proprioception. Introducing orthotics and proper footwear is also important. It is also necessary to monitor the state of the foot in order to modify undertaken therapies.

Tracheoesophageal fistula--a complication of prolonged tracheal intubation.

PubMed

Paraschiv, M

2014-01-01

Tracheoesophageal fistula most commonly occurs as a complication of prolonged tracheal intubation. The incidence decreased after the use of low pressure and high volume endotracheal cuffs, but the intensive care units continue to provide such cases. The abnormal tracheoesophageal communication causes pulmonary contamination (with severe suppuration) and impossibility to feed the patient. The prognosis is reserved, because most patients are debilitated and ventilator dependent, with severe neurological and cardiovascular diseases. The therapeutic options are elected based on respiratory, neurological and nutritional status. The aim of conservative treatment is to stop the contamination (drainage gastrostomy, feeding jejunostomy) and to treat the pulmonary infection and biological deficits. Endoscopic therapies can be tried in cases with surgical contraindication. Operation is addressed to selected cases and consists in the dissolution of the fistula, esophageal suture with or without segmental tracheal resection associated. Esophageal diversion is rarely required. The correct indication and timing of surgery, proper surgical technique and postoperative care are prerequisites for adequate results.

Tracheoesophageal fistula - a complication of prolonged tracheal intubation

PubMed Central

Paraschiv, M

2014-01-01

Tracheoesophageal fistula most commonly occurs as a complication of prolonged tracheal intubation. The incidence decreased after the use of low pressure and high volume endotracheal cuffs, but the intensive care units continue to provide such cases. The abnormal tracheoesophageal communication causes pulmonary contamination (with severe suppuration) and impossibility to feed the patient. The prognosis is reserved, because most patients are debilitated and ventilator dependent, with severe neurological and cardiovascular diseases. The therapeutic options are elected based on respiratory, neurological and nutritional status. The aim of conservative treatment is to stop the contamination (drainage gastrostomy, feeding jejunostomy) and to treat the pulmonary infection and biological deficits. Endoscopic therapies can be tried in cases with surgical contraindication. Operation is addressed to selected cases and consists in the dissolution of the fistula, esophageal suture with or without segmental tracheal resection associated. Esophageal diversion is rarely required. The correct indication and timing of surgery, proper surgical technique and postoperative care are prerequisites for adequate results. PMID:25713612

A hospital-based study to evaluate the incidence pattern of group A streptococcal throat infections from different age group patients.

PubMed

Ray, Dipanwita; Banerjee, Surajita; Bhattacharya, Sujata; Sinha, Sukanta; Bandyopadhyay, Debasis; Ghosal, Chaitry; Gupta, Siddhartha; Majumdar, Pallav Kumar; Saha, Somnath; Gupta, Soma; Bhattacharya, Basudev

2010-02-01

Streptococcus pyogenes(group A) is a major pathogen capable of causing a wide range of diseases in different age group of people. In this study 100 patients were selected who presented with the complaint of sore throat. All the patients were divided in four age groups. Streptococcus pyogenes colonies were confirmed on the basis of beta-haemolysis, bacitracin sensitivity test, and latex agglutination test for group A. Out of a total of 100 samples, 42 were confirmed as group A streptococcus. From this study, it has been observed that all age groups, with maximum occurrence in 5-15 years age group, were suffering from group A streptococcal pharyngitis. Therefore every case of sore throat especially affecting children should be investigated to detect the causative agent for initiation of proper therapy so that the more serious outcome like acute rheumatic fever (ARF) and acute glomerulonephritis (AGN) can be prevented.

Affect of Early Life Oxygen Exposure on Proper Lung Development and Response to Respiratory Viral Infections

PubMed Central

Domm, William; Misra, Ravi S.; O’Reilly, Michael A.

2015-01-01

Children born preterm often exhibit reduced lung function and increased severity of response to respiratory viruses, suggesting that premature birth has compromised proper development of the respiratory epithelium and innate immune defenses. Increasing evidence suggests that premature birth promotes aberrant lung development likely due to the neonatal oxygen transition occurring before pulmonary development has matured. Given that preterm infants are born at a point of time where their immune system is also still developing, early life oxygen exposure may also be disrupting proper development of innate immunity. Here, we review current literature in hopes of stimulating research that enhances understanding of how the oxygen environment at birth influences lung development and host defense. This knowledge may help identify those children at risk for disease and ideally culminate in the development of novel therapies that improve their health. PMID:26322310

Diagnosis and treatment of common metabolic spinal disorders in the geriatric population.

PubMed

Eck, J C; Humphreys, S C

1998-12-01

Bone is constantly resorbed and remodeled throughout life. After approximately age 30, there is a net loss of bone mass. This places the geriatric population at an increased risk of pathologic bone disorders that can lead to fractures and deformity. In this paper, we review bone metabolism and remodeling and introduce the proper diagnostic techniques. The most common pathologic spinal disorders are introduced, with emphasis on presentation and treatment options. To prevent excessive bone loss, patients should be educated on proper nutrition (calcium and vitamin D requirements) and lifestyle (avoiding alcohol and cigarette smoking). Sex hormone and drug therapies are available to reduce bone loss. New bisphosphonates such as alendronate sodium (Fosamax) have been effective in increasing bone mass. Early diagnosis and proper treatment of pathologic bone disorders can reduce the incidence of fracture and allow the patient a more productive and comfortable life.

Textiles for protection against microorganism

NASA Astrophysics Data System (ADS)

Sauperl, O.

2016-04-01

Concerning micro-organisms such as bacteria, viruses and fungi, there is a huge progress in the development of textile materials and procedures which should effectively protect against these various pathogens. In this sense there is especially problematic hospital environment, where it is necessary to take into account properly designed textile material which, when good selected and composed, act as a good barrier against transfer of micro-organisms through material mainly in its wet state. Respect to this it is necessary to be familiar with the rules regarding selection of the input material, the choice of proper yarn construction, the choice of the proper weaving mode, the rules regarding selection of antimicrobial-active compound suitable for (eco-friendly) treatment, and the choice of the most appropriate test method by which it is possible objectively to conclude on the reduction of selected microorganism. As is well known, fabrics are three-dimensional structures with void and non-void areas. Therefore, the physical-chemical properties of the textile material/fabric, the surface characteristics together with the shape of microorganism, and the carriers' characteristics contribute to control the transfer of microorganism through textile material. Therefore, careful planning of textile materials and treatment procedure with the compound which is able to reduce micro-organism satisfactory is particularly important, especially due to the fact that in hospital environment population with impaired immune system is mainly presented.

Topical therapies in hyperhidrosis care.

PubMed

Pariser, David M; Ballard, Angela

2014-10-01

Primary focal hyperhidrosis affects 3% of the US population; about the same number as psoriasis. More than half of these patients have primary focal axillary hyperhidrosis: sweating that is beyond what is anticipated or necessary for thermoregulation. Most topical therapies are based on aluminum salts, which work by a chemical reaction that forms plugs in the eccrine sweat ducts. Topical anticholinergics may also be used. Instruction on proper methods and timing of antiperspirants enhances effect and may be effective alone or in combination with other treatments in patients with hyperhidrosis. Copyright © 2014 Elsevier Inc. All rights reserved.

Electrolyte imbalance and sleep problems during anti-retroviral therapy: an under-recognized problem.

PubMed

Manzar, Md Dilshad; Sony, Peter; Salahuddin, Mohammed; Kumalo, Abera; Geneto, Mathewos; Pandi-Perumal, Seithikurippu R; Moscovitch, Adam; BaHammam, Ahmed S

2017-01-01

Human immunodeficiency virus (HIV) infection, and the anti-retroviral therapy (ART) associated complications necessitate that the medical care system keeps evolving for proper management of this group of patients. Electrolyte imbalance and sleep problems are common in patients on ART. Both of these conditions are associated with increased morbidity (such as acute kidney injury, chronic kidney disease, low CD4 count, non-adherence and depression) and mortality. Therefore, screening for both sleep problems and electrolytes imbalance may help to decrease the risk of complications in patients on ART.

Electrolyte imbalance and sleep problems during anti-retroviral therapy: an under-recognized problem

PubMed Central

Manzar, Md Dilshad; Sony, Peter; Salahuddin, Mohammed; Kumalo, Abera; Geneto, Mathewos; Pandi-Perumal, Seithikurippu R; Moscovitch, Adam; BaHammam, Ahmed S

2017-01-01

Human immunodeficiency virus (HIV) infection, and the anti-retroviral therapy (ART) associated complications necessitate that the medical care system keeps evolving for proper management of this group of patients. Electrolyte imbalance and sleep problems are common in patients on ART. Both of these conditions are associated with increased morbidity (such as acute kidney injury, chronic kidney disease, low CD4 count, non-adherence and depression) and mortality. Therefore, screening for both sleep problems and electrolytes imbalance may help to decrease the risk of complications in patients on ART. PMID:28966741

Prosthetic Consideration in Implant-supported Prosthesis: A Review of Literature

PubMed Central

Gowd, Manga Snigdha; Shankar, Thatapudi; Ranjan, Rajeev; Singh, Arpita

2017-01-01

Modern dentistry has changed tremendously with implant therapy. For the successful implant therapy, making a proper treatment plan considering both surgical and prosthetic part in mind is the key of success. Often practitioners tend to create a treatment plan overlooking the basic principles of prosthetic part. This present review has discussed various prosthetic consideration of implant-supported prosthesis. A step-by-step detailed prosthetic option with their indications has been discussed to help all dental implant practitioners in making of an optimal treatment plan for each case. PMID:28713760

Effects of particle size distribution in thick film conductors

NASA Technical Reports Server (NTRS)

Vest, R. W.

1983-01-01

Studies of particle size distribution in thick film conductors are discussed. The distribution of particle sizes does have an effect on fired film density but the effect is not always positive. A proper distribution of sizes is necessary, and while the theoretical models can serve as guides to selecting this proper distribution, improved densities can be achieved by empirical variations from the predictions of the models.

Selection and Placement of Students in Cooperative Programs

ERIC Educational Resources Information Center

Pender, Albert R.

1970-01-01

Factors to consider in properly implementing the selection-placement process are: (1) age, (2) needs, (3) interests, (4) aptitudes and abilities, (5) personality traits, (6) scholastic average, (7) attendance record, (8) appearance, (9) interpersonal relationships, (10) location, (11) hours, and (12) rotation. (DM)

Switching Patients to Home-Based Subcutaneous Immunoglobulin: an Economic Evaluation of an Interprofessional Drug Therapy Management Program.

PubMed

Perraudin, Clemence; Bourdin, Aline; Spertini, Francois; Berger, Jérôme; Bugnon, Olivier

2016-07-01

Home-based subcutaneous immunoglobulin (SCIg) therapy is an alternative to hospital-based intravenous infusions (IVIg). However, SCIg requires patient training and long-term support to ensure proper adherence, optimal efficacy and safety. We evaluated if switching patients to home-based SCIg including an interprofessional drug therapy management program (physician, community pharmacist and nurse) would be cost-effective within the Swiss healthcare system. A 3-year cost-minimization analysis was performed from a societal perspective comparing monthly IVIg in an outpatient clinic and home-based weekly SCIg including an interprofessional program. Healthcare costs (immunoglobulin, professional time, infusion pump and disposables) were derived from administrative data. Transportation and productivity loss were estimated by expert opinion. The results were expressed in Swiss francs (CHF) and converted to Euros and US dollars (1 CHF = 0.92€, 1 CHF = $1.02; www.xe.com , 12/14/2015). Under base case assumptions, SCIg was estimated to cost 35,862 CHF (33,134€; $36,595) per patient during the first year and 30,309 CHF (28,004€; $30,929) in subsequent years versus 35,370 CHF (32,679€; $36,095) per year for IVIg. The total savings from switching to SCIg with the interprofessional program were 9630 CHF (8897€; $9828) per patient over 3 years. The results were relatively sensitive to the cost per gram of IgG, the cost of equipment and the annual number of infusions. Home-based SCIg including an interprofessional therapy management program may be an efficient alternative for patients. The program provides long-term support from self-administration training to the responsible use of therapy (proper adherence, optimal efficacy and safety). Over the short term, additional costs from purchasing equipment and the drug therapy management program were offset by avoiding hospital costs.

Optimization of Antenna Current Feeding for the Alfvén Eigenmodes Active Diagnostic System of JET

NASA Astrophysics Data System (ADS)

Albarracin Manrique, Marcos A.; Ruchko, L.; Pires, C. J. A.; Galvão, R. M. O.; Elfimov, A. G.

2018-04-01

The possibility of exploring proper phasing of the feeding currents in the existing antenna of the Alfvén Eigenmodes Active Diagnostic system of JET, to excite pure toroidal spectra of Toroidal Alfvén Eigenmodes, is numerically investigated. Special attention is given to the actual perturbed fields excited in the plasma, which are calculated self-consistently using the antenna version of the CASTOR code. It is found that due to the close spacing of the JET antenna modules and quasi degeneracy of modes with medium to high values of the toroidal mode number n, although a proper choice of the phasing of the feeding currents of the antenna modules indeed leads to an increase of the perturbed fields of the selected mode, modes with nearby values of n are also excited with large amplitudes, so that a scheme to proper select the detected modes remains necessary. A scheme using different antenna position distribution is proposed to achieve successful optimization.

Galenics of dermal products--vehicles, properties and drug release.

PubMed

Daniels, Rolf; Knie, Ulrich

2007-05-01

The efficiency, tolerability, and applicability of topical agents are directly related to employed vehicles. Thus to achieve optimum topical therapy, a solid knowledge of the vehicles, their composition, and their physical and dermato-pharmacological actions are important. Common vehicles are complex mixtures consisting of diverse ingredients belonging to six major groups, i. e. hydrophilic and lipophilic bases, emulsifiers, gel-forming agents, preservatives, and antioxidants. This makes it possible to optimize both the cosmetic features and to adjust a vehicle to the properties of an incorporated drug and site of application. On the other hand it makes it difficult to make a proper choice between several alternatives or to use it in individual prescriptions. In order to simplify the selection of a formulation, it is useful to categorize them systemically into several groups, such as ointments, creams, gels, emulsions, and suspensions. Within these groups some general rules can be derived for the selection of a vehicle with respect to skin conditions and the application site. When active substances are incorporated into a base the dermato-biopharmaceutical properties of the whole system (drug + vehicle) also have to be considered. If for a given vehicle drug transport into the skin does not suffice, several methods are described to facilitate its penetration, such as by hydrating the skin or by adding chemical penetration enhancers.

Update on Middle Ear Barotrauma after Hyperbaric Oxygen Therapy—Insights on Pathophysiology

PubMed Central

Lima, Marco Antônio Rios; Farage, Luciano; Cury, Maria Cristina Lancia; Bahamad, Fayez

2014-01-01

Introduction Middle ear barotrauma is the most common side effect of hyperbaric oxygen therapy. Knowledge and understanding of its pathophysiology are crucial for an accurate diagnosis and proper decision making about treatment and prevention. Objective Describe up-to-date information on pathophysiology of middle ear barotrauma after hyperbaric oxygen therapy considering the physiology of pressure variation of the middle ear. Data Synthesis Middle ear barotrauma occurs especially during the compression phase of hyperbaric oxygen therapy. The hyperoxic environment in hyperbaric oxygen therapy leads to ventilatory dysfunction of the eustachian tube, especially in monoplace chambers, where the patients are pressurized with 100% O2, favoring middle ear barotrauma. Conclusion The eustachian tube, the tympanic cavity, and mastoid work together in a neural controlled feedback system in which various mechanisms concur for middle ear pressure regulation. PMID:25992091

Meeting the expectations of chronic tinnitus patients: comparison of a structured group therapy program for tinnitus management with a problem-solving group.

PubMed

Wise, K; Rief, W; Goebel, G

1998-06-01

Two different group treatments were evaluated in 144 in-patients suffering from impairment due to chronic tinnitus. A tinnitus management therapy (TMT) was developed using principles of cognitive-behavioral therapy and compared with problem solving group therapy. Self-ratings were used to evaluate the help patients found in dealing with life problems and tinnitus as well as the degree to which they felt they were being properly treated and taken seriously. Patients showed significantly more satisfaction with the TMT group and evaluated the help they found in coping with tinnitus and life problems significantly higher. Thus, in the light of unsatisfactory medical solutions and the poor acceptance of some psychological treatments for tinnitus, TMT appears to be an acceptable and helpful treatment program.

The relevance of psychodynamic psychotherapy to understanding therapist-patient sexual abuse and treatment of survivors.

PubMed

Yahav, Rivka; Oz, Sheri

2006-01-01

Regardless of the therapy modality, research continues to point to the therapeutic relationship as a major salient factor in clinical success or failure. When a patient is sexually abused by his or her therapist, this therapeutic relationship is cynically exploited in a way that does not properly serve the essential needs of the patient. When this patient then seeks reparative therapy, the subsequent therapist needs to pay close attention to issues of the relationship which were breached by the previous clinician. In this article, two case studies showing very different dynamics will be presented in order to demonstrate: (1) relevant factors related to transference, countertransference, projective identification, and the analytic third pertaining to the former, abusive therapy; and (2) needs versus wishes, and issues related to boundaries and self-disclosure in the corrective therapy.

Globular Clusters: Absolute Proper Motions and Galactic Orbits

NASA Astrophysics Data System (ADS)

Chemel, A. A.; Glushkova, E. V.; Dambis, A. K.; Rastorguev, A. S.; Yalyalieva, L. N.; Klinichev, A. D.

2018-04-01

We cross-match objects from several different astronomical catalogs to determine the absolute proper motions of stars within the 30-arcmin radius fields of 115 Milky-Way globular clusters with the accuracy of 1-2 mas yr-1. The proper motions are based on positional data recovered from the USNO-B1, 2MASS, URAT1, ALLWISE, UCAC5, and Gaia DR1 surveys with up to ten positions spanning an epoch difference of up to about 65 years, and reduced to Gaia DR1 TGAS frame using UCAC5 as the reference catalog. Cluster members are photometrically identified by selecting horizontal- and red-giant branch stars on color-magnitude diagrams, and the mean absolute proper motions of the clusters with a typical formal error of about 0.4 mas yr-1 are computed by averaging the proper motions of selected members. The inferred absolute proper motions of clusters are combined with available radial-velocity data and heliocentric distance estimates to compute the cluster orbits in terms of the Galactic potential models based on Miyamoto and Nagai disk, Hernquist spheroid, and modified isothermal dark-matter halo (axisymmetric model without a bar) and the same model + rotating Ferre's bar (non-axisymmetric). Five distant clusters have higher-than-escape velocities, most likely due to large errors of computed transversal velocities, whereas the computed orbits of all other clusters remain bound to the Galaxy. Unlike previously published results, we find the bar to affect substantially the orbits of most of the clusters, even those at large Galactocentric distances, bringing appreciable chaotization, especially in the portions of the orbits close to the Galactic center, and stretching out the orbits of some of the thick-disk clusters.

Dosimetry control and monitoring of selective retina therapy using optical coherence tomography

NASA Astrophysics Data System (ADS)

Kaufmann, Daniel; Burri, Christian; Arnold, Patrik; Koch, Volker M.; Meier, Christoph; Považay, Boris; Justiz, Joern

2017-07-01

Selective retina therapy and optical coherence tomography have been combined to monitor laser-tissue interaction in real-time. An ex-vivo study of porcine eyes unveils mechanisms that enable automated and accurate dose-control during laser-therapy.

Continuous subcutaneous insulin infusion: Special needs for children.

PubMed

Adolfsson, Peter; Ziegler, Ralph; Hanas, Ragnar

2017-06-01

Continuous subcutaneous insulin infusion (CSII) is a very common therapy for children with type 1 diabetes. Due to physiological differences they have other requirements for their insulin pump than adults. The main difference is the need for very low basal rates. Even though most available insulin pumps reach a high accuracy at usual basal rates, accuracy decreases for lower rates. In addition, the lowest delivered amount at 1 time is limiting the fine tuning of the basal rate as well as the option for temporary basal rates. Alarms in case of occlusions depend on accumulation of a certain amount of insulin in the catheter, and therefore the time until such an alarm is triggered is much longer with lower basal rates. Accordingly, the risk for hyperglycemia developing into diabetic ketoacidosis increases. The availability of bolus advisors facilitates the calculation of meal and correction boluses for children and their parents. However, there are some differences between the calculators, and the settings that the calculation is based on are very important. Better connectivity, for example with a system for continuous glucose monitoring, might help to further increase safety in the use of CSII in children. When selecting an insulin pump for a child, the features and characteristics of available pumps should be properly compared to ensure an effective and safe therapy. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prevalence and Predictors of Self-Medication with Antibiotics in Al Wazarat Health Center, Riyadh City, KSA

PubMed Central

Al Rasheed, Abdulrahman; Yagoub, Umar; Alkhashan, Hesham; Abdelhay, Osama; Alawwad, Ahmad; Al Aboud, Aboud; Al Battal, Saad

2016-01-01

Background. Antibiotics are responsible for most dramatic improvement in medical therapy in history. These medications contributed significantly to the decreasing mortality and morbidity when prescribed based on evidence of microbial infection. Objective. The aim of this study was to determine the prevalence and predictors of self-prescription with antibiotics in Al Wazarat Health Center, Riyadh City, Kingdom of Saudi Arabia. Material and Methods. Cross-sectional study was conducted in Al Wazarat Health Center between February 2014 and November 2014. Respondents were randomly selected using a multistage clustered random sampling technique. Data was entered into SPSS version 21 and analyzed. Descriptive statistics and multiple logistic regression models were applied. Results. A total of 681 patients have participated in this study with a response rate of 92%. The prevalence of self-prescription with antibiotics in Al Wazarat Health Center was 78.7%. Amoxicillin was the most used self-prescribed antibiotic with prevalence of (22.3%). Friend advice on self-prescription of antibiotics use (p = 0.000) and pharmacy near to the participants (p = 0.002) were the most common predictors for self-prescription with antibiotics. Conclusion. The level of self-prescribing antibiotics is relatively high among participants. Health education on the appropriate use of antibiotics is highly recommended. The proper use of treatment guidelines for antibiotic therapy will significantly reduce self-prescription with antibiotics. PMID:26881218

Factors influencing response to ingenol mebutate therapy for actinic keratosis of face and scalp

PubMed Central

Skroza, Nevena; Proietti, Ilaria; Bernardini, Nicoletta; Balduzzi, Veronica; Mambrin, Alessandra; Marchesiello, Anna; Tolino, Ersilia; Zuber, Sara; La Torre, Giuseppe; Potenza, Concetta

2017-01-01

AIM To determine factors independently influencing response to ingenol mebutate therapy and assess efficacy on clinical setting of non-hypertrophic non-hyperkeratotic actinic keratosis (AK). METHODS Consecutive patients affected by non-hypertrophic non-hyperkeratotic AKs of the face or scalp were enrolled to receive ingenol mebutate 0.015% gel on a selected skin area of 25 cm2 for 3 consecutive days. Local skin reactions were calculated at each follow up visit using a validated composite score. Efficacy was evaluated by the comparison of clinical and dermoscopic pictures before the treatment and at day 57, and classified as complete, partial and poor response. RESULTS A number of 130 patients were enrolled, of which 101 (77.7%) were treated on the face, while 29 (22.3%) on the scalp. The great majority of our study population (n = 119, 91.5%) reached at least a 75% clearance of AKs and, in particular, 58 patients (44.6%) achieved a complete response while 61 (46.9%) a partial one. Logistic backward multivariate analysis showed that facial localization, level of local skin reaction (LSR) at day 2, the highest LSR values and level of crusts at day 8 were factors independently associated with the achievement of a complete response. CONCLUSION Ingenol mebutate 0.015% gel, when properly applied, is more effective on the face than on the scalp and efficacy is directly associated to LSR score. PMID:29067277

A pilot study with very low-intensity, intermediate-frequency electric fields in patients with locally advanced and/or metastatic solid tumors.

PubMed

Salzberg, Marc; Kirson, Eilon; Palti, Yoram; Rochlitz, Christoph

2008-07-01

The transmission of electric fields using insulated electrodes has demonstrated that very low-intensity, properly tuned, intermediate-frequency electric fields, termed tumor-treating fields (TTFields), selectively stunts tumor cell growth and is accompanied by a decrease in tumor angiogenesis. This open, prospective pilot study was designed to evaluate the safety, tolerability, and efficacy profile of TTFields treatment in patients with locally advanced and/or metastatic solid tumors using the NovoTTF100A(TM) device. All 6 patients were heavily pre-treated with several lines of therapy; no additional standard treatment option was available to them. TTFields treatment using continuous NovoTTF-100A lasted a minimum of 14 days and was very well tolerated. No related serious adverse events occurred. Outcomes showed 1 partial response of a treated skin metastasis from a primary breast cancer, 3 cases where tumor growth was arrested during treatment, and 1 case of disease progression. One mesothelioma patient experienced lesion regression near TTFields with simultaneous tumor stability or progression in distal areas. Although the number of patients in this study is small, the lack of therapy toxicity and the efficacy observed in data gathered to date indicate the potential of TTFields as a new treatment modality for solid tumors, definitely warranting further investigation. (c) 2008 S. Karger AG, Basel

Necrotizing odontogenic fasciitis of head and neck extending to anterior mediastinum in elderly patients: innovative treatment with a review of the literature.

PubMed

Cortese, Antonio; Pantaleo, Giuseppe; Borri, Antonio; Amato, Massimo; Claudio, Pier Paolo

2017-02-01

Necrotizing fasciitis (NF) of odontogenic origin affecting the head and neck region is a rare but serious clinical condition, which, if diagnosed late, can lead to a fatal outcome. The early diagnosis of necrotizing fasciitis can be difficult. Delay in diagnosis leads to increase in the area of necrosis with a resulting increase in cosmetic deformity and life-threatening complication. In this study, we present two cases of elderly patients with aggressive NF affecting the neck and anterior mediastinum, which were of odontogenic origin. In the two patients selected necrotic skin and soft tissue were removed and wide exposure was achieved with debridement of the neck at the level of the affected layer of superficial cervical fascia. Saline solution was used as irrigation to treat the patients with acute necrotizing fasciitis. Difficulties in managing this condition with NF extent to deep anterior mediastinum is related to clavicle osteotomy or thoracotomy need with high surgical risks. In our technique, by gentle suction in anterior mediastinum, necrotic tissue resection was possible without any osteotomy need. Suctioning resection technique associated with hyperbaric, metabolic rebalance, and amino acid support in association with three types antibiotic therapy are fundamental points for correct therapy strategy, leading to full recovery and healing of NF patients even if in very unfavorable conditions. Multidisciplinary approach is paramount for proper treatment of this disease.

Burns induced by cupping therapy in a burn center in northeast china.

PubMed

Jing-Chun, Zhao; Jia-Ao, Yu; Chun-Jing, Xian; Kai, Shi; Lai-Jin, Lu

2014-07-01

Cupping therapy as a curative skill has been developed and applied throughout history. Despite reports of adverse effects, this therapy is considered to be relatively safe with no systemic reviews documenting negative side effects. The aim of this study was to explore methods that avoid the adverse effects sometimes associated with this therapy. Clinical records of 14 outpatients and inpatients that visited the First Hospital of Jilin University (Changchun, China) for management of burn injuries caused by cupping therapy were retrospectively reviewed. Characteristics, history of injury, and treatment of each patient was collected and analyzed. Burn injury induced by cupping therapy was not uncommon. Most of the injuries were mild to moderate and cured by conservative methods without severe complications. The use of wet cupping was more prevalent among injured patients than dry cupping. Cupping therapy as an ancient alternative treatment is still popular with a large number of devoted practitioners. Although there is the potential for injury during the application of this therapy, this is mostly preventable. Standardized training for health care professionals and increased the awareness among the public about the proper methods to administer this therapy to avoid adverse effects is important.

Reducing Stressful Aspects of Information Technology in Public Services.

ERIC Educational Resources Information Center

Quinn, Brian

1995-01-01

Identifies sources of technological stress for public services librarians and patrons and proposes ways to reduce stress, including communicating with staff, implementing a system gradually, providing adequate training, creating proper documentation, planning, considering ergonomics in hardware and software selection, selecting a good interface,…

GNSS Network Time Series Analysis

NASA Astrophysics Data System (ADS)

Balodis, J.; Janpaule, I.; Haritonova, D.; Normand, M.; Silabriedis, G.; Zarinjsh, A.; Zvirgzds, J.

2012-04-01

Time series of GNSS station results of both the EUPOS®-RIGA and LATPOS networks has been developed at the Institute of Geodesy and Geoinformation (University of Latvia) using Bernese v.5.0 software. The base stations were selected among the EPN and IGS stations in surroundings of Latvia. In various day solutions the base station selection has been miscellaneous. Most frequently 5 - 8 base stations were selected from a set of stations {BOR1, JOEN, JOZE, MDVJ, METS, POLV, PULK, RIGA, TORA, VAAS, VISO, VLNS}. The rejection of "bad base stations" was performed by Bernese software depending on the quality of proper station data in proper day. This caused a reason of miscellaneous base station selection in various days. The results of time series are analysed. The question aroused on the nature of some outlying situations. The seasonal effect of the behaviour of the network has been identified when distance and elevation changes between stations has been analysed. The dependence from various influences has been recognised.

Interferential and horizontal therapies in chronic low back pain due to multiple vertebral fractures: a randomized, double blind, clinical study.

PubMed

Zambito, A; Bianchini, D; Gatti, D; Rossini, M; Adami, S; Viapiana, O

2007-11-01

Chronic low back pain due to multiple vertebral fractures is of difficult management. Electrical nerve stimulation is frequently used, but its efficacy has never been properly evaluated. In a randomized placebo-controlled clinical trial, we have shown that both interferential currents and horizontal therapy are more effective than placebo for functional. Multiple vertebral fractures almost invariably ensue in chronic low back pain that remains of difficult management. Electrical nerve stimulation is frequently used but its efficacy has never been properly evaluated. One hundred and fifteen women with chronic back pain due to previous multiple vertebral osteoporotic fractures (CBPMF) were randomly assigned to either interferential currents (IFT), horizontal therapy (HT) or sham HT administered for 30 minutes daily for 5 days per week for two weeks together with a standard exercise program. Efficacy assessment was obtained at baseline and at week 2, 6 and 14 and included a functional questionnaire (Backill), the standard visual analog scale (VAS) and the mean analgesic consumption. At week 2 a significant and similar improvement in both the VAS and Backill score was observed in the three groups. The two scores continued to improve in the two active groups with changes significantly (p < 0.001) greater than those observed in control patients at week 6 and 14. The use of analgesic medications improved only in the HT group. This randomized double-blind controlled study provides the first evidence that IFT and HT therapy are significantly effective in alleviating both pain and disability in patients with CBPMF.

SU-F-J-194: Development of Dose-Based Image Guided Proton Therapy Workflow

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

Pham, R; Sun, B; Zhao, T

Purpose: To implement image-guided proton therapy (IGPT) based on daily proton dose distribution. Methods: Unlike x-ray therapy, simple alignment based on anatomy cannot ensure proper dose coverage in proton therapy. Anatomy changes along the beam path may lead to underdosing the target, or overdosing the organ-at-risk (OAR). With an in-room mobile computed tomography (CT) system, we are developing a dose-based IGPT software tool that allows patient positioning and treatment adaption based on daily dose distributions. During an IGPT treatment, daily CT images are acquired in treatment position. After initial positioning based on rigid image registration, proton dose distribution is calculatedmore » on daily CT images. The target and OARs are automatically delineated via deformable image registration. Dose distributions are evaluated to decide if repositioning or plan adaptation is necessary in order to achieve proper coverage of the target and sparing of OARs. Besides online dose-based image guidance, the software tool can also map daily treatment doses to the treatment planning CT images for offline adaptive treatment. Results: An in-room helical CT system is commissioned for IGPT purposes. It produces accurate CT numbers that allow proton dose calculation. GPU-based deformable image registration algorithms are developed and evaluated for automatic ROI-delineation and dose mapping. The online and offline IGPT functionalities are evaluated with daily CT images of the proton patients. Conclusion: The online and offline IGPT software tool may improve the safety and quality of proton treatment by allowing dose-based IGPT and adaptive proton treatments. Research is partially supported by Mevion Medical Systems.« less

Chromosome segregation drives division site selection in Streptococcus pneumoniae.

PubMed

van Raaphorst, Renske; Kjos, Morten; Veening, Jan-Willem

2017-07-18

Accurate spatial and temporal positioning of the tubulin-like protein FtsZ is key for proper bacterial cell division. Streptococcus pneumoniae (pneumococcus) is an oval-shaped, symmetrically dividing opportunistic human pathogen lacking the canonical systems for division site control (nucleoid occlusion and the Min-system). Recently, the early division protein MapZ was identified and implicated in pneumococcal division site selection. We show that MapZ is important for proper division plane selection; thus, the question remains as to what drives pneumococcal division site selection. By mapping the cell cycle in detail, we show that directly after replication both chromosomal origin regions localize to the future cell division sites, before FtsZ. Interestingly, Z-ring formation occurs coincidently with initiation of DNA replication. Perturbing the longitudinal chromosomal organization by mutating the condensin SMC, by CRISPR/Cas9-mediated chromosome cutting, or by poisoning DNA decatenation resulted in mistiming of MapZ and FtsZ positioning and subsequent cell elongation. Together, we demonstrate an intimate relationship between DNA replication, chromosome segregation, and division site selection in the pneumococcus, providing a simple way to ensure equally sized daughter cells.

Classification and treatment of periprosthetic supracondylar femur fractures.

PubMed

Ricci, William

2013-02-01

Locked plating and retrograde nailing are two accepted methods for treatment of periprosthetic distal femur fractures. Each has relative benefits and potential pitfalls. Appropriate patient selection and knowledge of the specific femoral component geometry are required to optimally choose between these two methods. Locked plating may be applied to most periprosthetic distal femur fractures. The fracture pattern, simple or comminuted, will dictate the specific plating technique, compression plating or bridge plating. Nailing requires an open intercondylar box and a distal fragment of enough size to allow interlocking. With proper patient selection and proper techniques, good results can be obtained with either method. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Streamflow data

USGS Publications Warehouse

Holmes, Robert R.; Singh, Vijay P.

2016-01-01

The importance of streamflow data to the world’s economy, environmental health, and public safety continues to grow as the population increases. The collection of streamflow data is often an involved and complicated process. The quality of streamflow data hinges on such things as site selection, instrumentation selection, streamgage maintenance and quality assurance, proper discharge measurement techniques, and the development and continued verification of the streamflow rating. This chapter serves only as an overview of the streamflow data collection process as proper treatment of considerations, techniques, and quality assurance cannot be addressed adequately in the space limitations of this chapter. Readers with the need for the detailed information on the streamflow data collection process are referred to the many references noted in this chapter. 

Stereotactic body radiation therapy for abdominal oligometastases: a biological and clinical review

PubMed Central

2012-01-01

Advances in imaging and biological targeting have led to the development of stereotactic body radiation therapy (SBRT) as an alternative treatment of extracranial oligometastases. New radiobiological concepts, such as ceramide-induced endothelial apoptosis after hypofractionated high-dose SBRT, and the identification of patients with oligometastatic disease by microRNA expression may yet lead to further developments. Key factors in SBRT are delivery of a high dose per fraction, proper patient positioning, target localisation, and management of breathing–related motion. Our review addresses the radiation doses and schedules used to treat liver, abdominal lymph node (LN) and adrenal gland oligometastases and treatment outcomes. Reported local control (LC) rates for liver and abdominal LN oligometastases are high (median 2-year actuarial LC: 61 -100% for liver oligometastases; 4-year actuarial LC: 68% in a study of abdominal LN oligometastases). Early toxicity is low-to-moderate; late adverse effects are rare. SBRT of adrenal gland oligometastases shows promising results in the case of isolated lesions. In conclusion, properly conducted SBRT procedures are a safe and effective treatment option for abdominal oligometastases. PMID:22852764

When to consider transfusion therapy for patients with non-transfusion-dependent thalassaemia.

PubMed

Taher, A T; Radwan, A; Viprakasit, V

2015-01-01

Non-transfusion-dependent thalassaemia (NTDT) refers to all thalassaemia disease phenotypes that do not require regular blood transfusions for survival. Thalassaemia disorders were traditionally concentrated along the tropical belt stretching from sub-Saharan Africa through the Mediterranean region and the Middle East to South and South-East Asia, but global migration has led to increased incidence in North America and Northern Europe. Transfusionists may be familiar with β-thalassaemia major because of the lifelong transfusions needed by these patients. Although patients with NTDT do not require regular transfusions for survival, they may require transfusions in some instances such as pregnancy, infection or growth failure. The complications associated with NTDT can be severe if not properly managed, and many are directly related to chronic anaemia. Awareness of NTDT is important, and this review will outline the factors that should be taken into consideration when deciding whether to initiate and properly plan for transfusion therapy in these patients in terms of transfusion interval and duration of treatment. © 2014 The Authors. Vox Sanguinis published by John Wiley & Sons Ltd on behalf of International Society of Blood Transfusion.

Naval Sea Systems Command Did Not Properly Apply Guidance Regarding Contracting Officers Representatives

DTIC Science & Technology

2016-03-18

Contract _______________________________ 10 PCO and ACO Did Not Ensure Appointment of COR ________________________________________ 12 NAVSEA Did Not Properly...sample was selected, NAVSEA had issued work for 36 availabilities on the contract—obligating $102.5M. { The procuring contracting officer ( PCO ) at...Responsibilities,” Section 1.602-2, “Responsibilities,” May 29, 2014. 3 The contracting officers for the contract reviewed are the PCO at NAVSEA

Therapies in inborn errors of oxidative metabolism

PubMed Central

Schiff, Manuel; Bénit, Paule; Jacobs, Howard T.; Vockley, Jerry; Rustin, Pierre

2014-01-01

Mitochondrial diseases encompass a wide range of presentations and mechanisms, dictating a need to consider both broad-based and disease-specific therapies. The manifestations of mitochondrial dysfunction and the response to therapy vary between individuals. This probably reflects the genetic complexity of mitochondrial biology, which requires an excess of 2000 genes for proper function, with numerous interfering epigenetic and environmental factors. Accordingly, we are increasingly aware of the complexity of these diseases which involve far more than merely decreased ATP supply. Indeed, recent therapeutic progress has addressed only specific disease entities. In this review present and prospective therapeutic approaches will be discussed on the basis of targets and mechanism of action, but with a broad outlook on their potential applications. PMID:22633959

29 CFR 1607.1 - Statement of purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... incorporate a single set of principles which are designed to assist employers, labor organizations, employment... are designed to provide a framework for determining the proper use of tests and other selection procedures. These guidelines do not require a user to conduct validity studies of selection procedures where...

29 CFR 1607.1 - Statement of purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... incorporate a single set of principles which are designed to assist employers, labor organizations, employment... are designed to provide a framework for determining the proper use of tests and other selection procedures. These guidelines do not require a user to conduct validity studies of selection procedures where...

29 CFR 1607.1 - Statement of purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... incorporate a single set of principles which are designed to assist employers, labor organizations, employment... are designed to provide a framework for determining the proper use of tests and other selection procedures. These guidelines do not require a user to conduct validity studies of selection procedures where...

29 CFR 1607.1 - Statement of purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... incorporate a single set of principles which are designed to assist employers, labor organizations, employment... are designed to provide a framework for determining the proper use of tests and other selection procedures. These guidelines do not require a user to conduct validity studies of selection procedures where...

29 CFR 1607.1 - Statement of purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... incorporate a single set of principles which are designed to assist employers, labor organizations, employment... are designed to provide a framework for determining the proper use of tests and other selection procedures. These guidelines do not require a user to conduct validity studies of selection procedures where...

Grading dermatologic adverse events of cancer treatments: the Common Terminology Criteria for Adverse Events Version 4.0.

PubMed

Chen, Alice P; Setser, Ann; Anadkat, Milan J; Cotliar, Jonathan; Olsen, Elise A; Garden, Benjamin C; Lacouture, Mario E

2012-11-01

Dermatologic adverse events to cancer therapies have become more prevalent and may to lead to dose modifications or discontinuation of life-saving or prolonging treatments. This has resulted in a new collaboration between oncologists and dermatologists, which requires accurate cataloging and grading of side effects. The Common Terminology Criteria for Adverse Events Version 4.0 is a descriptive terminology and grading system that can be used for uniform reporting of adverse events. A proper understanding of this standardized classification system is essential for dermatologists to properly communicate with all physicians caring for patients with cancer. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

[Focus: baker's asthma. Epidemiology, diagnosis and treatment of baker's asthma].

PubMed

Romano, Canzio

2014-01-01

Baker's asthma, though having been recognized and studied since long time, still stays one of the most common causes of occupational asthma. Moreover, our understanding of the causative agents, the pathophysiological mnechanisms, the usefulness of medical surveillance, the proper treatment and prevention of the disease is still scanty. This is due to either to its complex pathogenesis or to possible confoundings, besides the still inadequate quality and standardization of the tools available as far as the allergologic diagnosis is concerned. Proper medical surveillance, validated causal therapies, efficient primary prevention are still uncertain. Change of employment or relocation is often impossible, particularly among artisan workers. Various evidences have been critically revised and summarized.

"Have you seen your aura lately?" examining boundary-work in holistic health pamphlets.

PubMed

Ho, Evelyn Y

2007-01-01

An increasing number of people in the United States are using holistic therapies. Both encouraging and informing this trend in growth, printed leaflets are a popular and important medium for holistic health practitioners. Using a discourse analytic approach, the author analyzed pamphlets and printed texts distributed at a holistic health fair. These texts reflect and construct specific understandings of holistic health and proper health care. Understood through the notion of boundary-work, pamphlets demarcated holism as the proper way of conceptualizing health and health care. However, holistic medicine's boundaries are quite porous, as these practices are also legitimized through the use of scientific conventions and the practice of integration, both commonly associated with biomedicine.

VizieR Online Data Catalog: 1876 open clusters multimembership catalog (Sampedro+, 2017)

NASA Astrophysics Data System (ADS)

Sampedro, L.; Dias, W. S.; Alfaro, E. J.; Monteiro, H.; Molino, A.

2017-10-01

We use version 3.5 of the New Optically Visible Open Clusters and Candidates catalogue (hereafter DAML02; Dias et al., 2002, Cat. B/ocl), to select a sample of 2167 open clusters to be analysed. The stellar positions and the proper motions are taken from the UCAC4 (Zacharias et al., 2013, Cat. I/322). The catalogue contains data for over 113 million stars (105 million of them with proper-motion data), and is complete down to magnitude R=16. The positional accuracy of the listed objects is about 15-100mas per coordinate, depending on the magnitude. Formal errors in proper motions range from about 1 to 10mas/yr, depending on the magnitude and the observational history. Systematic errors in the proper motions are estimated to be about 1-4mas/yr. (2 data files).

Which factors hinder the decision of Polish HIV-positive patients to take up antiretroviral therapy?

PubMed

Rogowska-Szadkowska, D; Chlabicz, S; Oltarzewska, M A; Sawicka-Powierza, J

2009-03-01

The implementation of highly active antiretroviral therapy (HAART) in 1996 has significantly reduced mortality and morbidity for HIV-positive patients worldwide. However not all eligible persons start HAART. To identify reasons for therapy refusal by HIV-positive persons we performed a questionnaire study. The investigation was conducted among 321 HIV-positive individuals and focused on the decision to take up antiretroviral treatment. Out of 71 untreated patients, 34 (47.9%) admitted that in their case the therapy was not indicated, whereas 20 (28.3%) were afraid of potential side effects that might change their appearance, e.g. face lipoatrophy. Only the treated patients had been prepared to take up therapy, although 17 patients (6.0%) had not received any explanation of the therapy principles, aims or necessity to comply with medication regime. The therapy is generally not discussed with the patients for whom it is not currently indicated, which may contribute to the fixation of fears and prejudices. Doctors who treat HIV-positive patients should be aware of the prejudices and fears their patients have towards antiretroviral therapy in order to react properly and by means of the available antiretroviral drugs help prolong life and improve its quality.

Tumor-Treating Fields: Nursing Implications for an Emerging Technology
.

PubMed

Chang, Alice

2017-06-01

Tumor-treating fields (TTFields) are a new technology used for cancer treatment consisting of battery-powered, insulated electromagnetic transducers that are placed on the scalp. This wearable, adhesive device is a certified physician-prescribed therapy for patients with glioblastoma multiforme, a type of primary brain cancer. TTFields are being used concomitantly with temozolomide (Temodar®) in patients with newly diagnosed glioblastoma and as a monotherapy in patients with recurrent glioblastoma after radiation therapy and chemotherapy. Nursing professionals caring for patients using this emerging technology should be able to educate patients regarding proper use of TTFields and monitor for side effects.
.

[Secondary osteoporosis and glucocorticoid-induced osteoporosis].

PubMed

Orcel, P; Krane, S M

2000-10-01

In order to assess properly the diagnosis of osteoporosis, a short clinical investigation is required to address potential causes for bone loss. Osteoporosis used to be suspected in a patient with vertebral demineralization, but nowadays it is often diagnosed in a patient with a low bone mass on a screening dual-energy X-ray absorptiometry (DEXA). In this setting, it is important for the clinician to look for secondary osteoporosis, especially in men in whom secondary osteoporosis is more frequent than in women, before discussing any specific therapy. The major causes are longterm glucocorticoid therapy, endocrine (hypogonadism, primary hyperparathyroidism, hyperthyroidism), or digestive diseases.

The Role of Neoadjuvant Chemoradiation Therapy in Patients With Borderline Resectable Pancreatic Cancer With Isolated Venous Vascular Involvement.

PubMed

Lee, Jin Ho; Kang, Chang Moo; Bang, Seung Min; Choi, Jin Young; Seong, Jin Sil; Hwang, Ho Kyoung; Choi, Sung Hoon; Lee, Woo Jung

2015-08-01

The rationale for neoadjuvant chemoradiation therapy (Neo-CRT) and the definition of borderline resectable pancreatic cancer (BRPC) are still controversial. In particular, surgical treatment of BRPC with isolated venous vascular involvement (IVVI) is debatable.From January 2000 to December 2013, 84 patients diagnosed with BRPC according to NCCN guidelines were identified, and 70 patients were found to have BRPC with IVVI. We divided all 70 patients into 3 groups: surgery first without Neo-CRT (Group 1); pancreatectomy following Neo-CRT (Group 2); and no operation following Neo-CRT (Group 3). Patient characteristics including oncologic outcomes were analyzed for each of the 3 patients groups.Thirty-seven patients were female and 33 were male, with a mean age of 61.7 ± 9.74 years. Among the 70 BRPC patients with IVVI, 28 patients (40%) belonged to Group 1, 30 patients (42.9%) belonged to Group 2, and 12 patients (17.1%) belonged to Group 3. Pathological tumor size (P < 0.001), pT stage (P = 0.001), pTNM stage (P=0.002), combined vascular resection (P = 0.003), completeness of adjuvant therapy (P = 0.004) were found to be statistically significantly different between Groups 1 and 2. In addition, disease-free survival (P = 0.055) and disease-specific survival (DSS) (P=0.006) were improved in Group 2. Interestingly, when comparing DSS, there was no statistically significant difference between Groups 1 and 3 (P = 0.991).The clinical practice of pancreatectomy following Neo-CRT in BRPC with IVVI provided favorable oncologic outcomes. The effect of Neo-CRT in BRPC with IVVI may be multifactorial, providing proper patient selection, complete adjuvant chemotherapy, and potential therapeutic (downstaging) effect.

Diabetic foot infections: stepwise medical and surgical management.

PubMed

Armstrong, David G; Lipsky, Benjamin A

2004-06-01

Foot complications are common among diabetic patients; foot ulcers are among the more serious consequences. These ulcers frequently become infected, with potentially disastrous progression to deeper spaces and tissues. If not treated promptly and appropriately, diabetic foot infections can become incurable or even lead to septic gangrene, which may require foot amputation. Diagnosing infection in a diabetic foot ulcer is based on clinical signs and symptoms of inflammation. Properly culturing an infected lesion can disclose the pathogens and provide their antibiotic susceptibilities. Specimens for culture should be obtained after wound debridement to avoid contamination and optimise identification of pathogens. Staphylococcus aureus is the most common isolate in these infections; the increasing incidence of methicillin-resistant S. aureus over the past two decades has further complicated antibiotic treatment. While chronic infections are often polymicrobial, many acute infections in patients not previously treated with antibiotics are caused by a single pathogen, usually a gram-positive coccus. We offer a stepwise approach to treating diabetic foot infections. Most patients must first be medically stabilised and any metabolic aberrations should be addressed. Antibiotic therapy is not required for uninfected wounds but should be carefully selected for all infected lesions. Initial therapy is usually empirical but may be modified according to the culture and sensitivity results and the patient's clinical response. Surgical intervention is usually required in cases of retained purulence or advancing infection despite optimal medical therapy. Possible additional indications for surgical procedures include incision and drainage of an abscess, debridement of necrotic material, removal of any foreign bodies, arterial revascularisation and, when needed, amputation. Most foot ulcers occur on the plantar surface of the foot, thus requiring a plantar incision for any drainage procedure.

The Role of Ethnicity in the Higher Education Institution Selection Process

ERIC Educational Resources Information Center

Jordaan, Y.; Wiese, M.

2010-01-01

Changes in the higher education landscape have led to many higher education institutions reassessing their recruitment and marketing strategies. A proper understanding of the relative importance of the choice factors that prospective students consider when selecting a higher education institution will enable higher education administrators and…

Review of the results of the in vivo dosimetry during total skin electron beam therapy

PubMed Central

Guidi, Gabriele; Gottardi, Giovanni; Ceroni, Paola; Costi, Tiziana

2013-01-01

This work reviews results of in vivo dosimetry (IVD) for total skin electron beam (TSEB) therapy, focusing on new methods, data emerged within 2012. All quoted data are based on a careful review of the literature reporting IVD results for patients treated by means of TSEB therapy. Many of the reviewed papers refer mainly to now old studies and/or old guidelines and recommendations (by IAEA, AAPM and EORTC), because (due to intrinsic rareness of TSEB-treated pathologies) only a limited number of works and reports with a large set of numerical data and proper statistical analysis is up-to-day available in scientific literature. Nonetheless, a general summary of the results obtained by the now numerous IVD techniques available is reported; innovative devices and methods, together with areas of possible further and possibly multicenter investigations for TSEB therapies are highlighted. PMID:24936333

Endoscopic Therapy in Crohn's Disease: Principle, Preparation, and Technique.

PubMed

Chen, Min; Shen, Bo

2015-09-01

Stricture and fistula are common complications of Crohn's disease. Endoscopic balloon dilation and needle-knife stricturotomy has become a valid treatment option for Crohn's disease-associated strictures. Endoscopic therapy is also increasingly used in Crohn's disease-associated fistula. Preprocedural preparations, including routine laboratory testing, imaging examination, anticoagulant management, bowel cleansing and proper sedation, are essential to ensure a successful and safe endoscopic therapy. Adverse events, such as perforation and excessive bleeding, may occur during endoscopic intervention. The endoscopist should be well trained, always be cautious, anticipate for possible procedure-associated complications, be prepared for damage control during endoscopy, and have surgical backup ready. In this review, we discuss the principle, preparation, techniques of endoscopic therapy, as well as the prevention and management of endoscopic procedure-associated complications. We propose that inflammatory bowel disease endoscopy may be a part of training for "super" gastroenterology fellows, i.e., those seeking a career in advanced endoscopy or in inflammatory bowel disease.

Defining pathways for development of disease-modifying therapies in children with type 1 diabetes: a consensus report.

PubMed

Wherrett, Diane K; Chiang, Jane L; Delamater, Alan M; DiMeglio, Linda A; Gitelman, Stephen E; Gottlieb, Peter A; Herold, Kevan C; Lovell, Daniel J; Orchard, Trevor J; Ryan, Christopher M; Schatz, Desmond A; Wendler, David S; Greenbaum, Carla J

2015-10-01

Emerging data suggest that type 1 diabetes is a more aggressive disease in children than in adults, with important differences in pathophysiology and clinical course. Therefore, the efficacy of disease-modifying therapies may be different in the two populations. Understanding the developmental and regulatory pathways for type 1 diabetes-modifying therapies in children will enable industry, academia, funders, advocacy groups, and regulators to translate new science to clinical care. This consensus report characterizes the fundamental differences in type 1 diabetes between children and adults and proposes a thoughtful approach to better understand the development and regulatory pathways for type 1 diabetes therapies. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Options for the management of antiviral resistance during hepatitis B therapy: reflections on battles over a decade

PubMed Central

2013-01-01

Although much advancement has been achieved in the treatment of chronic hepatitis B, antiviral resistance is still a challenging issue. Previous generation antiviral agents have already developed resistance in a number of patients, and it is still being used especially in resource limited countries. Once antiviral resistance occurs, it predisposes to subsequent resistance, resulting in multidrug resistance. Therefore, prevention of initial antiviral resistance is the most important strategy, and appropriate choice and modification of therapy would be the cornerstone in avoiding treatment failures. Until now, management of antiviral resistance has been evolving from sequential therapy to combination therapy. In the era of tenofovir, the paradigm shifts again, and we have to decide when to switch and when to combine on the basis of newly emerging clinical data. We expect future eradication of chronic hepatitis B virus infection by proper prevention and optimal management of antiviral resistance. PMID:24133659

Misadministration of radiation therapy in veterinary medicine: a case report and literature review.

PubMed

Arkans, M M; Gieger, T L; Nolan, M W

2017-03-01

Recent technical advancements in radiation therapy have allowed for improved targeting of tumours and sparing nearby normal tissues, while simultaneously decreasing the risk for medical errors by incorporating additional safety checks into electronic medical record keeping systems. The benefits of these new technologies, however, depends on their proper integration and use in the oncology clinic. Despite the advancement of technology for treatment delivery and medical record keeping, misadministration errors have a significant impact on patient care in veterinary oncology. The first part of this manuscript describes a medical incident that occurred at an academic veterinary referral hospital, in a dog receiving a combination of stereotactic radiation therapy and full-course intensity-modulated, image-guided radiation therapy. The second part of the report is a literature review, which explores misadministration errors and novel challenges which arise with the implementation of advancing technologies in veterinary radiation oncology. © 2015 John Wiley & Sons Ltd.

Socioeconomic inequality in the use of rituximab therapy among non-Hodgkin lymphoma patients in Chinese public hospitals.

PubMed

Yu-Wen, Huang; Mei-Bian, Zhang; Xiang, Xu; Xiao-Hua, Xu; Quan, Zhou; Le, Jian

2014-03-01

Rituximab is a patient-paid effective monoclonal-antibody drug for non-Hodgkin lymphoma (NHL). Little is known in China, a country with unequal distribution of wealth and medical insurance systems, about the impact of socioeconomic status (SES) on selecting rituximab therapy in NHL patients. A total of 328 NHL inpatients in 2 public hospitals in Hangzhou were recruited and divided into 2 equal groups: with rituximab therapy and with no rituximab therapy group. Selection and frequency of rituximab therapy increased with duration of education and in urban citizens (P < .01). Officers and businessmen were more likely to use rituximab therapy compared with farmers (P < .01). Patients covered by Urban Employee Basic Medical Insurance were more likely to select rituximab therapy than those insured with Urban-Rural Residents Basic Medical Insurance (P < .01). There was an inequality in provision of rituximab therapy among Chinese NHL patients, and this was associated with differences in SES status. Effective measures are suggested to ameliorate the inequality issue.

Biomarker-guided antibiotic therapy-strengths and limitations.

PubMed

Nora, David; Salluh, Jorge; Martin-Loeches, Ignacio; Póvoa, Pedro

2017-05-01

Biomarkers as C-reactive protein (CRP) and procalcitonin (PCT) emerged as tools to help clinicians to diagnose infection and to properly initiate and define the duration of antibiotic therapy. Several randomized controlled trials, including adult critically ill patients, showed that PCT-guided antibiotic stewardship was repeatedly associated with a decrease in the duration of antibiotic therapy with no apparent harm. There are however some relevant limitations in these trials namely the low rate of compliance of PCT-guided algorithms, the high rate of exclusion (without including common clinical situations and pathogens) and the long duration of antibiotic therapy in control groups. Such limitations weakened the real impact of such algorithms in the clinical decision-making process and strengthened the concept that the initiation and the duration of antibiotic therapy cannot depend solely on a biomarker. Future efforts should address these limitations in order to better clarify the role of biomarkers on the complex and multifactorial issue of antibiotic management and to deeply understand its potential effect on mortality.

Clinical use of anti-TNF therapy and increased risk of infections

PubMed Central

Ali, Tauseef; Kaitha, Sindhu; Mahmood, Sultan; Ftesi, Abdul; Stone, Jordan; Bronze, Michael S

2013-01-01

Biologics such as antitumor necrosis factor (anti-TNF) drugs have emerged as important agents in the treatment of many chronic inflammatory diseases, especially in cases refractory to conventional treatment modalities. However, opportunistic infections have become a major safety concern in patients on anti-TNF therapy, and physicians who utilize these agents must understand the increased risks of infection. A literature review of the published data on the risk of bacterial, viral, fungal, and parasitic infections associated with anti-TNF therapy was performed and the clinical presentation, diagnostic tests, management, and prevention of opportunistic infections in patients receiving anti-TNF therapy were reviewed. Awareness of the therapeutic potential and associated adverse events is necessary for maximizing therapeutic benefits while minimizing adverse effects from anti-TNF treatments. Patients should be adequately vaccinated when possible and closely monitored for early signs of infection. When serious infections occur, withdrawal of anti-TNF therapy may be necessary until the infection has been identified and properly treated. PMID:23569399

Identification of Reduced-Order Thermal Therapy Models Using Thermal MR Images: Theory and Validation

PubMed Central

2013-01-01

In this paper, we develop and validate a method to identify computationally efficient site- and patient-specific models of ultrasound thermal therapies from MR thermal images. The models of the specific absorption rate of the transduced energy and the temperature response of the therapy target are identified in the reduced basis of proper orthogonal decomposition of thermal images, acquired in response to a mild thermal test excitation. The method permits dynamic reidentification of the treatment models during the therapy by recursively utilizing newly acquired images. Such adaptation is particularly important during high-temperature therapies, which are known to substantially and rapidly change tissue properties and blood perfusion. The developed theory was validated for the case of focused ultrasound heating of a tissue phantom. The experimental and computational results indicate that the developed approach produces accurate low-dimensional treatment models despite temporal and spatial noises in MR images and slow image acquisition rate. PMID:22531754

Triadic Model for Working with Parents in Child Therapy Settings

ERIC Educational Resources Information Center

Jeon, Mi-Hee; Myers, Charles E.

2017-01-01

Child therapists face challenges regarding whether they should meet needs of not only their child-clients but needs of the parents of their clients. Their difficulties arise from the fact that although they are specialized in counseling children, the majority of them lack proper training in or education on working with parents (Lolan, 2011). Given…

Mindfullness-Based Cognitive Therapy as a Complementary Treatment for Combat/Operational Stress and Combat Post-Traumatic Stress Disorder

DTIC Science & Technology

2008-01-01

FROM, OR REPRODUCTION OF ALL OR ANY PART OF THIS DOCUMENT IS PERMITTED PROVIDED PROPER ACKNOWLEDGEMENT IS MADE. 111 Table ofContents Page EXECUTIVE...to a threat of toxicity. Hypnotic and sedative medications12 are the final class of drugs to be considered. These decrease anxiety and agitation

Bipolar Disorder.

PubMed

Miller, Thomas H

2016-06-01

Bipolar disorder is a chronic mental health disorder that is frequently encountered in primary care. Many patients with depression may actually have bipolar disorder. The management of bipolar disorder requires proper diagnosis and awareness or referral for appropriate pharmacologic therapy. Patients with bipolar disorder require primary care management for comorbidities such as cardiovascular and metabolic disorders. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of Sample Selection on Estimates of Economic Impacts of Outdoor Recreation

Treesearch

Donald B.K. English

1997-01-01

Estimates of the economic impacts of recreation often come from spending data provided by a self-selected subset of a random sample of site visitors. The subset is frequently less than half the onsite sample. Biased vectors of per trip spending and impact estimates can result if self-selection is related to spending pattctns, and proper corrective procedures arc not...

Selecting Proper Plant Species for Mine Reclamation Using Fuzzy AHP Approach (Case Study: Chadormaloo Iron Mine of Iran)

NASA Astrophysics Data System (ADS)

Ebrahimabadi, Arash

2016-12-01

This paper describes an effective approach to select suitable plant species for reclamation of mined lands in Chadormaloo iron mine which is located in central part of Iran, near the city of Bafgh in Yazd province. After mine's total reserves are excavated, the mine requires to be permanently closed and reclaimed. Mine reclamation and post-mining land-use are the main issues in the phase of mine closure. In general, among various scenarios for mine reclamation process, i.e. planting, agriculture, forestry, residency, tourist attraction, etc., planting is the oldest and commonly-used technology for the reclamation of lands damaged by mining activities. Planting and vegetation play a major role in restoring productivity, ecosystem stability and biological diversity to degraded areas, therefore the main goal of this research work is to choose proper and suitable plants compatible with the conditions of Chadormaloo mined area, providing consistent conditions for future use. To ensure the sustainability of the reclaimed landscape, the most suitable plant species adapted to the mine conditions are selected. Plant species selection is a Multi Criteria Decision Making (MCDM) problem. In this paper, a fuzzy MCDM technique, namely Fuzzy Analytic Hierarchy Process (FAHP) is developed to assist chadormaloo iron mine managers and designers in the process of plant type selection for reclamation of the mine under fuzzy environment where the vagueness and uncertainty are taken into account with linguistic variables parameterized by triangular fuzzy numbers. The results achieved from using FAHP approach demonstrate that the most proper plant species are ranked as Artemisia sieberi, Salsola yazdiana, Halophytes types, and Zygophyllum, respectively for reclamation of Chadormaloo iron mine.

Anesthetic considerations for pediatric electroconvulsive therapy.

PubMed

Franklin, Andrew D; Sobey, Jenna H; Stickles, Eric T

2017-05-01

Electroconvulsive therapy is being used more frequently in the treatment of many chronic and acute psychiatric illnesses in children. The most common psychiatric indications for pediatric electroconvulsive therapy are refractory depression, bipolar disorder, schizophrenia, catatonia, and autism. In addition, a relatively new indication is the treatment of pediatric refractory status epilepticus. The anesthesiologist may be called upon to assist in the care of this challenging and vulnerable patient population. Unique factors for pediatric electroconvulsive therapy include the potential need for preoperative anxiolytic and inhalational induction of anesthesia, which must be weighed against the detrimental effects of anesthetic agents on the evoked seizure quality required for a successful treatment. Dexmedetomidine is likely the most appropriate preoperative anxiolytic as oral benzodiazepines are relatively contraindicated. Methohexital, though becoming less available at many institutions, remains the gold standard for induction of anesthesia for pediatric electroconvulsive therapy though ketamine, propofol, and sevoflurane are becoming increasingly viable options. Proper planning and communication between the multidisciplinary teams involved in the care of children presenting for electroconvulsive therapy treatments is vital to mitigating risks and achieving the greatest therapeutic benefit. © 2017 John Wiley & Sons Ltd.

Application of photodynamic therapy, laser therapy, and a cellulose membrane for calcaneal pressure ulcer treatment in a diabetic patient: A case report.

PubMed

Rosa, Luciano Pereira; da Silva, Francine Cristina; Vieira, Regiane Lima; Tanajura, Beatriz Rocha; da Silva Gusmão, Alana Gonçalves; de Oliveira, Janeide Muritiba; Dos Santos, Nathalia Aparecida Campanário; Bagnato, Vanderlei Salvador

2017-09-01

Diabetes mellitus is a metabolic disorder in which a person has high blood glucose levels due to inadequate insulin production by the pancreas. Wounds in these individuals cannot heal properly over time due to circulatory changes that hinder and stagnate the healing process. We report the case of an 82-year-old female type 2 diabetes mellitus carrier, presenting to clinical-dermatological examination pressure ulcer (PU) in the right calcaneus region. The patient was treated with photodynamic therapy using curcumin and blue light-emitting diodes (LEDs), laser therapy, and the application of a cellulose membrane in order to promote ulcer decontamination by local action, accelerate wound healing, and maintain favorable conditions of asepsis and moisture, respectively. The ulcer healing occurred after 30days of treatment and total epithelialization was observed. From the results obtained in this case report, we conclude that the combination of photodynamic therapy, laser therapy, and coating with a cellulose membrane is a promising treatment for the healing of PU in diabetic patients. Copyright © 2017 Elsevier B.V. All rights reserved.

Laser Interstitial Thermal Therapy Technology, Physics of Magnetic Resonance Imaging Thermometry, and Technical Considerations for Proper Catheter Placement During Magnetic Resonance Imaging-Guided Laser Interstitial Thermal Therapy.

PubMed

Patel, Nitesh V; Mian, Matthew; Stafford, R Jason; Nahed, Brian V; Willie, Jon T; Gross, Robert E; Danish, Shabbar F

2016-12-01

Laser-induced thermal therapy has become a powerful tool in the neurosurgical armamentarium. The physics of laser therapy are complex, but a sound understanding of this topic is clinically relevant, as many centers have incorporated it into their treatment algorithm, and educated patients are demanding consideration of its use for their disease. Laser ablation has been used for a wide array of intracranial lesions. Laser catheter placement is guided by stereotactic planning; however, as the procedure has popularized, the number of ways in which the catheter can be inserted has also increased. There are many technical nuances for laser placement, and, to date, there is not a clear understanding of whether any one technique is better than the other. In this review, we describe the basic physics of magnetic resonance-guided laser-induced thermal therapy and describe the several common techniques for accurate Visualase laser catheter placement in a stepwise fashion. MRg-LITT, magnetic resonance-guided laser-induced thermal therapyPAD, precision aiming device.

Photodynamic therapy toward selective endometrial ablation

NASA Astrophysics Data System (ADS)

Tadir, Yona; Tromberg, Bruce J.; Krasieva, Tatiana B.; Berns, Michael W.

1993-05-01

Potential applications of photodynamic therapy for endometrial disease are discussed. Experimental models that may lead to diagnosis and treatment of endometriosis as well as selective endometrial ablation are summarized.

An Update on Clinical Burden, Diagnostic Tools, and Therapeutic Options of Staphylococcus aureus

PubMed Central

Reddy, Prakash Narayana; Srirama, Krupanidhi; Dirisala, Vijaya R

2017-01-01

Staphylococcus aureus is an important pathogen responsible for a variety of diseases ranging from mild skin and soft tissue infections, food poisoning to highly serious diseases such as osteomyelitis, endocarditis, and toxic shock syndrome. Proper diagnosis of pathogen and virulence factors is important for providing timely intervention in the therapy. Owing to the invasive nature of infections and the limited treatment options due to rampant spread of antibiotic-resistant strains, the trend for development of vaccines and antibody therapy is increasing at rapid rate than development of new antibiotics. In this article, we have discussed elaborately about the host-pathogen interactions, clinical burden due to S aureus infections, status of diagnostic tools, and treatment options in terms of prophylaxis and therapy. PMID:28579798

Prospective study to determine early hypertrophy of the contra-lateral liver lobe after unilobar, Yttrium-90, selective internal radiation therapy in patients with hepatocellular carcinoma.

PubMed

Teo, Jin Yao; Allen, John Carson; Ng, David Chee Eng; Abdul Latiff, Julianah Bee; Choo, Su Pin; Tai, David Wai-Meng; Low, Albert Su Chong; Cheah, Foong Koon; Chang, Jason Pik Eu; Kam, Juinn Huar; Lee, Victor T W; Chung, Alexander Yaw Fui; Chan, Chung Yip; Chow, Pierce Kah Hoe; Goh, Brian K P

2018-05-01

Liver resection is a major curative option in patients presenting with hepatocellular carcinoma. An inadequate functional liver remnant is a major limiting factor precluding liver resection. In recent years, hypertrophy of the functional liver remnant after selective internal radiation therapy hypertrophy has been observed, but the degree of hypertrophy in the early postselective internal radiation therapy period has not been well studied. We conducted a prospective study on patients undergoing unilobar, Yttrium-90 selective internal radiation therapy for hepatocellular carcinoma to evaluate early hypertrophy at 4-6 weeks and 8-12 weeks after selective internal radiation therapy. In the study, 24 eligible patients were recruited and had serial volumetric measurements performed. The median age was 66 years (38-75 years). All patients were either Child-Pugh Class A or B, and 6/24 patients had documented, clinically relevant portal hypertension; 15 of the 24 patients were hepatitis B positive. At 4-6 weeks, modest hypertrophy was seen (median 3%; range -12 to 42%) and this increased at 8-12 weeks (median 9%; range -12 to 179%). No preprocedural factors predictive of hypertrophy were identified. Hypertrophy of the functional liver remnant after selective internal radiation therapy with Yttrium-90 occurred in a subset of patients but was modest and unpredictable in the early stages. Selective internal radiation therapy cannot be recommended as a standard treatment modality to induce early hypertrophy for patients with hepatocellular carcinoma. (Surgery 2017;160:XXX-XXX.). Copyright © 2017 Elsevier Inc. All rights reserved.

Play Therapy: Facilitative Use of Child's Play in Elementary School Counseling.

ERIC Educational Resources Information Center

Landreth, Garry L.

1987-01-01

Reviews five major developments in play therapy: psychoanalysis, release therapy, relationship therapy, nondirective therapy, and play therapy in school settings. Suggests ways school counselors can use play therapy. Describes play therapy facilities, location selection, and play materials. Lists objectives of play therapy and how teachers can aid…

A Case of Ruptured Aneurysm of the Proper Esophageal Artery with Symptomatic Mediastinal Hematoma

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

Liu, Jiajia; Sato, Yusuke, E-mail: yusuke@doc.med.akita-u.ac.jp; Takahashi, Satoshi

Mediastinal aneurysms are rare but potentially life-threatening. Among these, bronchial artery aneurysms are most frequently reported, whereas up to now aneurysms of the proper esophageal artery had never been reported. A 69-year-old woman was referred to our hospital for treatment of a massive mediastinal hematoma. Enhanced computed tomography and selective proper esophageal arteriography revealed a 5-mm aneurysm in the proper esophageal artery that arises from the thoracic aorta at the Th8 level and has an anastomotic branch with the bronchial artery peripherally. Transcatheter arterial embolization was successfully performed using a mixture of N-butyl cyanoacrylate and lipiodol (1:3 ratio, 0.3 ml). Post-embolizationmore » angiography showed no filling into the aneurysm. The patient recovered with no complications and was discharged on the 25th post-procedure day.« less

Classification of urine sediment based on convolution neural network

NASA Astrophysics Data System (ADS)

Pan, Jingjing; Jiang, Cunbo; Zhu, Tiantian

2018-04-01

By designing a new convolution neural network framework, this paper breaks the constraints of the original convolution neural network framework requiring large training samples and samples of the same size. Move and cropping the input images, generate the same size of the sub-graph. And then, the generated sub-graph uses the method of dropout, increasing the diversity of samples and preventing the fitting generation. Randomly select some proper subset in the sub-graphic set and ensure that the number of elements in the proper subset is same and the proper subset is not the same. The proper subsets are used as input layers for the convolution neural network. Through the convolution layer, the pooling, the full connection layer and output layer, we can obtained the classification loss rate of test set and training set. In the red blood cells, white blood cells, calcium oxalate crystallization classification experiment, the classification accuracy rate of 97% or more.

Target Selection for the SDSS-III MARVELS Survey

NASA Astrophysics Data System (ADS)

Paegert, Martin; Stassun, Keivan G.; De Lee, Nathan; Pepper, Joshua; Fleming, Scott W.; Sivarani, Thirupathi; Mahadevan, Suvrath; Mack, Claude E., III; Dhital, Saurav; Hebb, Leslie; Ge, Jian

2015-06-01

We present the target selection process for the Multi-object APO Radial Velocity Exoplanets Large-area Survey (MARVELS), which is part of the Sloan Digital Sky Survey (SDSS) III. MARVELS is a medium-resolution (R ∼ 11,000) multi-fiber spectrograph capable of obtaining radial velocities for 60 objects at a time in order to find brown dwarfs and giant planets. The survey was configured to target dwarf stars with effective temperatures approximately between 4500 and 6250 K. For the first 2 years MARVELS relied on low-resolution spectroscopic pre-observations to estimate the effective temperature and log (g) for candidate stars and then selected suitable dwarf stars from this pool. Ultimately, the pre-observation spectra proved ineffective at filtering out giant stars; many giants were incorrectly classified as dwarfs, resulting in a giant contamination rate of ∼30% for the first phase of the MARVELS survey. Thereafter, the survey instead applied a reduced proper motion cut to eliminate giants and used the Infrared Flux Method to estimate effective temperatures, using only extant photmetric and proper-motion catalog information. The target selection method introduced here may be useful for other surveys that need to rely on extant catalog data for selection of specific stellar populations.

Lowering the Radiation Dose in Dental Offices.

PubMed

Radan, Elham

2017-04-01

While the use of dental imaging continues to evolve into more advanced modalities such as 3-D cone beam computed tomography, in addition to conventional 2-D imaging (intraoral, panoramic and cephalometric), the public concern for radiation safety is also increasing. This article is a guide for how to reduce patients’ exposure to the minimum with proper selection criteria (as needed only if it benefits the patient) and knowledge of effective doses, exposure parameters and proper collimation.

Proper poster presentation: a visual and verbal ABC.

PubMed

Wright, V; Moll, J M

1987-08-01

The 58 posters exhibited at the 1985 Annual General Meeting of the British Society for Rheumatology have been analysed for 13 variables considered important in the construction of a good poster. In particular the attributes of information, simplicity and visual attractiveness were studied. The time spent by viewers was also measured for one selected poster each in immunology, biochemistry, therapeutics and clinical medicine. On the basis of this survey, nine recommendations for proper presentation were made.

Influence of acoustic impedance of multilayer acoustic systems on the transfer function of ultrasonic airborne transducers.

PubMed

Gudra, Tadeusz; Opieliński, Krzysztof J

2002-05-01

In different solutions of ultrasonic transducers radiating acoustic energy into the air there occurs the problem of the proper selection of the acoustic impedance of one or more matching layers. The goal of this work was a computer analysis of the influence of acoustic impedance on the transfer function of piezoceramic transducers equipped with matching layers. Cases of resonance and non-resonance matching impedance in relation to the transfer function and the energy transmission coefficient for solid state-air systems were analysed. With stable thickness of matching layers the required shape of the transfer function can be obtained through proper choice of acoustic impedance were built (e.g. maximal flat function). The proper choice of acoustic impedance requires an elaboration of precise methods of synthesis of matching systems. Using the known matching criteria (Chebyshev's, DeSilets', Souquet's), the transfer function characteristics of transducers equipped with one, two, and three matching layers as well as the optimisation methods of the energy transmission coefficient were presented. The influence of the backside load of the transducer on the shape of transfer function was also analysed. The calculation results of this function for different loads of the transducer backside without and with the different matching layers were presented. The proper load selection allows us to obtain the desired shape of the transfer function, which determines the pulse shape generated by the transducer.

Development of guidelines for proper selection of finer graded aggregate base for Georgia pavements - phase I.

DOT National Transportation Integrated Search

2014-09-01

In this study, the effects of No. 810 screening contents in GAB on pavement performance and GAB strength were investigated. One : Group I (013C) source and three Group II sources (028C, 048C, and 158C) were selected and specimens were prepared for Pr...

DNA fingerprinting sets for four southern pines

Treesearch

Craig Echt; Sedley Josserand

2018-01-01

DNA markers can provide valuable genetic information for forest tree research, breeding, conservation, and restoration programs. When properly evaluated, selected sets of DNA markers can be used to efficiently get information about genetic diversity in regions, forests, or stands, or in seed lots and orchards. Selected markers also can be used to determine parentage or...

Chiral catalysts immobilized on achiral polymers: effect of the polymer support on the performance of the catalyst.

PubMed

Altava, Belén; Burguete, M Isabel; García-Verdugo, Eduardo; Luis, Santiago V

2018-04-23

Positive effects of the polymeric support on the performance of supported chiral catalysts, in terms of activity, stability and selectivity-enantioselectivity, have been reported when the support is properly selected and optimized opening the way to the design of more efficient catalytic systems.

Embedded Multiprocessor Technology for VHSIC Insertion

NASA Technical Reports Server (NTRS)

Hayes, Paul J.

1990-01-01

Viewgraphs on embedded multiprocessor technology for VHSIC insertion are presented. The objective was to develop multiprocessor system technology providing user-selectable fault tolerance, increased throughput, and ease of application representation for concurrent operation. The approach was to develop graph management mapping theory for proper performance, model multiprocessor performance, and demonstrate performance in selected hardware systems.

Strongylus vulgaris associated with usage of selective therapy on Danish horse farms-is it reemerging?

PubMed

Nielsen, M K; Vidyashankar, A N; Olsen, S N; Monrad, J; Thamsborg, S M

2012-10-26

Nematodes belonging to the order Strongylida are ubiquitous in grazing horses, and the large strongyle Strongylus vulgaris is considered the most pathogenic. This parasite was originally described widely prevalent in equine establishments, but decades of frequent anthelmintic treatment appears to have reduced the prevalence dramatically. Increasing levels of anthelmintic resistance in cyathostomin parasites have led to implementation of selective therapy to reduce further development of resistance. It has been hypothesized that S. vulgaris could reoccur under these less intensive treatment circumstances. The aim with the present study was to evaluate the occurrence of S. vulgaris and the possible association with usage of selective therapy. A total of 42 horse farms in Denmark were evaluated for the presence of S. vulgaris using individual larval cultures. Farms were either using a selective therapy principle based on regular fecal egg counts from all horses, or they treated strategically without using fecal egg counts. A total of 662 horses were included in the study. Covariate information at the farm and horse level was collected using a questionnaire. The overall prevalence of S. vulgaris was 12.2% at the individual level and 64.3% at the farm level. Farms using selective therapy had horse and farm prevalences of 15.4% and 83.3%, respectively, while the corresponding results for farms not using selective therapy were 7.7% and 38.9%. These findings were found statistically significant at both the horse and the farm level. Stud farms using selective therapy were especially at risk, and occurrence of S. vulgaris was significantly associated with the most recent deworming occurring more than six months prior. The results suggest that a strict interpretation of the selective therapy regimen can be associated with an increased prevalence of S. vulgaris. This suggests that modifications of the parasite control programs could be considered on the studied farms, but it remains unknown to which extent this can be associated with increased health risks for infected horses. Copyright © 2012 Elsevier B.V. All rights reserved.

Reducer Selection When Doing Overall Paint Jobs Using Enamel Paints. Lesson Plan No. 1 of Auto Repair and Painting.

ERIC Educational Resources Information Center

Tyau, Layton M.

This lesson, which is part of a high school course in auto body repair and painting, deals with selecting a reducer when doing overall paint jobs using enamel paints. Students are taught the general properties of different types of enamel paints and selection of the proper reducer for each type of paint, depending on the weather and the specific…

Contract Source Selection: An Analysis of Lowest Price Technically Acceptable and Tradeoff Strategies

DTIC Science & Technology

2016-06-01

thorough market research, acquisition professionals must decide at an early stage which source selection strategy (lowest price technically...minimizing risk and ensuring best value for all stakeholders. On the basis of thorough market research, acquisition professionals must decide at an early...price-based, market -driven environment from requirements development through properly disposal. Source selection must be 8 made on a ‘best value

A State-of-the-Art Review: Personalization of Tinnitus Sound Therapy.

PubMed

Searchfield, Grant D; Durai, Mithila; Linford, Tania

2017-01-01

Background: There are several established, and an increasing number of putative, therapies using sound to treat tinnitus. There appear to be few guidelines for sound therapy selection and application. Aim: To review current approaches to personalizing sound therapy for tinnitus. Methods: A "state-of-the-art" review (Grant and Booth, 2009) was undertaken to answer the question: how do current sound-based therapies for tinnitus adjust for tinnitus heterogeneity? Scopus, Google Scholar, Embase and PubMed were searched for the 10-year period 2006-2016. The search strategy used the following key words: "tinnitus" AND "sound" AND "therapy" AND "guidelines" OR "personalized" OR "customized" OR "individual" OR "questionnaire" OR "selection." The results of the review were cataloged and organized into themes. Results: In total 165 articles were reviewed in full, 83 contained sufficient details to contribute to answering the study question. The key themes identified were hearing compensation, pitched-match therapy, maskability, reaction to sound and psychosocial factors. Although many therapies mentioned customization, few could be classified as being personalized. Several psychoacoustic and questionnaire-based methods for assisting treatment selection were identified. Conclusions: Assessment methods are available to assist clinicians to personalize sound-therapy and empower patients to be active in therapy decision-making. Most current therapies are modified using only one characteristic of the individual and/or their tinnitus.

Urinary tract infection caused by Chromobacterium violaceum.

PubMed

Pant, Narayan Dutt; Sharma, Manisha

2015-01-01

Chromobacterium violaceum, a proteobacterium, is a facultative anaerobe, which is generally present as the normal flora of water and soil in tropical and subtropical regions. The infection due to Chromobacterium violaceum is rare but mostly fatal. It is responsible for causing fatal cases of septicemia, visceral abscesses, skin and soft tissue infections, meningitis, diarrhea, and rarely urinary tract infection. The bacteria has high propensity to spread causing sepsis. Delayed proper treatment due to limited awareness related to the C. violaceum infection is responsible for the high mortality rate. Here, we describe a rare case of urinary tract infection by C. violaceum in a chronic kidney disease patient, which was managed with timely proper antimicrobial therapy as per the culture sensitivity report.

Metrology and Calibration

NASA Technical Reports Server (NTRS)

Mathews, Kenneth W.; Wachter, James R.

2018-01-01

The purpose of this NASA Technical Standard is to ensure the accuracy of measurements affecting safety and mission success through the proper selection, calibration, and use of Measuring and Test Equipment (MTE).

Treatment and pathogenesis of acute hyperkalemia

PubMed Central

Mushiyakh, Yelena; Dangaria, Harsh; Qavi, Shahbaz; Ali, Noorjahan; Pannone, John; Tompkins, David

2012-01-01

This article focuses on the pathogenesis, clinical manifestations, and various treatment modalities for acute hyperkalemia and presents a systematic approach to selecting a treatment strategy. Hyperkalemia, a life-threatening condition caused by extracellular potassium shift or decreased renal potassium excretion, usually presents with non-specific symptoms. Early recognition of moderate to severe hyperkalemia is vital in preventing fatal cardiac arrhythmias and muscle paralysis. Management of hyperkalemia includes the elimination of reversible causes (diet, medications), rapidly acting therapies that shift potassium into cells and block the cardiac membrane effects of hyperkalemia, and measures to facilitate removal of potassium from the body (saline diuresis, oral binding resins, and hemodialysis). Hyperkalemia with potassium level more than 6.5 mEq/L or EKG changes is a medical emergency and should be treated accordingly. Treatment should be started with calcium gluconate to stabilize cardiomyocyte membranes, followed by insulin injection, and b-agonists administration. Hemodialysis remains the most reliable method to remove potassium from the body and should be used in cases refractory to medical treatment. Prompt detection and proper treatment are crucial in preventing lethal outcomes. PMID:23882341

Management of Pancreatic Calculi: An Update.

PubMed

Tandan, Manu; Talukdar, Rupjyoti; Reddy, Duvvur Nageshwar

2016-11-15

Pancreatolithiasis, or pancreatic calculi (PC), is a sequel of chronic pancreatitis (CP) and may occur in the main ducts, side branches or parenchyma. Calculi are the end result, irrespective of the etiology of CP. PC contains an inner nidus surrounded by successive layers of calcium carbonate. These calculi obstruct the pancreatic ducts and produce ductal hypertension, which leads to pain, the cardinal feature of CP. Both endoscopic therapy and surgery aim to clear these calculi and decrease ductal hypertension. In small PC, endoscopic retrograde cholangiopancreatography (ERCP) followed by sphincterotomy and extraction is the treatment of choice. Large calculi require fragmentation by extracorporeal shock wave lithotripsy (ESWL) prior to their extraction or spontaneous expulsion. In properly selected cases, ESWL followed by ERCP is the standard of care for the management of large PC. Long-term outcomes following ESWL have demonstrated good pain relief in approximately 60% of patients. However, ESWL has limitations. Per oral pancreatoscopy and intraductal lithotripsy represent techniques in evolution, and in current practice their use is limited to centers with considerable expertise. Surgery should be offered to all patients with extensive PC, associated multiple ductal strictures or following failed endotherapy.

Analysis of Pre-Analytic Factors Affecting the Success of Clinical Next-Generation Sequencing of Solid Organ Malignancies.

PubMed

Chen, Hui; Luthra, Rajyalakshmi; Goswami, Rashmi S; Singh, Rajesh R; Roy-Chowdhuri, Sinchita

2015-08-28

Application of next-generation sequencing (NGS) technology to routine clinical practice has enabled characterization of personalized cancer genomes to identify patients likely to have a response to targeted therapy. The proper selection of tumor sample for downstream NGS based mutational analysis is critical to generate accurate results and to guide therapeutic intervention. However, multiple pre-analytic factors come into play in determining the success of NGS testing. In this review, we discuss pre-analytic requirements for AmpliSeq PCR-based sequencing using Ion Torrent Personal Genome Machine (PGM) (Life Technologies), a NGS sequencing platform that is often used by clinical laboratories for sequencing solid tumors because of its low input DNA requirement from formalin fixed and paraffin embedded tissue. The success of NGS mutational analysis is affected not only by the input DNA quantity but also by several other factors, including the specimen type, the DNA quality, and the tumor cellularity. Here, we review tissue requirements for solid tumor NGS based mutational analysis, including procedure types, tissue types, tumor volume and fraction, decalcification, and treatment effects.

Treatment Concept for a Patient with a High Smile Line and Gingival Pigmentation: A Case Report.

PubMed

Zarone, Fernando; Leone, Renato; Ferrari, Marco; Sorrentino, Roberto

Today, innovative restorative materials and techniques allow for minimally invasive prosthetic procedures, which are paramount to the preservation of hard and soft dental tissues. An integrated approach combining dental and esthetic medical therapies could be useful to improve the quality of life of patients, improving function, esthetics, and self-confidence. Oral esthetics depends on several variables, including tooth visibility and proportions as well as healthy gingival tissues. Proper integration between teeth and periodontal tissues plays an important role in esthetic success, which is mainly represented by an appealing smile. The present case report was aimed at describing the multidisciplinary treatment of a woman who was unsatisfied with the shape of her central incisors and the dark gingival pigmentation displayed by a high smile line. The patient was treated with minimally invasive combined periodontal, prosthetic, and esthetic medical techniques. The described multidisciplinary approach based on surgical gingival depigmentation, adhesive ceramic veneers, and selective botulinum toxin injection was effective in solving the undesired high smile line and achieving patient satisfaction.

Foot Structure in Boys with Down Syndrome

PubMed Central

Nowak, Krzysztof; Omorczyk, Jarosław; Ambroży, Tadeusz; Nosiadek, Leszek

2017-01-01

Introduction and Aim Down syndrome (DS) is associated with numerous developmental abnormalities, some of which cause dysfunctions of the posture and the locomotor system. The analysis of selected features of the foot structure in boys with DS versus their peers without developmental disorders is done. Materials and Methods The podoscopic examination was performed on 30 boys with DS aged 14-15 years. A control group consisted of 30 age- and gender-matched peers without DS. Results The feet of boys with DS are flatter compared to their healthy peers. The hallux valgus angle is not the most important feature differentiating the shape of the foot in the boys with DS and their healthy peers. In terms of the V toe setting, healthy boys had poorer results. Conclusions Specialized therapeutic treatment in individuals with DS should involve exercises to increase the muscle strength around the foot joints, enhancing the stabilization in the joints and proprioception. Introducing orthotics and proper footwear is also important. It is also necessary to monitor the state of the foot in order to modify undertaken therapies. PMID:28904967

Treatment of older patients with colorectal cancer: a perspective review

PubMed Central

Kordatou, Z.; Kountourakis, P.

2014-01-01

In a continuously aging population, the burden of colorectal cancer (CRC) is rising among older patients. Despite the fact that almost half of the cases occur in patients over 75 years, this age group is subjected to disparities regarding diagnostic and therapeutic options. So far, exclusion of older patients from randomized clinical trials has resulted in a lack of evidence-based guidelines. Nevertheless, newer data from studies specifically targeting older patients and subgroup analyses indicate that proper treatment planning and specific medical and geriatric assessment can achieve a safe and beneficial treatment result in older patients, often with similar outcomes to their younger counterparts. Resection of the primary tumour, if feasible, should be the primary goal of surgery aiming for cure, although it should be avoided under emergency conditions. Chronological age per se should not be an exclusion criterion for adjuvant or palliative chemotherapy, or targeted therapies. Careful patient selection, dose adjustments, close monitoring and early intervention in the event of side effects are essential. The benefits of treatment must be balanced with potential effects of treatment and patients’ wishes. PMID:24790652

Coronary artery bypass grafting in octogenarians: only when percutaneous coronary intervention is not feasible?

PubMed

Nicolini, Francesco

2015-11-01

The aim of this study was to review recent literature reporting the results of coronary revascularization by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in patients older than 80 years. The review of recent studies on octogenarians demonstrates a surgical CABG advantage in the case of patients with increasing baseline coronary risk, such as severe multivessel disease, chronic total occlusions, and left ventricular dysfunction. PCI seems to be more appropriate for less severe degree and distribution of coronary lesions, and for subgroups of patients with higher surgical risk, such as acute coronary syndromes, reoperations, malignancy, dementia, poor mobility, frailty, and serious comorbidities contraindicating extracorporeal circulation. It is not the case that CABG is indicated only when there are contraindications to PCI. CABG confers more benefit than PCI in patients with increasing baseline cardiac risk, in the absence of serious systemic diseases that can reasonably reduce their life expectancy.CABG and PCI, with proper selection, should be considered complementary rather than competitive procedures in the therapy of octogenarians affected by coronary artery disease.

A low cost, adaptive mixed reality system for home-based stroke rehabilitation.

PubMed

Chen, Yinpeng; Baran, Michael; Sundaram, Hari; Rikakis, Thanassis

2011-01-01

This paper presents a novel, low-cost, real-time adaptive multimedia environment for home-based upper extremity rehabilitation of stroke survivors. The primary goal of this system is to provide an interactive tool with which the stroke survivor can sustain gains achieved within the clinical phase of therapy and increase the opportunity for functional recovery. This home-based mediated system has low cost sensing, off the shelf components for the auditory and visual feedback, and remote monitoring capability. The system is designed to continue active learning by reducing dependency on real-time feedback and focusing on summary feedback after a single task and sequences of tasks. To increase system effectiveness through customization, we use data from the training strategy developed by the therapist at the clinic for each stroke survivor to drive automated system adaptation at the home. The adaptation includes changing training focus, selecting proper feedback coupling both in real-time and in summary, and constructing appropriate dialogues with the stroke survivor to promote more efficient use of the system. This system also allows the therapist to review participant's progress and adjust the training strategy weekly.

[Metabolic therapy with iodine 131 in patients with chronic renal failure. Clinical case].

PubMed

Vázquez-Rodríguez Barbero, Inmaculada; Espadas-Maeso, María José; Muñoz-Morales, Ana; Flores-Gómez, Pilar; Serrano-Carretero, María Belén; Castedo-Sal, Juan José; Sánchez Rey-Castro, Elena; Zamorano-Córdoba, Antonio

2015-01-01

62 year-old male with CKD stage 5 in dialysis program since 2012 who underwent surgery for papillary thyroid carcinoma with lymph node metastasis. Subsequently, the patient was admitted to the Unit of Metabolic Therapy at his reference hospital, where he is administered 80 millicuries of iodine-131 as a treatment associated with the surgery, unable to have his conventional dialysis, nursing interventions required in various stages of implementation of the continuous extrarenal clearance techniques (TCDE) were performed. The following care values were addressed targeted to patients undergoing treatment with I(131): specific equipment, personal protective measures and major diagnoses and nursing interventions. TCDE, despite being attributed to very critical patients, they can be extrapolated to other patients in a given time. TCDE allowed these patients to undergo dialysis in a safe environment for staff, ensuring proper disposal of contaminated liquids. TCDE were an effective treatment for the removal of I131, a single ssesion being necessary to normalize the levels of radioactivity. Coordination between services allewed ensure proper and effective treatment for the patient. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Scoliosis Research Society (SRS) Criteria and Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) 2008 Guidelines in Non-Operative Treatment of Idiopathic Scoliosis.

PubMed

Korbel, Krzysztof; Kozinoga, Mateusz; Stoliński, Łukasz; Kotwicki, Tomasz

2014-07-28

According to the Scoliosis Research Society (SRS), idiopathic scoliosis (IS) is a curvature of more than 10° Cobb angle, affecting 2-3% of pediatric population. Idiopathic scoliosis accounts for 80% of all scoliosis cases. Non-operative principles in the therapy of idiopathic scoliosis, including Scoliosis Research Society (SRS) criteria and guidelines proposed by the experts of the Society on Scoliosis Orthopedic and Rehabilitation Treatment (SOSORTS) were presented. The possibility to carry out quality of life assessments in a conservative procedure was also demonstrated. Based on the natural history of idiopathic scoliosis, SRS criteria, SOSORT 2008 experts' opinion and the knowledge of the possibilities of psychological assessment of conservative IS treatment, rules were proposed regarding nonsurgical IS therapy procedures, with special consideration being paid to the proper treatment start time (age, Risser test, biological maturity, Cobb angle), possibility of curvature progression, the importance of physiotherapy and psychological assessment. The knowledge of SRS criteria and SOSORT guidelines regarding the conservative treatment of IS are essential for proper treatment (the right time to start treatment), and supports establishment of interdisciplinary treatment teams, consisting of a physician, a physiotherapist, an orthopedic technician and a psychologist.

Effects of dance therapy on the selected hematological and rheological indicators in older women.

PubMed

Filar-Mierzwa, Katarzyna; Marchewka, Anna; Bac, Aneta; Kulis, Aleksandra; Dąbrowski, Zbigniew; Teległów, Aneta

2017-01-01

The aim of this study was to analyze the effects of dance therapy on selected hematological and rheological indicators in older women. The study included 30 women (aged 71.8±7.4), and the control group comprised of 10 women of corresponding age. Women from the experimental group were subjected to a five-month dance therapy program (three 45-minute sessions per week); women from the control group were not involved in any regular physical activity. Blood samples from all the women were examined for hematological, rheological, and biochemical parameters prior to the study and five months thereafter. The dance therapy program was reflected by a significant improvement of erythrocyte count and hematocrit. Furthermore, the dance therapy resulted in a significant increase in the plasma viscosity, while no significant changes in glucose and fibrinogen levels were noted. Dance therapy modulates selected hematological parameters of older women; it leads to increase in erythrocyte count and hematocrit level. Dance therapy is reflected by higher plasma viscosity. Concentrations of fibrinogen and glucose are not affected by the dance therapy in older women, suggesting maintenance of homeostasis. Those findings advocate implementation of dance therapy programs in older women.

Alternative Oral Agents in Prophylaxis and Therapy of Uterine Fibroids-An Up-to-Date Review.

PubMed

Ciebiera, Michał; Łukaszuk, Krzysztof; Męczekalski, Błażej; Ciebiera, Magdalena; Wojtyła, Cezary; Słabuszewska-Jóźwiak, Aneta; Jakiel, Grzegorz

2017-12-01

Uterine fibroids (UFs) are the most common tumors of the female genital tract. The effect of UFs on the quality of life and the overall cost of treatment are significant issues worldwide. Tumor size and location are the two specific factors which influence the occurrence of symptoms, the need for, and method of, treatment (some tumors require surgery while some can be treated with selected drugs). Primary prevention and treatment of early UF disease are worthy goals that might have a great impact on health care systems. Several treatments and prophylactic methods can be used in this endeavor. This publication presents current data about lesser-known substances which may have a beneficial effect on the treatment or prophylaxis of UFs and can be administered orally, serving as an alternative to (or complement of) surgery or selective progesterone receptor modulators (SPRMs). Early prevention and treatment of UFs in women from high-risk groups should be our priority. Innovative forms of UF management are under intensive investigation and may be promising options in the near future. Many of them evaluated vitamin D, paricalcitol, epigallocatechin gallate (EGCG), elagolix, aromatase inhibitors (AIs), and cabergoline and deemed them to be safe and effective. The next step in such projects should be properly constructed randomized control trials (RCTs), carried out by successive phases.

Alternative Oral Agents in Prophylaxis and Therapy of Uterine Fibroids—An Up-to-Date Review

PubMed Central

Łukaszuk, Krzysztof; Męczekalski, Błażej; Ciebiera, Magdalena; Wojtyła, Cezary; Słabuszewska-Jóźwiak, Aneta; Jakiel, Grzegorz

2017-01-01

Uterine fibroids (UFs) are the most common tumors of the female genital tract. The effect of UFs on the quality of life and the overall cost of treatment are significant issues worldwide. Tumor size and location are the two specific factors which influence the occurrence of symptoms, the need for, and method of, treatment (some tumors require surgery while some can be treated with selected drugs). Primary prevention and treatment of early UF disease are worthy goals that might have a great impact on health care systems. Several treatments and prophylactic methods can be used in this endeavor. This publication presents current data about lesser-known substances which may have a beneficial effect on the treatment or prophylaxis of UFs and can be administered orally, serving as an alternative to (or complement of) surgery or selective progesterone receptor modulators (SPRMs). Early prevention and treatment of UFs in women from high-risk groups should be our priority. Innovative forms of UF management are under intensive investigation and may be promising options in the near future. Many of them evaluated vitamin D, paricalcitol, epigallocatechin gallate (EGCG), elagolix, aromatase inhibitors (AIs), and cabergoline and deemed them to be safe and effective. The next step in such projects should be properly constructed randomized control trials (RCTs), carried out by successive phases. PMID:29194370

How to allocate limited healthcare resources: Lessons from the introduction of antiretroviral therapy in rural Mozambique

PubMed Central

Dodson, Zan M.; Agadjanian, Victor; Driessen, Julia

2016-01-01

Proper allocation of limited healthcare resources is a challenging task for policymakers in developing countries. Allocation of and access to these resources typically varies based on how need is defined, thus determining how individuals access and acquire healthcare. Using the introduction of antiretroviral therapy in southern Mozambique as an example, we examine alternative definitions of need for rural populations and how they might impact the allocation of this vital health service. Our results show that how need is defined matters when allocating limited healthcare resources and the use of need-based metrics can help ensure more optimal distribution of services. PMID:28596630

Hydronephrosis does not preclude curative resection of pelvic recurrences after colorectal surgery.

PubMed

Henry, Leonard R; Sigurdson, Elin; Ross, Eric; Hoffman, John P

2005-10-01

In one third of patients who die of rectal cancer, a pelvic recurrence after resection represents isolated disease for which re-resection may provide cure. These extensive resections can carry high morbidity. Proper patient selection is desirable but difficult. Hydronephrosis has been documented previously to portend a poor prognosis, and some consider it a contraindication to attempted resection. It was our goal to review our experience and either confirm or refute these conclusions. We performed a retrospective analysis of 90 patients resected with curative intent for pelvic recurrence at our center from 1988 through 2003. Seventy-one records documented the preoperative presence or absence of hydronephrosis. Clinical and pathologic data were recorded. The groups with and without hydronephrosis were compared. There were 15 patients with hydronephrosis in this study and 56 without. Although patients with hydronephrosis had shorter overall survival, disease-free survival, and rate of local control, none of these differences was statistically significant. Patients in the hydronephrosis group were younger and had higher-stage primary tumors and larger recurrent tumors. Subsequently, they underwent more extensive resections and were more likely to be treated with adjuvant therapies. There was no difference in the rate of margin-negative resections between the groups. Hydronephrosis correlates with younger patients with larger recurrent tumors undergoing more extensive operations and multimodality therapy but does not preclude curative (R0) resection or independently affect overall survival, disease-free survival, or local control. We believe that it should not be considered a contraindication to attempting curative resection.

Osteoarthritis Patients' Experiences of Pharmacotherapy for Pain Management in Iran: A Qualitative Study.

PubMed

Zamanzadeh, Vahid; Ahmadi, Fazlollah; Behshid, Mozhgan; Irajpoor, Alireza; Zakeri-Milani, Parvin

2017-06-01

Despite the effectiveness of pharmacotherapy for pain management in patients with osteoarthritis (OA), personal biases in the selection, administration, and continuation of pharmacotherapy challenge the proper management of symptoms and the effectiveness of the therapy. This study was conducted to carry out an in-depth examination of the experiences of patients with OA about their use of pharmacotherapy for the OA pain management and the existing challenges. The present qualitative study was conducted on 17 patients with OA, 5 of their family members and 8 healthcare personnel using a conventional content analysis approach. Data were collected through 35 interviews, which were unstructured at first but became semi-structured later on. Data collection continued until data saturation and analyzed simultaneously. The criteria used to determine the rigor of the study included the credibility, transferability, dependability and conformability of the data. The analysis of the data revealed 3 main categories and 8 subcategories. The main categories including preference for non-pharmacological modalities, preference for symptomatic slow-acting drugs for osteoarthritis (SySADOAs) and preference for vitamins and minerals. Briefing the patients on the therapeutic goals, participating them in the clinical decision-making process, modifying drug administration patterns through prescribing the minimum effective dosage and substituting alternative therapies whenever possible, consistently monitoring the therapeutic responses and any unexpected complications and use of complementary treatments, makes up strategies that can help improve OA pain management. © Georg Thieme Verlag KG Stuttgart · New York.

What is the Optimal Strategy for Adaptive Servo-Ventilation Therapy?

PubMed

Imamura, Teruhiko; Kinugawa, Koichiro

2018-05-23

Clinical advantages in the adaptive servo-ventilation (ASV) therapy have been reported in selected heart failure patients with/without sleep-disorder breathing, whereas multicenter randomized control trials could not demonstrate such advantages. Considering this discrepancy, optimal patient selection and device setting may be a key for the successful ASV therapy. Hemodynamic and echocardiographic parameters indicating pulmonary congestion such as elevated pulmonary capillary wedge pressure were reported as predictors of good response to ASV therapy. Recently, parameters indicating right ventricular dysfunction also have been reported as good predictors. Optimal device setting with appropriate pressure setting during appropriate time may also be a key. Large-scale prospective trial with optimal patient selection and optimal device setting is warranted.

Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium.

PubMed

Gribble, Phillip A; Delahunt, Eamonn; Bleakley, Chris; Caulfield, Brian; Docherty, Carrie L; Fourchet, François; Fong, Daniel; Hertel, Jay; Hiller, Claire; Kaminski, Thomas W; McKeon, Patrick O; Refshauge, Kathryn M; van der Wees, Philip; Vicenzino, Bill; Wikstrom, Erik A

2013-08-01

The International Ankle Consortium is an international community of researchers and clinicians whose primary scholastic purpose is to promote scholarship and dissemination of research-informed knowledge related to pathologies of the ankle complex. The constituents of the International Ankle Consortium and other similar organizations have yet to properly define the clinical phenomenon known as chronic ankle instability (CAI) and its related characteristics for consistent patient recruitment and advancement of research in this area. Although research on CAI and awareness of its impact on society and healthcare systems have grown substantially in the last 2 decades, the inconsistency in participant/patient selection criteria across studies presents a potential obstacle to addressing the problem properly. This major gap within the literature limits the ability to generalize this evidence to the target patient population. Therefore, there is a need to provide standards for patient/participant selection criteria in research focused on CAI, with justifications using the best available evidence.

Use of personal protective equipment for respiratory protection.

PubMed

Sargent, Edward V; Gallo, Frank

2003-01-01

Management of hazards in biomedical research facilities requires the application of the traditional industrial hygiene responsibilities of anticipation, recognition, evaluation, and control to characterize the work environment, evaluate tasks and equipment, identify hazards, define exposure groups, and recommend controls. Generally, the diversity and unique characteristics of hazards faced by laboratory and animal facility employees and the short-term and low-level nature of the exposures factor into the selection of proper exposure control measures in the laboratory. The proper selection of control measures is based on a hierarchy of elimination and minimization by engineering controls, followed last by personal protective equipment when exposures cannot be eliminated. Once it is decided that personal protective equipment is needed, specific regulations and guidelines define safety standards for research facilities, including the elements of a sound respiratory protection program. These elements include respirator selection (including appropriate protection factors), medical evaluation, fit testing, training, inspection, maintenance and care, quality, quantity and flow of breathing air, and routine and emergency use procedures.

A New Technique of Site Selection for Hardwoods

Treesearch

James B. Baker; W. M. Broadfoot

1978-01-01

A problem foresters often face in establishing hardwood plantations is selecting proper sites for various species. Before planting, a forest manager should have confidence that a site is suitable for a particular species, and for investment planning he would like to have some idea of the site's potential productivity. This paper describes how to use a new...

Does WIC Work? The Effects of WIC on Pregnancy and Birth Outcomes

ERIC Educational Resources Information Center

Bitler, Marianne P.; Currie, Janet

2005-01-01

Support for WIC, the Special Supplemental Nutrition Program for Women, Infants, and Children, is based on the belief that "WIC works." This consensus has lately been questioned by researchers who point out that most WIC research fails to properly control for selection into the program. This paper evaluates the selection problem using rich data…

Ischaemic stroke management at Al-Shifa Hospital in the Gaza Strip: a clinical audit.

PubMed

Abukaresh, Amir; Al-Abadlah, Rami; Böttcher, Bettina; El-Essi, Khamis

2018-02-21

In the 2014 Palestinian annual health report, cerebrovascular accident was ranked as the third leading cause of death in the occupied Palestinian territory. Cerebrovascular accident is also one the most common causes of disability worldwide. Good management decreases mortality and morbidity. The aim of this study was to assess the current management of patients with ischaemic stroke at the Al-Shifa Hospital and to compare this with international guidelines. For this clinical audit, we used simple random sampling to select files of patients admitted with the diagnosis of ischaemic stroke to the Al-Shifa Hospital. Data collection sheets were completed, and clinical practice was compared with the 2013 American Stroke Association guidelines. Between January and June, 2016, 254 patients were admitted with ischaemic stroke, haemorrhagic stroke, or transient ischaemic attack. We selected 55 patient files. The International Classification of Diseases coding for cerebral infarction in patient files was relatively good, with 92% of files correctly coded. However, we found a substantial weakness in the documentation of duration, progression of symptoms (documented in 20% of files only), and physiotherapy assessment. Most essential acute investigations were done on time (for all [100%] patients needing blood count, renal function tests, and CT scan and for 42 [76%] patients needing ECG). However, thrombolytic drugs were not used because they were not available. Long-term antiplatelet therapy was provided properly to 51 (92%) patients discharged from hospital. However, the initial doses of antiplatelet therapy were generally lower than the international recommendations. Findings also showed a marked inconformity of blood pressure management, especially with respect to the treatment decision and the choice of antihypertensive drug. No local guidelines exist. Furthermore, the lack of availability of thrombolysis medication and the poor deviation in blood pressure management show a lack of evidence-based practice. These findings point to the urgent need for the development of local, evidence-based guidelines. None. Copyright © 2018 Elsevier Ltd. All rights reserved.

Adverse Effects Associated With Newer Diabetes Therapies.

PubMed

Akiyode, Oluwaranti F; Adesoye, Adebola A

2017-04-01

The increasing number of newer type 2 diabetes therapies has allowed providers an increased armamentarium for the optimal management of patients with diabetes. In fact, these newer agents have unique benefits in the management of type 2 diabetes. However, they are also associated with certain adverse effects. This review article aims to describe the notable adverse effects of these newer antidiabetic therapies including the glucagon-like peptide 1 receptor agonists, dipeptidyl peptidase-4 inhibitors, and the sodium-glucose cotransporter 2 inhibitors. The adverse effects reviewed herein include pancreatitis, medullary thyroid carcinoma, heart failure, gastrointestinal disturbances, renal impairment, and genitourinary infections. More clinical data are necessary to solidify the association of some of these adverse effects with the newer diabetes agents. However, it is important for health care practitioners to be well informed and prepared to properly monitor patients for these adverse effects.

New anti-angiogenic strategies in pediatric solid malignancies: agents and biomarkers of a near future.

PubMed

Taylor, Melissa; Rössler, Jochen; Geoerger, Birgit; Vassal, Gilles; Farace, Françoise

2010-07-01

Antiangiogenic strategies are affording considerable interest and have become a major milestone in therapeutics of various adult cancers. However, progress has been slow to expand such therapies to patients with pediatric solid malignancies. This review discusses the principal pathways for angiogenesis in pediatric solid malignancies and summarizes recent preclinical and clinical data on antiangiogenesis strategies in these tumors. The reader will gain state-of-the-art knowledge in the current advancements of antiangiogenic therapies in pediatric clinical trials in regard to supporting preclinical data, and in the status of potential biomarkers investigated for monitoring angiogenesis inhibitors. Mechanisms of resistance to antiangiogenic therapy will also be discussed. Finally, we describe our experience in the monitoring of circulating endothelial cells and progenitors and their potential role as biomarkers of metastatic disease and resistance to antiangiogenic therapies. Evaluation and development of antiangiogenesis protocols are starting and represent a crucial step in the management of pediatric solid malignancies today. Emphasis should be placed on the development of proper surrogate markers to monitor antiangiogenic activity and on the possible long-term effects of these therapies in a pediatric population.

[Conservative therapy of cartilage defects of the upper ankle joint].

PubMed

Smolenski, U C; Best, N; Bocker, B

2008-03-01

Cartilage defects of the upper ankle joint reflect the problem that great force is transmitted and balanced out over a relatively small surface area. As a pathophysiological factor, cartilage-bone contusions play a significant role in the development of cartilage defects of the upper ankle joint. Physiotherapeutic procedures belong to the standard procedures of conservative therapy. The use and selection of the type of therapy is based on empirical considerations and experience and investigations on effectiveness of particular therapies are relatively rare. At present a symptom-oriented therapy of cartilage defects of the upper ankle joint seems to be the most sensible approach. It can be assumed that it makes sense that the symptomatic treatment of cartilage defects or initial stages of arthritis also includes the subsequent symptoms of pain, irritated condition and limited function. This leads to starting points for physiotherapy with respect to pain therapy, optimisation of pressure relationships, avoidance of pressure points, improvement of diffusion and pressure release. In addition to the differential physiotherapeutic findings, the determination of a curative, preventive or rehabilitative procedure is especially important. In physical therapy special importance is placed on a scheduled serial application corresponding to the findings, employing the necessary methods, such as physiotherapy, sport therapy, medical mechanics, manual therapy, massage, electrotherapy and warmth therapy. From this the findings-related therapy is proposed as a practical therapy concept: locomotive apparatus pain therapy, optimisation of pressure relationships, improvement of diffusion and decongestion therapy. Therapy options have been selected base on the current literature and are summarised in tabular form. The art of symptomatic therapy of cartilage defects of the upper ankle joint does not lie in the multitude of sometimes speculative procedures, but in the targeted selection of a therapy regime based on the therapeutic goal, a corresponding application dose and serial design.

Silicosis: Learn the Facts!

MedlinePlus

... during water tank construction. He wore a charcoal filter respirator while sandblasting, but it was the wrong ... properly fitted and selected respirator (e.g. particulate filter or airline supplied air respirator) designated for protection ...

Decision Making: The Toughest Job in the World

ERIC Educational Resources Information Center

Bullis, Robert V.

1977-01-01

The four phases in rational decision-making are (1) diagnosis, (2) discovering alternative solutions, (3) analyzing and comparing alternatives, and (4) selecting the proper alternative or plan to follow. (Author)

KIDNEY STONES: AN UPDATE ON CURRENT PHARMACOLOGICAL MANAGEMENT AND FUTURE DIRECTIONS

PubMed Central

Xu, Hongshi; Zisman, Anna L.; Coe, Fredric L.; Worcester, Elaine M.

2013-01-01

Introduction Kidney stones are a common problem worldwide with substantial morbidities and economic costs. Medical therapy reduces stone recurrence significantly. Much progress has been made in the last several decades in improving therapy of stone disease. Areas covered 1) effect of medical expulsive therapy on spontaneous stone passage, 2) pharmacotherapy in the prevention of stone recurrence, 3) future directions in the treatment of kidney stone disease. Expert Opinion fluid intake to promote urine volume of at least 2.5L each day is essential to prevent stone formation. Dietary recommendations should be adjusted based on individual metabolic abnormalities. Properly dosed thiazide treatment is the standard therapy for calcium stone formers with idiopathic hypercalciuria. Potassium alkali therapy is considered for hypocitraturia, but caution should be taken to prevent potential risk of calcium phosphate stone formation. For absorptive hyperoxaluria, low oxalate diet and increased dietary calcium intake are recommended. Pyridoxine has been shown effective in some cases of primary hyperoxaluria type I. Allopurinol is used in calcium oxalate stone formers with hyperuricosuria. Treatment of cystine stones remains challenging. Tiopronin can be used if urinary alkalinization and adequate fluid intake are insufficient. For struvite stones, complete surgical removal coupled with appropriate antibiotic therapy is necessary. PMID:23438422

Monitoring/Imaging and Regenerative Agents for Enhancing Tissue Engineering Characterization and Therapies.

PubMed

Santiesteban, Daniela Y; Kubelick, Kelsey; Dhada, Kabir S; Dumani, Diego; Suggs, Laura; Emelianov, Stanislav

2016-03-01

The past three decades have seen numerous advances in tissue engineering and regenerative medicine (TERM) therapies. However, despite the successes there is still much to be done before TERM therapies become commonplace in clinic. One of the main obstacles is the lack of knowledge regarding complex tissue engineering processes. Imaging strategies, in conjunction with exogenous contrast agents, can aid in this endeavor by assessing in vivo therapeutic progress. The ability to uncover real-time treatment progress will help shed light on the complex tissue engineering processes and lead to development of improved, adaptive treatments. More importantly, the utilized exogenous contrast agents can double as therapeutic agents. Proper use of these Monitoring/Imaging and Regenerative Agents (MIRAs) can help increase TERM therapy successes and allow for clinical translation. While other fields have exploited similar particles for combining diagnostics and therapy, MIRA research is still in its beginning stages with much of the current research being focused on imaging or therapeutic applications, separately. Advancing MIRA research will have numerous impacts on achieving clinical translations of TERM therapies. Therefore, it is our goal to highlight current MIRA progress and suggest future research that can lead to effective TERM treatments.

Biomarker-guided antibiotic therapy—strengths and limitations

PubMed Central

Salluh, Jorge; Martin-Loeches, Ignacio; Póvoa, Pedro

2017-01-01

Biomarkers as C-reactive protein (CRP) and procalcitonin (PCT) emerged as tools to help clinicians to diagnose infection and to properly initiate and define the duration of antibiotic therapy. Several randomized controlled trials, including adult critically ill patients, showed that PCT-guided antibiotic stewardship was repeatedly associated with a decrease in the duration of antibiotic therapy with no apparent harm. There are however some relevant limitations in these trials namely the low rate of compliance of PCT-guided algorithms, the high rate of exclusion (without including common clinical situations and pathogens) and the long duration of antibiotic therapy in control groups. Such limitations weakened the real impact of such algorithms in the clinical decision-making process and strengthened the concept that the initiation and the duration of antibiotic therapy cannot depend solely on a biomarker. Future efforts should address these limitations in order to better clarify the role of biomarkers on the complex and multifactorial issue of antibiotic management and to deeply understand its potential effect on mortality. PMID:28603723

[Attention therapy for children - long-term affects of the ATTENTIONER].

PubMed

Jacobs, Claus; Petermann, Franz

2008-11-01

A high percentage of children are affected by attention deficit disorders. For a large proportion the cardinal symptom is inattention; in particular, deficits in selective attention prevail. The ATTENTIONER offers an effective training method for the treatment of selective attention deficit. In 2007, long-term effects of therapy were already reported by Jacobs and Petermann, who examined children ten weeks after therapy on average. In the current study three measurements were conducted: pre-intervention, post-intervention, and at follow-up ten to 76 months after post-intervention. Significant long-term effects on measures of selective attention were observed. At follow-up the majority of patients achieved average results which were not clinically relevant. For most children stable therapy effects can be achieved with the ATTENTIONER.

[Risks for atherosclerosis in post-menopausal women and in women with hormonal replacement therapy].

PubMed

Halerz-Nowakowska, B; Warenik-Szymankiewicz, A; Grotowski, W; Słopień, R; Maciejewska, M; Hadaś, K

1997-09-01

The aim of our study was the evaluation of atherogenesis in postmenopausal women and after HRT in correlation with BMI, IGF-I and lipid profile. We have found unfavourable changes in lipid profile in positive correlation with BMI, after three months treatment we have found decrease in concentration of total cholesterol and LDL cholesterol between women with proper BMI.

Biosafety considerations for autopsy.

PubMed

Nolte, Kurt B; Taylor, David G; Richmond, Jonathan Y

2002-06-01

An autopsy may subject prosectors and others to a wide variety of infectious agents, including bloodborne and aerosolized pathogens such as human immunodeficiency virus, hepatitis B and C viruses, and Mycobacterium tuberculosis. Other hazards include toxic chemicals (e.g., formalin, cyanide, and organophosphates) and radiation from radionuclides used for patient therapy and diagnosis. These risks can be substantially mitigated through proper assessment, personal protective equipment, appropriate autopsy procedures, and facility design.

Orthodontic Management in Aggressive Periodontitis

PubMed Central

Bhattarai, Bhagabat

2017-01-01

Aggressive periodontitis is a type of periodontitis with early onset and rapid progression and mostly affecting young adults who occupy a large percentage of orthodontic patients. The role of the orthodontist is important in screening the disease, making a provisional diagnosis, and referring it to a periodontist for immediate treatment. The orthodontist should be aware of the disease not only before starting the appliance therapy, but also during and after the active mechanotherapy. The orthodontic treatment plan, biomechanics, and appliance system may need to be modified to deal with the teeth having reduced periodontal support. With proper force application and oral hygiene maintenance, orthodontic tooth movement is possible without any deleterious effect in the tooth with reduced bone support. With proper motivation and interdisciplinary approach, orthodontic treatment is possible in patients with controlled aggressive periodontitis. PMID:28299350

A comprehensive review and update on the non-biologic treatment of adult noninfectious uveitis: part I.

PubMed

Lee, Kyungmin; Bajwa, Asima; Freitas-Neto, Clovis A; Metzinger, Jamie Lynne; Wentworth, Bailey A; Foster, C Stephen

2014-10-01

Treatment of adult, noninfectious uveitis remains a challenge for ophthalmologists around the world. The disease accounts for almost 10% of preventable blindness in the US and can be idiopathic or associated with infectious and systemic disorders. Strong evidence is still emerging to indicate that pharmacologic strategies presently used in rheumatologic or autoimmune disease may be translated to the treatment of intraocular inflammation. Corticosteroid monotherapy is widely regarded as wholly inappropriate, due to the unfavorable risk/benefit profile and poor long-term outcomes. Treatment plans have shifted away from low-dose, chronic corticosteroid therapy for maintenance, towards medium- to high-dose therapy for acute inflammation, followed immediately by initiation of immunomodulatory therapy. These therapies follow the 'stepladder approach', whereby least to more aggressive therapies are trialed to induce remission of inflammation, eventually without corticosteroids of any form (topical, local and systemic). This two-part review gives a comprehensive overview of the existing medical treatment options for patients with adult, noninfectious uveitis, as well as important advances for the treatment of ocular inflammation. Part I covers classic immunomodulation and latest information on corticosteroid therapy. The hazard of chronic corticosteroid use for the treatment of adult, noninfectious uveitis is well-documented. Corticosteroid-sparing therapies, which offer a very favorable risk-benefit profile when administered properly, should be substituted.

A State-of-the-Art Review: Personalization of Tinnitus Sound Therapy

PubMed Central

Searchfield, Grant D.; Durai, Mithila; Linford, Tania

2017-01-01

Background: There are several established, and an increasing number of putative, therapies using sound to treat tinnitus. There appear to be few guidelines for sound therapy selection and application. Aim: To review current approaches to personalizing sound therapy for tinnitus. Methods: A “state-of-the-art” review (Grant and Booth, 2009) was undertaken to answer the question: how do current sound-based therapies for tinnitus adjust for tinnitus heterogeneity? Scopus, Google Scholar, Embase and PubMed were searched for the 10-year period 2006–2016. The search strategy used the following key words: “tinnitus” AND “sound” AND “therapy” AND “guidelines” OR “personalized” OR “customized” OR “individual” OR “questionnaire” OR “selection.” The results of the review were cataloged and organized into themes. Results: In total 165 articles were reviewed in full, 83 contained sufficient details to contribute to answering the study question. The key themes identified were hearing compensation, pitched-match therapy, maskability, reaction to sound and psychosocial factors. Although many therapies mentioned customization, few could be classified as being personalized. Several psychoacoustic and questionnaire-based methods for assisting treatment selection were identified. Conclusions: Assessment methods are available to assist clinicians to personalize sound-therapy and empower patients to be active in therapy decision-making. Most current therapies are modified using only one characteristic of the individual and/or their tinnitus. PMID:28970812

Training development for pavement preservation.

DOT National Transportation Integrated Search

2013-05-01

This research project strives to help the Iowa Department of Transportation (DOT) fully achieve the full benefits of pavement : preservation through training on proper selection, design, and application of pavement preservation treatments. In some ca...

Laying the Groundwork.

ERIC Educational Resources Information Center

Kretchmer, Mark R.

2000-01-01

Discusses how to avoid costly errors in high-tech retrofits through proper planning and coordination. Guidelines are offered for selecting cable installers, using multi-disciplinary consulting engineering firm, and space planning when making high-tech retrofits. (GR)

Construction of Lagrangians and Hamiltonians from the Equation of Motion

ERIC Educational Resources Information Center

Yan, C. C.

1978-01-01

Demonstrates that infinitely many Lagrangians and Hamiltonians can be constructed from a given equation of motion. Points out the lack of an established criterion for making a proper selection. (Author/GA)

49 CFR 240.7 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... engineer under this part, (2) Has been selected by the railroad to teach others proper train handling... upon which the operation of trains is governed by one or more of the following methods of operation...

How to Select Children's Shoes

MedlinePlus

... not properly fitted for your child's foot. Shoe Construction Shoes consist of four parts: the upper, the ... Society ® Orthopaedic Foot & Ankle Foundation 9400 W. Higgins Road, Suite 220, Rosemont, IL 60018 800-235-4855 ...

47 CFR 1.822 - General selection procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... pleadings properly filed against it, the Commission determines that a substantial and material question of... stating the time, place, and nature of the hearing, this order shall instruct the applicant to submit its...

Proper body mechanics from an engineering perspective.

PubMed

Mohr, Edward G

2010-04-01

The economic viability of the manual therapy practitioner depends on the number of massages/treatments that can be given in a day or week. Fatigue or injuries can have a major impact on the income potential and could ultimately reach the point which causes the practitioner to quit the profession, and seek other, less physically demanding, employment. Manual therapy practitioners in general, and massage therapists in particular, can utilize a large variety of body postures while giving treatment to a client. The hypothesis of this paper is that there is an optimal method for applying force to the client, which maximizes the benefit to the client, and at the same time minimizes the strain and effort required by the practitioner. Two methods were used to quantifiably determine the effect of using "poor" body mechanics (Improper method) and "best" body mechanics (Proper/correct method). The first approach uses computer modeling to compare the two methods. Both postures were modeled, such that the biomechanical effects on the practitioner's elbow, shoulder, hip, knee and ankle joints could be calculated. The force applied to the client, along with the height and angle of application of the force, was held constant for the comparison. The second approach was a field study of massage practitioners (n=18) to determine their maximal force capability, again comparing methods using "Improper and Proper body mechanics". Five application methods were tested at three different application heights, using a digital palm force gauge. Results showed that there was a definite difference between the two methods, and that the use of correct body mechanics can have a large impact on the health and well being of the massage practitioner over both the short and long term. Copyright 2009 Elsevier Ltd. All rights reserved.

Compliance of Iranian dentists with safety standards of oral radiology

PubMed Central

Shahab, S; Kavosi, A; Nazarinia, H; Mehralizadeh, S; Mohammadpour, M; Emami, M

2012-01-01

Objectives Dentists use radiographs in their daily practice. Their knowledge and behaviour towards radiographic examination can affect patients' exposure to radiation. The aim of this study was to survey the knowledge and behaviour of Iranian dentists regarding oral radiology safety standards. Methods 1000 questionnaires were given to the participants of the 48th Annual Congress of the Iranian Dental Association, of which 700 were returned. The participants were asked about demographic data, primary knowledge of radiation protection, selection criteria, radiographic equipment and technique, methods of patient and personnel protection and management of radiographic waste. Descriptive analysis of data was performed. Results 44% of respondents said the initial radiograph they took was of the periapical view of a limited area. 12% preferred the periapical paralleling technique. F-speed film was used by 9% and E-speed film by 62%. Only 2% had digital receptors. Proper exposure time was selected by 26.5%. The use of long and rectangular collimators was 15% and 6%, respectively. 34% occasionally covered their patients with both thyroid shields and lead aprons. 36% used the position and distance rule correctly for their own protection. Proper disposal of the used processing solutions and the lead foils were done by only 1% and 3%, respectively. Conclusions It can be concluded that the majority of dentists in the study group did not select the proper method, material and equipment in order to minimize the exposure of their patient to unnecessary radiation in dental radiography. PMID:22301640

Recent advances in lithotripsy technology and treatment strategies: A systematic review update

PubMed Central

Elmansy, H.E.; Lingeman, J.E.

2017-01-01

Introduction Shock wave lithotripsy (SWL) is a well – established treatment option for urolithiasis. The technology of SWL has undergone significant changes in an attempt to better optimize the results while reducing failure rates. There are some important limitations that restrict the use of SWL. In this review, we aim to place these advantages and limitations in perspective, assess the current role of SWL, and discuss recent advances in lithotripsy technology and treatment strategies. Methods A comprehensive review was conducted to identify studies reporting outcomes on ESWL. We searched for literature (PubMed, Embase, Medline) that focused on the physics of shock waves, theories of stone disintegration, and studies on optimising shock wave application. Relevant articles in English published since 1980 were selected for inclusion. Results Efficacy has been shown to vary between lithotripters. To maximize stone fragmentation and reduce failure rates, many factors can be optimized. Factors to consider in proper patient selection include skin – to – stone distance and stone size. Careful attention to the rate of shock wave administration, proper coupling of the treatment head to the patient have important influences on the success of lithotripsy. Conclusion Proper selection of patients who are expected to respond well to SWL, as well as attention to the technical aspects of the procedure are the keys to SWL success. Studies aiming to determine the mechanisms of shock wave action in stone breakage have begun to suggest new treatment strategies to improve success rates and safety. PMID:27890653

Image-guided positioning and tracking.

PubMed

Ruan, Dan; Kupelian, Patrick; Low, Daniel A

2011-01-01

Radiation therapy aims at maximizing tumor control while minimizing normal tissue complication. The introduction of stereotactic treatment explores the volume effect and achieves dose escalation to tumor target with small margins. The use of ablative irradiation dose and sharp dose gradients requires accurate tumor definition and alignment between patient and treatment geometry. Patient geometry variation during treatment may significantly compromise the conformality of delivered dose and must be managed properly. Setup error and interfraction/intrafraction motion are incorporated in the target definition process by expanding the clinical target volume to planning target volume, whereas the alignment between patient and treatment geometry is obtained with an adaptive control process, by taking immediate actions in response to closely monitored patient geometry. This article focuses on the monitoring and adaptive response aspect of the problem. The term "image" in "image guidance" will be used in a most general sense, to be inclusive of some important point-based monitoring systems that can be considered as degenerate cases of imaging. Image-guided motion adaptive control, as a comprehensive system, involves a hierarchy of decisions, each of which balances simplicity versus flexibility and accuracy versus robustness. Patient specifics and machine specifics at the treatment facility also need to be incorporated into the decision-making process. Identifying operation bottlenecks from a system perspective and making informed compromises are crucial in the proper selection of image-guidance modality, the motion management mechanism, and the respective operation modes. Not intended as an exhaustive exposition, this article focuses on discussing the major issues and development principles for image-guided motion management systems. We hope these information and methodologies will facilitate conscientious practitioners to adopt image-guided motion management systems accounting for patient and institute specifics and to embrace advances in knowledge and new technologies subsequent to the publication of this article.

Advanced Heart Failure Therapies for Cancer Therapeutics-Related Cardiac Dysfunction.

PubMed

Bianco, Christopher M; Al-Kindi, Sadeer G; Oliveira, Guilherme H

2017-04-01

End-stage heart failure in cancer survivors may result from cardiotoxic chemotherapy and/or chest radiation and require advanced therapies, including left ventricular assist devices (LVADs) and transplantation. Traditionally, such therapies have been underutilized in cancer survivors owing to lack of experience and perceived risk of cancer recurrence. Recent data from large registries, however, have shown excellent outcomes of LVADs and transplantation in cancer survivors, albeit subject to careful selection and special considerations. This article summarizes all aspects of advanced heart failure therapies in patients with cancer therapy-related cardiac dysfunction and underscores the need for careful selection of these candidates. Copyright © 2016 Elsevier Inc. All rights reserved.

The Perceptions of Educators on the Involvement of Teacher Unions during the Filling of Promotional Posts

ERIC Educational Resources Information Center

Zengele, Thulani; Coetzer, Izaak

2014-01-01

Well-managed schools are characterised by the presence of properly selected and dedicated educators. The authors argue that the uncontrolled involvement of unions in the selection and promotion of teachers may lead to the infringement of educators' rights and poor performance during the execution of their duties. Findings in the study reveal that…

Two-Year College Succession Planning: Utilizing the Mission Statement for Selection of the Vice President of Human Resources

ERIC Educational Resources Information Center

Lacey-Nevitt, Lucia

2012-01-01

Colleges have a critical investment in the proper selection of key executive administrative positions with high quality leadership and character since leadership transitions can be unsettling and costly, and governing boards have a vested interest in getting it right. The problem is that two-year colleges are facing a strategic planning crisis…

Species selection in hardwoods research: variations in baseline physiological responses of select temperate hardwood tree species

Treesearch

Shaneka S. Lawson; Paula M. Pijut; Charles H. Michler

2013-01-01

Drought periods are becoming more extreme worldwide and the ability of plants to contribute towards atmospheric flux is being compromised. Properly functioning stomata provide an exit for water that has been absorbed by the roots, funneled into various cell parts, and eventually released into the atmosphere via transpiration. By observing the effects that weather...

Atomic density effects on temperature characteristics and thermal transport at grain boundaries through a proper bin size selection

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

Vo, Truong Quoc; Kim, BoHung, E-mail: muratbarisik@iyte.edu.tr, E-mail: bohungk@ulsan.ac.kr; Barisik, Murat, E-mail: muratbarisik@iyte.edu.tr, E-mail: bohungk@ulsan.ac.kr

2016-05-21

This study focuses on the proper characterization of temperature profiles across grain boundaries (GBs) in order to calculate the correct interfacial thermal resistance (ITR) and reveal the influence of GB geometries onto thermal transport. The solid-solid interfaces resulting from the orientation difference between the (001), (011), and (111) copper surfaces were investigated. Temperature discontinuities were observed at the boundary of grains due to the phonon mismatch, phonon backscattering, and atomic forces between dissimilar structures at the GBs. We observed that the temperature decreases gradually in the GB area rather than a sharp drop at the interface. As a result, threemore » distinct temperature gradients developed at the GB which were different than the one observed in the bulk solid. This behavior extends a couple molecular diameters into both sides of the interface where we defined a thickness at GB based on the measured temperature profiles for characterization. Results showed dependence on the selection of the bin size used to average the temperature data from the molecular dynamics system. The bin size on the order of the crystal layer spacing was found to present an accurate temperature profile through the GB. We further calculated the GB thickness of various cases by using potential energy (PE) distributions which showed agreement with direct measurements from the temperature profile and validated the proper binning. The variation of grain crystal orientation developed different molecular densities which were characterized by the average atomic surface density (ASD) definition. Our results revealed that the ASD is the primary factor affecting the structural disorders and heat transfer at the solid-solid interfaces. Using a system in which the planes are highly close-packed can enhance the probability of interactions and the degree of overlap between vibrational density of states (VDOS) of atoms forming at interfaces, leading to a reduced ITR. Thus, an accurate understanding of thermal characteristics at the GB can be formulated by selecting a proper bin size.« less

The Full-sky Astrometric Mapping Explorer - Astrometry for the New Millennium

NASA Astrophysics Data System (ADS)

Horner, S. D.; Germain, M. E.; Greene, T. P.; Harris, F. H.; Johnson, M. S.; Johnson, K. J.; Monet, D. G.; Murison, M. A.; Phillips, J. D.; Reasenberg, R. D.; Seidelmann, P. K.; Urban, S. E.; Vassar, R. H.

FAME is designed to perform an all-sky, astrometric survey with unprecedented accuracy. It will create a rigid astrometric catalog of ~40,000,000 stars with visual band magnitudes 5 < V < 15. For bright stars, 5 < V < 9, FAME will determine positions and parallaxes accurate to < 50 microarcseconds, with proper motion errors < 50 microarcseconds/year. For fainter stars, 9 < V < 15, FAME will determine positions and parallaxes accurate to < 300 microarcseconds, with proper motion errors < 300 microarcseconds/year. It will also collect photometric data on these 40,000,000 stars in four Sloan DSS colors. The FAME data will provide a rigid, accurate, optical, astrometric grid. The proper motion data, combined with Hipparcos and other data should be ideal for use by the Space Interferometry Mission (SIM) to select its astrometric reference grid stars. FAME will also identify stars with nonlinear proper motions as candidates for further study by SIM, Terrestrial Planet Finder, and future ground based interferometers as possible planetary systems. The fundamental astrometric data provided at relatively low cost by FAME will help optimize the scientific return from these future projects. This is in addition to the considerable direct scientific return from FAME. It will redefine the extragalactic distance scale and provide a large, rich database of information on stellar properties that will enable numerous science investigations into stellar structure and evolution, the dynamics of the Milky Way, and stellar companions including brown dwarfs and giant planets. NASA has selected the Full-sky Astrometric Mapping Explorer (FAME) to be one of five MIDEX missions to be funded for a concept study. This concept study will be submitted to NASA on 18 June, with final selection, scheduled for September, of two of these missions for fli ght in 2003 or 2004. FAME is a joint development e ffort of the U.S. Naval Observatory, the Smithsonian Astrophysical Observatory, the Infrared Processing and Analysis Center, Lockheed Martin Missiles and Space, the Naval Research Laboratory, and Omitron Incorporated.

Atomic density effects on temperature characteristics and thermal transport at grain boundaries through a proper bin size selection

NASA Astrophysics Data System (ADS)

Vo, Truong Quoc; Barisik, Murat; Kim, BoHung

2016-05-01

This study focuses on the proper characterization of temperature profiles across grain boundaries (GBs) in order to calculate the correct interfacial thermal resistance (ITR) and reveal the influence of GB geometries onto thermal transport. The solid-solid interfaces resulting from the orientation difference between the (001), (011), and (111) copper surfaces were investigated. Temperature discontinuities were observed at the boundary of grains due to the phonon mismatch, phonon backscattering, and atomic forces between dissimilar structures at the GBs. We observed that the temperature decreases gradually in the GB area rather than a sharp drop at the interface. As a result, three distinct temperature gradients developed at the GB which were different than the one observed in the bulk solid. This behavior extends a couple molecular diameters into both sides of the interface where we defined a thickness at GB based on the measured temperature profiles for characterization. Results showed dependence on the selection of the bin size used to average the temperature data from the molecular dynamics system. The bin size on the order of the crystal layer spacing was found to present an accurate temperature profile through the GB. We further calculated the GB thickness of various cases by using potential energy (PE) distributions which showed agreement with direct measurements from the temperature profile and validated the proper binning. The variation of grain crystal orientation developed different molecular densities which were characterized by the average atomic surface density (ASD) definition. Our results revealed that the ASD is the primary factor affecting the structural disorders and heat transfer at the solid-solid interfaces. Using a system in which the planes are highly close-packed can enhance the probability of interactions and the degree of overlap between vibrational density of states (VDOS) of atoms forming at interfaces, leading to a reduced ITR. Thus, an accurate understanding of thermal characteristics at the GB can be formulated by selecting a proper bin size.

Root canal irrigants

PubMed Central

Kandaswamy, Deivanayagam; Venkateshbabu, Nagendrababu

2010-01-01

Successful root canal therapy relies on the combination of proper instrumentation, irrigation, and obturation of the root canal. Of these three essential steps of root canal therapy, irrigation of the root canal is the most important determinant in the healing of the periapical tissues. The primary endodontic treatment goal must thus be to optimize root canal disinfection and to prevent reinfection. In this review of the literature, various irrigants and the interactions between irrigants are discussed. We performed a Medline search for English-language papers published untill July 2010. The keywords used were ‘root canal irrigants’ and ‘endodontic irrigants.’ The reference lists of each article were manually checked for additional articles of relevance. PMID:21217955

The importance of genetic diagnosis for Duchenne muscular dystrophy

PubMed Central

Aartsma-Rus, Annemieke; Ginjaar, Ieke B; Bushby, Kate

2016-01-01

Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy are caused by mutations in the dystrophin-encoding DMD gene. Large deletions and duplications are most common, but small mutations have been found as well. Having a correct diagnosis is important for family planning and providing proper care to patients according to published guidelines. With mutation-specific therapies under development for DMD, a correct diagnosis is now also important for assessing whether patients are eligible for treatments. This review discusses different mutations causing DMD, diagnostic techniques available for making a genetic diagnosis for children suspected of DMD and the importance of having a specific genetic diagnosis in the context of emerging genetic therapies for DMD. PMID:26754139

In vivo selection to improve gene therapy of hematopoietic disorders.

PubMed

Persons, Derek A; Nienhuis, Arthur W

2002-10-01

Successful gene therapy of hematopoietic disorders lacking intrinsic natural selection for genetically corrected cells will require efficient ex vivo gene transfer into autologous hematopoietic stem cells (HSCs). For these diseases, currently available gene transfer methodologies are unlikely to result in therapeutic numbers of corrected HSCs, especially in the setting of minimal recipient conditioning. A strategy to increase the numbers of genetically corrected HSCs in an individual is therefore highly desirable. One approach to overcome the barrier of limiting numbers of genetically corrected cells is to endow them with a competitive advantage conferred by inclusion of a 'selectable' gene in the therapeutic vector. Herein, we review recent progress in the development of in vivo selection systems, which hold promise in facilitating successful gene therapy.

Nanostructured porous Si-based nanoparticles for targeted drug delivery

PubMed Central

Shahbazi, Mohammad-Ali; Herranz, Barbara; Santos, Hélder A.

2012-01-01

One of the backbones in nanomedicine is to deliver drugs specifically to unhealthy cells. Drug nanocarriers can cross physiological barriers and access different tissues, which after proper surface biofunctionalization can enhance cell specificity for cancer therapy. Recent developments have highlighted the potential of mesoporous silica (PSiO2) and silicon (PSi) nanoparticles for targeted drug delivery. In this review, we outline and discuss the most recent advances on the applications and developments of cancer therapies by means of PSiO2 and PSi nanomaterials. Bio-engineering and fine tuning of anti-cancer drug vehicles, high flexibility and potential for sophisticated release mechanisms make these nanostructures promising candidates for “smart” cancer therapies. As a result of their physicochemical properties they can be controllably loaded with large amounts of drugs and coupled to homing molecules to facilitate active targeting. The main emphasis of this review will be on the in vitro and in vivo studies. PMID:23507894

Radioimmunotherapy as the first line of treatment in non-Hodgkin lymphoma.

PubMed

Eskian, Mahsa; Khorasanizadeh, MirHojjat; Zinzani, Pier L; Rezaei, Nima

2018-06-01

Non-Hodgkin lymphoma (NHL) is the most common hematologic malignancy. The estimated deaths and new cases of NHL in the USA in 2018 have reached 19,910 and 74,680, respectively, with 5-year survival rate of 71%. Therapeutic interventions for NHL consist of chemotherapy, radiation therapy and immunotherapy. Radioimmunotherapy (RIT) is a potential alternative treatment for NHL that is currently used in different lines of treatment. Studies show that nuclear medicine physicians and radiation oncologists are not yet certain about the proper line for administration of RIT. Herein, we have reviewed the efficiency and toxicity of RIT as the first line of treatment, and discussed potential novel indications, and strategies such as modifying induction therapy and using rituximab maintenance to optimize the efficiency of RIT as the first line of treatment. Our review indicates that it is more logical to postpone conventional therapies to the second or third lines of treatment instead of RIT.

Non-pharmacologic labour pain relief.

PubMed

Prasertcharoensuk, Witoon; Thinkhamrop, Jadsada

2004-10-01

Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of alternative and complementary therapies for pain management in labour. To examine the effectiveness of complementary and alternative therapies for pain management in labour on maternal and perinatal morbidity. The trials included three trials of hypnosis (n = 189), one involving audio-analgesia (n = 25), one involving (n = 22), and one trial of music (n = 30). Women receiving hypnosis were more satisfied with their pain management in labour compared with controls (RR 2.33, 95% CI 1.55 to 4.71). No differences were seen for women recieving, music or audio analgesia. Hypnosis may be beneficial for the management of pain during labour. However, few complementary therapies have been subjected to proper scientific study.

Gastroparesis: a review of current and emerging treatment options

PubMed Central

Enweluzo, Chijioke; Aziz, Fahad

2013-01-01

Gastroparesis is a motility disorder of the stomach causing delay in food emptying from the stomach without any evidence of mechanical obstruction. The majority of cases are idiopathic. Patients need to be diagnosed properly by formal testing, and the evaluation of the severity of the gastroparesis may assist in guiding therapy. Initially, dietary modifications are encouraged, which include frequent and small semisolid-based meals. Promotility medications, like erythromycin, and antiemetics, like prochlorperazine, are offered for symptom relief. In patients who are refractory to pharmacologic treatment, more invasive options, such as intrapyloric botulinum toxin injections, placement of a jejunostomy tube, or implantation of a gastric stimulator, can be considered. Hemin therapy and gastric electric stimulation are emerging treatment options that are still at different stages of research. Regenerative medicine and stem cell-based therapies also hold promise for gastroparesis in the near future. PMID:24039443

[Reciprocal relationships between orthodontics and periodontics in esthetic treatments].

PubMed

Monnet-Corti, Virginie; Barrin, Arnaud; Goubron, Cyril

2012-06-01

The objective of this article is to review various unsightly periodontal defects and the treatments that have previously been used to eliminate them in order to establish guidelines for future therapy. The inter-relationship between orthodontic and periodontal disciplines is well established and needs no defense here. Periodontal tissues change throughout life and the same is true for the smile. The periodontium is an essential component of the appearance of the face as well as the lips. These are dynamic esthetic criteria while the gingiva and the static character of the dentition also contribute to the character of an individual's smile. In order to conduct orthodontic therapy most effectively it is essential that orthodontists and periodontists utilize a coordinated approach. From the beginning, they must establish an etiological diagnosis of any esthetic defects that will insure that their joint therapy is conducted appropriately and at the proper moment. © EDP Sciences, SFODF, 2012.

Sex therapy and mastectomy.

PubMed

Witkin, M H

1975-01-01

Because the emotional trauma associated with a mastectomy exceeds the physical trauma, the recovery of the woman is greatly affected by the response of her husband or lover. Sex therapy, therefore, involves the couple. The approach described here is aimed at assisting the couple to confront and intergrate the mastectomy experience. The use of a prosthesis is discouraged during intercourse because it delays such confrontation; certain sex therapy exercises (body imagery and sensate focus) are usually recommended because they facilitate confrontation and acceptance. These, modified for the circumstances, are described. It is suggested that intercourse be attempted as early as possible, and that if physical weakness or psychological trepidation intervenes, the physical desire and caring of the husband be expressed nonetheless. The "professional" attitudes that psychotherapy is always indicated for mastectomy patients and that the proper role of the husband is matter-of-fact denial are rejected; emphasis is placed on the beneficial consequences of sharing of all emotions.

Locating underwater objects. [technology transfer

NASA Technical Reports Server (NTRS)

Grice, C. F.

1974-01-01

Underwater search operations are considered to be engineering and operational problems. A process for proper definition of the problem and selection of instrumentation and operational procedures is described. An outline of underwater search instrumentation and techniques is given.

Candida Glabrata Esophagitis: new case reports and management

PubMed Central

Macêdo, Danielle Patrícia Cerqueira; da Silva, Vanessa Karina Alves; de Almeida Farias, Aline Mary; de Melo, Luciana Resende Bandeira; Wilheim, Ana Botler; Neves, Rejane Pereira

2008-01-01

Candida esophagitis (CE) is a common opportunistic infection in the immunocompromised host. C. glabrata is rarely cited as agent of CE and has been underestimated due to lack of proper identification. In this study, two cases of C. glabrata esophagitis in AIDS and chagasic patients are reported. Diagnosis of Candida species should be considered an important key for the ideal choice of antifungal therapy against this mycosis. PMID:24031216

Riboswitch-Mediated Aptamer Binding for Imaging and Therapy (RABIT): A Novel Technique to Selectively Target an Intracellular Ligand Specific for Ovarian Cancer

DTIC Science & Technology

2014-10-01

AD_________________ Award Number: W81XWH-12-1-0554 TITLE: Riboswitch-Mediated Aptamer Binding for...TITLE AND SUBTITLE Riboswitch-Mediated Aptamer Binding for Imaging and Therapy (RABIT): A Novel Technique to Selectively Target an Intracellular...for imaging and low toxicity for therapy. We will make a riboswitch consisting of two aptamers and a sensor region that can hybridize with the

Pharmacodynamics of nicotine: implications for rational treatment of nicotine addiction.

PubMed

Benowitz, N L

1991-05-01

Rational treatment of the pharmacologic aspects of tobacco addiction includes nicotine substitution therapy. Understanding the pharmacodynamics of nicotine and its role in the addiction process provides a basis for rational therapeutic intervention. Pharmacodynamic considerations are discussed in relation to the elements of smoking cessation therapy: setting objectives, selecting appropriate medication and dosing form, selecting the optimal doses and dosage regimens, assessing therapeutic outcome, and adjusting therapy to optimize benefits and minimize risks.

Expert opinion on the management of infections in the diabetic foot.

PubMed

Lipsky, B A; Peters, E J G; Senneville, E; Berendt, A R; Embil, J M; Lavery, L A; Urbančič-Rovan, V; Jeffcoate, W J

2012-02-01

This update of the International Working Group on the Diabetic Foot incorporates some information from a related review of diabetic foot osteomyelitis (DFO) and a systematic review of the management of infection of the diabetic foot. The pathophysiology of these infections is now well understood, and there is a validated system for classifying the severity of infections based on their clinical findings. Diagnosing osteomyelitis remains difficult, but several recent publications have clarified the role of clinical, laboratory and imaging tests. Magnetic resonance imaging has emerged as the most accurate means of diagnosing bone infection, but bone biopsy for culture and histopathology remains the criterion standard. Determining the organisms responsible for a diabetic foot infection via culture of appropriately collected tissue specimens enables clinicians to make optimal antibiotic choices based on culture and sensitivity results. In addition to culture-directed antibiotic therapy, most infections require some surgical intervention, ranging from minor debridement to major resection, amputation or revascularization. Clinicians must also provide proper wound care to ensure healing of the wound. Various adjunctive therapies may benefit some patients, but the data supporting them are weak. If properly treated, most diabetic foot infections can be cured. Providers practising in developing countries, and their patients, face especially challenging situations. Copyright © 2012 John Wiley & Sons, Ltd.

[Implants for genital prolapse : Contra mesh surgery].

PubMed

Hampel, C

2017-12-01

Alloplastic transvaginal meshes have become very popular in the surgery of pelvic organ prolapse (POP) as did alloplastic suburethral slings in female stress incontinence surgery, but without adequate supporting data. The simplicity of the mesh procedure facilitates its propagation with acceptance of higher revision and complication rates. Since attending physicians do more and more prolapse surgeries without practicing or teaching alternative techniques, expertise in these alternatives, which might be very useful in cases of recurrence, persistence or complications, is permanently lost. It is doubtful that proper and detailed information about alternatives, risks, and benefits of transvaginal alloplastic meshes is provided to every single prolapse patient according to the recommendations of the German POP guidelines, since the number of implanted meshes exceeds the number of properly indicated mesh candidates by far. Although there is no dissent internationally about the available mesh data, thousands of lawsuits in the USA, insolvency of companies due to claims for compensation and unambiguous warnings from foreign urological societies leave German urogynecologists still unimpressed. The existing literature in pelvic organ prolapse exclusively focusses on POP stage and improvement of that stage with surgical therapy. Instead, typical prolapse symptoms should trigger therapy and improvement of these symptoms should be the utmost treatment goal. It is strongly recommended for liability reasons to obtain specific written informed consent.

[Treatment of nontumoral portal vein thrombosis in cirrhosis].

PubMed

Bañares, Rafael; Catalina, María-Vega

2014-07-01

Portal vein thrombosis in cirrhosis is a relatively common complication associated with the presence of an accompanying prothrombotic phenotype of advanced cirrhosis. The consequences of portal vein thrombosis are relevant because it can be associated with impaired hepatic function, might contraindicate hepatic transplantation and could increase morbidity in the surgical procedure. There is controversy concerning the most effective treatment of portal vein thrombosis, which is based on information that is seldom robust and whose primary objective is to achieve a return to vessel patency. Various studies have suggested that starting anticoagulation therapy early is associated with portal vein repatency more frequently than without treatment and has a low rate of complications. There are no proven data on the type of anticoagulant (low-molecular-weight heparins or dicoumarin agents) and the treatment duration. The implementation of TIPS is technically feasible in thrombosis without cavernous transformation and is associated with portal vein recanalization in a significant proportion of cases. Thrombolytic therapy does not appear to present an adequate balance between efficacy and safety; its use is therefore not supported for this indication. The proper definition of treatment for portal vein thrombosis requires properly designed studies to delimit the efficacy and safety of the various alternatives. Copyright © 2014 Elsevier España, S.L. All rights reserved.

A unique tripartite collision tumor of the esophagus

PubMed Central

Schizas, Dimitrios; Michalinos, Adamantios; Alexandrou, Paraskevi; Moris, Demetrios; Baliou, Evangelia; Tsilimigras, Diamantis; Throupis, Theodore; Liakakos, Theodore

2017-01-01

Abstract Rationale: We report a unique case of a tripartite esophageal collision tumor consisting of three separate histologic types. Patients concerns: Therapeutic dilemmas on the proper treatment of those rare neoplasms remain unanswered considering both proper surgical therapy and adjuvant therapy. Diagnose: In this paper, we report a unique case of a patient with a tripartite esophageal collision tumor consisting of a small cell carcinoma, an adenocarcinoma of medium differentiation and a signet ring cell carcinoma. Diagnosis is difficult as clinical presentation of the patient was undistinguishable from other, commoner tumor types. Interventions: The patient's diagnostic and therapeutic course along with available data on the collisions tumor's biological behavior and treatment are briefly discussed. Outcomes: Esophagectomy is the best treatment options for these patients. Unique nature of this tumor demands aggresive oncologic treatment. Lessons: Collision tumors are rare neoplasms consisting of distinct cell populations developing in juxtaposition to one another without any areas of intermingling. Various cell types can be found. However, collision neoplasms of the esophagus combining adenomatous and neuroendocrine components are exceedingly rare, with only 5 cases described to date in the literature. Given their rarity, limited information is available on their tumorigenesis, biological behavior and clinical course. In general, these tumors are aggressive neoplasms and significantly affect patient treatment and prognosis. PMID:29245236

Second-order polynomial model to solve the least-cost lumber grade mix problem

Treesearch

Urs Buehlmann; Xiaoqiu Zuo; R. Edward Thomas

2010-01-01

Material costs when cutting solid wood parts from hardwood lumber for secondary wood products manufacturing account for 20 to 50 percent of final product cost. These costs can be minimized by proper selection of the lumber quality used. The lumber quality selection problem is referred to as the least-cost lumber grade mix problem in the industry. The objective of this...

AFRL Projects to Replace Cadmium

DTIC Science & Technology

2005-03-01

Protocol does not – Identify/ select a material or process – Impose processing restrictions on candidates – Implement a material or process into production...within proper limits • Use XRF to measure composition and thickness – Strippability • Remove coating within 60 minutes • Replate coating and pass...product information available? Magnetron Sputtering to Replace Cd • Task 2: Coating Deposition and Screening – Selection of qualified vendors and

Exploding Balloons, Deformed Balls, Strange Reflections and Breaking Rods: Slow Motion Analysis of Selected Hands-On Experiments

ERIC Educational Resources Information Center

Vollmer, Michael; Mollmann, Klaus-Peter

2011-01-01

A selection of hands-on experiments from different fields of physics, which happen too fast for the eye or video cameras to properly observe and analyse the phenomena, is presented. They are recorded and analysed using modern high speed cameras. Two types of cameras were used: the first were rather inexpensive consumer products such as Casio…

[Proper antibiotic therapy. From penicillin to pharmacogenomic].

PubMed

Caramia, G; Ruffini, E

2012-04-01

Antibiotics have always been considered one of the wonder discoveries of the 20th century. The use of penicillin by Flaming, opened up the golden era of antibiotics and now is hard to imagine the practice of medicine without antibiotics. Life-threatening infections, such as meningitis, endocarditis, bacteremic pneumonia sepsis, would again prove fatal. Also aggressive chemotherapy and transplant procedures would prove impossible. Another real wonder has been the rise of antibiotic resistance soon after the clinical use of penicillin in hospitals and communities. Several study demonstrated an excessive amount of antibiotic prescribing for communities patients and inpatients and in some hospital up to 50% of antibiotic usage is inappropriate: the benefits of antibiotic treatment come with the risk of antibiotic resistance development. In hospitals, infections caused by antibiotic-resistant bacteria are associated with higher mortality, morbidity and prolonged hospital stay compared with infections caused by antibiotic-susceptible bacteria. A variety of strategies has been proposed to reduce the cost and improve the quality of medication use. Education, guidelines and evidence based recommendations are considered to be essential elements of any program designed to influence prescribing behavior and can provide a foundation of knowledge that will enhance and increase the acceptance of stewardship strategies. Evidence-based recommendations, an approach to clinical practice helping to make decisions based on clinical expertise and on intimate knowledge of the individual patient's situations, beliefs, and priorities, enhance antimicrobial stewardship, that include appropriate selection, dosing, route, and duration of antimicrobial therapy can maximize clinical cure or prevention of infection while limiting the unintended consequences, such as the emergence of resistance, adverse drug events, and cost. These evidence-based guidelines are not a substitute for clinical judgment, and clinical discretion is always required in their application. Genome studies have identified hundreds of genetic polymorphism important determinants of the efficacy of therapy and several trial demonstrated the successful use of pharmacogenomic testing to reduce the incidence of hypersensitivity reactions in patients. Knowing the phenotype of a patient prior to therapy, optimal dose and type drugs can be prescribed to achieve better management of patients.

An integrated model for adolescent inpatient group therapy.

PubMed

Garrick, D; Ewashen, C

2001-04-01

This paper proposes an integrated group therapy model to be utilized by psychiatric and mental health nurses; one innovatively designed to meet the therapeutic needs of adolescents admitted to inpatient psychiatric programs. The writers suggest a model of group therapy primarily comprised of interpersonal approaches within a feminist perspective. The proposed group focus is on active therapeutic engagement with adolescents to further interpersonal learning and to critically examine their contextualized lived experiences. Specific client and setting factors relevant to the selection of therapeutic techniques are reviewed. Selected theoretical models of group therapy are critiqued in relation to group therapy with adolescents. This integrated model of group therapy provides a safe and therapeutic forum that enriches clients' personal and interpersonal experiences as well as promotes healthy exploration, change, and empowerment.

New nearby white dwarfs from Gaia DR1 TGAS and UCAC5/URAT

NASA Astrophysics Data System (ADS)

Scholz, R.-D.; Meusinger, H.; Jahreiß, H.

2018-05-01

Aims: Using an accurate Tycho-Gaia Astrometric Solution (TGAS) 25 pc sample that is nearly complete for GK stars and selecting common proper motion (CPM) candidates from the 5th United States Naval Observatory CCD Astrograph Catalog (UCAC5), we search for new white dwarf (WD) companions around nearby stars with relatively small proper motions. Methods: To investigate known CPM systems in TGAS and to select CPM candidates in TGAS+UCAC5, we took into account the expected effect of orbital motion on the proper motion and proper motion catalogue errors. Colour-magnitude diagrams (CMDs) MJ /J - Ks and MG /G - J were used to verify CPM candidates from UCAC5. Assuming their common distance with a given TGAS star, we searched for candidates that occupied similar regions in the CMDs as the few known nearby WDs (four in TGAS) and WD companions (three in TGAS+UCAC5). The CPM candidates with colours and absolute magnitudes corresponding neither to the main sequence nor to the WD sequence were considered as doubtful or subdwarf candidates. Results: With a minimum proper motion of 60 mas yr-1, we selected three WD companion candidates; two of which are also confirmed by their significant parallaxes measured in URAT data, whereas the third may also be a chance alignment of a distant halo star with a nearby TGAS star that has an angular separation of about 465 arcsec. One additional nearby WD candidate was found from its URAT parallax and GJKs photometry. With HD 166435 B orbiting a well-known G1 star at ≈24.6 pc with a projected physical separation of ≈700 AU, we discovered one of the hottest WDs, classified by us as DA2.0 ± 0.2, in the solar neighbourhood. We also found TYC 3980-1081-1 B, a strong cool WD companion candidate around a recently identified new solar neighbour with a TGAS parallax corresponding to a distance of ≈8.3 pc and our photometric classification as ≈M2 dwarf. This raises the question of whether previous assumptions on the completeness of the WD sample to a distance of 13 pc were correct. Partly based on observations with the 2.2 m telescope of the German-Spanish Astronomical Centre at Calar Alto, Spain

Precision Medicine and PET/Computed Tomography: Challenges and Implementation.

PubMed

Subramaniam, Rathan M

2017-01-01

Precision Medicine is about selecting the right therapy for the right patient, at the right time, specific to the molecular targets expressed by disease or tumors, in the context of patient's environment and lifestyle. Some of the challenges for delivery of precision medicine in oncology include biomarkers for patient selection for enrichment-precision diagnostics, mapping out tumor heterogeneity that contributes to therapy failures, and early therapy assessment to identify resistance to therapies. PET/computed tomography offers solutions in these important areas of challenges and facilitates implementation of precision medicine. Copyright © 2016 Elsevier Inc. All rights reserved.

[Role of pediatricians in the diagnosis and therapy of dyslexia, dysgraphia and dyscalculia].

PubMed

Gergely, Katalin; Lakos, Renáta

2013-02-10

Pediatricians play an important role in the diagnosis and therapy of children with dyslexia, dysgraphia or dyscalculia. These syndromes strongly affect children's school performance. Children with dyslexia, dysgraphia or dyscalculia show a significant underachievement in reading, writing or counting and their failure to meet the school requirements undermines their self confidence and positive self-concept. As a result, children with learning problems often become aggressive, frustrated or play the clown in the classroom. According to the Hungarian law children with any learning difficulties have the right to get special education by their specific symptoms. In the realisation of the law and equity the pediatrician's expertise is essential and has an important role in the therapeutical procedures. However, the pediatrician's role is more complex than writing an opinion. Pediatricians can help by giving a detailed description about these syndromes and explain them how they can help their child, what are the main difficulties during the child's studies, what kind of therapies can be efficient and how they can make their child's school years easier. During the assessment most of the parents ask the following questions: What does dyslexia, dyscalculia or dysgraphia exactly mean? Is it a handicap or a learning difficulty? Could the child live a normal life? With the proper answer and with an inclusive attitude pediatricians can help both the parents and the children to create a liveable lifestyle and make their children's schoolwork more successful. The authors' opinions are to close the medical and the pedagogical view, because without the cooperation of these two scientific fields, the theme affected parents, children and teachers cannot get proper help to find better solution and support for their problems. In the survey the authors intend to give a complex view about the symptoms of these syndromes and try to give useful advice for pediatricians how they can support their patients emphasizing the key role of pediatricians and clinical expertises in the early recognition and therapy.

Categorization of erosion control matting for slope applications.

DOT National Transportation Integrated Search

2013-12-25

Erosion control is an important aspect of any Georgia Department of Transportation (GDOT) construction project, with the extreme negative impacts of high sediment loads in natural waterways having been well documented. Selection of a proper erosion c...

25 CFR 226.9 - Rental and drilling obligations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... restricted homestead selection, the lease shall terminate unless rental at the rate of not less than $1 per... action may be necessary or proper for the protection of the natural resources of the leased land and the...

25 CFR 226.9 - Rental and drilling obligations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... restricted homestead selection, the lease shall terminate unless rental at the rate of not less than $1 per... action may be necessary or proper for the protection of the natural resources of the leased land and the...

Construction and Characterization of External Cavity Diode Lasers for Atomic Physics

PubMed Central

Hardman, Kyle S.; Bennetts, Shayne; Debs, John E.; Kuhn, Carlos C. N.; McDonald, Gordon D.; Robins, Nick

2014-01-01

Since their development in the late 1980s, cheap, reliable external cavity diode lasers (ECDLs) have replaced complex and expensive traditional dye and Titanium Sapphire lasers as the workhorse laser of atomic physics labs1,2. Their versatility and prolific use throughout atomic physics in applications such as absorption spectroscopy and laser cooling1,2 makes it imperative for incoming students to gain a firm practical understanding of these lasers. This publication builds upon the seminal work by Wieman3, updating components, and providing a video tutorial. The setup, frequency locking and performance characterization of an ECDL will be described. Discussion of component selection and proper mounting of both diodes and gratings, the factors affecting mode selection within the cavity, proper alignment for optimal external feedback, optics setup for coarse and fine frequency sensitive measurements, a brief overview of laser locking techniques, and laser linewidth measurements are included. PMID:24796259

Vitamin E in the prevention of cardiovascular disease: the importance of proper patient selection

PubMed Central

Vardi, Moshe; Levy, Nina S.; Levy, Andrew P.

2013-01-01

Vitamin E is a naturally occurring fat-soluble antioxidant which has been proposed as a treatment for both primary and secondary protection against cardiovascular (CV) events. Promising data from observational epidemiological studies associating higher vitamin E dietary intake with lower risk of CV events have not been validated in randomized controlled clinical trials assessing the effect of vitamin E on CV outcomes. While the pendulum of medical opinion has swung to suggest that high dose vitamin E supplements have no place in the treatment and prevention of CV disease, new data is emerging that allows identification of a specific target population for this treatment, namely patients with diabetes mellitus and the haptoglobin genotype 2-2. This review details the scientific basis and clinical evidence related to the effect of vitamin E on CV outcomes, and the importance of proper patient selection in gaining therapeutic benefit from this intervention. PMID:23505320

Construction and characterization of external cavity diode lasers for atomic physics.

PubMed

Hardman, Kyle S; Bennetts, Shayne; Debs, John E; Kuhn, Carlos C N; McDonald, Gordon D; Robins, Nick

2014-04-24

Since their development in the late 1980s, cheap, reliable external cavity diode lasers (ECDLs) have replaced complex and expensive traditional dye and Titanium Sapphire lasers as the workhorse laser of atomic physics labs. Their versatility and prolific use throughout atomic physics in applications such as absorption spectroscopy and laser cooling makes it imperative for incoming students to gain a firm practical understanding of these lasers. This publication builds upon the seminal work by Wieman, updating components, and providing a video tutorial. The setup, frequency locking and performance characterization of an ECDL will be described. Discussion of component selection and proper mounting of both diodes and gratings, the factors affecting mode selection within the cavity, proper alignment for optimal external feedback, optics setup for coarse and fine frequency sensitive measurements, a brief overview of laser locking techniques, and laser linewidth measurements are included.

[Selective mutism].

PubMed

Ytzhak, A; Doron, Y; Lahat, E; Livne, A

2012-10-01

Selective mutism is an uncommon disorder in young children, in which they selectively don't speak in certain social situations, while being capable of speaking easily in other social situations. Many etiologies were proposed for selective mutism including psychodynamic, behavioral and familial etc. A developmental etiology that includes insights from all the above is gaining support. Accordingly, mild language impairment in a child with an anxiety trait may be at the root of developing selective mutism. The behavior will be reinforced by an avoidant pattern in the family. Early treatment and followup for children with selective mutism is important. The treatment includes non-pharmacological therapy (psychodynamic, behavioral and familial) and pharmacologic therapy--mainly selective serotonin reuptake inhibitors (SSRI).

Clinical Management of ADHD in a Family Medicine Residency Program: Comparison with AAP Guidelines.

PubMed

Skelley, Jessica W; Carpenter, P Chase; Morehead, M Shawn; Murphy, Patrick L

2016-06-01

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder. Research has shown that even with the growing incidence of children diagnosed as having ADHD, physicians may find providing optimal care to these patients challenging. Our objective was to contrast existing clinical management of ADHD in a family medicine setting with published American Academy of Pediatrics guidelines and review the literature pertinent to differences. A report was generated for all visits with "ADHD" or "ADD" (attention-deficit disorder) as a current or past medical problem that had been addressed at the family medicine clinic from July 2012 to June 2014. A total of 60 pediatric patients were identified. A retrospective chart review of clinical practice and management patterns for these patients was completed using a standardized data collection form based on the 2011 ADHD treatment guidelines set by the American Academy of Pediatrics. Fifty-seven (95%) patients had documentation of at least one core symptom of ADHD, and 27 (45%) patients had documentation of these symptoms in more than one setting (clinic/school/home). Only 30 (50%) patients were assessed at the initial ADHD visit for coexisting conditions. Coexisting conditions were found to be present in 20 (33.3%) patients. Of these 20 patients, coexisting conditions were not addressed during the visit in 12 (60%) patients before drug therapy for ADHD was initially prescribed. Behavioral therapy was initiated as first-line monotherapy in one of the nine preschool-age patients (4-5 years old). Fifty-two (86.7%) patients received a preferred initial medication as identified by guidelines, and 41 (78.8%) of those patients received an appropriate initial dose. Fifty-one (85%) patients were assessed for improvement of symptoms, and 39 (65%) were assessed for adverse events. Of 62 documented medication adjustments, 54 (87.1%) adjustments coincided with current practice guidelines. Sixteen (26.7%) patients were referred to mental health specialists. This retrospective review identified areas of strength and weakness for attending physicians and medical residents in the diagnosis, evaluation, and treatment of children with ADHD. A significant need was identified for more physician-focused education on the evaluation of coexisting conditions and long-term management associated with ADHD therapy. Further training in the initiation of behavioral therapy as a first-line treatment above drug therapy and proper medication selection in children aged 4 to 5 years also are recommended.

Chaperoning the Cancer: The Proteostatic Functions of the Heat Shock Proteins in Cancer.

PubMed

Vahid, Sepideh; Thaper, Daksh; Zoubeidi, Amina

2017-01-01

Protein homeostasis (proteostasis) is vital for the survival of cells in physiological and pathological conditions. Particularly, cancer cells are in constant state of cellular stress due to rapid proliferation and decreased quality control in proteosynthesis and therefore, are exceedingly dependent on the homeostasis pathways. Among the complex biological mechanisms regulating proteostasis are the highly conserved molecular chaperones, heat shock proteins (HSPs). HSPs assist cell survival by catalysing the proper folding of proteins, modulation of the apoptotic machinery and finally regulating the protein degradation machinery, providing either the stability or the degradation of selected proteins under stress conditions. Inevitably, HSPs are upregulated in malignancies and participate in different hallmarks of cancer, with indispensable roles in the onset and progression of the disease. Moreover, high levels of HSPs contribute to poor prognosis and treatment resistance in various cancers. Therefore these molecular chaperones present as attractive targets for anti-cancer therapy. This review describes how HSPs regulate different hallmarks of cancer and provides an overview on the most relevant patents which have recently appeared in the literature. The patents were extracted from Google Patents (2012-2016) while the clinical trial results were mined from www.clinicaltrial.gov. Review of literature shows that the proteostatic functions of HSPs can modify different hallmarks of cancer. Moreover, targeting HSPs (notably HSP27, HSP70 and HSP90) exhibited positive results in clinical trials so far. However, more studies should be designed to optimize the efficacy of mono or combination therapy in various malignancies. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Diabetic foot infections: Current treatment and delaying the 'post-antibiotic era'.

PubMed

Lipsky, Benjamin A

2016-01-01

Treatment for diabetic foot infections requires properly diagnosing infection, obtaining an appropriate specimen for culture, assessing for any needed surgical procedures and selecting an empiric antibiotic regimen. Therapy will often need to be modified based on results of culture and sensitivity testing. Because of excessive and inappropriate use of antibiotics for treating diabetic foot infections, resistance to the usually employed bacteria has been increasing to alarming levels. This article reviews recommendations from evidence-based guidelines, informed by results of systematic reviews, on treating diabetic foot infections. Data from the pre-antibiotic era reported rates of mortality of about 9% and of high-level leg amputations of about 70%. Outcomes have greatly improved with appropriate antibiotic therapy. While there are now many oral and parenteral antibiotic agents that have demonstrated efficacy in treating diabetic foot infections, the rate of infection with multidrug-resistant pathogens is growing. This problem requires a multi-focal approach, including providing education to both clinicians and patients, developing robust antimicrobial stewardship programmes and using new diagnostic and therapeutic technologies. Recently, new methods have been developed to find novel antibiotic agents and to resurrect old treatments, like bacteriophages, for treating these difficult infections. Medical and political leaders have recognized the serious global threat posed by the growing problem of antibiotic resistance. By a multipronged approach that includes exerting administrative pressure on clinicians to do the right thing, investing in new technologies and encouraging the profitable development of new antimicrobials, we may be able to stave off the coming 'post-antibiotic era'. Copyright © 2016 John Wiley & Sons, Ltd.

Vascular applications of contrast-enhanced ultrasound imaging.

PubMed

Mehta, Kunal S; Lee, Jake J; Taha, Ashraf G; Avgerinos, Efthymios; Chaer, Rabih A

2017-07-01

Contrast-enhanced ultrasound (CEUS) imaging is a powerful noninvasive modality offering numerous potential diagnostic and therapeutic applications in vascular medicine. CEUS imaging uses microbubble contrast agents composed of an encapsulating shell surrounding a gaseous core. These microbubbles act as nearly perfect intravascular reflectors of ultrasound energy and may be used to enhance the overall contrast and quality of ultrasound images. The purpose of this narrative review is to survey the current literature regarding CEUS imaging and discuss its diagnostic and therapeutic roles in current vascular and selected nonvascular applications. The PubMed, MEDLINE, and Embase databases were searched until July 2016 using the PubMed and Ovid Web-based search engines. The search terms used included contrast-enhanced, microbubble, ultrasound, carotid, aneurysm, and arterial. The diagnostic and therapeutic utility of CEUS imaging has grown exponentially, particularly in the realms of extracranial carotid arterial disease, aortic disease, and peripheral arterial disease. Studies have demonstrated that CEUS imaging is diagnostically superior to conventional ultrasound imaging in identifying vessel irregularities and measuring neovascularization to assess plaque vulnerability and end-muscle perfusion. Groups have begun to use microbubbles as agents in therapeutic applications for targeted drug and gene therapy delivery as well as for the enhancement of sonothrombolysis. The emerging technology of microbubbles and CEUS imaging holds considerable promise for cardiovascular medicine and cancer therapy given its diagnostic and therapeutic utility. Overall, with proper training and credentialing of technicians, the clinical implications are innumerable as microbubble technology is rapidly bursting onto the scene of cardiovascular medicine. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Phenytoin (Dilantin) and acupuncture therapy in the treatment of intractable oral and facial pain.

PubMed

Lu, Dominic P; Lu, Winston I; Lu, Gabriel P

2011-01-01

Phenytoin is an anti-convulsant and anti-arrhythmic medication. Manufactured by various pharmaceutical companies with various brand names, phenytoin (PHT) is also known as Dilantain, Hydantoin or Phenytek in the United States; Dilantain or Remytoine in Canada; Epamin, Hidantoina in Mexico; and Fenidatoin or Fenitron or other names elsewhere in the world. Phenytoin (PHT) is especially useful for patients suffering from intractable oral and facial pain especially those who exhibit anger, stress, depression and irrational emotions commonly seen in the patients with oral and facial pain. When used properly, Phenytoin is also an effective anxiolysis drug in addition to its theraputic effects on pain and can be used alone or, even better, if combined with other compatible sedatives. Phenytoin is particularly valuable when combined with acupuncture for patients with trigeminal neuralgia, glossopharyneal neuralgia, Bell's palsy, and some other facial paralysis and pain. It also has an advantage of keeping the patient relatively lucid after treatment. Either PHT or acupuncture alone can benefit patients but the success of treatment outcome may be limited. We found by combining both acupuncture and PHT with Selective Drug Uptake Enhancement by stimulating middle finger at the first segment of ventral (palmar) and lateral surfaces, as well as prescribing PHT with the dosage predetermined for each patient by Bi-Digital O-Ring Test (BDORT), the treatment outcome was much better resulted with less recurrence and intensity of pain during episodes of attack. Patients with Bell's palsy were most benefited by acupuncture therapy that could completely get rid of the illness.

PARP Inhibitors in Reproductive System Cancers: Current Use and Developments.

PubMed

O'Sullivan Coyne, Geraldine; Chen, Alice P; Meehan, Robert; Doroshow, James H

2017-02-01

The repair of DNA damage is a critical cellular process governed by multiple biochemical pathways that are often found to be defective in cancer cells. The poly(ADP-ribose) polymerase (PARP) family of proteins controls response to single-strand DNA breaks by detecting these damaged sites and recruiting the proper factors for repair. Blocking this pathway forces cells to utilize complementary mechanisms to repair DNA damage. While PARP inhibition may not, in itself, be sufficient to cause tumor cell death, inhibition of DNA repair with PARP inhibitors is an effective cytotoxic strategy when it is used in patients who carry other defective DNA-repair mechanisms, such as mutations in the genes BRCA 1 and 2. This discovery has supported the development of PARP inhibitors (PARPi), agents that have proven effective against various types of tumors that carry BRCA mutations. With the application of next-generation sequencing of tumors, there is increased interest in looking beyond BRCA mutations to identify genetic and epigenetic aberrations that might lead to similar defects in DNA repair, conferring susceptibility to PARP inhibition. Identification of these genetic lesions and the development of screening assays for their detection may allow for the selection of patients most likely to respond to this class of anticancer agents. This article provides an overview of clinical trial results obtained with PARPi and describes the companion diagnostic assays being established for patient selection. In addition, we review known mechanisms for resistance to PARPi and potential strategies for combining these agents with other types of therapy.

Dual tracer functional imaging of gastroenteropancreatic neuroendocrine tumors using 68Ga-DOTA-NOC PET-CT and 18F-FDG PET-CT: competitive or complimentary?

PubMed

Naswa, Niraj; Sharma, Punit; Gupta, Santosh Kumar; Karunanithi, Sellam; Reddy, Rama Mohan; Patnecha, Manish; Lata, Sneh; Kumar, Rakesh; Malhotra, Arun; Bal, Chandrasekhar

2014-01-01

This study aimed to compare the diagnostic performance of Ga-DOTANOC PET/CT with F-FDG PET/CT in the patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Data of 51 patients with definite histological diagnosis of GEP-NET who underwent both Ga-DOTA-NOC PET-CT and F-FDG PET-CT within a span of 15 days were selected for this retrospective analysis. Sensitivity, specificity, and predictive values were calculated for Ga-DOTA-NOC PET-CT and F-FDG PET-CT, and results were compared both on patientwise and regionwise analysis. Ga-DOTA-NOC PET-CT is superior to F-FDG PET-CT on patientwise analysis (P < 0.0001). On regionwise analysis, Ga-DOTA-NOC PET-CT is superior to F-FDG PET-CT only for lymph node metastases (P < 0.003). Although Ga-DOTA-NOC PET-CT detected more liver and skeletal lesions compared with F-FDG PET-CT, the difference was not statistically significant. In addition, the results of combined imaging helped in selecting candidates who would undergo the appropriate mode of treatment, whether octreotide therapy or conventional chemotherapy Ga-DOTA-NOC PET-CT seems to be superior to F-FDG PET-CT for imaging GEP-NETs. However, their role seems to be complementary because combination of Ga-DOTA-NOC PET-CT and F-FDG PET-CT in such patients helps demonstrate the total disease burden and segregate them to proper therapeutic groups.

ProSelection: A Novel Algorithm to Select Proper Protein Structure Subsets for in Silico Target Identification and Drug Discovery Research.

PubMed

Wang, Nanyi; Wang, Lirong; Xie, Xiang-Qun

2017-11-27

Molecular docking is widely applied to computer-aided drug design and has become relatively mature in the recent decades. Application of docking in modeling varies from single lead compound optimization to large-scale virtual screening. The performance of molecular docking is highly dependent on the protein structures selected. It is especially challenging for large-scale target prediction research when multiple structures are available for a single target. Therefore, we have established ProSelection, a docking preferred-protein selection algorithm, in order to generate the proper structure subset(s). By the ProSelection algorithm, protein structures of "weak selectors" are filtered out whereas structures of "strong selectors" are kept. Specifically, the structure which has a good statistical performance of distinguishing active ligands from inactive ligands is defined as a strong selector. In this study, 249 protein structures of 14 autophagy-related targets are investigated. Surflex-dock was used as the docking engine to distinguish active and inactive compounds against these protein structures. Both t test and Mann-Whitney U test were used to distinguish the strong from the weak selectors based on the normality of the docking score distribution. The suggested docking score threshold for active ligands (SDA) was generated for each strong selector structure according to the receiver operating characteristic (ROC) curve. The performance of ProSelection was further validated by predicting the potential off-targets of 43 U.S. Federal Drug Administration approved small molecule antineoplastic drugs. Overall, ProSelection will accelerate the computational work in protein structure selection and could be a useful tool for molecular docking, target prediction, and protein-chemical database establishment research.

Proper-motion Study of the Magellanic Clouds Using SPM Material

NASA Astrophysics Data System (ADS)

Vieira, Katherine; Girard, Terrence M.; van Altena, William F.; Zacharias, Norbert; Casetti-Dinescu, Dana I.; Korchagin, Vladimir I.; Platais, Imants; Monet, David G.; López, Carlos E.; Herrera, David; Castillo, Danilo J.

2010-12-01

Absolute proper motions are determined for stars and galaxies to V = 17.5 over a 450 deg2 area that encloses both Magellanic Clouds. The proper motions are based on photographic and CCD observations of the Yale/San Juan Southern Proper Motion program, which span a baseline of 40 years. Multiple, local relative proper-motion measures are combined in an overlap solution using photometrically selected Galactic disk stars to define a global relative system that is then transformed to absolute using external galaxies and Hipparcos stars to tie into the ICRS. The resulting catalog of 1.4 million objects is used to derive the mean absolute proper motions of the Large Magellanic Cloud (LMC) and the Small Magellanic Cloud (SMC); (μαcos δ, μδ)LMC = (1.89, + 0.39) ± (0.27, 0.27) masyr-1 and (μαcos δ, μδ)SMC = (0.98, - 1.01) ± (0.30, 0.29) masyr-1. These mean motions are based on best-measured samples of 3822 LMC stars and 964 SMC stars. A dominant portion (0.25 mas yr-1) of the formal errors is due to the estimated uncertainty in the inertial system of the Hipparcos Catalog stars used to anchor the bright end of our proper motion measures. A more precise determination can be made for the proper motion of the SMC relative to the LMC; (μαcos δ, μδ)SMC-LMC = (-0.91, - 1.49) ± (0.16, 0.15) masyr-1. This differential value is combined with measurements of the proper motion of the LMC taken from the literature to produce new absolute proper-motion determinations for the SMC, as well as an estimate of the total velocity difference of the two clouds to within ±54 km s-1. The absolute proper-motion results are consistent with the Clouds' orbits being marginally bound to the Milky Way, albeit on an elongated orbit. The inferred relative velocity between the Clouds places them near their binding energy limit and, thus, no definitive conclusion can be made as to whether or not the Clouds are bound to one another.

[The case of Wegener's granulomatosis of the nose, larynx and ear].

PubMed

Wojciechowski, I; Piotrowski, S; Zaniewska-Kulesza, I; Komorowska, E

2001-01-01

We have described a rare case of Wegener's granulomatosis in our 41-year old patient, located in the nose, larynx and ear. The disease usually presents as a triad of respiratory, vascular and kidney location. It may occur as a rapid or indolent progress. We have shown in our paper diagnostic difficulties connected with this disease. The biopsies of involved organs and blood tests are the best steps of establish proper diagnosis. Antineutrophil cytoplasmic antibodies (ANCA) are typical markers of Wegeners's granulomatosis. The conservative therapy including immunosuppression and surgical treatment (laserotherapy) are main methods of management. Our patient was given antibiotic therapy, and immunosuppressive therapy. Her condition improved during the first hospitalisation. Remission lasted very short, and she was admitted to the hospital again and underwent intensive investigations and therapy. We observed dyspnea caused by subglottic stenosis. The histologic examination of the tracheal mucosa showed granulomatous inflammation. After intensive therapy our patient felt better. She has been in our records till now, we observe no progress of disease. Finally, we would like to pay attention to the fact, that early diagnosis is important to prevent complications such subglottic stenosis which can lead to death.

DNA/RNA-based formulations for treatment of breast cancer.

PubMed

Xie, Zhaolu; Zeng, Xianghui

2017-12-01

To develop a successful formulation for the gene therapy of breast cancer, an effective therapeutic nucleic acid and a proper delivery system are essential. Increased understanding of breast cancer, and developments in biotechnology, material science and nanotechnology have provided a major impetus in the development of effective formulations for the gene therapy of breast cancer. Areas covered: We discuss DNA/RNA-based formulations that can inhibit the growth of breast cancer cells and control the progress of breast cancer. Targets for the gene therapy of breast cancer, DNA/RNA-based therapeutics and delivery systems are summarized. And examples of successful DNA/RNA-based formulations for breast cancer gene therapy are reviewed. Expert opinion: Several challenges remain in developing effective DNA/RNA-based formulations for treatment of breast cancer. Firstly, most of the currently utilized targets are not effective enough as monotherapy for breast cancer. Secondly, the requirements for co-delivery system make the preparation of formulation more complicated. Thirdly, nanoparticles with the modification of tumor-targeting ligands could be more unstable in circulation and normal tissues. Lastly, immune responses against the viral vectors are unfavorable for the gene therapy of breast cancer because of the damage to the host and the impaired therapeutic ability.

Therapeutic group therapy improved self-efficacy of school age children.

PubMed

Cleodora, Cindy; Mustikasari; Gayatri, Dewi

2018-02-01

The survival of children against disaster can be seen from their confidence in their ability (self-efficacy). Self-efficacy can help children to determine their ability against disaster as preparedness. The proper intervention to increase self-efficacy as a protective factor is a therapeutic group therapy. The aim of this research is to measure the increase of self-efficacy of school age children against earthquake and Tsunami through therapeutic group therapy. This research used quasi-experimental design with pre-post-tests with control group. The sample involved in this study is 69 children, where 35 of them are in the experimental group while the rest 34 children are in the control group consisting of school children at the IV and V graders of elementary school. The result of the research showed that the self-efficacy of school children is improved significantly after being treated with therapeutic group therapy (p value < 0,05), those who were not treated with therapeutic group therapy have no significant improvement (p value > 0,05). This research is recommended to be conducted on school age children to improve their self-efficacy against disaster through health education. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

A comprehensive review and update on the biologic treatment of adult noninfectious uveitis: part II.

PubMed

Lee, Kyungmin; Bajwa, Asima; Freitas-Neto, Clovis A; Metzinger, Jamie Lynne; Wentworth, Bailey A; Foster, C Stephen

2014-11-01

Treatment of adult, noninfectious uveitis remains a major challenge for ophthalmologists around the world, especially in regard to recalcitrant cases. It is reported to comprise approximately 10% of preventable blindness in the USA. The cause of uveitis can be idiopathic or associated with infectious and systemic disorders. The era of biologic medical therapies provides new options for patients with otherwise treatment-resistant inflammatory eye disease. This two-part review gives a comprehensive overview of the existing medical treatment options for patients with adult, noninfectious uveitis, as well as important advances for the treatment ocular inflammation. Part I covers classic immunomodulation and latest information on corticosteroid therapy. In part II, emerging therapies are discussed, including biologic response modifiers, experimental treatments and ongoing clinical studies for uveitis. The hazard of chronic corticosteroid use in the treatment of adult, noninfectious uveitis is well documented. Corticosteroid-sparing therapies, which offer a very favorable risk-benefit profile when administered properly, should be substituted. Although nothing is currently approved for on-label use in this indication, many therapies, through either translation or novel basic science research, have the potential to fill the currently exposed gaps.

Neuromuscular stimulation therapy after incomplete spinal cord injury promotes recovery of interlimb coordination during locomotion

NASA Astrophysics Data System (ADS)

Jung, R.; Belanger, A.; Kanchiku, T.; Fairchild, M.; Abbas, J. J.

2009-10-01

The mechanisms underlying the effects of neuromuscular electrical stimulation (NMES) induced repetitive limb movement therapy after incomplete spinal cord injury (iSCI) are unknown. This study establishes the capability of using therapeutic NMES in rodents with iSCI and evaluates its ability to promote recovery of interlimb control during locomotion. Ten adult female Long Evans rats received thoracic spinal contusion injuries (T9; 156 ± 9.52 Kdyne). 7 days post-recovery, 6/10 animals received NMES therapy for 15 min/day for 5 days, via electrodes implanted bilaterally into hip flexors and extensors. Six intact animals served as controls. Motor function was evaluated using the BBB locomotor scale for the first 6 days and on 14th day post-injury. 3D kinematic analysis of treadmill walking was performed on day 14 post-injury. Rodents receiving NMES therapy exhibited improved interlimb coordination in control of the hip joint, which was the specific NMES target. Symmetry indices improved significantly in the therapy group. Additionally, injured rodents receiving therapy more consistently displayed a high percentage of 1:1 coordinated steps, and more consistently achieved proper hindlimb touchdown timing. These results suggest that NMES techniques could provide an effective therapeutic tool for neuromotor treatment following iSCI.

SU-F-T-649: Dosimetric Evaluation of Non-Coplanar Arc Therapy Using a Novel Rotating Gamma Ray System

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

Eldib, A; Chibani, O; Jin, L

2016-06-15

Purpose: Stereotactic intra and extra-cranial body radiation therapy has evolved with advances in treatment accuracy, effective radiation dose, and parameters necessary to maximize machine capabilities. Novel gamma systems with a ring type gantry were developed having the ability to perform oblique arcs. The aim of this study is to explore the dosimetric advantages of this new system. Methods: The rotating Gamma system is named CybeRay (Cyber Medical Corp., Xian, China). It has a treatment head of 16 cobalt-60 sources focused to the isocenter, which can rotate 360° on the ring gantry and swing 35° in the superior direction. Treatment plansmore » were generated utilizing our in-house Monte Carlo treatment planning system. A cylindrical phantom was modeled with 2mm voxel size. Dose inside the cylindrical phantom was calculated for coplanar and non-coplanar arcs. Dosimetric differences between CybeRay cobalt beams and CyberKnife 6MV beams were compared in a lung phantom and for previously treated SBRT patients. Results: The full width at half maxima of cross profiles in the S-I direction for the coplanar setup matched the cone sizes, while for the non-coplanar setup, FWHM was larger by 2mm for a 10mm cone and about 5mm for larger cones. In the coronal and sagittal view, coplanar beams showed elliptical shaped isodose lines, while non-coplanar beams showed circular isodose lines. Thus proper selection of the oblique angle and cone size can aid optimal dose matching to the target volume. Comparing a single 5mm cone from CybeRay to that from CyberKnife showed similar penumbra in a lung phantom but CybeRay had significant lower doses beyond lung tissues. Comparable treatment plans were obtained with CybeRay as that from CyberKnife.ConclusionThe noncoplanar multiple source arrangement of CybeRay will be of great clinical benefits for stereotactic intra and extra-cranial radiation therapy.« less

Alcohol and the pancreas.

PubMed

Schenker, S; Montalvo, R

1998-01-01

Alcoholic pancreatitis may be one of the most serious adverse consequences of alcohol abuse. Its diagnosis, as it has for many years, depends primarily on clinical acumen in interpreting properly the symptoms and signs of abdominal distress, buttressed by elevated pancreatic enzymes (amylase and lipase). More recently, the use of computerized tomography (CT) in selected situations has been both of confirmatory and prognostic value. Severity of abnormality by CT correlates reasonably well with a variety of clinical-laboratory clusters (APACHE system, Ranson's criteria, etc.) and aids in therapy. The pathogenesis of alcoholic pancreatitis is not fully defined. The ultimate picture is one of tissue autolysis by activated proteolytic enzymes. The triggers for such activation, however, are still not known. They are represented by three main theories: (1) large duct obstruction and/or increased permeability relative to pancreatic secretion, (2) small duct obstruction due to proteinaceous precipitates, and (3) a direct toxic-metabolic effect of ethanol on pancreatic acinar cells. While not mutually exclusive, we favor the last hypothesis as being most consistent with the effects of ethanol on other organ systems. The direct effects of ethanol and/or its metabolites may be mediated, at least in part, via oxidative stress or the generation of fatty acid ethyl esters. Autolysis (regardless of proximate mechanism(s)) leads to inflammation likely mediated via release of various cytokines. It also should be appreciated that "acute" pancreatitis (the topic of this chapter) likely represents an acute process within a chronic pancreatic exposure and injury from alcoholic abuse. The key question of why pancreatitis develops in only a small number of alcohol abusers is not resolved. Therapy depends on the severity of alcoholic pancreatitis, which is defined by clinical-laboratory and often CT criteria. Mild pancreatitis usually resolves acutely with alcohol abstention and supportive therapy. Severe pancreatitis has a significant morbidity and mortality, mainly related to the degree of pancreatic necrosis and infection. It requires meticulous combined medical-surgical care.

Creating Knock-outs of Conserved Oligomeric Golgi complex subunits using CRISPR-mediated gene editing paired with a selection strategy based on glycosylation defects associated with impaired COG complex function

PubMed Central

Blackburn, Jessica Bailey; Lupashin, Vladimir V.

2017-01-01

Summary The Conserved Oligomeric Golgi (COG) complex is a key evolutionally conserved multisubunit protein machinery that regulates tethering and fusion of intra-Golgi transport vesicles. The Golgi apparatus specifically promotes sorting and complex glycosylation of glycoconjugates. Without proper glycosylation and processing, proteins and lipids will be mislocalized and/or have impaired function. The Golgi glycosylation machinery is kept in homeostasis by a careful balance of anterograde and retrograde trafficking to ensure proper localization of the glycosylation enzymes and their substrates. This balance, like other steps of membrane trafficking, is maintained by vesicle trafficking machinery that includes COPI vesicular coat proteins, SNAREs, Rabs, and both coiled-coil and multi-subunit vesicular tethers. COG complex interacts with other membrane trafficking components and is essential for proper localization of Golgi glycosylation machinery. Here we describe using CRISPR-mediated gene editing coupled with a phenotype-based selection strategy directly linked to the COG complex’s role in glycosylation homeostasis to obtain COG complex subunit knock-outs (KOs). This has resulted in clonal KOs for each COG subunit in HEK293T cells and gives the ability to further probe the role of the COG complex in Golgi homeostasis. PMID:27632008

A Deep Proper Motion Catalog Within the Sloan Digital Sky Survey Footprint. II. The White Dwarf Luminosity Function

NASA Astrophysics Data System (ADS)

Munn, Jeffrey A.; Harris, Hugh C.; von Hippel, Ted; Kilic, Mukremin; Liebert, James W.; Williams, Kurtis A.; DeGennaro, Steven; Jeffery, Elizabeth; Dame, Kyra; Gianninas, A.; Brown, Warren R.

2017-01-01

A catalog of 8472 white dwarf (WD) candidates is presented, selected using reduced proper motions from the deep proper motion catalog of Munn et al. Candidates are selected in the magnitude range 16< r< 21.5 over 980 square degrees, and 16< r< 21.3 over an additional 1276 square degrees, within the Sloan Digital Sky Survey (SDSS) imaging footprint. Distances, bolometric luminosities, and atmospheric compositions are derived by fitting SDSS ugriz photometry to pure hydrogen and helium model atmospheres (assuming surface gravities {log} {\\text{}}g=8). The disk white dwarf luminosity function (WDLF) is constructed using a sample of 2839 stars with 5.5< {M}{bol}< 17, with statistically significant numbers of stars cooler than the turnover in the luminosity function. The WDLF for the halo is also constructed, using a sample of 135 halo WDs with 5< {M}{bol}< 16. We find space densities of disk and halo WDs in the solar neighborhood of 5.5+/- 0.1× {10}-3 {{pc}}-3 and 3.5+/- 0.7× {10}-5 {{pc}}-3, respectively. We resolve the bump in the disk WDLF due to the onset of fully convective envelopes in WDs, and see indications of it in the halo WDLF as well.

Optimal design and experimental validation of a simulated moving bed chromatography for continuous recovery of formic acid in a model mixture of three organic acids from Actinobacillus bacteria fermentation.

PubMed

Park, Chanhun; Nam, Hee-Geun; Lee, Ki Bong; Mun, Sungyong

2014-10-24

The economically-efficient separation of formic acid from acetic acid and succinic acid has been a key issue in the production of formic acid with the Actinobacillus bacteria fermentation. To address this issue, an optimal three-zone simulated moving bed (SMB) chromatography for continuous separation of formic acid from acetic acid and succinic acid was developed in this study. As a first step for this task, the adsorption isotherm and mass-transfer parameters of each organic acid on the qualified adsorbent (Amberchrom-CG300C) were determined through a series of multiple frontal experiments. The determined parameters were then used in optimizing the SMB process for the considered separation. During such optimization, the additional investigation for selecting a proper SMB port configuration, which could be more advantageous for attaining better process performances, was carried out between two possible configurations. It was found that if the properly selected port configuration was adopted in the SMB of interest, the throughout and the formic-acid product concentration could be increased by 82% and 181% respectively. Finally, the optimized SMB process based on the properly selected port configuration was tested experimentally using a self-assembled SMB unit with three zones. The SMB experimental results and the relevant computer simulation verified that the developed process in this study was successful in continuous recovery of formic acid from a ternary organic-acid mixture of interest with high throughput, high purity, high yield, and high product concentration. Copyright © 2014 Elsevier B.V. All rights reserved.

Atomoxetine restores the response inhibition network in Parkinson's disease.

PubMed

Rae, Charlotte L; Nombela, Cristina; Rodríguez, Patricia Vázquez; Ye, Zheng; Hughes, Laura E; Jones, P Simon; Ham, Timothy; Rittman, Timothy; Coyle-Gilchrist, Ian; Regenthal, Ralf; Sahakian, Barbara J; Barker, Roger A; Robbins, Trevor W; Rowe, James B

2016-08-01

Parkinson's disease impairs the inhibition of responses, and whilst impulsivity is mild for some patients, severe impulse control disorders affect ∼10% of cases. Based on preclinical models we proposed that noradrenergic denervation contributes to the impairment of response inhibition, via changes in the prefrontal cortex and its subcortical connections. Previous work in Parkinson's disease found that the selective noradrenaline reuptake inhibitor atomoxetine could improve response inhibition, gambling decisions and reflection impulsivity. Here we tested the hypotheses that atomoxetine can restore functional brain networks for response inhibition in Parkinson's disease, and that both structural and functional connectivity determine the behavioural effect. In a randomized, double-blind placebo-controlled crossover study, 19 patients with mild-to-moderate idiopathic Parkinson's disease underwent functional magnetic resonance imaging during a stop-signal task, while on their usual dopaminergic therapy. Patients received 40 mg atomoxetine or placebo, orally. This regimen anticipates that noradrenergic therapies for behavioural symptoms would be adjunctive to, not a replacement for, dopaminergic therapy. Twenty matched control participants provided normative data. Arterial spin labelling identified no significant changes in regional perfusion. We assessed functional interactions between key frontal and subcortical brain areas for response inhibition, by comparing 20 dynamic causal models of the response inhibition network, inverted to the functional magnetic resonance imaging data and compared using random effects model selection. We found that the normal interaction between pre-supplementary motor cortex and the inferior frontal gyrus was absent in Parkinson's disease patients on placebo (despite dopaminergic therapy), but this connection was restored by atomoxetine. The behavioural change in response inhibition (improvement indicated by reduced stop-signal reaction time) following atomoxetine correlated with structural connectivity as measured by the fractional anisotropy in the white matter underlying the inferior frontal gyrus. Using multiple regression models, we examined the factors that influenced the individual differences in the response to atomoxetine: the reduction in stop-signal reaction time correlated with structural connectivity and baseline performance, while disease severity and drug plasma level predicted the change in fronto-striatal effective connectivity following atomoxetine. These results suggest that (i) atomoxetine increases sensitivity of the inferior frontal gyrus to afferent inputs from the pre-supplementary motor cortex; (ii) atomoxetine can enhance downstream modulation of frontal-subcortical connections for response inhibition; and (iii) the behavioural consequences of treatment are dependent on fronto-striatal structural connections. The individual differences in behavioural responses to atomoxetine highlight the need for patient stratification in future clinical trials of noradrenergic therapies for Parkinson's disease. © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Evaluation of VHF-FM Shore-Based Direction Finding Triangulation System in Massachusetts Bay Area

DOT National Transportation Integrated Search

1983-06-01

The evaluation consisted of the following phases: (1) System definition and site selection; System calibration; Operational evaluation; Cost/benefit analysis. It was concluded that properly implemented shore-based direction finding systems in either ...

Measuring non-recurrent congestion in small to medium sized urban areas.

DOT National Transportation Integrated Search

2013-05-01

Understanding the relative magnitudes of recurrent vs. non-recurrent congestion in an urban area is critical to the selection of proper countermeasures and the appropriate allocation of resources to address congestion problems. Small to medium sized ...

[Outpatient treatment of selective mutism: long-standing selective mutism in a 17-year-old male].

PubMed

Herdener-Pinnekamp, Katharina; Gundelfinger, Ronnie; Steinhausen, Hans-Christoph

2010-01-01

The present case report describes the successful treatment of a 17 year old male adolescent suffering for 10 years from selective mutism. Following a summary review of recent publications on therapy approaches, the report describes the treatment concept in the present case, including detailed assessment of co-morbid disorders, motivation for change, behaviour therapy with supporting drug intervention, and intensive co-operation with parents and other caretakers.

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

Karunanithy, Narayan; Gordon, Fabiana, E-mail: fabiana.gordon@imperial.ac.uk; Hodolic, Marina

Purpose: In the presence of variant hepatic arterial anatomy, obtaining whole-liver coverage with yttrium 90 (Y90) radioembolization may be challenging. The purpose of this study was to determine whether a technique whereby variant hepatic arterial branches are embolized and then Y90 is administered selectively into one remaining hepatic arterial branch results in whole-liver coverage and effective therapy. A retrospective comparison of treatment response was made between a group of patients who underwent this technique before Y90 administration and a group of patients who received standard Y90 administration as a single dose into the proper hepatic artery or in divided dosesmore » into the immediate hepatic artery branches. The rest of the workup and treatment were identical in both groups, including routine embolization of potential nonhepatic, nontarget vessels (e.g., the gastroduodenal artery). Methods: A total of 32 patients (mean age 56.9 years, range 39-77 years) treated with Y90 between June 2004 and March 2008 were analyzed. The primary malignancy was colorectal in 29, breast in 2, and cholangiocarcinoma in 1. Group 1 comprised 20 patients who had no alterations to their hepatic arterial supply. Group 2 comprised 12 cases who had undergone prior embolization of hepatic arterial branches before administration of Y90. The response to treatment was assessed by comparing standardized uptake value (SUV) on the pre- and postprocedure fludeoxyglucose positron emission tomographic studies of representative lesions within the right and left lobes of the liver. Results: In group 1, significant response (P < 0.001) was seen among right lobe lesions but not among left lobe lesions (P = 0.549). In group 2, there was a significant response among both right (P = 0.028) and left (P = 0.014) lobe lesions. No difference was found in the response of right lobe lesions (P = 0.726) between groups 1 and 2; a significantly greater response was found in group 2 compared to group 1 (P = 0.004) for left lobe lesions. Conclusion: Selective Y90 radioembolization after manipulation of hepatic arterial blood supply leads to an even distribution within the entire liver. When variations in hepatic arterial anatomy exist, this technique allows effective whole-liver radioembolization therapy from a single selective arterial injection.« less

Focal cryotherapy for localized prostate cancer: a report from the national Cryo On-Line Database (COLD) Registry.

PubMed

Ward, John F; Jones, J Stephen

2012-06-01

Study Type - Therapy (cohort) Level of Evidence 2b What's known on the subject? and What does the study add? Selective destruction of targeted prostate tissue is now technically feasible. Much has been theorized but little is known about the proper patient selection or treatment outcomes to determine if this organ preserving approach to prostate cancer has merit for further study and diffusion into wider practice. Herein we present the largest retrospective registry report of men treated with sub-total prostate cryotherapy in order to begin to understand how this treatment is being applied despite the paucity of data. •  To identify recent trends in focal cryotherapy from a prospectively maintained treatment registry. •  To describe treatment outcomes after uncontrolled application of focally ablative techniques within community practice. •  We conducted an analysis of the COLD Registry to identify patients treated with partial gland prostate cryoablation between 1997 and 2007. •  Preoperative characteristics and postoperative cancer-specific and functional outcomes were assembled for analysis. •  The COLD Registry contained information for 5853 patients and focal cryotherapy was the codified procedure in 1160 patients (19.8%). •  A dramatic increase in focal treatments was observed, from 46 in 1999 to 567 in 2005 (P < 0.01). •  The biochemical recurrence-free rate (ASTRO definition) at 36 months was 75.7%. •  Prostate biopsy, performed in 164/1160 of patients (14.1%), was positive in 43 (26.3%) of those suspected of cancer recurrence, but in only 3.7% (43/1160) of treated patients. •  Urinary continence (defined as use of 0 pads) was 98.4%. Maintenance of spontaneous erections was 58.1%. Prolonged urinary retention (>30 days) occurred in six (1.1%) patients. Rectourethral fistula was observed in one (0.1%) patient. •  Focal cryoablation is increasingly used for selected patients with prostate cancer. •  Oncological efficacy in the present series appears similar to that of whole-gland cryoablation. •  The impact of focal cryoablation on urinary, sexual and bowel function appears to be less than that of radical therapies, although preservation of sexual function is not as high as might be expected. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

[A Case of Recurrent Gastric Cancer with Grade 3 Proteinuria Caused by Ramucirumab plus Paclitaxel Therapy].

PubMed

Kimura, Yutaka; Makari, Yoichi; Mikami, Jota; Hiraki, Yoko; Kato, Hiroaki; Iwama, Mitsuru; Shiraishi, Osamu; Yasuda, Atsushi; Shinkai, Masayuki; Imano, Motohiro; Imamoto, Haruhiko; Fujita, Junya; Furukawa, Hiroshi; Yasuda, Takushi

2017-11-01

Proteinuria is one of the characteristic adverse events by ramucirumab(RAM)plus paclitaxel(PTX)combination therapy for advanced gastric cancer. We reported a case of recurrent gastric cancer with grade(gr)3 proteinuria caused by RAM plus PTX therapy. 77-year-old woman was underwent distal gastrectomy in 76 years old for gastric cancer that was diagnosed mucinous adenocarcinoma, fStage III C(T4aN3H0P0CY0M0)and received adjuvant chemotherapy of S-1 for 1 year. She suffered from peritoneal recurrence with ascites after 1 year and 4 months of the operation and RAM(8mg/kg; day 1 and 15)plus PTX(80mg/m2; day 1, 8 and 15)therapy was administrated as second-line chemotherapy. After 1 course, weekly PTX has been continued for gr 3 proteinuria and the ascites disappeared after 4 courses. This successful case might indicate that it was important for patients with gr 3 proteinuria as adverse event to consider discontinuance of RAM and continuation of PTX according to the proper usage guide of RAM.

Management of Pancreatic Calculi: An Update

PubMed Central

Tandan, Manu; Talukdar, Rupjyoti; Reddy, Duvvur Nageshwar

2016-01-01

Pancreatolithiasis, or pancreatic calculi (PC), is a sequel of chronic pancreatitis (CP) and may occur in the main ducts, side branches or parenchyma. Calculi are the end result, irrespective of the etiology of CP. PC contains an inner nidus surrounded by successive layers of calcium carbonate. These calculi obstruct the pancreatic ducts and produce ductal hypertension, which leads to pain, the cardinal feature of CP. Both endoscopic therapy and surgery aim to clear these calculi and decrease ductal hypertension. In small PC, endoscopic retrograde cholangiopancreatography (ERCP) followed by sphincterotomy and extraction is the treatment of choice. Large calculi require fragmentation by extracorporeal shock wave lithotripsy (ESWL) prior to their extraction or spontaneous expulsion. In properly selected cases, ESWL followed by ERCP is the standard of care for the management of large PC. Long-term outcomes following ESWL have demonstrated good pain relief in approximately 60% of patients. However, ESWL has limitations. Per oral pancreatoscopy and intraductal lithotripsy represent techniques in evolution, and in current practice their use is limited to centers with considerable expertise. Surgery should be offered to all patients with extensive PC, associated multiple ductal strictures or following failed endotherapy. PMID:27784844

Transnasal Endoscopic Optic Nerve Decompression in Post Traumatic Optic Neuropathy.

PubMed

Gupta, Devang; Gadodia, Monica

2018-03-01

To quantify the successful outcome in patients following optic nerve decompression in post traumatic unilateral optic neuropathy in form of improvement in visual acuity. A prospective study was carried out over a period of 5 years (January 2011 to June 2016) at civil hospital Ahmedabad. Total 20 patients were selected with optic neuropathy including patients with direct and indirect trauma to unilateral optic nerve, not responding to conservative management, leading to optic neuropathy and subsequent impairment in vision and blindness. Decompression was done via Transnasal-Ethmo-sphenoidal route and outcome was assessed in form of post-operative visual acuity improvement at 1 month, 6 months and 1 year follow up. After surgical decompression complete recovery of visual acuity was achieved in 16 (80%) patients and partial recovery in 4 (20%). Endoscopic transnasal approach is beneficial in traumatic optic neuropathy not responding to steroid therapy and can prevent permanent disability if earlier intervention is done prior to irreversible damage to the nerve. Endoscopic optic nerve surgery can decompress the traumatic and oedematous optic nerve with proper exposure of orbital apex and optic canal without any major intracranial, intraorbital and transnasal complications.

Correlation-based pattern recognition for implantable defibrillators.

PubMed Central

Wilkins, J.

1996-01-01

An estimated 300,000 Americans die each year from cardiac arrhythmias. Historically, drug therapy or surgery were the only treatment options available for patients suffering from arrhythmias. Recently, implantable arrhythmia management devices have been developed. These devices allow abnormal cardiac rhythms to be sensed and corrected in vivo. Proper arrhythmia classification is critical to selecting the appropriate therapeutic intervention. The classification problem is made more challenging by the power/computation constraints imposed by the short battery life of implantable devices. Current devices utilize heart rate-based classification algorithms. Although easy to implement, rate-based approaches have unacceptably high error rates in distinguishing supraventricular tachycardia (SVT) from ventricular tachycardia (VT). Conventional morphology assessment techniques used in ECG analysis often require too much computation to be practical for implantable devices. In this paper, a computationally-efficient, arrhythmia classification architecture using correlation-based morphology assessment is presented. The architecture classifies individuals heart beats by assessing similarity between an incoming cardiac signal vector and a series of prestored class templates. A series of these beat classifications are used to make an overall rhythm assessment. The system makes use of several new results in the field of pattern recognition. The resulting system achieved excellent accuracy in discriminating SVT and VT. PMID:8947674

Personalized, bilateral whole-body somatosensory cortex stimulation to relieve fatigue in multiple sclerosis.

PubMed

Cancelli, Andrea; Cottone, Carlo; Giordani, Alessandro; Migliore, Simone; Lupoi, Domenico; Porcaro, Camillo; Mirabella, Massimiliano; Rossini, Paolo Maria; Filippi, Maria Maddalena; Tecchio, Franca

2017-07-01

The patients suffering from multiple sclerosis (MS) often consider fatigue the most debilitating symptom they experience, but conventional medicine currently offers poorly efficacious therapies. We executed a replication study of an innovative approach for relieving MS fatigue. According to the sample size estimate, we recruited 10 fatigued MS patients who received 5-day transcranial direct current stimulation (tDCS) in a randomized, double-blind, Sham-controlled, crossover study, with modified Fatigue Impact Scale (mFIS) score reduction at the end of the treatment as primary outcome. A personalized anodal electrode, shaped on the magnetic resonance imaging (MRI)-derived individual cortical folding, targeted the bilateral whole-body primary somatosensory cortex (S1) with an occipital cathode. The amelioration of fatigue symptoms after Real stimulation (40% of baseline) was significantly larger than after Sham stimulation (14%, p = 0.012). Anodal whole body S1 induced a significant fatigue reduction in mildly disabled MS patients when the fatigue-related symptoms severely hampered their quality of life. This second result in an independent group of patients supports the idea that neuromodulation interventions that properly select a personalized target might be a suitable non-pharmacological treatment for MS fatigue.

Chronic active Epstein-Barr virus infection with mosquito allergy successfully treated with reduced-intensity unrelated allogeneic bone marrow transplantation in a boy.

PubMed

Matsunaga, Takayuki; Kurosawa, Hidemitsu; Okuya, Mayuko; Nakajima, Daisuke; Hagisawa, Susumu; Sato, Yuya; Fukushima, Keitaro; Sugita, Kenichi; Arisaka, Osamu

2009-03-01

EBV-infected T-/NK cells play an important role in the pathogenesis of mosquito allergy, and the prognosis of most patients with mosquito allergy is poor without proper treatment. We describe a 13-yr-old boy who had CAEBV with mosquito allergy and was successfully treated with BMT from an unrelated donor after reduced-intensity preconditioning. Because combination chemotherapy failed to achieve CR, we performed unrelated BMT to reconstitute normal immunity and eradicate any residual EBV-infected cells. To reduce complications after BMT, we selected a reduced-intensity preconditioning regimen consisting of fludarabine, l-phenylalanine mustard, and antithymocyte Ig instead of a conventional myeloablative preconditioning. Although grade II acute GVHD developed, it was successfully controlled with immunosuppressive therapy. After 27 months, the patient has been well without any signs of CAEBV, and the EBV DNA has been undetectable with real-time PCR analysis. We conclude that RIST from the bone marrow of an unrelated donor is indicated for some patients who have CAEBV that is refractory to chemotherapy and who have no HLA-matched related donors or cord blood as a source of stem cells.

Pseudobulbar affect: prevalence and management

PubMed Central

Ahmed, Aiesha; Simmons, Zachary

2013-01-01

Pseudobulbar affect (PBA) may occur in association with a variety of neurological diseases, and so may be encountered in the setting of amyotrophic lateral sclerosis, extrapyramidal and cerebellar disorders, multiple sclerosis, traumatic brain injury, Alzheimer’s disease, stroke, and brain tumors. The psychological consequences and the impact on social interactions may be substantial. Although it is most commonly misidentified as a mood disorder, particularly depression or a bipolar disorder, there are characteristic features that can be recognized clinically or assessed by validated scales, resulting in accurate identification of PBA, and thus permitting proper management and treatment. Mechanistically, PBA is a disinhibition syndrome in which pathways involving serotonin and glutamate are disrupted. This knowledge has permitted effective treatment for many years with antidepressants, particularly tricyclic antidepressants and selective serotonin reuptake inhibitors. A recent therapeutic breakthrough occurred with the approval by the Food and Drug Administration of a dextromethorphan/quinidine combination as being safe and effective for treatment of PBA. Side effect profiles and contraindications differ for the various treatment options, and the clinician must be familiar with these when choosing the best therapy for an individual, particularly elderly patients and those with multiple comorbidities and concomitant medications. PMID:24348042

Pseudobulbar affect: prevalence and management.

PubMed

Ahmed, Aiesha; Simmons, Zachary

2013-01-01

Pseudobulbar affect (PBA) may occur in association with a variety of neurological diseases, and so may be encountered in the setting of amyotrophic lateral sclerosis, extrapyramidal and cerebellar disorders, multiple sclerosis, traumatic brain injury, Alzheimer's disease, stroke, and brain tumors. The psychological consequences and the impact on social interactions may be substantial. Although it is most commonly misidentified as a mood disorder, particularly depression or a bipolar disorder, there are characteristic features that can be recognized clinically or assessed by validated scales, resulting in accurate identification of PBA, and thus permitting proper management and treatment. Mechanistically, PBA is a disinhibition syndrome in which pathways involving serotonin and glutamate are disrupted. This knowledge has permitted effective treatment for many years with antidepressants, particularly tricyclic antidepressants and selective serotonin reuptake inhibitors. A recent therapeutic breakthrough occurred with the approval by the Food and Drug Administration of a dextromethorphan/quinidine combination as being safe and effective for treatment of PBA. Side effect profiles and contraindications differ for the various treatment options, and the clinician must be familiar with these when choosing the best therapy for an individual, particularly elderly patients and those with multiple comorbidities and concomitant medications.

Translational Control in Plasmodium and Toxoplasma Parasites

PubMed Central

Joyce, Bradley R.; Sullivan, William J.; Nussenzweig, Victor

2013-01-01

The life cycles of apicomplexan parasites such as Plasmodium spp. and Toxoplasma gondii are complex, consisting of proliferative and latent stages within multiple hosts. Dramatic transformations take place during the cycles, and they demand precise control of gene expression at all levels, including translation. This review focuses on the mechanisms that regulate translational control in Plasmodium and Toxoplasma, with a particular emphasis on the phosphorylation of the α subunit of eukaryotic translation initiation factor 2 (eIF2α). Phosphorylation of eIF2α (eIF2α∼P) is a conserved mechanism that eukaryotic cells use to repress global protein synthesis while enhancing gene-specific translation of a subset of mRNAs. Elevated levels of eIF2α∼P have been observed during latent stages in both Toxoplasma and Plasmodium, indicating that translational control plays a role in maintaining dormancy. Parasite-specific eIF2α kinases and phosphatases are also required for proper developmental transitions and adaptation to cellular stresses encountered during the life cycle. Identification of small-molecule inhibitors of apicomplexan eIF2α kinases may selectively interfere with parasite translational control and lead to the development of new therapies to treat malaria and toxoplasmosis. PMID:23243065

Translational control in Plasmodium and toxoplasma parasites.

PubMed

Zhang, Min; Joyce, Bradley R; Sullivan, William J; Nussenzweig, Victor

2013-02-01

The life cycles of apicomplexan parasites such as Plasmodium spp. and Toxoplasma gondii are complex, consisting of proliferative and latent stages within multiple hosts. Dramatic transformations take place during the cycles, and they demand precise control of gene expression at all levels, including translation. This review focuses on the mechanisms that regulate translational control in Plasmodium and Toxoplasma, with a particular emphasis on the phosphorylation of the α subunit of eukaryotic translation initiation factor 2 (eIF2α). Phosphorylation of eIF2α (eIF2α∼P) is a conserved mechanism that eukaryotic cells use to repress global protein synthesis while enhancing gene-specific translation of a subset of mRNAs. Elevated levels of eIF2α∼P have been observed during latent stages in both Toxoplasma and Plasmodium, indicating that translational control plays a role in maintaining dormancy. Parasite-specific eIF2α kinases and phosphatases are also required for proper developmental transitions and adaptation to cellular stresses encountered during the life cycle. Identification of small-molecule inhibitors of apicomplexan eIF2α kinases may selectively interfere with parasite translational control and lead to the development of new therapies to treat malaria and toxoplasmosis.

Portal Vein Thrombosis

PubMed Central

Chawla, Yogesh K.; Bodh, Vijay

2015-01-01

Portal vein thrombosis is an important cause of portal hypertension. PVT occurs in association with cirrhosis or as a result of malignant invasion by hepatocellular carcinoma or even in the absence of associated liver disease. With the current research into its genesis, majority now have an underlying prothrombotic state detectable. Endothelial activation and stagnant portal blood flow also contribute to formation of the thrombus. Acute non-cirrhotic PVT, chronic PVT (EHPVO), and portal vein thrombosis in cirrhosis are the three main variants of portal vein thrombosis with varying etiological factors and variability in presentation and management. Procoagulant state should be actively investigated. Anticoagulation is the mainstay of therapy for acute non-cirrhotic PVT, with supporting evidence for its use in cirrhotic population as well. Chronic PVT (EHPVO) on the other hand requires the management of portal hypertension as such and with role for anticoagulation in the setting of underlying prothrombotic state, however data is awaited in those with no underlying prothrombotic states. TIPS and liver transplant may be feasible even in the setting of PVT however proper selection of candidates and type of surgery is warranted. Thrombolysis and thrombectomy have some role. TARE is a new modality for management of HCC with portal vein invasion. PMID:25941431

The effect of volatility on percutaneous absorption.

PubMed

Rouse, Nicole C; Maibach, Howard I

2016-01-01

Topically applied chemicals may volatilize, or evaporate, from skin leaving behind a chemical residue with new percutaneous absorptive capabilities. Understanding volatilization of topical medications, such as sunscreens, fragrances, insect repellants, cosmetics and other commonly applied topicals may have implications for their safety and efficacy. A systematic review of English language articles from 1979 to 2014 was performed using key search terms. Articles were evaluated to assess the relationship between volatility and percutaneous absorption. A total of 12 articles were selected and reviewed. Key findings were that absorption is enhanced when coupled with a volatile substance, occlusion prevents evaporation and increases absorption, high ventilation increases volatilization and reduces absorption, and pH of skin has an affect on a chemical's volatility. The articles also brought to light that different methods may have an affect on volatility: different body regions; in vivo vs. in vitro; human vs. Data suggest that volatility is crucial for determining safety and efficacy of cutaneous exposures and therapies. Few articles have been documented reporting evaporation in the context of percutaneous absorption, and of those published, great variability exists in methods. Further investigation of volatility is needed to properly evaluate its role in percutaneous absorption.

Analysis of radiation parameters to control the effects of Nd:YAG laser surgery on gastric malignancies

NASA Astrophysics Data System (ADS)

Pelayo-Fernández, M. L.; Fanjul-Vélez, F.; Salas-García, I.; Hernández-González, A.; Arce-Diego, J. L.

2015-07-01

Endoscopic laser surgery provides an advantageous alternative to Argon Plasma Coagulation, endoscopic tweezers or electro-ablation in gastroenterology that facilitates a selective ablation of stomach tumors with an additional hemostatic effect in the surrounding tissue. This coagulation effect can also be employed for the treatment of gastric ulcers. It is mandatory to control the laser parameters regardless of the desired effect, either cancerous tissue ablation or coagulation to prevent ulcerous bleeding, in order to avoid stomach wall perforation or an insufficient therapeutic outcome. Dosimetric models constitute an attractive tool to determine the proper light dose in order to offer a customized therapy planning that optimizes the treatment results. In this work, a model for Nd:YAG laser surgery is applied to predict both the coagulation zone in gastric ulcers and the removal in adenocarcinomas under different laser setups. Results show clear differences in the effective zone of the gastric malignancy affected by both coagulation and ablation. Therefore the current model could be employed in the clinical practice to plan the optimal laser beam parameters to treat a certain type of pathologic stomach tissue with variable morphology and without risk of perforation or undertreated parts.

Corticosteroid Therapy in Childhood Asthma

PubMed Central

Tollackson, Kenneth A.

1965-01-01

Fortunately, nearly all cases of asthma in childhood can be managed successfully without the use of adrenal corticosteroids. However, when used properly the corticoids enable that small group of children who have not responded to traditional allergic management to lead normal lives. The action of these compounds is a pharmacologic and not a physiologic one. The adrenal corticosteroids suppress the symptoms of childhood asthma but in no way serve as curative agents of allergic disease. PMID:14347975

The evolution of chronic opioid therapy and recognizing addiction.

PubMed

Daum, Akiva M; Berkowitz, Oren; Renner, John A

2015-05-01

Chronic pain is one of the most common complaints in the United States. Opioids have become a frequently prescribed treatment for patients with chronic nonmalignant pain. Concurrently, opioid use disorders have risen to epidemic levels. Studies investigating iatrogenic opioid addiction have been of limited quality. Aberrant drug-related behaviors may be warning signs of impending addiction. Proper screening and close monitoring are essential for managing patients on opioids for chronic nonmalignant pain.

Vaginitis. Reducing the number of refractory cases.

PubMed

Josey, W E

1977-09-01

Therapeutic failure in vaginitis can be minimized if all cases are properly diagnosed and specific therapy is given. Use of wet mounts combined with liberal use of cultures, especially for Corynebacterium vaginale, should result in an accurate diagnosis in over 90% of cases. Treatment of choice for candidiasis is nystatin or miconazole nitrate applied topically. For trichomoniasis, metronidazole should be given orally to both sexual partners. Ampicillin, cephalexin, or cephradine are recommended for C vaginale infection.

The American History of PTSD: Civil War -- Vietnam

DTIC Science & Technology

2011-03-21

ABSTRACTION FROM, OR REPRODUCTION OF ALL OR ANY PART OF TillS DOCUI\\1ENT IS PERl\\flTTED PROVIDED PROPER ACKNOWLEDGEI\\1ENT IS MADE. Acknowledgments I would...treatment procedure for "shell shock" involved administering a hypnotic therapy designed to restore the victim’s memory through the trancelike repetition and...of the most effective methods of ensuring long lasting recovery. However, the negative cmmotations associated with hypnotism ensured that only a

Photosynthetic response, survival, and growth of three ponderosa pine stocktypes under water stress enhanced by vegetative competition

Treesearch

Jeremiah R. Pinto; John D. Marshall; R. Kasten Dumroese; Anthony S. Davis; Douglas R. Cobos

2012-01-01

Selecting the proper stock type for reforestation on dry sites can be critical for the long-term survival and growth of seedlings. In this study, we use a novel approach to understand stock type selection on a site where drought was induced with vegetative competition. Three ponderosa pine (Pinus ponderosa Lawson & C. Lawson var. ponderosa C. Lawson) seedling stock...

Software selection based on analysis and forecasting methods, practised in 1C

NASA Astrophysics Data System (ADS)

Vazhdaev, A. N.; Chernysheva, T. Y.; Lisacheva, E. I.

2015-09-01

The research focuses on the problem of a “1C: Enterprise 8” platform inboard mechanisms for data analysis and forecasting. It is important to evaluate and select proper software to develop effective strategies for customer relationship management in terms of sales, as well as implementation and further maintenance of software. Research data allows creating new forecast models to schedule further software distribution.

Environmental Biotechnology: Moving from the Flask to the Field

DTIC Science & Technology

1991-09-30

biosorption , Biosorption of metal ions is a phenome- non exhibited by both alive and dead microbial cells. The detailed investigation of the mechanism of... biosorption has revealed that biosorption is a physical-chemical process whereby selected areas of the microbial cell exhibit high selectivity and...dead cells than by the same cells alive. The use of proper chemical solutions (eluants) is capable of reversing the equilibrium of biosorption

CHANGING OUR DIAGNOSTIC PARADIGM: MOVEMENT SYSTEM DIAGNOSTIC CLASSIFICATION

PubMed Central

Kamonseki, Danilo H.; Staker, Justin L.; Lawrence, Rebekah L.; Braman, Jonathan P.

2017-01-01

Proper diagnosis is a first step in applying best available treatments, and prognosticating outcomes for clients. Currently, the majority of musculoskeletal diagnoses are classified according to pathoanatomy. However, the majority of physical therapy treatments are applied toward movement system impairments or pain. While advocated within the physical therapy profession for over thirty years, diagnostic classification within a movement system framework has not been uniformly developed or adopted. We propose a basic framework and rationale for application of a movement system diagnostic classification for atraumatic shoulder pain conditions, as a case for the broader development of movement system diagnostic labels. Shifting our diagnostic paradigm has potential to enhance communication, improve educational efficiency, facilitate research, directly link to function, improve clinical care, and accelerate preventive interventions. PMID:29158950

Riboswitch-Mediated Aptamer Binding for Imaging and Therapy (RABIT): A Novel Technique to Selectively Target an Intracelluar Ligand Specific for Ovarian Cancer

DTIC Science & Technology

2015-12-01

Award Number: W81XWH-12-1-0554 TITLE: Riboswitch-Mediated Aptamer Binding for Imaging and Therapy (RABIT): A Novel Technique to Selectively...ADDRESS. 1. REPORT DATE December 2015 2. REPORT TYPE Final 3. DATES COVERED 15Sep2012 - 14Sep2015 4. TITLE AND SUBTITLE Riboswitch-Mediated Aptamer ...with very high specificity, low background for imaging and low toxicity for therapy. We will make a riboswitch consisting of two aptamers and a

Evaluation of an Expert System for the Generation of Speech and Language Therapy Plans.

PubMed

Robles-Bykbaev, Vladimir; López-Nores, Martín; García-Duque, Jorge; Pazos-Arias, José J; Arévalo-Lucero, Daysi

2016-07-01

Speech and language pathologists (SLPs) deal with a wide spectrum of disorders, arising from many different conditions, that affect voice, speech, language, and swallowing capabilities in different ways. Therefore, the outcomes of Speech and Language Therapy (SLT) are highly dependent on the accurate, consistent, and complete design of personalized therapy plans. However, SLPs often have very limited time to work with their patients and to browse the large (and growing) catalogue of activities and specific exercises that can be put into therapy plans. As a consequence, many plans are suboptimal and fail to address the specific needs of each patient. We aimed to evaluate an expert system that automatically generates plans for speech and language therapy, containing semiannual activities in the five areas of hearing, oral structure and function, linguistic formulation, expressive language and articulation, and receptive language. The goal was to assess whether the expert system speeds up the SLPs' work and leads to more accurate, consistent, and complete therapy plans for their patients. We examined the evaluation results of the SPELTA expert system in supporting the decision making of 4 SLPs treating children in three special education institutions in Ecuador. The expert system was first trained with data from 117 cases, including medical data; diagnosis for voice, speech, language and swallowing capabilities; and therapy plans created manually by the SLPs. It was then used to automatically generate new therapy plans for 13 new patients. The SLPs were finally asked to evaluate the accuracy, consistency, and completeness of those plans. A four-fold cross-validation experiment was also run on the original corpus of 117 cases in order to assess the significance of the results. The evaluation showed that 87% of the outputs provided by the SPELTA expert system were considered valid therapy plans for the different areas. The SLPs rated the overall accuracy, consistency, and completeness of the proposed activities with 4.65, 4.6, and 4.6 points (to a maximum of 5), respectively. The ratings for the subplans generated for the areas of hearing, oral structure and function, and linguistic formulation were nearly perfect, whereas the subplans for expressive language and articulation and for receptive language failed to deal properly with some of the subject cases. Overall, the SLPs indicated that over 90% of the subplans generated automatically were "better than" or "as good as" what the SLPs would have created manually if given the average time they can devote to the task. The cross-validation experiment yielded very similar results. The results show that the SPELTA expert system provides valuable input for SLPs to design proper therapy plans for their patients, in a shorter time and considering a larger set of activities than proceeding manually. The algorithms worked well even in the presence of a sparse corpus, and the evidence suggests that the system will become more reliable as it is trained with more subjects.

Evaluation of an Expert System for the Generation of Speech and Language Therapy Plans

PubMed Central

López-Nores, Martín; García-Duque, Jorge; Pazos-Arias, José J; Arévalo-Lucero, Daysi

2016-01-01

Background Speech and language pathologists (SLPs) deal with a wide spectrum of disorders, arising from many different conditions, that affect voice, speech, language, and swallowing capabilities in different ways. Therefore, the outcomes of Speech and Language Therapy (SLT) are highly dependent on the accurate, consistent, and complete design of personalized therapy plans. However, SLPs often have very limited time to work with their patients and to browse the large (and growing) catalogue of activities and specific exercises that can be put into therapy plans. As a consequence, many plans are suboptimal and fail to address the specific needs of each patient. Objective We aimed to evaluate an expert system that automatically generates plans for speech and language therapy, containing semiannual activities in the five areas of hearing, oral structure and function, linguistic formulation, expressive language and articulation, and receptive language. The goal was to assess whether the expert system speeds up the SLPs’ work and leads to more accurate, consistent, and complete therapy plans for their patients. Methods We examined the evaluation results of the SPELTA expert system in supporting the decision making of 4 SLPs treating children in three special education institutions in Ecuador. The expert system was first trained with data from 117 cases, including medical data; diagnosis for voice, speech, language and swallowing capabilities; and therapy plans created manually by the SLPs. It was then used to automatically generate new therapy plans for 13 new patients. The SLPs were finally asked to evaluate the accuracy, consistency, and completeness of those plans. A four-fold cross-validation experiment was also run on the original corpus of 117 cases in order to assess the significance of the results. Results The evaluation showed that 87% of the outputs provided by the SPELTA expert system were considered valid therapy plans for the different areas. The SLPs rated the overall accuracy, consistency, and completeness of the proposed activities with 4.65, 4.6, and 4.6 points (to a maximum of 5), respectively. The ratings for the subplans generated for the areas of hearing, oral structure and function, and linguistic formulation were nearly perfect, whereas the subplans for expressive language and articulation and for receptive language failed to deal properly with some of the subject cases. Overall, the SLPs indicated that over 90% of the subplans generated automatically were “better than” or “as good as” what the SLPs would have created manually if given the average time they can devote to the task. The cross-validation experiment yielded very similar results. Conclusions The results show that the SPELTA expert system provides valuable input for SLPs to design proper therapy plans for their patients, in a shorter time and considering a larger set of activities than proceeding manually. The algorithms worked well even in the presence of a sparse corpus, and the evidence suggests that the system will become more reliable as it is trained with more subjects. PMID:27370070

Preparation of fluorescent mesoporous hollow silica-fullerene nanoparticles via selective etching for combined chemotherapy and photodynamic therapy

NASA Astrophysics Data System (ADS)

Yang, Yannan; Yu, Meihua; Song, Hao; Wang, Yue; Yu, Chengzhong

2015-07-01

Well-dispersed mesoporous hollow silica-fullerene nanoparticles with particle sizes of ~50 nm have been successfully prepared by incorporating fullerene molecules into the silica framework followed by a selective etching method. The fabricated fluorescent silica-fullerene composite with high porosity demonstrates excellent performance in combined chemo/photodynamic therapy.Well-dispersed mesoporous hollow silica-fullerene nanoparticles with particle sizes of ~50 nm have been successfully prepared by incorporating fullerene molecules into the silica framework followed by a selective etching method. The fabricated fluorescent silica-fullerene composite with high porosity demonstrates excellent performance in combined chemo/photodynamic therapy. Electronic supplementary information (ESI) available. See DOI: 10.1039/c5nr02769a

[Risk factors and coronary heart disease prevention in selected Lódź population--part II].

PubMed

Kowalski, Jan; Kos, Małgorzata; Gburek, Jolanta; Wrocławski, Witold; Pawlicki, Lucjan

2005-12-01

Evaluation of the knowledge on CHD risk factors in selected Lódź population was made. Realization of primary and secondary CHD prevention principles was assessed. Over 20% of patients with CHD and over 38% of subjects without CHD did not realize the prevention principles. Hypolipemic therapy was effective only in 44.21% of patients with CHD and 35.9% of subjects without CHD. Antihypertensive therapy was successful in about 55% of patients with CHD and 35% of subjects without CHD. The results of our study have shown low effectiveness of both CHD prevention principles realization and hipolipemic and antihypertensive therapy in selected Lódź population.

Hierarchical hybrid control of manipulators: Artificial intelligence in large scale integrated circuits

NASA Technical Reports Server (NTRS)

Greene, P. H.

1972-01-01

Both in practical engineering and in control of muscular systems, low level subsystems automatically provide crude approximations to the proper response. Through low level tuning of these approximations, the proper response variant can emerge from standardized high level commands. Such systems are expressly suited to emerging large scale integrated circuit technology. A computer, using symbolic descriptions of subsystem responses, can select and shape responses of low level digital or analog microcircuits. A mathematical theory that reveals significant informational units in this style of control and software for realizing such information structures are formulated.

CRANE POSITIONING APPARATUS

DOEpatents

Landsiedel, F.W.; Wolff, H.

1960-06-28

An apparatus is described for automatically accomplishing the final accurate horizontal positioning of a crane after the latter has been placed to within 1/8 in. of its selected position. For this purpose there is provided a tiltable member on the crane mast for lowering into contact with a stationary probe. Misalignment of the tiltable member, with respect to the probe as the member is lowered, causes tilting of the latter to actuate appropriate switches that energize motors for bringing the mast into proper position. When properly aligned the member is not tilted and a central switch is actuated to indicate the final alignment of the crane.

Mars Tumbleweed Simulation Using Singular Perturbation Theory

NASA Technical Reports Server (NTRS)

Raiszadeh, Behzad; Calhoun, Phillip

2005-01-01

The Mars Tumbleweed is a new surface rover concept that utilizes Martian winds as the primary source of mobility. Several designs have been proposed for the Mars Tumbleweed, all using aerodynamic drag to generate force for traveling about the surface. The Mars Tumbleweed, in its deployed configuration, must be large and lightweight to provide the ratio of drag force to rolling resistance necessary to initiate motion from the Martian surface. This paper discusses the dynamic simulation details of a candidate Tumbleweed design. The dynamic simulation model must properly evaluate and characterize the motion of the tumbleweed rover to support proper selection of system design parameters. Several factors, such as model flexibility, simulation run times, and model accuracy needed to be considered in modeling assumptions. The simulation was required to address the flexibility of the rover and its interaction with the ground, and properly evaluate its mobility. Proper assumptions needed to be made such that the simulated dynamic motion is accurate and realistic while not overly burdened by long simulation run times. This paper also shows results that provided reasonable correlation between the simulation and a drop/roll test of a tumbleweed prototype.

A Case of Treatment- resistant Depression and Body Dysmorphic Disorder: The Role of Electroconvulsive Therapy Revisited.

PubMed

Mahato, Ram S; San Gabriel, Maria Chona P; Longshore, Carrol T; Schnur, David B

2016-01-01

Body dysmorphic disorder is a common, often disabling condition, and is frequently comorbid with major depressive disorder. Selective serotonin reuptake inhibitors constitute first line set of somatic interventions but the management of refractory patients remains challenging. Electroconvulsive therapy, an often highly beneficial treatment for medication resistant-depression, is not considered an effective therapeutic alternative for treatment refractory body dysmorphic disorder. Here we present a 50-year-old woman with body dysmorphic disorder and comorbid major depressive disorder who remained incapacitated and suicidal despite several trials with selective serotonin reuptake inhibitors and antipsychotic medication. Depressive and dysmorphic symptoms appeared to resolve with electroconvulsive therapy, and remission was sustained for two months. Electroconvulsive therapy has an important place in the management of treatment- resistant depression associated with body dysmorphic disorder, and, in select cases, may be effective for dysmorphic symptoms as well.

Psychotherapy of an aging transvestite.

PubMed

Wise, T N

1979-01-01

Proper categorization of individuals with gender dysphoria allows rational psychotherapy. The treatment of an aging transvestite who requested sexual reassignment is presented to demonstrate the clinical features of the disorder and the course of the illness. The initial task was to place the patient into the proper clinical category of individuals with gender dysphorias. The clinical details of this disorder include an episoidic course with individuals who have previously had clear masculine identities. In the past they have been labeled secondary or marginal transsexuals as well as fetishtic cross-dressers. The patient, who had a long-standing history of cross-dressing, reacted to specific life stresses by the symptomatic wish for sexual reassignment. The individual psychotherapy consisted of phases of symptomatic expression, emerging depression, interpersonal awareness, symptom resolution and disavowel of the wish for sexual reassignment. The genesis of this perversion appears to be identification with a phallic maternal figure. Discussion of the descriptive and dynamic literature is reported in relation to the reported case. Identification of important losses in this patient's recent life allowed proper diagnosis and appropriate ongoing therapy to prevent the patient from irreversible surgery for a condition that was a symptom not an ingrained belief of gender dysphoria.

Open versus closed reduction: diacapitular fractures of the mandibular condyle.

PubMed

Chrcanovic, Bruno Ramos

2012-09-01

The purpose of the study was to review the literature regarding the evolution of current thoughts on management of diacapitular fractures (DFs) of the mandibular condyle. An electronic search in PubMed was undertaken in March 2012. The titles and abstracts from these results were read to identify studies within the selection criteria. Eligibility criteria included studies reporting clinical series of DFs, including both animal and human studies, without date or language restrictions. The search strategy initially yielded 108 references. Twenty-eight studies were identified without repetition within the selection criteria. Additional hand-searching of the reference lists of selected studies yielded three additional papers. The current indications for open reduction and internal fixation (ORIF) of DFs described in the literature are: (a) fractures affecting the lateral condyle with reduction of mandibular height; (b) fractures in which the proximal fragment dislocates laterally out of the glenoid fossa, which cannot be reduced by closed or open treatment of another part of the mandibular fracture. The indications for conservative treatment are: (a) fractures that do not shorten the condylar height (a fracture with displacement of the medial parts of the condyle); (b) undisplaced fractures; (c) comminution of the condylar head, when the bony fragments are too small for stable fixation; and (d) fractures in children. As the temporomandibular joint disk plays an important role as a barrier preventing ankylosis, it is important to reposition the disk (if displaced/dislocated) during the surgical treatment of DFs. The lateral pterygoid muscle should never be stripped from the medially displaced fragment because its desinsertion disrupts circulation to the medial bony fragment, and also because this muscle helps to restore the muscle function after surgery. ORIF of selected DFs improves prognosis by anatomical bone and soft tissue recovery when combined with physical therapy. If conducted properly, surgical treatment of DFs is a safe and predictable procedure and yields good results.

Impact of Compliance on Dysphagia Rehabilitation in Head and Neck Cancer Patients – Results from a Multi-center Clinical Trial

PubMed Central

Krisciunas, Gintas P.; McCulloch, Timothy M.; Lazarus, Cathy L.; Pauloski, Barbara R.; Meyer, Tanya K.; Graner, Darlene; Van Daele, Douglas J.; Silbergleit, Alice K.; Crujido, Lisa R.; Rybin, Denis; Doros, Gheorghe; Kotz, Tamar; Langmore, Susan E.

2016-01-01

Purpose A 5yr, 16 site, randomized controlled trial enrolled 170 HNC survivors into active (estim + swallow exercise) or control (sham estim + swallowing exercise) arms. Primary analyses showed that estim did not enhance swallowing exercises. This secondary analysis determined if/how patient compliance impacted outcomes. Methods A home program, performed 2×/day, 6d/wk, for 12wks included stretches and 60 swallows paired with real or sham estim. Regular clinic visits ensured proper exercise execution and detailed therapy checklists tracked patient compliance which was defined by mean number of sessions performed per week (0-12 times) over the 12wk intervention period. “Compliant” was defined as performing 10-12 sessions/wk. Outcomes were change in PAS, HNCI, PSS, OPSE, and hyoid excursion. ANCOVA analyses determined if outcomes differed between real/sham and compliant/noncompliant groups after 12wks of therapy. Results Of the 170 patients enrolled, 153 patients had compliance data. The mean number of sessions performed was 8.57/wk (median=10.25). Fifty four percent of patients (n=83) were considered “compliant”. After 12wks of therapy, compliant patients in the sham estim group realized significantly better PAS scores than compliant patients in the active estim group (p=0.0074). When pooling all patients together, there were no significant differences in outcomes between compliant and non-compliant patients. Conclusions The addition of estim to swallowing exercises resulted in worse swallowing outcomes than exercises alone, which was more pronounced in compliant patients. Since neither compliant nor non-compliant patients benefitted from swallowing exercises, the proper dose and/or efficacy of swallowing exercises must also be questioned in this patient population. PMID:27848021

Impact of Compliance on Dysphagia Rehabilitation in Head and Neck Cancer Patients: Results from a Multi-center Clinical Trial.

PubMed

Krisciunas, Gintas P; Castellano, Kerlly; McCulloch, Timothy M; Lazarus, Cathy L; Pauloski, Barbara R; Meyer, Tanya K; Graner, Darlene; Van Daele, Douglas J; Silbergleit, Alice K; Crujido, Lisa R; Rybin, Denis; Doros, Gheorghe; Kotz, Tamar; Langmore, Susan E

2017-04-01

A 5-year, 16-site, randomized controlled trial enrolled 170 HNC survivors into active (estim + swallow exercise) or control (sham estim + swallowing exercise) arms. Primary analyses showed that estim did not enhance swallowing exercises. This secondary analysis determined if/how patient compliance impacted outcomes. A home program, performed 2 times/day, 6 days/week, for 12 weeks included stretches and 60 swallows paired with real or sham estim. Regular clinic visits ensured proper exercise execution, and detailed therapy checklists tracked patient compliance which was defined by mean number of sessions performed per week (0-12 times) over the 12-week intervention period. "Compliant" was defined as performing 10-12 sessions/week. Outcomes were changes in PAS, HNCI, PSS, OPSE, and hyoid excursion. ANCOVA analyses determined if outcomes differed between real/sham and compliant/noncompliant groups after 12 weeks of therapy. Of the 170 patients enrolled, 153 patients had compliance data. The mean number of sessions performed was 8.57/week (median = 10.25). Fifty-four percent of patients (n = 83) were considered "compliant." After 12 weeks of therapy, compliant patients in the sham estim group realized significantly better PAS scores than compliant patients in the active estim group (p = 0.0074). When pooling all patients together, there were no significant differences in outcomes between compliant and non-compliant patients. The addition of estim to swallowing exercises resulted in worse swallowing outcomes than exercises alone, which was more pronounced in compliant patients. Since neither compliant nor non-compliant patients benefitted from swallowing exercises, the proper dose and/or efficacy of swallowing exercises must also be questioned in this patient population.

Introduction of a PCT-based algorithm to guide antibiotic prescription in COPD exacerbation.

PubMed

Picart, J; Moiton, M P; Gaüzère, B-A; Gazaille, V; Combes, X; DiBernardo, S

2016-12-01

Prescribing antibiotics for COPD exacerbations is not easy. Procalcitonin (PCT) is a useful biomarker that helps reduce the rate of antibiotic therapies. However, its proper cut-off levels are often unknown. We aimed to assess the impact of a PCT-based algorithm to guide antibiotic therapy prescription in COPD exacerbations. We conducted an observational, retrospective, and before/after study. We reviewed physician practices regarding PCT test and antibiotic therapy prescription to all patients hospitalized for COPD exacerbation. We then analyzed the rate of antibiotic prescriptions and the number of PCT tests prescribed before and after the introduction of a protocol validated by previous high-power studies. The primary endpoint was the rate of antibiotic prescriptions. A total of 124 patients before protocol and 121 patients after protocol were included. Antibiotic prescriptions decreased by 41% after protocol introduction (59% vs. 35%, P<0.001), with no increase in morbidity and mortality at Day 30. Compliance with protocol was complete in 60% of cases and partial (no PCT guidance to discontinue antibiotics) in 8% of cases. Both antibiotic duration (8.3 days vs. 8.7 days) and length of hospital stay (8.5 days vs. 8.3 days, P=0.78) did not change. Hospital physicians are already using PCT-based algorithm to guide antibiotic prescription in COPD exacerbations. Disseminating information on the appropriate PCT cut-off level to use to decide whether or not to initiate antibiotics is effective. Its proper use should be clarified to reduce antibiotic prescriptions to these overexposed patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Hyperactivity--Drug Therapy/Food Additives/Allergies. A Selective Bibliography. Exceptional Child Bibliography Series No. 602.

ERIC Educational Resources Information Center

ERIC Clearinghouse on Handicapped and Gifted Children, Reston, VA.

The annotated bibliography on Hyperactivity--Drug Therapy/Food Additives/Allergies contains approximately 65 abstracts and associated indexing information for documents or journal articles published from 1968 to 1975 and selected from the computer files of the Council for Exceptional Children's Information Services and the Education Resources…

The impact of feature selection on one and two-class classification performance for plant microRNAs.

PubMed

Khalifa, Waleed; Yousef, Malik; Saçar Demirci, Müşerref Duygu; Allmer, Jens

2016-01-01

MicroRNAs (miRNAs) are short nucleotide sequences that form a typical hairpin structure which is recognized by a complex enzyme machinery. It ultimately leads to the incorporation of 18-24 nt long mature miRNAs into RISC where they act as recognition keys to aid in regulation of target mRNAs. It is involved to determine miRNAs experimentally and, therefore, machine learning is used to complement such endeavors. The success of machine learning mostly depends on proper input data and appropriate features for parameterization of the data. Although, in general, two-class classification (TCC) is used in the field; because negative examples are hard to come by, one-class classification (OCC) has been tried for pre-miRNA detection. Since both positive and negative examples are currently somewhat limited, feature selection can prove to be vital for furthering the field of pre-miRNA detection. In this study, we compare the performance of OCC and TCC using eight feature selection methods and seven different plant species providing positive pre-miRNA examples. Feature selection was very successful for OCC where the best feature selection method achieved an average accuracy of 95.6%, thereby being ∼29% better than the worst method which achieved 66.9% accuracy. While the performance is comparable to TCC, which performs up to 3% better than OCC, TCC is much less affected by feature selection and its largest performance gap is ∼13% which only occurs for two of the feature selection methodologies. We conclude that feature selection is crucially important for OCC and that it can perform on par with TCC given the proper set of features.

Selection of drug-resistant HIV-1 during the early phase of viral decay is uncommon in treatment-naïve patients initiated on a three- or four-drug antiretroviral regimen including lamivudine.

PubMed

Bergroth, Tobias; Ekici, Halime; Gisslén, Magnus; Loes, Sabine Kinloch-de; Goh, Li-Ean; Freedman, Andrew; Lampe, Fiona; Johnson, Margaret A; Sönnerborg, Anders

2009-01-01

Therapy failure due to drug resistance development is a common phenomenon in HIV-infected patients. However, when the drug pressure leads to the earliest selection of drug-resistant HIV-1 populations is still unclear. In this study, the extent to which selection of the HIV-1 reverse transcriptase M184I/V mutations occur during the initial phase of viral decay in treatment-naïve HIV-1 infected patients receiving antiretroviral therapy (ART) was examined. Plasma virus from three cohorts of treatment-naïve patients initiating quadruple (n = 43), triple (n = 14) or dual (n = 15) lamivudine-containing ART were analyzed for M184I/V during the first 6 months of therapy using direct sequencing and a sensitive selective real-time PCR method. Among quadruple ART patients, who all were treated at primary HIV-1 infection, only one patient developed M184V after 6 weeks of therapy, having had wild-type virus at baseline. No mutations were found in chronically infected patients on triple ART. In patients on dual therapy, M184I/V mutants were found frequently. Selection of M184I/V mutants was found to be rare during the initial phase of viral decay after initiation of ART in adherent patients given a three or four-drug combination, in contrast to those receiving a less potent regimen. The results suggest that triple and quadruple lamivudine + PI or PI/r containing ART given to treatment-naïve adherent patients is potent enough to prevent development of resistance during the first months of therapy.

Potential of Using Mobile Phone Data to Assist in Mission Analysis and Area of Operations Planning

DTIC Science & Technology

2015-08-01

tremendously beneficial especially since a sizeable portion of the population are nomads , changing location based on season. A proper AO...provided: a. User_id: Selected User’s random ID b. Timestamp: 24 h format YYYY-MM-DD-HH:M0:00 (the second digits of the minutes and all the seconds...yearly were selected. This data provided: a. User_id: Selected User’s random ID b. Timestamp: 24 h format YYYY-MM-DD-HH:M0:00 (the second digits

Investigation of Engineering and Design Considerations in Selecting Conveyors for Densified Refuse-Derived Fuel (dRDF) and dRDF: Coal Mixtures.

DTIC Science & Technology

1981-08-01

or discharge paths of material over the end pulley of a conveyor are important to the proper design and function of discharge chutes , wear plates or...8217 ’iESL-TR-81-58 INVESTIGATION OF ENGINEERING AND DESIGN CONSIDERATIONS IN SELECTING CONVEYORS FOR DENSIFIED REFUSE-DERIVED FUEL (dRDF) AND dRDF: COAL...Engineering and Design Final Report Considerations in Selecting Conveyors for JUN 1980 - SEP 1981 Densified Refuse-Derived Fuel (dRDF) and 6. PERFORMING ORG

Comparison of Control Group Generating Methods.

PubMed

Szekér, Szabolcs; Fogarassy, György; Vathy-Fogarassy, Ágnes

2017-01-01

Retrospective studies suffer from drawbacks such as selection bias. As the selection of the control group has a significant impact on the evaluation of the results, it is very important to find the proper method to generate the most appropriate control group. In this paper we suggest two nearest neighbors based control group selection methods that aim to achieve good matching between the individuals of case and control groups. The effectiveness of the proposed methods is evaluated by runtime and accuracy tests and the results are compared to the classical stratified sampling method.

Expanding the therapeutic use of androgens via selective androgen receptor modulators (SARMs)

PubMed Central

Gao, Wenqing; Dalton, James T.

2007-01-01

Selective androgen receptor modulators (SARMs) are a novel class of androgen receptor (AR) ligands that might change the future of androgen therapy dramatically. With improved pharmacokinetic characteristics and tissue-selective pharmacological activities, SARMs are expected to greatly extend the clinical applications of androgens to osteoporosis, muscle wasting, male contraception and diseases of the prostate. Mechanistic studies with currently available SARMs will help to define the contributions of differential tissue distribution, tissue-specific expression of 5α-reductase, ligand-specific regulation of gene expression and AR interactions with tissue-specific coactivators to their observed tissue selectivity, and lead to even greater expansion of selective anabolic therapies. PMID:17331889

76 FR 64328 - Proposed Information Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-18

... financial resources) is minimized, collection instruments are clearly understood, and the impact of... disaster deployments, the Corporation's expectations for performance upon selection, and the application...: Evaluate whether the proposed collection of information is necessary for the proper performance of the...

Sprayer technology: reduce spray drift

USDA-ARS?s Scientific Manuscript database

Enhancing environmental quality and sustaining the economic viability of food production are keys to sustainable agriculture. Modern vegetable production uses a variety of materials to manage pest problems. Selecting the proper spray nozzle for the application of liquid products is critical to red...

Differential Decomposition of Bacterial and Viral Fecal Indicators in Common Human Pollution Types

EPA Science Inventory

Understanding the decomposition of microorganisms associated with different human fecal pollution types is necessary for proper implementation of many water qualitymanagement practices, as well as predicting associated public health risks. Here, thedecomposition of select cultiva...

Maintaining Your Threads.

ERIC Educational Resources Information Center

Delack, Renee J.

1996-01-01

Describes how keeping carpets in good condition depends not only on proper maintenance but also on careful carpet selection at the outset. Offers advice for restoring a carpet's new appearance through vacuuming and hot-water extraction and suggests ways to manage spots and stains. (RJM)

7 CFR 1773.42 - Clearing accounts.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Clearing accounts. The CPA's workpapers must contain an analysis of all clearing accounts. Based upon the CPA's determination of materiality, an appropriate sample of transactions should be selected for testing. The CPA's workpapers must document that transactions were reviewed for proper allocation between...

Intrapersonal and Interpersonal Models: Blending Gestalt and Family Therapies

ERIC Educational Resources Information Center

Hatcher, Chris

1978-01-01

Family therapy is primarily focused upon interpersonal or transactional issues. Gestalt therapy is particularly well suited for short term work on intrapersonal and boundary issues. This paper shows how the selective integration of the two approaches provides a significant, new dimension in the development of family therapy. (Author)

The effect of music video exposure on students' perceived clinical applications of popular music in the field of music therapy: a pilot study.

PubMed

Gooding, Lori F; Mori-Inoue, Satoko

2011-01-01

The purpose of this study was to examine the effect of video exposure on music therapy students' perceptions of clinical applications of popular music in the field of music therapy. Fifty-one participants were randomly divided into two groups and exposed to a popular song in either audio-only or music video format. Participants were asked to indicate clinical applications; specifically, participants chose: (a) possible population(s), (b) most appropriate population(s), (c) possible age range(s), (d) most appropriate age ranges, (e) possible goal area(s) and (f) most appropriate goal area. Data for each of these categories were compiled and analyzed, with no significant differences found in the choices made by the audio-only and video groups. Three items, (a) selection of the bereavement population, (b) selection of bereavement as the most appropriate population and (c) selection of the age ranges of pre teen/mature adult, were additionally selected for further analysis due to their relationship to the video content. Analysis results revealed a significant difference between the video and audio-only groups for the selection of these specific items, with the video group's selections more closely aligned to the video content. Results of this pilot study suggest that music video exposure to popular music can impact how students choose to implement popular songs in the field of music therapy.

Treatment algorithm in 2014 for advanced non-small cell lung cancer: therapy selection by tumour histology and molecular biology.

PubMed

Manegold, Christian

2014-09-01

The availability of antineoplastic monoclonal antibodies, small molecules and newer cytotoxics such as pemetrexed, the EGFR-tyrosine kinase inhibitors erlotinib, gefitinib, afatinib as well as the anti-angiogenic bevacizumab and the ALK-inhibitor crizotinib has recently changes the treatment algorithm of advanced non-small cell lung cancer. Decision making in 2014 is characterized by customizing therapy, by selecting a specific therapeutic regimen based on the histotype and the genotype of the tumour. This refers to first-line induction therapy and maintenance therapy as well, but also to subsequent lines of therapy since anti-neoplastic drugs and regimens used upfront clinically influence the selection of agents/regimes considered for second-/third-line treatment. Consequently, therapy customization through tumour histology and molecular markers has significantly influenced the work of pathologists around the globe and the process of obtaining an extended therapeutically relevant tumour diagnosis. Not only histological sub-typing became standard but molecular information is also considered of increasing importance for treatment selection. Routine molecular testing in certified laboratories must be established, and the diagnostic process should ideally be performed under the guidance of evidence based recommendation. The process of investigating and implementing medical targeting in lung cancer therefore, requires advanced diagnostic techniques and expertise and because of its large dimension is costly and influenced by the limitation of financial and clinical resources. Copyright © 2014. Published by Elsevier Urban & Partner Sp. z o.o.

Boronated porhyrins and methods for their use

DOEpatents

Miura, Michiko; Shelnutt, John A.; Slatkin, Daniel N.

1999-03-02

The present invention covers boronated porphyrins containing multiple carborane cages which selectively accumulate in neoplastic tissue within the irradiation volume and thus can be used in cancer therapies such as boron neutron capture therapy and photodynamic therapy.

Progress in Rectal Cancer Treatment

PubMed Central

Ceelen, Wim P.

2012-01-01

The dramatic improvement in local control of rectal cancer observed during the last decades is to be attributed to attention to surgical technique and to the introduction of neoadjuvant therapy regimens. Nevertheless, systemic relapse remains frequent and is currently insufficiently addressed. Intensification of neoadjuvant therapy by incorporating chemotherapy with or without targeted agents before the start of (chemo)radiation or during the waiting period to surgery may present an opportunity to improve overall survival. An increasing number of patients can nowadays undergo sphincter preserving surgery. In selected patients, local excision or even a “wait and see” approach may be feasible following active neoadjuvant therapy. Molecular and genetic biomarkers as well as innovative imaging techniques may in the future allow better selection of patients for this treatment option. Controversy persists concerning the selection of patients for adjuvant chemotherapy and/or targeted therapy after neoadjuvant regimens. The currently available evidence suggests that in complete pathological responders long-term outcome is excellent and adjuvant therapy may be omitted. The results of ongoing trials will help to establish the ideal tailored approach in resectable rectal cancer. PMID:22970381

Topical treatment of psoriasis.

PubMed

Laws, Philip M; Young, Helen S

2010-08-01

The majority of patients with psoriasis can be safely and effectively treated with topical therapy alone, either under the supervision of a family physician or dermatologist. For those requiring systemic agents, topical therapies can provide additional benefit. Optimal use of topical therapy requires an awareness of the range and efficacy of all products. The review covers the efficacy and role of topical therapies including emollients, corticosteroids, vitamin D analogs, calcineurin inhibitors, dithranol, coal tar, retinoids, keratolyics and combination therapy. The report was prepared following a PubMed and Embase literature search up to April 2010. The paper provides a broad review of the relevant topical therapeutic options available in routine clinical practice for the management of psoriasis and a recommendation for selection of treatment. Topical therapies used appropriately provide a safe and effective option for the management of psoriasis. An awareness of the available products and their efficacy is key to treatment selection and patient satisfaction.

Divergent clonal selection dominates medulloblastoma at recurrence

PubMed Central

Morrissy, A. Sorana; Garzia, Livia; Shih, David J. H.; Zuyderduyn, Scott; Huang, Xi; Skowron, Patryk; Remke, Marc; Cavalli, Florence M. G.; Ramaswamy, Vijay; Lindsay, Patricia E.; Jelveh, Salomeh; Donovan, Laura K.; Wang, Xin; Luu, Betty; Zayne, Kory; Li, Yisu; Mayoh, Chelsea; Thiessen, Nina; Mercier, Eloi; Mungall, Karen L.; Ma, Yusanne; Tse, Kane; Zeng, Thomas; Shumansky, Karey; Roth, Andrew J. L.; Shah, Sohrab; Farooq, Hamza; Kijima, Noriyuki; Holgado, Borja L.; Lee, John J. Y.; Matan-Lithwick, Stuart; Liu, Jessica; Mack, Stephen C.; Manno, Alex; Michealraj, K. A.; Nor, Carolina; Peacock, John; Qin, Lei; Reimand, Juri; Rolider, Adi; Thompson, Yuan Y.; Wu, Xiaochong; Pugh, Trevor; Ally, Adrian; Bilenky, Mikhail; Butterfield, Yaron S. N.; Carlsen, Rebecca; Cheng, Young; Chuah, Eric; Corbett, Richard D.; Dhalla, Noreen; He, An; Lee, Darlene; Li, Haiyan I.; Long, William; Mayo, Michael; Plettner, Patrick; Qian, Jenny Q.; Schein, Jacqueline E.; Tam, Angela; Wong, Tina; Birol, Inanc; Zhao, Yongjun; Faria, Claudia C.; Pimentel, José; Nunes, Sofia; Shalaby, Tarek; Grotzer, Michael; Pollack, Ian F.; Hamilton, Ronald L.; Li, Xiao-Nan; Bendel, Anne E.; Fults, Daniel W.; Walter, Andrew W.; Kumabe, Toshihiro; Tominaga, Teiji; Collins, V. Peter; Cho, Yoon-Jae; Hoffman, Caitlin; Lyden, David; Wisoff, Jeffrey H.; Garvin, James H.; Stearns, Duncan S.; Massimi, Luca; Schüller, Ulrich; Sterba, Jaroslav; Zitterbart, Karel; Puget, Stephanie; Ayrault, Olivier; Dunn, Sandra E.; Tirapelli, Daniela P. C.; Carlotti, Carlos G.; Wheeler, Helen; Hallahan, Andrew R.; Ingram, Wendy; MacDonald, Tobey J.; Olson, Jeffrey J.; Van Meir, Erwin G.; Lee, Ji-Yeoun; Wang, Kyu-Chang; Kim, Seung-Ki; Cho, Byung-Kyu; Pietsch, Torsten; Fleischhack, Gudrun; Tippelt, Stephan; Ra, Young Shin; Bailey, Simon; Lindsey, Janet C.; Clifford, Steven C.; Eberhart, Charles G.; Cooper, Michael K.; Packer, Roger J.; Massimino, Maura; Garre, Maria Luisa; Bartels, Ute; Tabori, Uri; Hawkins, Cynthia E.; Dirks, Peter; Bouffet, Eric; Rutka, James T.; Wechsler-Reya, Robert J.; Weiss, William A.; Collier, Lara S.; Dupuy, Adam J.; Korshunov, Andrey; Jones, David T. W.; Kool, Marcel; Northcott, Paul A.; Pfister, Stefan M.; Largaespada, David A.; Mungall, Andrew J.; Moore, Richard A.; Jabado, Nada; Bader, Gary D.; Jones, Steven J. M.; Malkin, David; Marra, Marco A.; Taylor, Michael D.

2016-01-01

The development of targeted anti-cancer therapies through the study of cancer genomes is intended to increase survival rates and decrease treatment-related toxicity. We treated a transposon–driven, functional genomic mouse model of medulloblastoma with ‘humanized’ in vivo therapy (microneurosurgical tumour resection followed by multi-fractionated, image-guided radiotherapy). Genetic events in recurrent murine medulloblastoma exhibit a very poor overlap with those in matched murine diagnostic samples (<5%). Whole-genome sequencing of 33 pairs of human diagnostic and post-therapy medulloblastomas demonstrated substantial genetic divergence of the dominant clone after therapy (<12% diagnostic events were retained at recurrence). In both mice and humans, the dominant clone at recurrence arose through clonal selection of a pre-existing minor clone present at diagnosis. Targeted therapy is unlikely to be effective in the absence of the target, therefore our results offer a simple, proximal, and remediable explanation for the failure of prior clinical trials of targeted therapy. PMID:26760213

Basis for selecting optimum antibiotic regimens for secondary peritonitis.

PubMed

Maseda, Emilio; Gimenez, Maria-Jose; Gilsanz, Fernando; Aguilar, Lorenzo

2016-01-01

Adequate management of severely ill patients with secondary peritonitis requires supportive therapy of organ dysfunction, source control of infection and antimicrobial therapy. Since secondary peritonitis is polymicrobial, appropriate empiric therapy requires combination therapy in order to achieve the needed coverage for both common and more unusual organisms. This article reviews etiological agents, resistance mechanisms and their prevalence, how and when to cover them and guidelines for treatment in the literature. Local surveillances are the basis for the selection of compounds in antibiotic regimens, which should be further adapted to the increasing number of patients with risk factors for resistance (clinical setting, comorbidities, previous antibiotic treatments, previous colonization, severity…). Inadequate antimicrobial regimens are strongly associated with unfavorable outcomes. Awareness of resistance epidemiology and of clinical consequences of inadequate therapy against resistant bacteria is crucial for clinicians treating secondary peritonitis, with delicate balance between optimization of empirical therapy (improving outcomes) and antimicrobial overuse (increasing resistance emergence).

[The Learning Effectiveness of Nurses Participating in a Simulated Radiation Therapy Skin Care Workshop].

PubMed

Lee, Yu-San; Kao, Yu-Hsiu

2016-08-01

The skin reaction rate is 60-95% in cancer patients that receive radiation therapy. This therapy is likely to cause physical and mental discomfort and prolong treatment for patients. The current emphasis on lectures rather than practice to help nurses learn proper skin care practices likely imposes difficulties for nurses to handle various clinical situations. To investigate the learning effectiveness of a simulated radiation therapy skin care workshop for nurses. A total of 34 nurses at a hospital in one health system in northern Taiwan who had never used radiation therapy to provide care to patients were enrolled in this quasi-experimental study. A single group pretest, posttest and post-posttest (6 weeks after intervention) approach was used. At the simulated radiation therapy skin care workshop, we used teaching strategies including Ausubel's direct instruction teaching method and practice on simulated wounds on pig skins. Outcomes were evaluated using "the questionnaire of radiation therapy skin care" and "direct observation of procedural skills checklist". The results from the simulated radiation therapy skin care workshop were analyzed using GEE (generalized estimating equation). The post-posttest and posttest scores increased significantly; knowledge mean score 3.14 (< .001) vs 2.64 (< .001), attitude mean score 2.06 (p < .05) vs 2.24 (p < .001), and skill mean score 2.79 (p < .001) vs 1.68 (p < .001). The simulated radiation therapy skin care workshop demonstrated significant and positive effects on learning outcomes. Therefore, we recommend incorporating this workshop into clinical nursing education and training strategies in the future.

Endocrine and metabolic emergencies in children: hypocalcemia, hypoglycemia, adrenal insufficiency, and metabolic acidosis including diabetic ketoacidosis

PubMed Central

2015-01-01

It is important to fast diagnosis and management of the pediatric patients of the endocrine metabolic emergencies because the signs and symptoms of these disorders are nonspecific. Delayed diagnosis and treatment may lead to serious consequences of the pediatric patients, for example, cerebral dysfunction leading to coma or death of the patients with hypoglycemia, hypocalcemia, adrenal insufficiency, or diabetic ketoacidosis. The index of suspicion of the endocrine metabolic emergencies should be preceded prior to the starting nonspecific treatment. Importantly, proper diagnosis depends on the collection of blood and urine specimen before nonspecific therapy (intravenous hydration, electrolytes, glucose or calcium injection). At the same time, the taking of precise history and searching for pathognomonic physical findings should be performed. This review was described for fast diagnosis and proper management of hypoglycemic emergencies, hypocalcemia, adrenal insufficiency, and metabolic acidosis including diabetic ketoacidosis. PMID:26817004

Very Low-mass Stars and Brown Dwarfs in Upper Scorpius Using Gaia DR1: Mass Function, Disks, and Kinematics

NASA Astrophysics Data System (ADS)

Cook, Neil J.; Scholz, Aleks; Jayawardhana, Ray

2017-12-01

Our understanding of the brown dwarf population in star-forming regions is dependent on knowing distances and proper motions and therefore will be improved through the Gaia space mission. In this paper, we select new samples of very low-mass objects (VLMOs) in Upper Scorpius using UKIDSS colors and optimized proper motions calculated using Gaia DR1. The scatter in proper motions from VLMOs in Upper Scorpius is now (for the first time) dominated by the kinematic spread of the region itself, not by the positional uncertainties. With age and mass estimates updated using Gaia parallaxes for early-type stars in the same region, we determine masses for all VLMOs. Our final most complete sample includes 453 VLMOs of which ˜125 are expected to be brown dwarfs. The cleanest sample is comprised of 131 VLMOs, with ˜105 brown dwarfs. We also compile a joint sample from the literature that includes 415 VLMOs, out of which 152 are likely brown dwarfs. The disk fraction among low-mass brown dwarfs (M< 0.05 {M}⊙ ) is substantially higher than in more massive objects, indicating that disks around low-mass brown dwarfs survive longer than in low-mass stars overall. The mass function for 0.01< M< 0.1 {M}⊙ is consistent with the Kroupa Initial Mass Function. We investigate the possibility that some “proper motion outliers” have undergone a dynamical ejection early in their evolution. Our analysis shows that the color-magnitude cuts used when selecting samples introduce strong bias into the population statistics due to varying levels of contamination and completeness.

Gene Therapy in Heart Failure.

PubMed

Fargnoli, Anthony S; Katz, Michael G; Bridges, Charles R; Hajjar, Roger J

2017-01-01

Heart failure is a significant burden to the global healthcare system and represents an underserved market for new pharmacologic strategies, especially therapies which can address root cause myocyte dysfunction. Modern drugs, surgeries, and state-of-the-art interventions are costly and do not improve survival outcome measures. Gene therapy is an attractive strategy, whereby selected gene targets and their associated regulatory mechanisms can be permanently managed therapeutically in a single treatment. This in theory could be sustainable for the patient's life. Despite the promise, however, gene therapy has numerous challenges that must be addressed together as a treatment plan comprising these key elements: myocyte physiologic target validation, gene target manipulation strategy, vector selection for the correct level of manipulation, and carefully utilizing an efficient delivery route that can be implemented in the clinic to efficiently transfer the therapy within safety limits. This chapter summarizes the key developments in cardiac gene therapy from the perspective of understanding each of these components of the treatment plan. The latest pharmacologic gene targets, gene therapy vectors, delivery routes, and strategies are reviewed.

Drexel at TREC 2014 Federated Web Search Track

DTIC Science & Technology

2014-11-01

of its input RS results. 1. INTRODUCTION Federated Web Search is the task of searching multiple search engines simultaneously and combining their...or distributed properly[5]. The goal of RS is then, for a given query, to select only the most promising search engines from all those available. Most...result pages of 149 search engines . 4000 queries are used in building the sample set. As a part of the Vertical Selection task, search engines are

Task Analysis - Aircraft Structural Maintenance AFSC 458X2

DTIC Science & Technology

1989-08-01

GAGES OR METERS 13 10 23 SELECT WEIGHT MEASURING SCALES 15 6 21 RECALL TYPES, PROPERTIES, AND CHARACTERISTICS 8 11 19 OF PLASTICS SELECT COMMON...SURFACES (K0494) 121 00480 SHOT PEEN METAL SURFACES (K0498) 123 00490 BALANCE AIRCRAFT CONTROL SURFACES 125 00500 CLEAN PLASTICS (0275) 127 00510...STORE TRANSPARENT PLASTICS IN PROPER ENVIRONMENT (J0299) 128 00520 POLISH OUT SURFACE SCRATCHES 129 00530 CUT PLASTICS 131 00540 RESEARCH AIRCRAFT

[Chemical databases and virtual screening].

PubMed

Rognan, Didier; Bonnet, Pascal

2014-12-01

A prerequisite to any virtual screening is the definition of compound libraries to be screened. As we describe here, various sources are available. The selection of the proper library is usually project-dependent but at least as important as the screening method itself. This review details the main compound libraries that are available for virtual screening and guide the reader to the best possible selection according to its needs. © 2014 médecine/sciences – Inserm.

A Simple Joint Estimation Method of Residual Frequency Offset and Sampling Frequency Offset for DVB Systems

NASA Astrophysics Data System (ADS)

Kwon, Ki-Won; Cho, Yongsoo

This letter presents a simple joint estimation method for residual frequency offset (RFO) and sampling frequency offset (STO) in OFDM-based digital video broadcasting (DVB) systems. The proposed method selects a continual pilot (CP) subset from an unsymmetrically and non-uniformly distributed CP set to obtain an unbiased estimator. Simulation results show that the proposed method using a properly selected CP subset is unbiased and performs robustly.

Cluster membership probability: polarimetric approach

NASA Astrophysics Data System (ADS)

Medhi, Biman J.; Tamura, Motohide

2013-04-01

Interstellar polarimetric data of the six open clusters Hogg 15, NGC 6611, NGC 5606, NGC 6231, NGC 5749 and NGC 6250 have been used to estimate the membership probability for the stars within them. For proper-motion member stars, the membership probability estimated using the polarimetric data is in good agreement with the proper-motion cluster membership probability. However, for proper-motion non-member stars, the membership probability estimated by the polarimetric method is in total disagreement with the proper-motion cluster membership probability. The inconsistencies in the determined memberships may be because of the fundamental differences between the two methods of determination: one is based on stellar proper motion in space and the other is based on selective extinction of the stellar output by the asymmetric aligned dust grains present in the interstellar medium. The results and analysis suggest that the scatter of the Stokes vectors q (per cent) and u (per cent) for the proper-motion member stars depends on the interstellar and intracluster differential reddening in the open cluster. It is found that this method could be used to estimate the cluster membership probability if we have additional polarimetric and photometric information for a star to identify it as a probable member/non-member of a particular cluster, such as the maximum wavelength value (λmax), the unit weight error of the fit (σ1), the dispersion in the polarimetric position angles (overline{ɛ }), reddening (E(B - V)) or the differential intracluster reddening (ΔE(B - V)). This method could also be used to estimate the membership probability of known member stars having no membership probability as well as to resolve disagreements about membership among different proper-motion surveys.

Occurrence of etravirine/rilpivirine-specific resistance mutations selected by efavirenz and nevirapine in Kenyan patients with non-B HIV-1 subtypes failing antiretroviral therapy.

PubMed

Crawford, Keith W; Njeru, Dorothy; Maswai, Jonah; Omondi, Milton; Apollo, Duncan; Kimetto, Jane; Gitonga, Lawrence; Munyao, James; Langat, Raphael; Aoko, Appolonia; Tarus, Jemutai; Khamadi, Samoel; Hamm, Tiffany E

2014-01-28

Resistance to efavirenz and nevirapine has not been associated with mutations at position 138 of reverse transcriptase. In an evaluation of virologic suppression rates in PEPFAR (President's Emergency Plan For AIDS Relief) clinics in Kenya among patients on first-line therapy (RV288), 63% (617/975) of randomly selected patients on antiretroviral therapy were suppressed (HIV RNA<400 copies/ml). Among those with non-nucleoside reverse transcriptase inhibitor resistance (n = 101), 14 (13.8%) had substitutions at 138 (A, G, K or Q), mutations selected only by etravirine and rilpivirine in subtype B viruses. All 14 patients received efavirenz or nevirapine, not etravirine or rilpivirine, and were predominantly subtype A1. This may be the first report of efavirenz and nevirapine selecting these mutations in these subtypes.

Augmentation of the posterior maxilla: a proposed hierarchy of treatment selection.

PubMed

Fugazzotto, Paul A

2003-11-01

Literature is reviewed that discusses treatment results following Cauldwel Luc approach sinus augmentation therapy or osteotome sinus augmentation therapy, with and without simultaneous implant placement. A hierarchy of treatment selection for the augmentation of the posterior maxilla, based upon quantity and position of residual alveolar bone crestal to the floor of the sinus, is proposed.

[THE ROLE OF PRESSURE ULCER SURROUNDING SKIN PREPARATION PRIOR TO THE APPLICATION OF WOUND DRESSING].

PubMed

Kulišić, S Marinović

2016-01-01

Pressure ulcer develops as a result of many factors, primarily pressure, tensile forces and ischemia with immobility and incontinence. Targeted and properly designed preventive measures reduce the incidence and complications of pressure ulcers, among which the most common are infections. An important preventive measure is protection of the surrounding skin before the application of wound dressings. Skin changes dictate the use of emollients and topical therapy according to dermatological status.

Critical Care of Pet Birds.

PubMed

Jenkins, Jeffrey Rowe

2016-05-01

Successful care of the critical pet bird patient is dependent on preparation and planning and begins with the veterinarian and hospital staff. An understanding of avian physiology and pathophysiology is key. Physical preparation of the hospital or clinic includes proper equipment and understanding of the procedures necessary to provide therapeutic and supportive care to the avian patient. An overview of patient intake and assessment, intensive care environment, and fluid therapy is included. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of a Computerized Antithrombotic Risk Assessment Tool on the Prescription of Thromboprophylaxis in Atrial Fibrillation: Hospital Setting.

PubMed

Pandya, E; Masood, N; Wang, Y; Krass, I; Bajorek, B

2018-01-01

The computerized antithrombotic risk assessment tool (CARAT) is an online decision-support algorithm that facilitates a systematic review of a patient's stroke risk, bleeding risk, and pertinent medication safety considerations, to generate an individualized treatment recommendation. The CARAT was prospectively applied across 2 hospitals in the greater Sydney area. Its impact on antithrombotics utilization for thromboprophylaxis in patients with nonvalvular atrial fibrillation was evaluated. Factors influencing prescribers' treatment selection were identified. The CARAT recommended a change in baseline therapy for 51.8% of patients. Among anticoagulant-eligible patients (ie, where the risk of stroke outweighed the risk of bleeding) using "nil therapy" or antiplatelet therapy at baseline, the CARAT recommended an upgrade to warfarin in 60 (30.8%) patients. For those in whom the bleeding risk outweighed the stroke risk, the CARAT recommended a downgrade from warfarin to safer alternatives (eg, aspirin) in 37 (19%) patients. Among the "most eligible" (ie, high stroke risk, low bleeding risk, no contraindications; n = 75), the CARAT recommended warfarin for all cases. Discharge therapy observed a marginal increase in anticoagulation prescription in eligible patients (n = 116; 57.8% vs 64.7%, P = .35) compared to baseline. Predictors of warfarin use (vs antiplatelets) included congestive cardiac failure, diabetes mellitus, and polypharmacy. The CARAT was able to optimize the selection of therapy, increasing anticoagulant use among eligible patients. With the increasing complexity of decision-making, such tools may be useful adjuncts in therapy selection in atrial fibrillation. Future studies should explore the utility of such tools in selecting therapies from within an expanded treatment armamentarium comprising the non-vitamin K antagonist oral anticoagulants.

Children's UTIs in the new millennium. Diagnosis, investigation, and treatment of childhood urinary tract infections in the year 2001.

PubMed Central

White, C. T.; Matsell, D. G.

2001-01-01

OBJECTIVE: To provide an effective approach for family physicians treating children presenting with urinary tract infections (UTIs). QUALITY OF EVIDENCE: The information presented, and articles quoted, are drawn from both review of the literature and recent consensus guidelines. Data and recommendations come from prospective multicentre trials; retrospective reviews; expert consensus statements; and some smaller trials, commentaries, and editorials. MAIN MESSAGE: Urinary tract infections are often seen in family practice. Diagnosis requires suspicion and a realization that children, especially those younger than 2 years, often have very few, nonspecific signs of infection. Obtaining a proper urine sample is vital, because true infections require radiographic studies. Antibiotic prophylaxis is promoted because of the link between vesicoureteral reflux, recurrent UTIs, and renal scarring and hypertension. We generally provide prophylaxis until children are 3 or 4 years, when risk of damage from reflux is lessened and timely urine samples are easier to obtain for prompt therapy. Surgical opinion is sought only when medical management has failed. Failure is defined as either recurrent infections and pyelonephritis or poor renal growth. CONCLUSION: To diagnose UTIs in children, physicians must suspect them, obtain proper urine samples, order appropriate investigations to rule out underlying anatomic abnormalities, and treat with appropriate antibiotics considering both organism sensitivities and length of therapy. PMID:11561337

Complete remission of a case of hepatocellular carcinoma with tumor invasion in inferior vena cava and with pulmonary metastasis successfully treated with repeated arterial infusion chemotherapy.

PubMed

Kogure, Takayuki; Iwasaki, Takao; Ueno, Yoshiyuki; Kanno, Noriatsu; Fukushima, Koji; Yamagiwa, Yoko; Nagasaki, Futoshi; Kakazu, Eiji; Matsuda, Yasunori; Kido, Osamu; Nakagome, Yu; Ninomiya, Masashi; Shimosegawa, Tooru

2007-01-01

We report the case of a patient having hepatocellular carcinoma with tumor invasion to the inferior vena cava and with multiple pulmonary metastases who was treated with repeated one-shot administration of epirubicin, cisplatin, and mitomycin C by hepatic artery and bronchial artery, which led to complete remission. A 72-year-old woman was diagnosed with infiltrative hepatocellular carcinoma with Vv3, multiple intrahepatic metastases, and multiple pulmonary metastases associated with compensated liver cirrhosis. One-shot infusion of epirubicin, cisplatin, and mitomycin C was performed through proper hepatic artery and bronchial artery for twice at eight weeks of intervals. Pulmonary metastases disappeared and intrahepatic lesions indicated marked shrinkage leaving a scar-like lesion with decreases in tumor markers. After six months and 20 months, tumor markers indicated increasing tendency but no evident recurrence was found by computed tomography or hepatic arteriography. One-shot infusion of the same regimens through proper hepatic artery was performed and tumor markers decreased to normal levels. After 14 months of the last therapy, no evidence of recurrence has been found on image analysis or in tumor markers. This arterial infusion therapy is well tolerated for the patients with compensated liver cirrhosis and might be promising for the effective treatment of advanced hepatocellular carcinoma with pulmonary metastases.

Breast Cancer Treatment (PDQ®)—Health Professional Version

Cancer.gov

Breast cancer treatment commonly includes various combinations of surgery, radiation therapy, chemotherapy, and hormone therapy. Prognosis and selection of therapy is influenced by clinical and pathology features. Get detailed information about breast cancer in this summary for clinicians.

Boronated porhyrins and methods for their use

DOEpatents

Miura, M.; Shelnutt, J.A.; Slatkin, D.N.

1999-03-02

The present invention covers boronated porphyrins containing multiple carborane cages which selectively accumulate in neoplastic tissue within the irradiation volume and thus can be used in cancer therapies such as boron neutron capture therapy and photodynamic therapy. 3 figs.

Development of design guidelines for proper selection of graded aggregate base in Maryland state highways.

DOT National Transportation Integrated Search

2015-01-01

The mechanical and drainage properties of graded aggregate base material are the level one input in mechanistic : pavement design. Maryland State Highway Administration (SHA) is in need of guidelines for evaluation of stiffness : and drainage charact...

Cover crops for Alabama

USDA-ARS?s Scientific Manuscript database

Cover crops are grown to benefit the following crop as well as to improve the soil, but they are normally not intended for harvest. Selecting the right cover crops for farming operations can improve yields, soil and water conservation and quality, and economic productivity. Properly managed cover ...

Active Learning through Online Instruction

ERIC Educational Resources Information Center

Gulbahar, Yasemin; Kalelioglu, Filiz

2010-01-01

This article explores the use of proper instructional techniques in online discussions that lead to meaningful learning. The research study looks at the effective use of two instructional techniques within online environments, based on qualitative measures. "Brainstorming" and "Six Thinking Hats" were selected and implemented…

Updating the USDA ARS rotary wing nozzle models

USDA-ARS?s Scientific Manuscript database

Optimizing aerial spray applications requires proper setup of the sprayer system, particularly with respect to nozzle selection and operation, which significantly affects spray deposition, product efficacy, and spray drift. Droplet size from an aerial application is a function of the combination of...

Hazardous Waste: Cleanup and Prevention.

ERIC Educational Resources Information Center

Vandas, Steve; Cronin, Nancy L.

1996-01-01

Discusses hazardous waste, waste disposal, unsafe exposure, movement of hazardous waste, and the Superfund clean-up process that consists of site discovery, site assessment, clean-up method selection, site clean up, and site maintenance. Argues that proper disposal of hazardous waste is everybody's responsibility. (JRH)

Characterization of low temperature creep properties of crack sealants using bending beam rehometry.

DOT National Transportation Integrated Search

2009-11-01

Crack sealing has been widely used as a routine preventative maintenance practice. Given its proper installation, crack sealants can extend : pavement service life by three to five years. However, current specifications for the selection of crack sea...

Characterization of low temperature mechanical properties of crack sealants utilizing direct tension test.

DOT National Transportation Integrated Search

2008-11-01

Crack sealing has been widely used as a routine preventative maintenance practice. Given its proper : installation, crack sealants can extend pavement service life by three to five years. However, current : specifications for the selection of crack s...

Health Instruction Packages: Injections.

ERIC Educational Resources Information Center

Dunkleman, Ellie; And Others

Text, illustrations, and exercises are utilized in this set of four learning modules designed to instruct nursing students in techniques and equipment utilized for intramuscular injections. The first module, "Equipment for Intramuscular Injections" by Ellie Dunkleman, presents guidelines for selecting needles of the proper length and…

Identification of commonly encountered Pratylenchus in Oregon

USDA-ARS?s Scientific Manuscript database

Pratylenchus species are commonly encountered in soil samples collected from a diversity of economically important crops in Oregon, including potato and small fruits. Proper identification is critical to the selection of an appropriate management strategy since, in many cases, populations are an as...

34 CFR 428.21 - What selection criteria does the Secretary use?

Code of Federal Regulations, 2013 CFR

2013-07-01

... individuals enrolled in vocational education programs, and how those needs should influence teaching strategies and program design. (ii) Understanding of bilingual vocational training methodologies. (iii... points) The Secretary reviews each application for an effective plan of management that ensures proper...

34 CFR 428.21 - What selection criteria does the Secretary use?

Code of Federal Regulations, 2014 CFR

2014-07-01

... individuals enrolled in vocational education programs, and how those needs should influence teaching strategies and program design. (ii) Understanding of bilingual vocational training methodologies. (iii... points) The Secretary reviews each application for an effective plan of management that ensures proper...

7 CFR 1773.42 - Clearing accounts.

Code of Federal Regulations, 2011 CFR

2011-01-01

... § 1773.42 Clearing accounts. The CPA's workpapers must contain an analysis of all clearing accounts. Based upon the CPA's determination of materiality, an appropriate sample of transactions should be selected for testing. The CPA's workpapers must document that transactions were reviewed for proper...

7 CFR 1773.42 - Clearing accounts.

Code of Federal Regulations, 2012 CFR

2012-01-01

... § 1773.42 Clearing accounts. The CPA's workpapers must contain an analysis of all clearing accounts. Based upon the CPA's determination of materiality, an appropriate sample of transactions should be selected for testing. The CPA's workpapers must document that transactions were reviewed for proper...

7 CFR 1773.42 - Clearing accounts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... § 1773.42 Clearing accounts. The CPA's workpapers must contain an analysis of all clearing accounts. Based upon the CPA's determination of materiality, an appropriate sample of transactions should be selected for testing. The CPA's workpapers must document that transactions were reviewed for proper...

7 CFR 1773.42 - Clearing accounts.

Code of Federal Regulations, 2013 CFR

2013-01-01

... § 1773.42 Clearing accounts. The CPA's workpapers must contain an analysis of all clearing accounts. Based upon the CPA's determination of materiality, an appropriate sample of transactions should be selected for testing. The CPA's workpapers must document that transactions were reviewed for proper...

Tested Demonstrations.

ERIC Educational Resources Information Center

Gilbert, George L., Ed.

1983-01-01

Presents background information and procedures for producing sequential color reactions. With proper selection of pH indicator dyes, most school colors can be produced after mixing colorless solutions. Procedures for producing white/purple and red/white/blue colors are outlined. Also outlines preparation of 2, 4, 2', 4',…

The Screening Role of an Introductory Course in Cognitive Therapy Training

ERIC Educational Resources Information Center

Pehlivanidis, Artemios; Papanikolaou, Katerina; Politis, Antonis; Liossi, Angeliki; Daskalopoulou, Evgenia; Gournellis, Rossetos; Soldatos, Marina; Papakosta, Vasiliki Maria; Zervas, Ioannis; Papakostas, Yiannis G.

2006-01-01

Objective: This study examines the role of an introductory course in cognitive therapy and the relative importance of trainees' characteristics in the selection process for an advanced course in cognitive therapy. Method: The authors assessed the files of all trainees who completed one academic year introductory course in cognitive therapy over…

How nutritional status, diet and dietary supplements can affect autism. A review.

PubMed

Kawicka, Anna; Regulska-Ilow, Bozena

2013-01-01

Autism is a neurodevelopmental disorder with symptoms arising that are apparent throughout the patient's lifespan. Autism Spectrum Disorders (ASD) are characterised by impaired social and communication interactions as well as restricted, repetitive interests and behaviour. Currently in Poland, about 50 000 people suffer from autism, of which 1/5 are children. Epidemiological studies show that the incidence of autism is increasing, which may be due to the diagnostic category of ASD having been developed. Of vital importance in the treatment of autism, is early diagnosis which is conducive to more rapidly improving the quality of patients' health. It is believed that both genetic and environmental factors may affect the development of the disease. Moreover, expert opinion emphasises the importance of making an adequate diagnosis when the first symptoms of autism start appearing which can be both psychological, gastro-intestinal and metabolic ones. Conventional treatment is based on the combination of behavioural and dietary therapy together with pharmacotherapy. For example, adapting an appropriate diet could help alleviate the disease severity, as well as the psychological and gastrointestinal symptoms. Much scientific research has indicated that pathogenesis of autism may have a beginning already in foetal life. During pregnancy, specialists should take special heed of metabolic disorders, which can increase the risk ofASD in children. One of the dietician's tasks are to properly assess the nutritional status of mothers before and during pregnancy, thereby allowing changes in nutrition to be made wherever necessary in order that metabolic indicators be improved. Thus an important part of autism therapy is the improving patient's nutritional status to prevent the onset of gastrointestinal symptoms. Adopting diets and tailored to individual disease symptoms, is linked to the nutritional requirements and food preferences of the patient. Specialists also emphasise that continual monitoring of the diet and nutritional status of children with ASD is required. It is also essential to start adequate dietary management in autistic patients with overweight, obesity or wasting, caused by improper nutrition. Frequently only a dietary therapy is insufficient to effectively treat autism. Many studies demonstrate the need to supplement the nutritional deficiencies of autistic patients with fatty acids omega-3, probiotics, vitamins and minerals in combination with medical and psychological interventions. A properly designed elimination diet adapted to the patient's individual may also lead to relief of the autism symptoms and the occurrence of gastrointestinal disorders. Parents and caregivers should therefore be aware of the benefits of nutritional therapy and need for proper monitoring the treatment of patients with ASD. A review of nutritional factors, dietary treatments and diet supplementation in patients with ASD is presented.

[Evaluation and classification of drug therapy for breast cancer with bone-only metastasis].

PubMed

Meng, X Y; Song, S T

2017-03-23

Skeleton is one of the most common metastatic organs for breast cancer, which has a better prognosis than visceral metastases. Bone-only metastasis was defined"non-measurable" in the RECIST (Response Evaluation Criteria in Solid Tumors) criteria, and was excluded by clinical trials. However, patients with bone-only metastasis are also in need of effective treatment to prolong survival. Endocrine therapy is the most important treatment for bone metastatic patients. Tumor response of bone metastases can be determined objectively by bone-window CT. Effective treatment should be continued if the symptoms are relieved or osteogenesis is observed. Osteoblastic change in bone-window CT is a sign of improvement after treatment. Endocrine therapy is proper for ER-positive patients. The patients with initial osteoblastic metastasis should not be treated with salvage chemotherapy or anti-HER2 treatment, only if osteolytic metastasis or visceral metastasis is observed. Bishosphonates are just auxiliary drugs in bone metastasis, which should not be abused.

Hemiplegic shoulder pain: implications for occupational therapy treatment.

PubMed

Gilmore, Paula E; Spaulding, Sandi J; Vandervoort, Anthony A

2004-02-01

Hemiplegic shoulder pain is common after stroke causing hemiplegia. It adversely affects the recovery of arm function and independence in activities of daily living. Subluxation, abnormal tone and limited range of motion or capsular constrictions have been reported as potential causes. Other factors such as rotator cuff tears, brachial plexus injury, shoulder-hand syndrome and other pre-existing pathological conditions may also be associated with hemiplegic shoulder pain. The etiology remains unclear, but hemiplegic shoulder pain may result from a combination of the above factors. This literature review examines the possible causes of hemiplegic shoulder pain and discusses the implications for occupational therapy treatment. Occupational therapy interventions include proper positioning, facilitation of movement through purposeful therapeutic activities, increasing passive range of motion, implementation of external supports and treatment of shoulder-hand syndrome. Understanding the processes involved will assist with effective assessment, treatment and prevention of hemiplegic shoulder pain. This will facilitate clients' participation in rehabilitation programs and move them towards attainment of optimal function.

An abbreviated history of osseous surgery.

PubMed

Rudy, Robert J; Marcuschamer, Eduardo

2011-01-01

Various forms of periodontal therapy, including surgery, have been advocated and documented in the dental literature during the last three centuries. This variety of treatment modalities has been developed to address the anatomical consequences (pocket formation and bone loss) sustained from chronic periodontal disease. The marked differences in techniques have created significant controversies between the greatest leaders in dentistry and their equally influential disciples. Nevertheless, these leaders have always shared a common goal: the preservation of the natural dentition in a harmonious environment of health, comfort, and proper function. This article discusses the history of periodontal osseous surgery, including not only the technical issues, but also the conceptual underpinnings of this form of therapeutic intervention. In the process of examining this subject closely, three main controversies in the field of periodontics are brought into sharper focus: non-surgical versus surgical periodontal therapy; gingivectomy versus osseous resective periodontal therapy; and the nature of clinical decision-making: scientific and evidenced-based versus subjective clinical judgement.

A new appraisal of iodine refractory thyroid cancer.

PubMed

Vaisman, Fernanda; Carvalho, Denise P; Vaisman, Mario

2015-12-01

Thyroid cancer incidence is increasing all over the world - mostly due to an increase in the detection of small tumors that were previously undetected. A small percentage of these tumors lose the ability to uptake and/or to respond to radioiodine (RAI) therapy, especially in metastatic patients. There are several new therapeutic options that have emerged in the last 5 years to treat RAI refractory thyroid cancer patients, however, it is very important to properly identify RAI refractory patients and to clarify those appropriate for these treatments. In this review, we discuss the RAI refractory definitions and the criteria that have been suggested based on RAI uptake in the post therapy scan, as well as the response after RAI therapy and the possible molecular mechanisms involved in this process. We offer a review of the therapeutic options available at the moment and the therapeutic considerations based on a patient's individualized personal characteristics, primary tumor histology, tumor burden and location and velocity of lesion growth. © 2015 Society for Endocrinology.

Low back pain in physical therapists: a cultural approach to analysis and intervention.

PubMed

Hanson, Heather; Wagner, Mairead; Monopoli, Vanessa; Keysor, Julie

2007-01-01

Low back pain is one of the most prevalent work related injuries in the physical therapy profession. New graduates and therapists working in rehabilitation and acute care hospitals are at the highest risk for developing low back pain [9]. Although physical therapists are trained in maintaining proper body mechanics and preventing work related injuries, between 30% and 63% of therapists will experience low back pain at some point in their careers [2,4,9]. The culture of physical therapy is one of the primary factors contributing to this problem, with many therapists reporting that their decision to use back pain preventive strategies depends on their colleagues' use of these strategies. The authors will use Green and Kreuter's PRECEDE-PROCEED model to identify behavioral, environmental, educational and ecological factors contributing to the problem; then will propose a health promotion intervention using the social action theory at the community level to decrease work-related low back pain in physical therapists while simultaneously addressing the culture of physical therapy.

The Promise of Cell Based Therapies for Diabetic Complications: challenges and solutions

PubMed Central

Jarajapu, Yagna P.R.; Grant, Maria B.

2013-01-01

The discovery of endothelial progenitor cells (EPCs) in human peripheral blood advanced the field of cell-based therapeutics for many pathological conditions. Despite the lack of agreement about the existence and characteristics of EPCs, autologous EPC populations represent a novel treatment option for complications requiring therapeutic revascularization and vascular repair. Patients with diabetic complications represent a population of patients that may benefit from cellular therapy yet their broadly dysfunctional cells may limit the feasibility of this approach. Diabetic EPCs have decreased migratory prowess and reduced proliferative capacity and an altered cytokine/ growth factor secretory profile that can accelerates deleterious repair mechanisms rather than support proper vascular repair. Furthermore, the diabetic environment poses additional challenges for the autologous transplantation of cells. The present review is focused on correcting diabetic EPC dysfunction and the challenges involved in the application of cell-based therapies for treatment of diabetic vascular complications. In addition, ex vivo and in vivo functional manipulation(s) of EPCs to overcome these hurdles are discussed. PMID:20299675

Selection of the battery pack parameters for an electric vehicle based on performance requirements

NASA Astrophysics Data System (ADS)

Koniak, M.; Czerepicki, A.

2017-06-01

Each type of vehicle has specific power requirements. Some require a rapid charging, other make long distances between charges, but a common feature is the longest battery life time. Additionally, the battery is influenced by factors such as temperature, depth of discharge and the operation current. The article contain the parameters of chemical cells that should be taken into account during the design of the battery for a specific application. This is particularly important because the batteries are not properly matched and can wear prematurely and cause an additional costs. The method of selecting the correct cell type should take previously discussed features and operating characteristics of the vehicle into account. The authors present methods of obtaining such characteristics along with their assessment and examples. Also there has been described an example of the battery parameters selection based on design assumptions of the vehicle and the expected performance characteristics. Selecting proper battery operating parameters is important due to its impact on the economic result of investments in electric vehicles. For example, for some Li-Ion technologies, the earlier worn out of batteries in a fleet of cruise boats or buses having estimated lifetime of 10 years is not acceptable, because this will cause substantial financial losses for the owner of the rolling stock. The presented method of choosing the right cell technology in the selected application, can be the basis for making the decision on future battery technical parameters.

On the use of published radiobiological parameters and the evaluation of NTCP models regarding lung pneumonitis in clinical breast radiotherapy.

PubMed

Svolos, Patricia; Tsougos, Ioannis; Kyrgias, Georgios; Kappas, Constantine; Theodorou, Kiki

2011-04-01

In this study we sought to evaluate and accent the importance of radiobiological parameter selection and implementation to the normal tissue complication probability (NTCP) models. The relative seriality (RS) and the Lyman-Kutcher-Burman (LKB) models were studied. For each model, a minimum and maximum set of radiobiological parameter sets was selected from the overall published sets applied in literature and a theoretical mean parameter set was computed. In order to investigate the potential model weaknesses in NTCP estimation and to point out the correct use of model parameters, these sets were used as input to the RS and the LKB model, estimating radiation induced complications for a group of 36 breast cancer patients treated with radiotherapy. The clinical endpoint examined was Radiation Pneumonitis. Each model was represented by a certain dose-response range when the selected parameter sets were applied. Comparing the models with their ranges, a large area of coincidence was revealed. If the parameter uncertainties (standard deviation) are included in the models, their area of coincidence might be enlarged, constraining even greater their predictive ability. The selection of the proper radiobiological parameter set for a given clinical endpoint is crucial. Published parameter values are not definite but should be accompanied by uncertainties, and one should be very careful when applying them to the NTCP models. Correct selection and proper implementation of published parameters provides a quite accurate fit of the NTCP models to the considered endpoint.

Liquid biopsies in gastrointestinal malignancies: when is the big day?

PubMed

Lopez, Anthony; Harada, Kazuto; Mizrak Kaya, Dilsa; Dong, Xiaochuan; Song, Shumei; Ajani, Jaffer A

2018-01-01

Tumor tissue sample is currently the gold standard for diagnosing gastrointestinal cancers, but also for genomic/immune component analyses that can help in the selection of therapy. However, this approach of studying a 'representative' sample of the tumor does not address inherent heterogeneity. Liquid biopsies, mainly represented by circulating tumor cells, circulating tumor DNA, tumor exosomes, and microRNAs, have the potential to assess various biomarkers for early detection of cancer, carrying out genomic/immune profiling for not only selection of appropriate therapy but also to monitor effect of therapy. Areas covered: This review summarizes the current evidence in the literature on liquid biopsies in gastrointestinal cancers concerning diagnosis, prognosis, and response to therapy. The following terms were used in PubMed: 'esophageal', 'gastric', 'colorectal', 'cancer', 'circulating tumor cells', 'circulating tumor DNA', microRNA', 'diagnosis', 'prognosis', 'response', 'resistance'. Expert commentary: Data increasingly supports the potential of liquid biopsies for early detection, selection of therapy, and monitoring response to therapy. One major question is whether assaying various components of the blood would accommodate considerable context-dependent heterogeneity of gastrointestinal tumors. There are many potential strategies to exploit liquid biopsy use. To put them in to perspective, well-designed and meticulous prospective studies will be needed to prove their usefulness.

Voice Therapy: A Need for Research.

ERIC Educational Resources Information Center

Reed, Charles G.

1980-01-01

Conceptual and methodological guidelines for voice therapy research are presented, and suggestions are offered for selecting experimental designs. Divergent terminology, philosophy, and issues of voice therapy are examined to serve as an overview and as a basis for research direction. (Author/DLS)

Applying causal mediation analysis to personality disorder research.

PubMed

Walters, Glenn D

2018-01-01

This article is designed to address fundamental issues in the application of causal mediation analysis to research on personality disorders. Causal mediation analysis is used to identify mechanisms of effect by testing variables as putative links between the independent and dependent variables. As such, it would appear to have relevance to personality disorder research. It is argued that proper implementation of causal mediation analysis requires that investigators take several factors into account. These factors are discussed under 5 headings: variable selection, model specification, significance evaluation, effect size estimation, and sensitivity testing. First, care must be taken when selecting the independent, dependent, mediator, and control variables for a mediation analysis. Some variables make better mediators than others and all variables should be based on reasonably reliable indicators. Second, the mediation model needs to be properly specified. This requires that the data for the analysis be prospectively or historically ordered and possess proper causal direction. Third, it is imperative that the significance of the identified pathways be established, preferably with a nonparametric bootstrap resampling approach. Fourth, effect size estimates should be computed or competing pathways compared. Finally, investigators employing the mediation method are advised to perform a sensitivity analysis. Additional topics covered in this article include parallel and serial multiple mediation designs, moderation, and the relationship between mediation and moderation. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

LocZ Is a New Cell Division Protein Involved in Proper Septum Placement in Streptococcus pneumoniae

PubMed Central

Holečková, Nela; Molle, Virginie; Buriánková, Karolína; Benada, Oldřich; Kofroňová, Olga; Ulrych, Aleš; Branny, Pavel

2014-01-01

ABSTRACT How bacteria control proper septum placement at midcell, to guarantee the generation of identical daughter cells, is still largely unknown. Although different systems involved in the selection of the division site have been described in selected species, these do not appear to be widely conserved. Here, we report that LocZ (Spr0334), a newly identified cell division protein, is involved in proper septum placement in Streptococcus pneumoniae. We show that locZ is not essential but that its deletion results in cell division defects and shape deformation, causing cells to divide asymmetrically and generate unequally sized, occasionally anucleated, daughter cells. LocZ has a unique localization profile. It arrives early at midcell, before FtsZ and FtsA, and leaves the septum early, apparently moving along with the equatorial rings that mark the future division sites. Consistently, cells lacking LocZ also show misplacement of the Z-ring, suggesting that it could act as a positive regulator to determine septum placement. LocZ was identified as a substrate of the Ser/Thr protein kinase StkP, which regulates cell division in S. pneumoniae. Interestingly, homologues of LocZ are found only in streptococci, lactococci, and enterococci, indicating that this close phylogenetically related group of bacteria evolved a specific solution to spatially regulate cell division. PMID:25550321

Adoptive natural killer cell therapy is effective in reducing pulmonary metastasis of Ewing sarcoma

PubMed Central

Tong, Alexander A.; Hashem, Hasan; Eid, Saada; Allen, Frederick; Kingsley, Daniel

2017-01-01

ABSTRACT The survival of patients with metastatic or relapsed Ewing sarcoma (ES) remains dismal despite intensification of combination chemotherapy and radiotherapy, precipitating the need for novel alternative therapies with minimal side effects. Natural killer (NK) cells are promising additions to the field of cellular immunotherapy. Adoptive NK cell therapy has shown encouraging results in hematological malignancies. Despite these initial promising successes, however, NK cell therapy for solid tumors remains to be investigated using in vivo tumor models. The purpose of this study is to evaluate the efficacy of ex vivo expanded human NK cells in controlling primary and metastatic ES tumor growth in vitro and in vivo. Using membrane-bound IL-21 containing K562 (K562-mbIL-21) expansion platform, we were able to obtain sufficient numbers of expanded NK (eNK) cells that display favorable activation phenotypes and inflammatory cytokine secretion, along with a strong in vitro cytotoxic effect against ES. Furthermore, eNK therapy significantly decreased lung metastasis without any significant therapeutic effect in limiting primary tumor growth in an in vivo xenograft model. Our data demonstrate that eNK may be effective against pulmonary metastatic ES, but challenges remain to direct proper trafficking and augmenting the cytotoxic function of eNK to target primary tumor sites. PMID:28507811

Diagnosis and treatment of gastroesophageal reflux disease

PubMed Central

Badillo, Raul; Francis, Dawn

2014-01-01

Gastroesophageal reflux disease (GERD) is a common disease with a prevalence as high as 10%-20% in the western world. The disease can manifest in various symptoms which can be grouped into typical, atypical and extra-esophageal symptoms. Those with the highest specificity for GERD are acid regurgitation and heartburn. In the absence of alarm symptoms, these symptoms can allow one to make a presumptive diagnosis and initiate empiric therapy. In certain situations, further diagnostic testing is needed to confirm the diagnosis as well as to assess for complications or alternate causes for the symptoms. GERD complications include erosive esophagitis, peptic stricture, Barrett’s esophagus, esophageal adenocarcinoma and pulmonary disease. Management of GERD may involve lifestyle modification, medical therapy and surgical therapy. Lifestyle modifications including weight loss and/or head of bed elevation have been shown to improve esophageal pH and/or GERD symptoms. Medical therapy involves acid suppression which can be achieved with antacids, histamine-receptor antagonists or proton-pump inhibitors. Whereas most patients can be effectively managed with medical therapy, others may go on to require anti-reflux surgery after undergoing a proper pre-operative evaluation. The purpose of this review is to discuss the current approach to the diagnosis and treatment of gastroesophageal reflux disease. PMID:25133039

Insights into cell-free therapeutic approach: Role of stem cell "soup-ernatant".

PubMed

Raik, Shalini; Kumar, Ajay; Bhattacharyya, Shalmoli

2018-03-01

Current advances in medicine have revolutionized the field of regenerative medicine dramatically with newly evolved therapies for repair or replacement of degenerating or injured tissues. Stem cells (SCs) can be harvested from different sources for clinical therapeutics, which include fetal tissues, umbilical cord blood, embryos, and adult tissues. SCs can be isolated and differentiated into desired lineages for tissue regeneration and cell replacement therapy. However, several loopholes need to be addressed properly before this can be extended for large-scale therapeutic application. These include a careful approach for patient safety during SC treatments and tolerance of recipients. SC treatments are associated with a number of risk factors and require successful integration and survival of transplanted cells in the desired microenvironment with concurrent tissue regeneration. Recent studies have focused on developing alternatives that can replace the cell-based therapy using paracrine factors. The development of stem "cell free" therapies can be devoted mainly to the use of soluble factors (secretome), extracellular vesicles, and mitochondrial transfer. The present review emphasizes on the paradigms related to the use of SC-based therapeutics and the potential applications of a cell-free approach as an alternative to cell-based therapy in the area of regenerative medicine. © 2017 International Union of Biochemistry and Molecular Biology, Inc.

Magneto-therapy of human joint cartilage.

PubMed

Wierzcholski, Krzysztof; Miszczak, Andrzej

2017-01-01

The topic of the present paper concerns the human joint cartilage therapy performed by the magnetic induction field. There is proved the thesis that the applied magnetic field for concrete cartilage illness should depend on the proper relative and concrete values of applied magnetic induction, intensity as well the time of treatment duration. Additionally, very important are frequencies and amplitudes of magnetic field as well as magnetic permeability of the synovial fluid. The research methods used in this paper include: magnetic induction field produced by a new Polish and German magneto electronic devices for the therapy of human joint cartilage diseases, stationary and movable magnetic applicators, magnetic bandage, ferrofluid injections, author's experience gained in Germany research institutes and practical results after measurements and information from patients. The results of this paper concern concrete parameters of time dependent electro-magnetic field administration during the joint cartilage therapy duration and additionally concern the corollaries which are implied from reading values gained on the magnetic induction devices. The main conclusions obtained in this paper are as follows: Time dependent magnetic induction field increases the dynamic viscosity of movable synovial fluid and decreases symptoms of cartilage illness for concrete intensity of magnetic field and concrete field line architecture. The ferrofluid therapy and phospholipids bilayer simultaneously with the administrated external electromagnetic field, increases the dynamic viscosity of movable synovial fluid.

Non-surgical management methods of noncavitated carious lesions.

PubMed

Tellez, Marisol; Gomez, Juliana; Kaur, Sundeep; Pretty, Iain A; Ellwood, Roger; Ismail, Amid I

2013-02-01

To critically appraise all evidence related to the efficacy of nonsurgical caries preventive methods to arrest or reverse the progression of noncavitated carious lesions (NCCls). A detailed search of Medline (via OVID), Cochrane Collaboration, Scielo, and EMBASE identified 625 publications. After title and abstract review, 103 publications were selected for further review, and 29 were finally included. The final publications evaluated the following therapies: fluorides (F) in varying vehicles (toothpaste, gel, varnish, mouthrinse, and combination), chlorhexidine (CHX) alone or in combination with F, resin infiltration (I), sealants (S), xylitol (X) in varying vehicles (lozenges, gum, or in combination with F and/or xylitol), casein phosphopeptide amorphous calcium phosphate (CPP-ACP) or in combination with calcium fluoride phosphate. All included studies were randomized clinical trials, were conducted with human subjects and natural NCCls, and reported findings that can yield outcomes measures such as caries incidence/increments, percentage of progression and/or arrest, odds ratio progression test to control, fluorescence loss/mean values, changes in lesion area/volume and lesion depth. Data were extracted from the selected studies and checked for errors. The quality of the studies was evaluated by three different methods (ADA, Cochrane, author's consensus). Sample size for these trials ranged between 15 and 3903 subjects, with a duration between 2 weeks and 4.02 years. More than half of the trials assessed had moderate to high risk of bias or may be categorized as 'poor'. The great majority (65.5%) did not use intention to treat analysis, 21% did not use any blinding techniques, and 41% reported concealment allocation procedures. Slightly more than half of the trials (55%) factored in background exposure to other fluoride sources, and only 41% properly adjusted for potential confounders. Fluoride interventions (varnishes, gels, and toothpaste) seem to have the most consistent benefit in decreasing the progression and incidence of NCCls. Studies using xylitol, CHX, and CPP-ACP vehicles alone or in combination with fluoride therapy are very limited in number and in the majority of the cases did not show a statistically significant reduction. Sealants and resin infiltration studies point to a potential consistent benefit in slowing the progression or reversing NCCls.

Bactericidal activity of propylene glycol, glycerine, polyethylene glycol 400, and polyethylene glycol 1000 against selected microorganisms

PubMed Central

Nalawade, Triveni Mohan; Bhat, Kishore; Sogi, Suma H. P.

2015-01-01

Aim: The aim of the present study was to evaluate the bactericidal activity of propylene glycol, glycerine, polyethylene glycol 400 (PEG 400), and polyethylene glycol 1000 (PEG 1000) against selected microorganisms in vitro. Materials and Methods: Five vehicles, namely propylene glycol, glycerine, PEG 400, PEG 1000, and combination of propylene glycol with PEG 400, were tested for their bactericidal activity. The minimum bactericidal concentration was noted against four standard strains of organisms, i.e. Streptococcus mutans American Type Culture Collection (ATCC) 25175, Streptococcus mutans ATCC 12598, Enterococcus faecalis ATCC 35550, and Escherichia coli ATCC 25922, using broth dilution assay. Successful endodontic therapy depends upon thorough disinfection of root canals. In some refractory cases, routine endodontic therapy is not sufficient, so intracanal medicaments are used for proper disinfection of canals. Intracanal medicaments are dispensed with vehicles which aid in increased diffusion through the dentinal tubules and improve their efficacy. Among the various vehicles used, glycerine is easily available, whereas others like propylene glycol and polyethylene glycol have to be procured from appropriate sources. Also, these vehicles, being viscous, aid in sustained release of the medicaments and improve their handling properties. The most commonly used intracanal medicaments like calcium hydroxide are ineffective on many microorganisms, while most of the other medicaments like MTAD (Mixture of Tetracycline, an Acid, and a Detergent) and Triple Antibiotic Paste (TAP) consist of antibiotics which can lead to development of antibiotic resistance among microorganisms. Thus, in order to use safer and equally effective intracanal medicaments, newer alternatives like chlorhexidine gluconate, ozonized water, etc., are being explored. Similarly, the five vehicles mentioned above are being tested for their antimicrobial activity in this study. Results: All vehicles exhibited bactericidal activity at 100% concentration. Conclusion: Propylene glycol was effective against three organisms namely S. mutans E. faecalis and E. coli and its bactericidal activity was at 50%, 25% and 50% respectively. PEG 1000 was effective against S. mutans and E. coli at 25%. Hence propylene glycol was effective on more number of organisms of which E. faecalis is a known resistant species. PEG 1000 was bactericidal at a lower concentration but was effective on two organisms only. PMID:25992336

Bactericidal activity of propylene glycol, glycerine, polyethylene glycol 400, and polyethylene glycol 1000 against selected microorganisms.

PubMed

Nalawade, Triveni Mohan; Bhat, Kishore; Sogi, Suma H P

2015-01-01

The aim of the present study was to evaluate the bactericidal activity of propylene glycol, glycerine, polyethylene glycol 400 (PEG 400), and polyethylene glycol 1000 (PEG 1000) against selected microorganisms in vitro. Five vehicles, namely propylene glycol, glycerine, PEG 400, PEG 1000, and combination of propylene glycol with PEG 400, were tested for their bactericidal activity. The minimum bactericidal concentration was noted against four standard strains of organisms, i.e. Streptococcus mutans American Type Culture Collection (ATCC) 25175, Streptococcus mutans ATCC 12598, Enterococcus faecalis ATCC 35550, and Escherichia coli ATCC 25922, using broth dilution assay. Successful endodontic therapy depends upon thorough disinfection of root canals. In some refractory cases, routine endodontic therapy is not sufficient, so intracanal medicaments are used for proper disinfection of canals. Intracanal medicaments are dispensed with vehicles which aid in increased diffusion through the dentinal tubules and improve their efficacy. Among the various vehicles used, glycerine is easily available, whereas others like propylene glycol and polyethylene glycol have to be procured from appropriate sources. Also, these vehicles, being viscous, aid in sustained release of the medicaments and improve their handling properties. The most commonly used intracanal medicaments like calcium hydroxide are ineffective on many microorganisms, while most of the other medicaments like MTAD (Mixture of Tetracycline, an Acid, and a Detergent) and Triple Antibiotic Paste (TAP) consist of antibiotics which can lead to development of antibiotic resistance among microorganisms. Thus, in order to use safer and equally effective intracanal medicaments, newer alternatives like chlorhexidine gluconate, ozonized water, etc., are being explored. Similarly, the five vehicles mentioned above are being tested for their antimicrobial activity in this study. All vehicles exhibited bactericidal activity at 100% concentration. Propylene glycol was effective against three organisms namely S. mutans E. faecalis and E. coli and its bactericidal activity was at 50%, 25% and 50% respectively. PEG 1000 was effective against S. mutans and E. coli at 25%. Hence propylene glycol was effective on more number of organisms of which E. faecalis is a known resistant species. PEG 1000 was bactericidal at a lower concentration but was effective on two organisms only.

Neonatal physical therapy. Part II: Practice frameworks and evidence-based practice guidelines.

PubMed

Sweeney, Jane K; Heriza, Carolyn B; Blanchard, Yvette; Dusing, Stacey C

2010-01-01

(1) To outline frameworks for neonatal physical therapy based on 3 theoretical models, (2) to describe emerging literature supporting neonatal physical therapy practice, and (3) to identify evidence-based practice recommendations. Three models are presented as a framework for neonatal practice: (1) dynamic systems theory including synactive theory and the theory of neuronal group selection, (2) the International Classification of Functioning, Disability and Health, and (3) family-centered care. Literature is summarized to support neonatal physical therapists in the areas of examination, developmental care, intervention, and parent education. Practice recommendations are offered with levels of evidence identified. Neonatal physical therapy practice has a theoretical and evidence-based structure, and evidence is emerging for selected clinical procedures. Continued research to expand the science of neonatal physical therapy is critical to elevate the evidence and support practice recommendations.

The importance of being dead: cell death mechanisms assessment in anti-sarcoma therapy.

PubMed

Rello-Varona, Santiago; Herrero-Martín, David; Lagares-Tena, Laura; López-Alemany, Roser; Mulet-Margalef, Núria; Huertas-Martínez, Juan; Garcia-Monclús, Silvia; García Del Muro, Xavier; Muñoz-Pinedo, Cristina; Tirado, Oscar Martínez

2015-01-01

Cell death can occur through different mechanisms, defined by their nature and physiological implications. Correct assessment of cell death is crucial for cancer therapy success. Sarcomas are a large and diverse group of neoplasias from mesenchymal origin. Among cell death types, apoptosis is by far the most studied in sarcomas. Albeit very promising in other fields, regulated necrosis and other cell death circumstances (as so-called "autophagic cell death" or "mitotic catastrophe") have not been yet properly addressed in sarcomas. Cell death is usually quantified in sarcomas by unspecific assays and in most cases the precise sequence of events remains poorly characterized. In this review, our main objective is to put into context the most recent sarcoma cell death findings in the more general landscape of different cell death modalities.