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Sample records for reykjavik prospective study

  1. High hand joint mobility is associated with radiological CMC1 osteoarthritis: the AGES-Reykjavik study

    PubMed Central

    Jónsson, H.; Elíasson, G. J.; Jónsson, Á.; Eiríksdóttir, G.; Sigurđsson, S.; Aspelund, T.; Harris, T. B.; Guđnason, V.

    2009-01-01

    Summary Objective Previous studies have indicated that joint hypermobility may affect the development of clinical and radiological hand osteoarthritis (OA), but this question has not been addressed in epidemiological studies. Our objective was to investigate this relationship in a population-based study. Patients and methods The study group consisted of 384 unselected older participants in the Age, Gene/Environment Susceptibility–Reykjavik Study (161 males, median age 76, range 69–90, and 223 females median age 75, range 69–92). The criterion used for joint mobility was the single maximal degree of hyperextension of digits 2 and 5 on both hands (HYP°). Results HYP° was more prevalent in females and on the left hand in both men and women. Both genders had a positive association between the degree of mobility measured by HYP° and radiological scores for the first carpometacarpal joint (CMC1) OA. Thus, those with HYP° ≥70 had an odds ratio of 3.05 (1.69–5.5, P < 0.001) of having a Kellgren–Lawrence score of ≥3 in a CMC1 joint. There was also a trend towards a negative association between HYP° and proximal interphalangeal joint scores. Conclusion Hand joint mobility, defined as hyperextension in the metacarpophalangeal joints (HYP°) is more prevalent in females and on the left side. It was associated with more severe radiographic OA in the CMC1 joints in this population. The reasons for this relationship are not known, but likely explanations involve ligament laxity and CMC1 joint stability. These findings may relate to the left-sided predominance of radiographic OA in the CMC1 joints observed in many prevalence studies. PMID:19010064

  2. The use of digital photographs for the diagnosis of hand osteoarthritis: the AGES-Reykjavik study

    PubMed Central

    2012-01-01

    Background The objective of the study was to standardize a method using digital photographs to diagnose and grade hand osteoarthritis (HOA), to compare it with radiographs and clinical examination with regard to prevalence and relation to symptoms, and finally to construct a simple shortened version suitable for use in very large studies, where a global estimate may be preferable. Methods High quality photographs with standard distance and hand positioning were analysed for the presence of HOA and subsequently compared with standard radiographs and clinical examination in 381 random participants in the AGES-Reykjavik Study, a large population study. The mean age of the participants was 76 years. Results Using the photographic method, the most commonly affected joints were the second DIP joints followed by the third DIP joints and second and third PIP joints. Both interobserver (ICC = 0.83) and intraobserver reading agreements (ICC = 0.89) were acceptable. On comparison with radiography and clinical examination, aggregate scores were significantly correlated (Rs 0.35-0.69), more so in females (Rs 0.53-0.72) than males. Hand pain in males showed very little association with HOA findings by the three methods but all methods showed a comparable moderate association with hand pain in females. The performance of photography in predicting pain on most days for at least a month in females was comparable to that of radiography and clinical examination (AUC 0.63 p = 0.004). Analysis of intermittent pain yielded similar results for in the DIP and PIP joints (OR 3.2-3.3, p < 0.01), but for the CMC1 joints, both radiography (OR 9.0, p < 0.0001), and clinical examination (OR 9.8, p < 0.0001), had higher predictive odds ratios for pain than photography (OR 3.6, p < 0.0001)., A shortened, rapidly performed form of reading photographs also showed a high degree of correlation with the other methods (Rs 0.56-0.82). Conclusion High quality hand photographs can be used to diagnose and

  3. Prevalence and determinants of carotid plaque in the cross-sectional REFINE-Reykjavik study

    PubMed Central

    Sturlaugsdottir, Ran; Aspelund, Thor; Bjornsdottir, Gudlaug; Sigurdsson, Sigurdur; Thorsson, Bolli; Eiriksdottir, Gudny; Gudnason, Vilmundur

    2016-01-01

    Objective Carotid plaque and intima-media thickness are non-invasive arterial markers that are used as surrogate end points for cardiovascular disease. The aim was to assess the prevalence and severity of carotid plaque, and examine its determinant risk factors and their association to the common carotid artery intima-media thickness (CCA-IMT) in a general population. Methods We examined 6524 participants aged 25–69 years in the population-based REFINE (Risk Evaluation For INfarct Estimates)-Reykjavik study. Plaques at the bifurcation and internal carotid arteries were evaluated. Mean CCA-IMT was measured in the near and far walls of the common carotid arteries. Results The prevalence of minimal, moderate and severe plaque was 35.0%, 8.9% and 1.1%, respectively, and the mean CCA-IMT was 0.73 (SD 0.14) mm. Age, sex, smoking and type 2 diabetes mellitus (T2DM) were the strongest risk factors associated with plaque, followed by systolic blood pressure, total cholesterol, body mass index and family history of myocardial infarct. Low educational level was also strongly and independently associated with plaque. CCA-IMT shared the same risk factors except for a non-significant association with T2DM and family history of myocardial infarction (MI). Participants with T2DM had greater plaque prevalence, 2-fold higher in those <50 years and 17–30% greater in age groups 50–54 to 60–64, and more significant plaques (moderate or severe) were the difference in prevalence was 24% in age group 50–54 and ≥60% in older age groups, compared with non-T2DM. Conclusions Carotid plaque and CCA-IMT have mostly common determinants. However, T2DM and family history of MI were associated with plaque but not with CCA-IMT. Greater prevalence and more severe plaques in individuals with T2DM raise the concern that with increasing prevalence of T2DM we may expect an increase in atherosclerosis and its consequences. PMID:27884845

  4. Effect of finite element model loading condition on fracture risk assessment in men and women: the AGES-Reykjavik study.

    PubMed

    Keyak, J H; Sigurdsson, S; Karlsdottir, G S; Oskarsdottir, D; Sigmarsdottir, A; Kornak, J; Harris, T B; Sigurdsson, G; Jonsson, B Y; Siggeirsdottir, K; Eiriksdottir, G; Gudnason, V; Lang, T F

    2013-11-01

    Proximal femoral (hip) strength computed by subject-specific CT scan-based finite element (FE) models has been explored as an improved measure for identifying subjects at risk of hip fracture. However, to our knowledge, no published study has reported the effect of loading condition on the association between incident hip fracture and hip strength. In the present study, we performed a nested age- and sex-matched case-control study in the Age Gene/Environment Susceptibility (AGES) Reykjavik cohort. Baseline (pre-fracture) quantitative CT (QCT) scans of 5500 older male and female subjects were obtained. During 4-7years follow-up, 51 men and 77 women sustained hip fractures. Ninety-seven men and 152 women were randomly selected as controls from a pool of age- and sex-matched subjects. From the QCT data, FE models employing nonlinear material properties computed FE-strength of the left hip of each subject in loading from a fall onto the posterolateral (FPL), posterior (FP) and lateral (FL) aspects of the greater trochanter (patent pending). For comparison, FE strength in stance loading (FStance) and total femur areal bone mineral density (aBMD) were also computed. For all loading conditions, the reductions in strength associated with fracture in men were more than twice those in women (p≤0.01). For fall loading specifically, posterolateral loading in men and posterior loading in women were most strongly associated with incident hip fracture. After adjusting for aBMD, the association between FP and fracture in women fell short of statistical significance (p=0.08), indicating that FE strength provides little advantage over aBMD for identifying female hip fracture subjects. However, in men, after controlling for aBMD, FPL was 424N (11%) less in subjects with fractures than in controls (p=0.003). Thus, in men, FE models of posterolateral loading include information about incident hip fracture beyond that in aBMD.

  5. Hand Osteoarthritis Severity is Associated with Total Knee Joint Replacements Independently of BMI. The Ages-Reykjavik Study

    PubMed Central

    Jonsson, Helgi; Helgadottir, Gudrun P; Aspelund, Thor; Eiriksdottir, Gudny; Sigurdsson, Sigurdur; Siggeirsdottir, Kristin; Ingvarsson, Thorvaldur; Harris, Tamara B; Launer, Lenore; Gudnason, Vilmundur

    2011-01-01

    Objective: To identify factors associated with having total knee replacement due to osteoarthritis in the AGES-Reykjavik Study, a large population based study of elderly Icelanders. Methods: Information about total knee and hip joint replacements (TKR,THR) and hand OA (HOA) severity was available in 2195 males and 2975 females, mean age 76±6 years. The prevalence of TKR was 223 (4.3%) and THR 316 (6.1%). We performed a backwards binary logistic regression analysis of possible OA associated variables including age, gender, abdominal circumference, BMI, hs-CRP, cholesterol, statin use, bone mineral density of the spine, education and smoking history as well as HOA severity and the presence of THR. Results: Only three factors showed significant associations with TKR; BMI (p=3.5x10-17), HOA severity (p=2.9x10-8) and THR (p=0.0002). The highest quintile of BMI was associated with a fivefold risk of TKR compared with the lowest (8% vs 1.6%), and severe HOA had a 2.4 fold risk compared with those with no HOA (8% vs 3.3%). There was no statistical interaction between BMI and HOA. Thus, individuals with BMI<23.5 with no evidence of HOA had a prevalence of TKR of 1.1%, while those with BMI>30.3 and severe HOA had a prevalence of 13.4%. Conclusions: Hand and hip osteoarthritis in conjunction with BMI are strongly associated with the prevalence of TKR due to osteoarthritis. Together, BMI and HOA severity seem to contribute to the majority of the total TKR prevalence. While BMI has long been recognized as the major risk factor for TKR, the influence of osteoarthritis at other sites may have been underestimated. PMID:21552415

  6. Pulse Pressure Relation to Aortic and Left Ventricular Structure in Older People in the AGES-Reykjavik Study

    PubMed Central

    Torjesen, Alyssa A; Sigurđsson, Sigurđur; Westenberg, Jos JM; Gotal, John D; Bell, Vanessa; Aspelund, Thor; Launer, Lenore J; de Roos, Albert; Gudnason, Vilmundur; Harris, Tamara B; Mitchell, Gary F

    2014-01-01

    High pulse pressure, a major cardiovascular risk factor, has been attributed to medial elastic fiber degeneration and aortic dilation, which transfers hemodynamic load to stiffer collagen. However, recent studies suggest higher pulse pressure is instead associated with smaller aortic diameter. Thus, we sought to elucidate relations of pulse pressure with aortic stiffness and aortic and cardiac dimensions. We used magnetic resonance imaging to examine relations of pulse pressure with lumen area and wall stiffness and thickness in the thoracic aorta and left ventricular structure in 526 participants (72 to 94 years of age, 295 women) in the community-based Age, Gene/Environment Susceptibility-Reykjavik Study. In a multivariable model that adjusted for age, sex, height, weight, and standard vascular risk factors, central pulse pressure had a negative relation with aortic lumen area (all effects expressed as mm Hg/SD; B=−8.1±1.2, P<0.001) and positive relations with left ventricular end-diastolic volume (B=3.8±1.0, P<0.001), carotid-femoral pulse wave velocity (B=3.6±1.0, P<0.001), and aortic wall area (B=3.0±1.2, P=0.015). Higher pulse pressure in older people is associated with smaller aortic lumen area and greater aortic wall stiffness and thickness and left ventricular volume. Relations of larger ventricular volume and smaller aortic lumen with higher pulse pressure suggest mismatch in hemodynamic load accommodation by the heart and aorta in older people. PMID:25024287

  7. Hydrogen sulfide and traffic-related air pollutants in association with increased mortality: a case-crossover study in Reykjavik, Iceland

    PubMed Central

    Finnbjornsdottir, Ragnhildur Gudrun; Elvarsson, Bjarki Thor; Gislason, Thorarinn; Rafnsson, Vilhjalmur

    2015-01-01

    Objectives To study the association between daily mortality and short-term increases in air pollutants, both traffic-related and the geothermal source-specific hydrogen sulfide (H2S). Design Population-based, time stratified case-crossover. A lag time to 4 days was considered. Seasonal, gender and age stratification were calculated. Also, the best-fit lag when introducing H2S >7 µg/m3 was selected by the Akaike Information Criterion (AIC). Setting The population of the greater Reykjavik area (n=181 558) during 2003–2009. Participants Cases were defined as individuals living in the Reykjavik capital area, 18 years or older (N=138 657), who died due to all natural causes (ICD-10 codes A00-R99) other than injury, poisoning and certain other consequences of external causes, or cardiovascular disease (ICD-10 codes I00-I99) during the study period. Main outcome measure Percentage increases in risk of death (IR%) following an interquartile range increase in pollutants. Results The total number of deaths due to all natural causes was 7679 and due to cardiovascular diseases was 3033. The interquartile range increased concentrations of H2S (2.6 µg/m3) were associated with daily all natural cause mortality in the Reykjavik capital area. The IR% was statistically significant during the summer season (lag 1: IR%=5.05, 95% CI 0.61 to 9.68; lag 2: IR%=5.09, 95% CI 0.44 to 9.97), among males (lag 0: IR%=2.26, 95% CI 0.23 to 4.44), and among the elderly (lag 0: IR%=1.94, 95% CI 0.12 to 1.04; lag 1: IR%=1.99, 95% CI 0.21 to 1.04), when adjusted for traffic-related pollutants and meteorological variables. The traffic-related pollutants were generally not associated with statistical significant IR%s. Conclusions The results suggest that ambient H2S air pollution may increase mortality in Reykjavik, Iceland. To the best of our knowledge, ambient H2S exposure has not previously been associated with increased mortality in population-based studies and therefore the results

  8. Brain tissue volumes in the general population of the elderly: the AGES-Reykjavik study.

    PubMed

    Sigurdsson, Sigurdur; Aspelund, Thor; Forsberg, Lars; Fredriksson, Jesper; Kjartansson, Olafur; Oskarsdottir, Bryndis; Jonsson, Palmi V; Eiriksdottir, Gudny; Harris, Tamara B; Zijdenbos, Alex; van Buchem, Mark A; Launer, Lenore J; Gudnason, Vilmundur

    2012-02-15

    Imaging studies have reported conflicting findings on how brain structure differs with age and sex. This may be explained by discrepancies and limitations in study population and study design. We report a study on brain tissue volumes in one of the largest cohorts of individuals studied to date of subjects with high mean age (mean ± standard deviation (SD) 76 ± 6 years). These analyses are based on magnetic resonance imaging (MRI) scans acquired at baseline on 4303 non-demented elderly, and 367 who had a second MRI, on average 2.5 ± 0.2 years later. Tissue segmentation was performed with an automatic image analysis pipeline. Total brain parenchymal (TBP) volume decreased with increasing age while there was an increase in white matter hyperintensities (WMH) in both sexes. A reduction in both normal white matter (NWM)- and gray matter (GM) volume contributed to the brain shrinkage. After adjusting for intra-cranial volume, women had larger brain volumes compared to men (3.32%, p < 0.001) for TBP volume in the cross-sectional analysis. The longitudinal analysis showed a significant age-sex interaction in TBP volume with a greater rate of annual change in men (-0.70%, 95%CI: -0.78% to -0.63%) than women (-0.55%, 95%CI: -0.61% to -0.49%). The annual change in the cross-sectional data was approximately 40% less than the annual change in the longitudinal data and did not show significant age-sex interaction. The findings indicate that the cross-sectional data underestimate the rate of change in tissue volumes with age as the longitudinal data show greater rate of change in tissue volumes with age for all tissues.

  9. Arterial stiffness, pressure and flow pulsatility and brain structure and function: the Age, Gene/Environment Susceptibility--Reykjavik study.

    PubMed

    Mitchell, Gary F; van Buchem, Mark A; Sigurdsson, Sigurdur; Gotal, John D; Jonsdottir, Maria K; Kjartansson, Ólafur; Garcia, Melissa; Aspelund, Thor; Harris, Tamara B; Gudnason, Vilmundur; Launer, Lenore J

    2011-11-01

    Aortic stiffness increases with age and vascular risk factor exposure and is associated with increased risk for structural and functional abnormalities in the brain. High ambient flow and low impedance are thought to sensitize the cerebral microcirculation to harmful effects of excessive pressure and flow pulsatility. However, haemodynamic mechanisms contributing to structural brain lesions and cognitive impairment in the presence of high aortic stiffness remain unclear. We hypothesized that disproportionate stiffening of the proximal aorta as compared with the carotid arteries reduces wave reflection at this important interface and thereby facilitates transmission of excessive pulsatile energy into the cerebral microcirculation, leading to microvascular damage and impaired function. To assess this hypothesis, we evaluated carotid pressure and flow, carotid-femoral pulse wave velocity, brain magnetic resonance images and cognitive scores in participants in the community-based Age, Gene/Environment Susceptibility--Reykjavik study who had no history of stroke, transient ischaemic attack or dementia (n = 668, 378 females, 69-93 years of age). Aortic characteristic impedance was assessed in a random subset (n = 422) and the reflection coefficient at the aorta-carotid interface was computed. Carotid flow pulsatility index was negatively related to the aorta-carotid reflection coefficient (R = -0.66, P<0.001). Carotid pulse pressure, pulsatility index and carotid-femoral pulse wave velocity were each associated with increased risk for silent subcortical infarcts (hazard ratios of 1.62-1.71 per standard deviation, P<0.002). Carotid-femoral pulse wave velocity was associated with higher white matter hyperintensity volume (0.108 ± 0.045 SD/SD, P = 0.018). Pulsatility index was associated with lower whole brain (-0.127 ± 0.037 SD/SD, P<0.001), grey matter (-0.079 ± 0.038 SD/SD, P = 0.038) and white matter (-0.128 ± 0.039 SD/SD, P<0.001) volumes. Carotid-femoral pulse

  10. Retinopathy in old persons with and without diabetes mellitus: the Age, Gene/Environment Susceptibility—Reykjavik Study (AGES-R)

    PubMed Central

    Gunnlaugsdottir, E.; Halldorsdottir, S.; Klein, R.; Eiriksdottir, G.; Klein, B. E.; Benediktsson, R.; Harris, T. B.; Launer, L. J.; Aspelund, T.; Gudnason, V.

    2012-01-01

    Aims/hypothesis We aimed to describe the prevalence of retinopathy in an aged cohort of Icelanders with and without diabetes mellitus. Methods The study population consisted of 4,994 persons aged ≥67 years, who participated in the Age, Gene/Environment Susceptibility—Reykjavik Study (AGES-R). Type 2 diabetes mellitus was defined as HbA1c ≥6.5% (>48 mmol/mol). Retinopathy was assessed by grading fundus photographs using the modified Airlie House adaptation of the Early Treatment Diabetic Retinopathy Study protocol. Associations between retinopathy and risk factors were estimated using odds ratios obtained from multivariate analyses. Results The overall prevalence of retinopathy in AGES-R was 12.4%. Diabetes mellitus was present in 516 persons (10.3%), for 512 of whom gradable fundus photos were available, including 138 persons (27.0%, 95% CI 23.2, 31.0) with any retinopathy. Five persons (1.0%, 95% CI 0.3, 2.3) had proliferative retinopathy. Clinically significant macular oedema was present in five persons (1.0%, 95% CI 0.3, 2.3). Independent risk factors for retinopathy in diabetic patients in a multivariate model included HbA1c, insulin use and use of oral hypoglycaemic agents, the last two being indicators of longer disease duration. In 4478 participants without diabetes mellitus, gradable fundus photos were available for 4,453 participants, with retinopathy present in 476 (10.7%, 95% CI 9.8, 11.6) and clinically significant macular oedema in three persons. Independent risk factors included increasing age and microalbuminuria. Conclusions/interpretation Over three-quarters (78%) of retinopathy cases were found in persons without diabetes and a strong association between microalbuminuria and non-diabetic retinopathy was found. These results may have implications for patient management of the aged. PMID:22134840

  11. A Staged Reading of the Play: Reykjavik

    NASA Astrophysics Data System (ADS)

    2017-01-01

    Reykjavik is the capital of Iceland, an island country located about 500 miles northwest of Scotland in the North Atlantic. In 1986 Mikhail Gorbachev, the Chairman of the Politburo of the Soviet Union and General Secretary of the Soviet Communist Party, invited Ronald Reagan, the President of the United States, to meet with him. The play Reykjavik is a dramatic reconstruction of the two-day summit meeting during which the world leaders almost reached agreement on the total abolition of their countries' nuclear weapons. The play uses the actual transcripts of the Reykjavik meeting as well as the memoirs of both Reagan and Gorbachev. Join us for a dramatic staged reading of Reykjavik and find out how close the two superpowers, the Soviet Union and the United States, came to eliminating their nuclear weapons. He playwright is Richard Rhodes, the Pulitzer Prize-winning author of 24 books. He has written his first play, and it spins off of his research into the history of nuclear weapons. The staged reading is performed by the Washington based Tonic Theater Company: http://www.tonictheater.org/[tonictheater.org]. After the performance, the play director and actors as well as experts on nuclear disarmament will be available for a talk-back discussion of the play with the audience. Produced by Brian Schwartz, Brooklyn College and the Graduate Center of the City University of New York and Gregory Mack of the APS Washington office.

  12. Type 3 finger length pattern is associated with total knee replacements due to osteoarthritis but not with hip replacements or hand osteoarthritis in the elderly: The AGES-Reykjavik study

    PubMed Central

    2013-01-01

    Background Recent case–control studies have shown an association between type 3 finger length pattern (longer ring finger than index finger) and knee osteoarthritis. This large cross-sectional study tests the hypothesis that the type 3 pattern is associated with total joint replacements due to osteoarthritis in a large population based study. Methods Finger length ratios were assessed visually on 5170 hand photographs (2975 females, 2195 males, mean age 76). In this population-based multidisciplinary study of aging in Reykjavik, Iceland, the prevalence of osteoarthritis associated total knee replacements was 223(4.3%) and total hip replacements 316(6.1%). We then performed a binary logistic regression analysis for total knee replacements and total hip replacements, including finger length patterns, osteoarthritis at other sites and other variables with possible association to osteoarthritis such as age, BMI and bone mineral density of the spine. Results The prevalence of the type 3 pattern was 50% (43% in females, 58% in males). The regression analysis revealed an odds ratio for total knee replacements of 1.65 (1.24-2.2) p = 0.0007, in the type 3 finger pattern group, similar in both genders. This association was independent of the associations we have previously reported between total knee replacements and BMI and the presence of hand osteoarthritis. No association was seen between finger length patterns and total hip replacements. Conclusion Finger length patterns read from digital photographs in this large study confirm previous radiographic observations with significant associations between the type 3 pattern and total knee replacements but not total hip replacements in both genders in this elderly group. PMID:23530906

  13. The Prospects Study and Desegregation.

    ERIC Educational Resources Information Center

    Puma, Michael J.

    1997-01-01

    Argues that greater caution is required when drawing conclusions from statistical results than the Armor study has done, and describes the "Prospects" study (begun in 1989), the largest longitudinal study of educational outcomes conducted in the United States. "Prospects" provides much data useful in evaluating the school…

  14. Analysis of a new extreme precipitation event in Reykjavik

    NASA Astrophysics Data System (ADS)

    Ólafsson, Haraldur; Ágústsson, Hálfdán

    2013-04-01

    On 28-29 December 2012 a new precipitation record of 70.4 mm in 24 hours was made in Reykjavik, Iceland. This extreme event is explored by means of observations and by numerical simulations by different models and different times of initialization. Several key factors in creating the precipitation extreme are identified: a) Slowly moving upper level low with high values of vorticity and vorticity advection. b) A south to north low-level temperature gradient set up by cold avection in the wake of a surface low and warm advection in easterly flow over Iceland, enhanced by the topography (foehn). This temperature gradient leads to strong vertical windshear with very weak winds at the surface, but up to 40 m/s from the SE in the upper troposphere. As there are no strong winds at low levels, there is hardly any precipitation shadow in Reykjavik, downstream of the Reykjanes mountains. In terms of considerable, but not extreme precipitation, the event was in general reasonably well forecasted 24 to 48 hours ahead. The above analysis leads to a method to identify extreme precipitation of this kind in large scale models. The method will be used to investigate the frequency of similar events in future climate scenarios.

  15. Learning Icelandic Language and Culture in Virtual Reykjavik: Starting to Talk

    ERIC Educational Resources Information Center

    Bédi, Branislav; Arnbjörnsdóttir, Birna; Vilhjálmsson, Hannes Högni; Helgadóttir, Hafdís Erla; Ólafsson, Stefán; Björgvinsson, Elías

    2016-01-01

    This paper describes how beginners of Icelandic as a foreign and second language responded to playing the first scene in Virtual Reykjavik, a video game-like environment where learners interact with virtual characters--Embodied Conversational Agents (ECAs). This game enables learners to practice speaking and listening skills, to learn about the…

  16. Prospective Teachers' Perspectives on Microteaching Lesson Study

    ERIC Educational Resources Information Center

    Fernandez, Maria L.; Robinson, Matthew

    2006-01-01

    Microteaching Lesson Study [MLS] is a cooperative learning experience that we felt could challenge our prospective teachers thinking about teaching and support their connection of theory and practice during an initial course on learning to teach mathematics. We studied seventy-four prospective teachers' perspectives on MLS over four sections of…

  17. Histidinaemia. Part III: Impact; a prospective study.

    PubMed

    Coulombe, J T; Kammerer, B L; Levy, H L; Hirsch, B Z; Scriver, C R

    1983-01-01

    We describe a prospective study of histidinaemia. Probands and siblings (n = 21) with typical histidinaemia in 16 families were ascertained by newborn screening; diagnosis was confirmed by appropriate investigations in each subject; none had been treated by low histidine diet. The median age of subjects with histidinaemia was 9.5 y (mean 10.0, SD 3.5, range 6-18). Age-matched sib-pairs and their mothers were studied. IQ scores (Full Scale, Verbal and Performance Scores), Visual-Motor Integration Performance (Bender Gestalt and Koppitz scores), Wide Range Achievement Test (Reading and Mathematics), school performance, and psychological history were evaluated, as well as the medical history (pregnancy, delivery, neonatal, post-natal development). Findings were correlated with biochemical phenotype. CNS development in histidinaemic subjects (mean and distribution of scores) was normal; outlier values did not correlate with degree of histidinaemia. We can conclude that histidinaemia detected by newborn screening is a non-disadaptive phenotype.

  18. Swiss prospective study on spider bites.

    PubMed

    Gnädinger, Markus; Nentwig, Wolfgang; Fuchs, Joan; Ceschi, Alessandro

    2013-09-04

    Knowledge of spider bites in Central Europe derives mainly from anecdotal case presentations; therefore we aimed to collect cases systematically. From June 2011 to November 2012 we prospectively collected 17 cases of alleged spider bites, and together with two spontaneous notifications later on, our database totaled 19 cases. Among them, eight cases could be verified. The causative species were: Cheiracanthium punctorium (3), Zoropsis spinimana (2), Amaurobius ferox, Tegenaria atrica and Malthonica ferruginea (1 each). Clinical presentation was generally mild, with the exception of Cheiracanthium punctorium, and patients recovered fully without sequelae. In Switzerland, spider bites generally have a benign clinical course, which is characterised by minor effects, with rapid and complete recovery. Since only verified spider bites can be regarded as spider bites, in the case of clinically important arachnidism, the spider should be sent to an expert for identification. Our study may help to diminish spider fear and reassure people who have experienced a bite.

  19. A Study of Prospective Teachers' Consumption Patterns on Special Days

    ERIC Educational Resources Information Center

    Saglam, Halil Ibrahim

    2016-01-01

    The purpose of this study was to identify prospective teachers' consumption patterns on special days. The sample was comprised of 29 prospective teachers (22 females and 7 males) who studied Primary School Teaching in the Faculty of Education at Sakarya University during the 2014-2015 Academic Year. The study was designed as a phenomenological…

  20. Study of Prospective Teachers' Conceptualization of Value Preferences

    ERIC Educational Resources Information Center

    Koruklu, Nermin; Aktamis, Hilal

    2012-01-01

    The purpose of this study was to determine whether there were any changes in the conceptualization of prospective teachers' values preferences during their university studies. The research group was composed of 208 prospective teachers who were studying at Science Education, Social Science Education and Fine Arts Education at Adnan Menderes…

  1. Ion cyclotron emission studies: Retrospects and prospects

    DOE PAGES

    Gorelenkov, N. N.

    2016-06-05

    Ion cyclotron emission (ICE) studies emerged in part from the papers by A.B. Mikhailovskii published in the 1970s. Among the discussed subjects were electromagnetic compressional Alfv,nic cyclotron instabilities with the linear growth rate similar ~ √(nα/ne) driven by fusion products, -particles which draw a lot of attention to energetic particle physics. The theory of ICE excited by energetic particles was significantly advanced at the end of the 20th century motivated by first DT experiments on TFTR and subsequent JET experimental studies which we highlight. Recently ICE theory was advanced by detailed theoretical and experimental studies on spherical torus (ST) fusionmore » devices where the instability signals previously indistinguishable in high aspect ratio tokamaks due to high toroidal magnetic field became the subjects of experiments. Finally, we discuss prospects of ICE theory applications for future burning plasma (BP) experiments such as those to be conducted in ITER device in France, where neutron and gamma rays escaping the plasma create extremely challenging conditions fusion alpha particle diagnostics.« less

  2. Ion cyclotron emission studies: Retrospects and prospects

    SciTech Connect

    Gorelenkov, N. N.

    2016-06-05

    Ion cyclotron emission (ICE) studies emerged in part from the papers by A.B. Mikhailovskii published in the 1970s. Among the discussed subjects were electromagnetic compressional Alfv,nic cyclotron instabilities with the linear growth rate similar ~ √(nα/ne) driven by fusion products, -particles which draw a lot of attention to energetic particle physics. The theory of ICE excited by energetic particles was significantly advanced at the end of the 20th century motivated by first DT experiments on TFTR and subsequent JET experimental studies which we highlight. Recently ICE theory was advanced by detailed theoretical and experimental studies on spherical torus (ST) fusion devices where the instability signals previously indistinguishable in high aspect ratio tokamaks due to high toroidal magnetic field became the subjects of experiments. Finally, we discuss prospects of ICE theory applications for future burning plasma (BP) experiments such as those to be conducted in ITER device in France, where neutron and gamma rays escaping the plasma create extremely challenging conditions fusion alpha particle diagnostics.

  3. Ion cyclotron emission studies: Retrospects and prospects

    NASA Astrophysics Data System (ADS)

    Gorelenkov, N. N.

    2016-05-01

    Ion cyclotron emission (ICE) studies emerged in part from the papers by A.B. Mikhailovskii published in the 1970s. Among the discussed subjects were electromagnetic compressional Alfvénic cyclotron instabilities with the linear growth rate √ {n_α /n_e } driven by fusion products, -particles which draw a lot of attention to energetic particle physics. The theory of ICE excited by energetic particles was significantly advanced at the end of the 20th century motivated by first DT experiments on TFTR and subsequent JET experimental studies which we highlight. More recently ICE theory was advanced by detailed theoretical and experimental studies on spherical torus (ST) fusion devices where the instability signals previously indistinguishable in high aspect ratio tokamaks due to high toroidal magnetic field became the subjects of experiments. We discuss further prospects of ICE theory applications for future burning plasma (BP) experiments such as those to be conducted in ITER device in France, where neutron and gamma rays escaping the plasma create extremely challenging conditions fusion alpha particle diagnostics.

  4. A Study on Chocolate Consumption in Prospective Teachers

    ERIC Educational Resources Information Center

    Ozgen, Leyla

    2016-01-01

    This study was planned and conducted to determine the chocolate consumption habits of prospective teachers. The study population was comprised of students attending the Faculty of Education at Gazi University in Ankara and the sample consisted of 251 prospective teachers selected with simple random sampling. 96.4% and 3.6% of the prospective…

  5. Neurosurgery in rural Nigeria: A prospective study

    PubMed Central

    Rabiu, Taopheeq Bamidele; Komolafe, Edward Oluwole

    2016-01-01

    Background: Africa has very few neurosurgeons. These are almost exclusively in urban centers. Consequently, people in rural areas, most of the African population, have poor or no access to neurosurgical care. We have recently pioneered rural neurosurgery in Nigeria. Objectives: This report details our initial experiences and the profile of neurosurgical admissions in our center. Methods: A prospective observational study of all neurosurgical patients managed at a rural tertiary health institution in Nigeria from December 2010 to May 2012 was done. Simple descriptive data analysis was performed. Results: A total of 249 males (75.2%) and 82 females (24.8%) were managed. The median age was 37 years (range: Day of birth – 94 years). Trauma was the leading cause of presentation with 225 (68.0%) and 35 (10.6%) having sustained head and spinal injuries, respectively. Operative intervention was performed in 54 (16.3%). Twenty-four (7.2%) patients discharged against medical advice, mostly for economic reasons. Most patients (208, 63.4%) had satisfactory outcome while 30 (9.1%) died. Conclusion: Trauma is the leading cause of rural neurosurgical presentations. There is an urgent need to improve access to adequate neurosurgical care in the rural communities. PMID:27695224

  6. Depression after CABG: a prospective study

    PubMed Central

    Nunes, Joana Kátya Veras Rodrigues Sampaio; de Figueiredo Neto, José Albuquerque; de Sousa, Rosângela Maria Lopes; Costa, Vera Lívia Xavier de Castro; Silva, Flor de Maria Araújo Mendonça; da Hora, Ana Flávia Lima Teles; da Silva, Edna Lúcia Coutinho; Reis, Lívia Mariane Castelo Branco

    2013-01-01

    Introduction Depression during or shortly after hospitalization elevated two to three times the risk of mortality or nonfatal cardiac events, significantly increasing the morbidity and mortality of these patients. Objective To assess the impact of revascularization on symptoms of depression in patients with coronary artery disease. Methods A prospective cohort study of 57 patients of both sexes undergoing coronary artery bypass grafting between June 2010 and June 2011. We used the SF-36 to assess quality of life, and the Beck Depression Inventory to detect depressive symptoms, applied preoperatively and six months. Results The prevalence of patients aged 60-69 years was 22 patients (38.60%), 39 men (68.42%), 26 described themselves as mixed race (45.61%), 16 literate (28.07 %) and 30 married (52.63%). The beck depression inventory score demonstrated increased after revascularization: 15 patients mild (26.32%) at time zero to 17 (29.82%) after. And with moderate, seven patients (12.28%) before and 10 (17.54%) after. In the categories of individuals with decreased minimum degree of 32 (56.14%) to 28 (49.12%), and severe of three (5.26%) for two (3.51%) patients. Association was observed between beck depression inventory, gender, age, lifestyle, comorbidities and quality of life. Conclusion There was a high prevalence of elevated beck depression inventory scores, lowest scores of depressive symptoms among men and association between the improvement of quality of life scores and beck depression inventory. PMID:24598954

  7. Investing in Prospective Cohorts for Etiologic Study of Occupational Exposures

    PubMed Central

    Blair, A.; Hines, C.J.; Thomas, K.W.; Alavanja, M.C.R.; Beane Freeman, L.E.; Hoppin, J.A.; Kamel, F.; Lynch, C.F.; Lubin, J.H.; Silverman, D.T.; Whelan, E.; Zahm, S. H.; Sandler, D. P.

    2015-01-01

    Prospective cohorts have played a major role in understanding the contribution of diet, physical activity, medical conditions, and genes to the development of many diseases, but have not been widely used for occupational exposures. Studies in agriculture are an exception. We draw upon our experience using this design to study agricultural workers to identify conditions that might foster use of prospective cohorts to study other occupational settings. Prospective cohort studies are perceived by many as the strongest epidemiologic design. It allows updating of information on exposure and other factors, collection of biologic samples before disease diagnosis for biomarker studies, assessment of effect modification by genes, lifestyle, and other occupational exposures, and evaluation of a wide range of health outcomes. Increased use of prospective cohorts would be beneficial in identifying hazardous exposures in the workplace. Occupational epidemiologists should seek opportunities to initiate prospective cohorts to investigate high priority, occupational exposures. PMID:25603935

  8. Women's Studies in the 1990s: Problems and Prospects.

    ERIC Educational Resources Information Center

    Allen, Judith

    1991-01-01

    This speech examines women's studies in Australia in the 1970s and 1980s, limitations and problems facing women's studies in the 1990s, and prospects. Discussed are effects of the "Dawkins Revolution," women's studies and feminist scholarship, women's studies curricula, institutional problems, political problems, and the changing faculty…

  9. Investing in Prospective Cohorts for Etiologic Study of Occupational Exposures

    EPA Science Inventory

    Prospective cohorts have played a major role in understanding the role of diet, physical activity, medical conditions, and genes in the development of many diseases, but have not been widely used in the study of occupational exposures. Studies in agriculture are an exception. W...

  10. PROSPECTIVE PREGNANCY STUDY DESIGNS FOR ASSESSING REPRODUCTIVE AND DEVELOPMENTAL TOXICANTS

    EPA Science Inventory

    Prospective Pregnancy Study Designs for Assessing Reproductive and Developmental Toxicants
    Germaine M. Buck,1 Courtney D. Johnson,1 Joseph Stanford,2 Anne Sweeney,3 Laura Schieve,4 John Rockett,5 Sherry G. Selevan,6 Steve Schrader 7

    Abstract
    The origin of successfu...

  11. Development in Children with Achondroplasia: A Prospective Clinical Cohort Study

    ERIC Educational Resources Information Center

    Ireland, Penelope J.; Donaghey, Samantha; McGill, James; Zankl, Andreas; Ware, Robert S.; Pacey, Verity; Ault, Jenny; Savarirayan, Ravi; Sillence, David; Thompson, Elizabeth; Townshend, Sharron; Johnston, Leanne M.

    2012-01-01

    Aim: Achondroplasia is characterized by delays in the development of communication and motor skills. While previously reported developmental profiles exist across gross motor, fine motor, feeding, and communication skills, there has been no prospective study of development across multiple areas simultaneously. Method: This Australasian…

  12. Students' Perception on the Prospect of Economics Education Study Program

    ERIC Educational Resources Information Center

    Meiriza, Mica Siar

    2015-01-01

    This study aims to determine the extent to which perceptions of students on the prospect of the Economics Education Program. The method used in this research is descriptive method in which the required data is obtained through questionnaire and technique of analyzing data used is percentages. Questionnaires were distributed through the Student…

  13. Offenders with Intellectual Disability: A Prospective Comparative Study

    ERIC Educational Resources Information Center

    Barron, P.; Hassiotis, A.; Banes, J.

    2004-01-01

    Intellectually disabled offenders (IDO) are a poorly served and under-recognized group, who are likely to require long-term specialist treatments and interventions. Method This prospective study investigated the characteristics and factors that influence outcome in this group, with particular reference to therapeutic interventions. Sixty-one…

  14. Prospects of Elliptic Flow Studies at NICA/MPD

    NASA Astrophysics Data System (ADS)

    Geraksiev, Nikolay

    2016-01-01

    As a key observable, anisotropic flow presents a unique insight into heavy ion collision physics. The presented poster reveals the prospects of studying elliptic flow at the NICA/MPD facility through the UrQMD model. Here, results for the elliptic flow of simulated and reconstructed hadrons at the planned NICA energy range are presented.

  15. Serum Vitamin D and Parathyroid Hormone in Relation to Cardiac Structure and Function: The ICELAND-MI Substudy of AGES-Reykjavik

    PubMed Central

    Visser, M.; Cotch, M. F.; Arai, A. E.; Garcia, M.; Harris, T. B.; Launer, L. J.; Eiríksdóttir, G.; Gudnason, V.; Brouwer, I. A.

    2013-01-01

    Context: Emerging evidence suggests that vitamin D and PTH may play a role in the development of cardiac diseases. Objective: We investigated whether 25-hydroxyvitamin D (25OHD) and PTH concentrations are cross-sectionally associated with cardiac structure and function using magnetic resonance imaging (MRI). Design, Setting, and Participants: ICELAND-MI is a substudy of the Age, Gene/Environment Susceptibility-Reykjavik Study, an older-aged community-dwelling cohort with oversampling of participants with diabetes (29%) and measurements between 2004 and 2007. Serum 25OHD concentrations were measured using an immunoassay (n = 992). Intact PTH concentrations were measured using a 2-site immunoassay (n = 203). We included 969 participants for this cross-sectional analysis (mean age 76 ± 5.3 years, 51% female). Mean 25OHD was 54.2 ± 25.5 nmol/L and the median PTH was 4.5 pmol/L (range 1.5–18). Main Outcomes: MRI to measure cardiac structure and function was the main outcome. Results: The lowest 25OHD category (<25 nmol/L) compared with the highest category (≥75 nmol/L) was associated with a smaller left and right atrial area in unadjusted analyses; however, the associations became nonsignificant after adjustment for covariates. The highest PTH quartile compared with the lowest quartile was significantly associated with a 7.3 g (95% confidence interval 0.8, 13.8) greater left ventricular (LV) mass and a 5.1% (−9.1, −1.1) lower LV ejection fraction compared with the lowest PTH quartile in the fully adjusted model. Conclusions: Serum 25OHD concentrations were not associated with MRI measures in an older white population. Higher PTH concentrations were associated with greater LV mass and lower systolic function and may point to a potential role for PTH as a determinant of cardiac remodeling. PMID:23585664

  16. Prospects for alpha particle studies on TFTR

    SciTech Connect

    Zweben, S.J.

    1987-05-01

    TFTR is expected to produce approximately 5 MW of alpha heating during the D/T Q approx. = 1 phase of operation in 1990. At that point the collective confinement properties and the heating effects of alpha particles become accessible for study for the first time. This paper outlines the potential performance of TFTR with respect to alpha particle production, the diagnostics which will be available for alpha particle measurements, and the physics issues which can be studied both before and during D/T operation.

  17. Prostate, Lung, Colon, and Ovary Prospective Study

    Cancer.gov

    A large cohort study of etiologic determinants of cancer carried out within an NCI trial for the evaluation of screening procedures for the early detection of prostate, lung, colon, and ovarian cancer (the PLCO Trial) at 10 U.S. screening centers

  18. Mastalgia-Cancer Relationship: A Prospective Study

    PubMed Central

    Yıldırım, Ali Cihat; Yıldız, Pınar; Yıldız, Mustafa; Kahramanca, Şahin; Kargıcı, Hülagü

    2015-01-01

    Objective Mastalgia is an important symptom affecting approximately 70% of women and it disrupts the quality of life especially due to the worry of having cancer. In our study, the type and severity of mastalgia symptom of patients who presented to the outpatient clinic with mastalgia complaint were assessed along with their physical examination findings and radiology results. The purpose of the study is to demonstrate the relationship between mastalgia and malignity when assessed in combination with the risk factors of patients. Materials and Methods The age, family history, menopausal status, age at the first childbirth, menarche, presence/absence of hormone replacement therapy, type of mastalgia, comorbidities and examination findings of 104 patients, who presented to the General Surgery outpatient clinic with mastalgia symptom, were recorded and assessed in the light of radiological study results. Results With respect to the mastalgia types of the patients, 38.5% had cyclic pain, 57.7% non-cyclic pain and 3.8% other types of pain. Mild mastalgia was present in 46.2% of the patients, moderate mastalgia in 24% and severe mastalgia in 29.8% of them. According to the BIRADS category, 48.1% of the patients were identified to have BIRADS 1 mass lesions, 39.4% BIRADS 2, 9.6% BIRADS 3 and 2.9% BIRADS 5 mass lesions. The patients who were identified to have BIRADS 5 mass lesions described non-cyclic and severe pain in the post-menopausal period. They had palpable masses along with the pain symptom. Conclusion Our study suggests that mastalgia symptom does not per se result in suspicion of malignancy, but physical examination and radiological imaging should also be used as needed for confirmation. Studies with a larger patient population are needed to shed light on the mastalgia epidemiology and its relationship with cancer.

  19. A Study on the Spatial Abilities of Prospective Social Studies Teachers: A Mixed Method Research

    ERIC Educational Resources Information Center

    Yurt, Eyüp; Tünkler, Vural

    2016-01-01

    This study investigated prospective social studies teachers' spatial abilities. It was conducted with 234 prospective teachers attending Social Studies Teaching departments at Education Faculties of two universities in Central and Southern Anatolia. This study, designed according to the explanatory-sequential design, is a mixed research method,…

  20. Smoking and Parkinson's disease: systematic review of prospective studies.

    PubMed

    Allam, Mohamed Farouk; Campbell, Michael J; Hofman, Albert; Del Castillo, Amparo Serrano; Fernández-Crehuet Navajas, Rafael

    2004-06-01

    We estimated the pooled risk of tobacco smoking for Parkinson's disease (PD). Inclusion criteria included systematic searches of MedLine, PsycLIT, Embase, Current Contents, previously published reviews, examination of cited reference sources, and personal contact and discussion with several investigators expert in the field. Published prospective studies on PD and cigarette smoking. When two or more studies were based on an identical study, the study that principally investigated the relationship or the study that was published last was used. Seven prospective studies were carried out between 1959 and 1997, of which six reported risk estimates. Four cohorts were based on standardised mortality rates, which were exclusively of male. Only one study included risk estimates for both males and females separately. The risk of ever smoker was 0.51 (95% confidence interval, 0.43 to 0.61). There was an obvious protective effect of current smoking in the pooled estimate (relative risk, 0.35; 95% CI, 0.26-0.47). Former smokers had lower risk compared with never smokers (relative risk, 0.66; 95% CI, 0.49-0.88). Although our pooled estimates show that smoking is inversely associated with the risk of PD, the four prospective studies that were based on follow-up of mortality of smokers had many limitations. Further studies evaluating the association between smoking and PD in women are strongly needed.

  1. Fatigue in advanced cancer: a prospective study.

    PubMed

    Hauser, Katherine; Walsh, Declan; Rybicki, Lisa A; Davis, Mellar P; Seyidova-Khoshknabi, Dilara

    2008-01-01

    Fatigue is a common advanced cancer symptom. Clinical features are not well known. The authors surveyed consecutive patients admitted to a palliative medicine program to identify clinical correlates of fatigue. Data collected included age, sex, performance status, primary site, prior chemotherapy/radiation therapy, and blood transfusions. Visual analogue scales assessed fatigue, quality of life, and ability to perform daily activities. Weight change was estimated. Laboratory results including lactate dehydrogenase and hemoglobin were recorded. Fatigue severity was associated with brain metastases, poor performance status, poor quality of life, and reduced ability to perform activities. Prior radiation therapy was associated with less severe fatigue. Age, sex, and hemoglobin level were not associated with fatigue. Fatigue was universal on referral. Brain metastases and poor quality of life independently predicted severity. Hemoglobin level did not predict fatigue. Further studies are necessary to define the clinical features and relationships of fatigue.

  2. Adherence to immunosuppression: a prospective diary study.

    PubMed

    Gordon, E J; Prohaska, T R; Gallant, M P; Siminoff, L A

    2007-12-01

    Immunosuppression adherence among kidney transplant recipients is essential for graft survival. However, nonadherence is common, jeopardizing graft survival. Besides skipping dosages, little is known about other forms of medication nonadherence and their underlying reasons. This study sought to examine patients' extent of medication adherence over time and reasons for nonadherence. Thirty-nine new kidney transplant recipients were asked to complete a month-long medication-taking diary that included reporting medication nonadherence such as skipped medications, medications taken early or late, taking dosages greater or less than prescribed, and the reason for each occurrence of nonadherence. Of the 20 (51%) patients who completed the diary, 11 (55%) reported at least 1 form of nonadherence. Eleven patients reported taking their immunosuppression at least 1 hour later than the prescribed time, 1 patient reported skipping medication, but no patients reported changing the dosage on their own. Immunosuppression was taken on average 1.5 hours after the prescribed time. Of those patients who took their medications late, there were on average 3.1 occasions of taking it late. The most common reasons for this behavior included health care-related issues, followed by oversleeping, being away from home, work-related barriers, and forgetting. The majority of kidney transplant recipients took medications later than prescribed during 1 month. Future research should determine the clinical impact on graft function of late administration of immunosuppression. Interventions should be designed to better assist kidney recipients with taking medications on time, especially when they are away from home.

  3. [Prenatal diagnosis. Review, personal and prospective studies].

    PubMed

    Engel, E; Empson, J; DeLozier, D; McGee, B; da Costa Woodson, E; Engel-de Montmollin, M; Carter, T; Lorber, C; Cassidy, S B; Millis, J; Heller, R M; Boehm, F; Vanhooydonk, J

    1979-07-07

    instruments is particularly useful in cases where a severe fetal morphologic malformation cannot currently be identified by indirect visualization (ultrasound) or by analysis of cytogenetic or molecular markers. 6. Pathological accumulations of alpha-fetoprotein which are associated with diverse feto-placental abnormalities (particularly open malformations of the neural tube) can be detected in the amniotic fluid and/or maternal blood. In extension of this approach, it is foreseeable that conditions existing prenatally will be diagnosed in a growing number of cases from the study of fetal cells and molecules which can be isolated from the venous blood of pregnant women. This will become feasible as a result of some well-developed techniques which allow separation of fetal from maternal cells and metabolites, and also to some extremely fine analytic techniques, notably examination of the DNA itself by means of restriction enzymes.

  4. Vitamin D and hypertension: Prospective study and meta-analysis

    PubMed Central

    Qi, Dan; Nie, Xiao-lu; Wu, Shouling; Cai, Jun

    2017-01-01

    Objectives The study sought to determine the link between vitamin D concentrations and incident hypertension in prospective study and meta-analysis. Methods The study was embedded in the Kailuan Study, a population-based cohort of adults that contains underground miners. In 2012, we studied 2,456 men and women free of prevalent hypertension, age 21 to 67 at baseline. Serum 25-hydroxyvitamin D was measured from previously frozen baseline samples using ELISA (Enzyme-Linked ImmunoadSorbent Assay). We use the logistic regression analysis to estimate the odd radio (ORs) 95% confidence intervals (CIs) for 25-hydroxyvitamin D [25(OH)D] concentrations with incident hypertension. To help place our new data in context, we conducted a systemic review and meta-analysis of previous prospective reports of vitamin D and hypertension. Results During a median follow-up of 2 years, 42.6% of the cohort (n = 1047) developed hypertension. Compared with the 25-hydroxyvitamin D >30ng/ml, 25-hydroxyvitamin D <20 ng/ml was associated with a greater hypertension risk (OR: 1.225 [95% CI: 1.010 to 1.485] p = 0.04), although the association was attenuated and not statistically significant after adjusting for potential confounders (OR: 1.092 [95% CI: 0.866 to 1.377] p = 0.456). This meta-analysis included seven prospective studies for 53,375 participants using adjusted HR founded a significant association between vitamin D deficiencies and incident hypertension (HRs = 1.235 (95% CI: 1.083 to 1.409, p = 0.002)). Conclusion Lower serum 25-hydroxyvitamin D concentrations were not associated with a greater risk of incident hypertension. More research is needed to further determine the role of 25-hydroxyvitamin D in hypertension prevention and therapy. PMID:28358827

  5. Is DVT prophylaxis overemphasized? A randomized prospective study.

    PubMed

    Kosir, M A; Kozol, R A; Perales, A; McGee, K; Beleski, K; Lange, P; Dahn, M

    1996-02-01

    This study was designed to prospectively evaluate a previously published prognostic index for predicting deep venous thrombosis (DVT) in general surgical patients with conventional prophylaxis. Patients undergoing procedures of at least 1 hr duration (abdominal, thoracic, head and neck, inguinal) requiring general or spinal anesthetic were prospectively randomized into the following groups: Group 1, sequential pneumatic compression devices during surgery and 2 days postoperatively; Group 2, subcutaneous heparin (5000 U q 12 hr) starting 1 hr before surgery and for 7 days postop; Group 3, control group. All patients underwent duplex evaluation of bilateral lower extremity deep venous systems preoperatively and on postoperative Days 1, 3, and 30. In addition, a previously developed predictive DVT incidence indicator, the prognostic index (PI), was calculated for each patient. A total of 137 patients were entered into the study with 29 removed for patient/staff reasons. There were no differences in PI among the three groups at the 0.05 level (ANOVA). The distribution of risk factors for DVT including increased age, body size, hemoglobin (Hb), and colorectal procedures were distributed evenly among the groups. Additional factors such as diabetes, COPD, PVD, immobilization, and cancer were also evenly distributed among the groups. The PI predicted a 20% incidence of DVT. For Groups 1 (n = 25), 2 (n = 38), and 3 (n = 45) no DVTs were detected over the 30 days of study. During the study period, 8 DVTs were detected by duplex evaluation in general surgical patients not in the study (1.5%). In conclusion, in a prospective randomized study using sequential pneumatic compression devices, subcutaneous heparin or no prophylaxis in matched general surgical patients at moderate to high risk for thromboembolism, no DVTs occurred for up to 30 days. Furthermore, neither a PI nor other factors associated with DVT accurately predicted the incidence of DVT in this patient population.

  6. Prospective study of chemical exposures and amyotrophic lateral sclerosis

    PubMed Central

    Weisskopf, MG; Morozova, N; O'Reilly, EJ; McCullough, ML; Calle, EE; Thun, MJ; Ascherio, A

    2009-01-01

    Background Although environmental toxins, including pesticides, are suspected of contributing to the risk of amyotrophic lateral sclerosis (ALS), no data exist from large prospective investigations. This study assessed the association between exposure to chemicals and risk of ALS in a prospective cohort study. Methods We prospectively assessed the relation between self-report of regular exposure to 11 different chemical classes or X-rays and ALS mortality among over 1 million participants in the American Cancer Society's Cancer Prevention Study II. Follow-up from 1989 through 2004 identified 617 deaths from ALS among men and 539 among women. We calculated adjusted rate ratios (RR) using Cox proportional hazards. Results The RR for ALS mortality among individuals exposed to pesticides/herbicides compared to the unexposed was 1.07 (95% confidence interval (CI): 0.79-1.44), but somewhat higher after excluding those with missing duration of pesticides exposure (RR: 1.44; 95% CI: 0.89-2.31; p=0.14). A non-significant increase in ALS mortality was found among individuals who reported exposure to formaldehyde (RR: 1.34; 95% CI: 0.93-1.92). Excluding those with missing duration of formaldehyde exposure, the RR was 2.47 (95% CI: 1.58-3.86), and there was a strongly significant dose-response relation with increasing years of exposure (p-trend=0.0004). Conclusions We found little evidence for an association between pesticides/herbicide exposure and ALS. In contrast, we found evidence suggesting an increased risk of ALS with formaldehyde exposure. Because of the longitudinal design, this result is unlikely to be due to bias, but it should nevertheless be interpreted cautiously and needs to be independently verified. PMID:19372290

  7. Haematological abnormalities in acute pancreatitis. A prospective study.

    PubMed Central

    Murphy, D.; Imrie, C. W.; Davidson, J. F.

    1977-01-01

    Twenty-five patients with acute pancreatitis were studied prospectively in the first week of their admission using haematological and coagulation tests. Platelet counts initially fell and later returned to admission levels. Rising levels of plasma fibrinogen were recorded. The kaolin cephalin clotting time was shorter than its control in twenty-one patients. Eighteen patients had elevated fibrinogen degradation products and fourteen had a positive ethanol gelation test. It is suggested that by taking into account the results in series of individual patients a degree of intravascular coagulation may be a common feature of acute pancreatitis. In one patient (presented in detail) strong evidence for disseminated intravascular coagulation was found PMID:887529

  8. Community Water Fluoridation and Intelligence: Prospective Study in New Zealand.

    PubMed

    Broadbent, Jonathan M; Thomson, W Murray; Ramrakha, Sandhya; Moffitt, Terrie E; Zeng, Jiaxu; Foster Page, Lyndie A; Poulton, Richie

    2015-01-01

    Objectives. This study aimed to clarify the relationship between community water fluoridation (CWF) and IQ. Methods. We conducted a prospective study of a general population sample of those born in Dunedin, New Zealand, between April 1, 1972, and March 30, 1973 (95.4% retention of cohort after 38 years of prospective follow-up). Residence in a CWF area, use of fluoride dentifrice and intake of 0.5-milligram fluoride tablets were assessed in early life (prior to age 5 years); we assessed IQ repeatedly between ages 7 to 13 years and at age 38 years. Results. No clear differences in IQ because of fluoride exposure were noted. These findings held after adjusting for potential confounding variables, including sex, socioeconomic status, breastfeeding, and birth weight (as well as educational attainment for adult IQ outcomes). Conclusions. These findings do not support the assertion that fluoride in the context of CWF programs is neurotoxic. Associations between very high fluoride exposure and low IQ reported in previous studies may have been affected by confounding, particularly by urban or rural status.

  9. Community Water Fluoridation and Intelligence: Prospective Study in New Zealand

    PubMed Central

    Thomson, W. Murray; Ramrakha, Sandhya; Moffitt, Terrie E.; Zeng, Jiaxu; Foster Page, Lyndie A.; Poulton, Richie

    2015-01-01

    Objectives. This study aimed to clarify the relationship between community water fluoridation (CWF) and IQ. Methods. We conducted a prospective study of a general population sample of those born in Dunedin, New Zealand, between April 1, 1972, and March 30, 1973 (95.4% retention of cohort after 38 years of prospective follow-up). Residence in a CWF area, use of fluoride dentifrice and intake of 0.5-milligram fluoride tablets were assessed in early life (prior to age 5 years); we assessed IQ repeatedly between ages 7 to 13 years and at age 38 years. Results. No clear differences in IQ because of fluoride exposure were noted. These findings held after adjusting for potential confounding variables, including sex, socioeconomic status, breastfeeding, and birth weight (as well as educational attainment for adult IQ outcomes). Conclusions. These findings do not support the assertion that fluoride in the context of CWF programs is neurotoxic. Associations between very high fluoride exposure and low IQ reported in previous studies may have been affected by confounding, particularly by urban or rural status. PMID:24832151

  10. Colonic atresia in cattle: A prospective study of 43 cases

    PubMed Central

    Ducharme, Norm G.; Arighi, Mimi; Horney, F. Don; Barker, Ian K.; Livesey, Michael A.; Hurtig, Mark H.; Johnson, Roger P.

    1988-01-01

    This prospective study was initiated to document the success rate obtained in the treatment of colonic atresia in calves, identify factors that influence survival rate, and to report the histopathological appearance of the proximal blind end of the ascending colon. Forty-three calves with intestinal obstruction due to colonic atresia were admitted to the Ontario Veterinary College between September 1982 and May 1986. Parameters recorded prospectively in this study included age, breed, sex, history, vital signs, acid-base and electrolyte status, location of intestinal atresia, medical and surgical management, and outcome. The typical history and clinical signs included failure to pass meconium or feces, decreased appetite, and progressive depression and abdominal distension. The most common site of colonic atresia was the midportion of the spiral loop of the ascending colon (n = 25). Of the 43 calves, three (7%) were euthanized at surgery, 21 (49%) died in the hospital, and 19 (44%) survived and were discharged from the hospital. Four of the surviving calves died subsequent to discharge giving an overall long-term (mean 15.9 months) survival rate of 35%. No significant risk factors were identified, although experienced surgeons showed a trend towards increased survival rate. ImagesFigure 2.Figure 3.Figure 4.Figure 5. PMID:17423141

  11. Stress and dysmenorrhoea: a population based prospective study

    PubMed Central

    Wang, L; Wang, X; Wang, W; Chen, C; Ronnennberg, A; Guang, W; Huang, A; Fang, Z; Zang, T; Wang, L; Xu, X

    2004-01-01

    Background: Dysmenorrhoea is the most common gynaecological disorder in women of reproductive age. Despite the association between stress and pregnancy outcomes, few studies have examined the possible link between stress and dysmenorrhoea. Aims and Methods: Using a population based cohort of Chinese women, the independent effect of women's perceived stress in the preceding menstrual cycle on the incidence of dysmenorrhoea in the subsequent cycle was investigated prospectively. The analysis included 1160 prospectively observed menstrual cycles from 388 healthy, nulliparous, newly married women who intended to conceive. The perception of stress and the occurrence of dysmenorrhoea in each menstrual cycle were determined from daily diaries recorded by the women. Results: After adjustment for important covariates, the risk of dysmenorrhoea was more than twice as great among women with high stress compared to those with low stress in the preceding cycle (OR = 2.4; 95% CI 1.4 to 4.3). The risk of dysmenorrhoea was greatest among women with both high stress and a history of dysmenorrhoea compared to women with low stress and no history of dysmenorrhoea (OR = 10.4, 95% CI 4.9 to 22.3). Stress in the follicular phase of the preceding cycles had a stronger association with dysmenorrhoea than stress in the luteal phase of the preceding cycles. Conclusion: This study shows a significant association between stress and the incidence of dysmenorrhoea, which is even stronger among women with a history of dysmenorrhoea. PMID:15550609

  12. Hypnosis and dental anesthesia in children: a prospective controlled study.

    PubMed

    Huet, Adeline; Lucas-Polomeni, Marie-Madeleine; Robert, Jean-Claude; Sixou, Jean-Louis; Wodey, Eric

    2011-01-01

    The authors of this prospective study initially hypothesized that hypnosis would lower the anxiety and pain associated with dental anesthesia. Thirty children aged 5 to 12 were randomly assigned to 2 groups receiving hypnosis (H) or not (NH) at the time of anesthesia. Anxiety was assessed at inclusion in the study, initial consultation, installation in the dentist's chair, and at the time of anesthesia using the modified Yale preoperative anxiety scale (mYPAS). Following anesthesia, a visual analogue scale (VAS) and a modified objective pain score (mOPS) were used to assess the pain experienced. The median mYPAS and mOPS scores were significantly lower in the H group than in the NH group. Significantly more children in the H group had no or mild pain. This study suggests that hypnosis may be effective in reducing anxiety and pain in children receiving dental anesthesia.

  13. [Prospect of application of molecular phylogeography in study of geoherbs].

    PubMed

    Yuan, Qingjun; Huang, Luqi; Guo, Lanping; Shao, Aijuan

    2009-08-01

    This paper firstly introduces the concept, method and current research of molecular phylogeography and then discusses its application in the study of geoherbs. The relativity between three genetic differentiation patterns of plant inferred by molecular phylogeography (i.e. allopatric fragmentation, restricted gene flow with isolation by distance and range expansion) and the formation of genuine character is analysed. Molecular authentication of geoherbs based on molecular phylogeography has the advantage of former molecular identification at technology and knowing genetic differentiation of geoherbs. Using molecular phylogeography for study on changing history of geoherbs habitat is also explicated. The problem of germplasm degeneration in cultural geoherbs could be effectively resolved by molecular phylogeography method. The application of molecular phylogeography in these subjects opens up prospects for study on geoherbs by using the principle and method of molecular phylogeography.

  14. A prospective study of occupation and prostate cancer risk.

    PubMed

    Zeegers, Maurice P A; Friesema, Ingrid H M; Goldbohm, R Alexandra; van den Brandt, Piet A

    2004-03-01

    A wide variety of occupations has been associated with prostate cancer in previous retrospective studies. Most attention has been paid to farming, metal working, and the rubber industry. Today, these results cannot be affirmed with confidence, because many associations could be influenced by recall bias, have been inconsistent, or have not been confirmed satisfactory in subsequent studies. This study was conducted to investigate and confirm these important associations in a large prospective cohort study. The authors conducted a prospective cohort study among 58,279 men. In September 1986, the cohort members (55-69 years) completed a self-administered questionnaire on potential cancer risk factors, including job history. Related job codes were clustered in professional groups. These predefined clusters were investigated in 3 time windows: 1) profession ever performed, 2) longest profession ever held, and 3) last profession held at baseline. Follow up for incident prostate cancer was established by linkage to cancer registries until December 1993. A case-cohort approach was used based on 830 cases and 1525 subcohort members. To minimize false-positive results, 99% confidence intervals (99% CI) were calculated. Although moderately decreased prostate cancer risks were found for electricians, farmers, firefighters, woodworkers, textile workers, butchers, salesmen, teachers, and clerical workers, none of the relative risks (RR) were found to be statistically significant. For road transporters, metal workers, and managers, no association with prostate cancer risk was found. Although the RR for railway workers, mechanics, welders, chemists, painters, and cooks was moderately increased, these estimates were not statistically significant. For men who reported to have ever worked in the rubber industry, we found a substantially increased prostate cancer risk, but not statistically significant (RR, 4.18; 99% CI = 0.22-80.45). For policemen, we found a substantial and

  15. A prospective study of bilateral inguinal hernia repair.

    PubMed Central

    Serpell, J. W.; Johnson, C. D.; Jarrett, P. E.

    1990-01-01

    A prospective study of outcome after inguinal hernia repair in patients undergoing simultaneous repair of bilateral hernias (n = 31), sequential repair of bilateral hernias (n = 5), and unilateral hernia repair (n = 75) is reported. There were no differences in wound complications, post-operative respiratory complications, or other adverse effects in the three groups. Operating time was similar in the unilateral and bilateral simultaneous repairs (median 55 min), but was longer (100 min) for the combination of two sequential repairs. Hospital stay was shortest for patients undergoing unilateral repair (2 days) but was less with bilateral simultaneous repair (4 days) than after two sequential repairs (total of 6 days). There were 12 (11%) wound complications of which five (5%) were infections. There was no difference in complication rate between unilateral and bilateral hernia repair. Postoperative recovery was assessed prospectively and was recorded at 1 month. There was no difference between unilateral and bilateral simultaneous repairs in the number of days before the patient was able to climb stairs easily, drive a car or return to work. The duration of the requirement for analgesia was similar in each group. We conclude that bilateral simultaneous hernia repair can be carried out with no greater morbidity than a unilateral repair, and the return to normal activity is as rapid. Bilateral hernias should be repaired simultaneously rather than sequentially. PMID:2221764

  16. Bullying increased suicide risk: prospective study of Korean adolescents.

    PubMed

    Kim, Young Shin; Leventhal, Bennett L; Koh, Yun-Joo; Boyce, W Thomas

    2009-01-01

    This study examines the independent impact of bullying on suicide risk. Bullying was assessed by peer nomination in a prospective study of 1,655 7th and 8th grade Korean students, and suicide by youth self-report. Odds Ratios (ORs) of bullying for suicidal risks were computed, controlling for other suicide risk factors. Victim-Perpetrators and female Victims at baseline showed increased risk for persistent suicidality (OR: 2.4-9.8). Male Incident Victims exhibited increased risk for suicidal behaviors and ideations (OR = 4.4, 3.6). Female Persistent Perpetrators exhibited increased risks for suicidal behaviors; male Incident Perpetrators had increased risk for suicidal ideations (OR = 2.7, 2.3). Baseline-only male Victim-Perpetrators showed increased risk for suicidal ideations. (OR = 6.4). Bullying independently increased suicide risks.

  17. A Model of Microteaching Lesson Study Implementation in the Prospective History Teacher Education

    ERIC Educational Resources Information Center

    Utami, Indah Wahyu Puji; Mashuri; Nafi'ah, Ulfatun

    2016-01-01

    Microteaching lesson study is a model to improve prospective teacher quality by incorporating several element of microteaching and lesson study. This study concern on the implementation of microteaching lesson study in prospective history teacher education. Microteaching lesson study model implemented in this study consist of three stages: plan,…

  18. Marine Microbiological Enzymes: Studies with Multiple Strategies and Prospects.

    PubMed

    Wang, Yan; Song, Qinghao; Zhang, Xiao-Hua

    2016-09-22

    Marine microorganisms produce a series of promising enzymes that have been widely used or are potentially valuable for our daily life. Both classic and newly developed biochemistry technologies have been broadly used to study marine and terrestrial microbiological enzymes. In this brief review, we provide a research update and prospects regarding regulatory mechanisms and related strategies of acyl-homoserine lactones (AHL) lactonase, which is an important but largely unexplored enzyme. We also detail the status and catalytic mechanism of the main types of polysaccharide-degrading enzymes that broadly exist among marine microorganisms but have been poorly explored. In order to facilitate understanding, the regulatory and synthetic biology strategies of terrestrial microorganisms are also mentioned in comparison. We anticipate that this review will provide an outline of multiple strategies for promising marine microbial enzymes and open new avenues for the exploration, engineering and application of various enzymes.

  19. Uniparental disomy in congenital disorders: A prospective study

    SciTech Connect

    Lindor, N.M.; Karnes, P.S.; Michels, V.V.

    1995-08-28

    Whole chromosome uniparental disomy (UPD) for several different chromosomes has been described in individuals with phenotypes that encompass a broad range of abnormalities. We prospectively searched for UPD in 25 cytogenetically normal individuals who had one or more of the following features: nonsyndromic multiple congenital anomalies, short stature, mental retardation, or dysmorphic findings. Using highly polymorphic microsatellite repeats, biparental inheritance of at least one locus on every chromosome was found in every individual and uniparental inheritance was not detected at any locus. If UPD does exist in this clinical setting, its frequency is less than 13.7% (95% confidence interval). Our data indicate that additional studies will be required to determine the true incidence of UPD in this population. 41 refs., 1 tab.

  20. Marine Microbiological Enzymes: Studies with Multiple Strategies and Prospects

    PubMed Central

    Wang, Yan; Song, Qinghao; Zhang, Xiao-Hua

    2016-01-01

    Marine microorganisms produce a series of promising enzymes that have been widely used or are potentially valuable for our daily life. Both classic and newly developed biochemistry technologies have been broadly used to study marine and terrestrial microbiological enzymes. In this brief review, we provide a research update and prospects regarding regulatory mechanisms and related strategies of acyl-homoserine lactones (AHL) lactonase, which is an important but largely unexplored enzyme. We also detail the status and catalytic mechanism of the main types of polysaccharide-degrading enzymes that broadly exist among marine microorganisms but have been poorly explored. In order to facilitate understanding, the regulatory and synthetic biology strategies of terrestrial microorganisms are also mentioned in comparison. We anticipate that this review will provide an outline of multiple strategies for promising marine microbial enzymes and open new avenues for the exploration, engineering and application of various enzymes. PMID:27669268

  1. [Postoperative pain therapy in urology. A prospective study].

    PubMed

    Gronau, E; Pannek, J; Benninghoff, A; Seibold, W; Senge, T

    2002-05-01

    A sufficient analgesic treatment in the early postoperative period is important for the patients comfort level. Moreover, physical therapy for prophylaxis of pneumonia and thrombosis is better tolerated. In a prospective study, we compared two postoperative pain management regimens to establish a sufficient pain management without the need of additional costs or manpower. Of 215 patients undergoing major urologic surgery, 111 patients received on demand medication exclusively (group 1), whereas 104 patients were treated with basic analgesics combined with on demand medication (group 2). Pain intensity, side effects and subjective well being were evaluated with a visual analogue scale and a standardised interview. Pain intensity and side effects were significantly lower in group 2. Thus, with combined analgesic treatment, postoperative pain relieve can be achieved safely and without additional costs.

  2. [Study and prospects for clinical diseases treated with scraping therapy].

    PubMed

    Wang, Ying-ying; Yang, Jin-sheng

    2009-02-01

    In order to explore characteristics of clinical diseases treated by scraping therapy, summarize laws of clinical application of scraping therapy, and prospect for research direction of scraping therapy in future, collect 437 articles about scraping therapy between 1994-2007 and analyze and summarize the treated diseases and methods of scraping therapy. Results indicate that scraping therapy has been widely applied to commonly encountered diseases and frequently encountered diseases in departments of internal medicine, surgery, gynecology and pediatrics, etc. with more obvious therapeutic effects. Clinically, it can combine with acupuncture and moxibustion, cupping, massage, blood-letting puncture and other methods. In future, the studies on standardization of manipulation and standards for assessment of therapeutic effect, suitable diseases and the mechanisms of scraping therapy, and development of tools and media, etc. of scraping therapy should be strengthened.

  3. Immediate postoperative complications in transsphenoidal pituitary surgery: A prospective study

    PubMed Central

    Chowdhury, Tumul; Prabhakar, Hemanshu; Bithal, Parmod K.; Schaller, Bernhard; Dash, Hari Hara

    2014-01-01

    Background: Considering the important role of pituitary gland in regulating various endocrine axes and its unique anatomical location, various postoperative complications can be anticipated resulting from surgery on pituitary tumors. We examined and categorized the immediate postoperative complications according to various tumor pathologies. Materials and Methods: We carried out a prospective study in 152 consecutive patients and noted various postoperative complications during neurosurgical intensive care unit stay (within 48 hrs of hospital stay) in patients undergoing transsphenoidal removal of pituitary tumors. Results: In our series, various groups showed different postoperative complications out of which, cerebrospinal fluid leak was the commonest followed by diabetes insipidus, postoperative nausea and vomiting, and hematoma at operation site. Conclusion: Various immediate postoperative complications can be anticipated in transsphenoidal pituitary surgery even though, it is considered to be relatively safe. PMID:25191182

  4. Volleyball injuries presenting in casualty: a prospective study.

    PubMed Central

    Solgård, L; Nielsen, A B; Møller-Madsen, B; Jacobsen, B W; Yde, J; Jensen, J

    1995-01-01

    During 1986, all sports injuries (n = 5222) were prospectively recorded at the two casualty departments in Arhus, Denmark. Volleyball injuries (n = 278) accounted for 5.3% of all sports injuries. An evaluation of the rehabilitation period and the consequences of the injuries was undertaken by questionnaire three years after the injury. The injury incidence was 1.9 injuries/1000 inhabitants/year. Hand, finger, and ankle sprains were the most frequent injuries. Female players had significantly more hand/finger injuries than male players, who incurred more ankle/foot injuries. Knee (6%) and ankle injuries (31%) were responsible for the longest duration of absence from sports participation. There were relatively few chronic injuries. The study suggests the need to enhance prophylactic measures with regard to blocking and overhand pass techniques, in order to reduce the number and extent of ankle and hand/finger injuries. PMID:8800857

  5. Bacterial keratitis: a prospective clinical and microbiological study

    PubMed Central

    Schaefer, F.; Bruttin, O.; Zografos, L.; Guex-Crosier, Y.

    2001-01-01

    AIM—To define the clinical and microbiological profile of bacterial keratitis at the Jules Gonin Eye Hospital and to test the in vitro bacterial resistance.
METHODS—Patients presenting with bacterial keratitis were prospectively followed; clinical features (age, risk factors, visual acuity) and response to therapy were analysed. Bacteriological profile was determined and the sensitivity/resistance of isolated strains were tested towards 12 ocular antibiotics (NCCLS disc diffusion test).
RESULTS—85 consecutive patients (mean age 44.3 (SD 20.7) years) were prospectively enrolled from 1 March 1997 to 30 November 1998. The following risk factors were identified: contact lens wear, 36%; blepharitis, 21%; trauma, 20%; xerophthalmia, 15%; keratopathies, 8%; and eyelid abnormalities, 6%. The most commonly isolated bacteria were Staphylococcus epidermidis, 40%; Staphylococcus aureus, 22%; Streptococcus pneumoniae, 8%; others Streptococcus species, 5%; Pseudomonas, 9%; Moraxella and Serratia marcescens, 5% each; Bacillus, Corynebacterium, Alcaligenes xyloxidans, Morganella morganii, and Haemophilus influenza, 1% each. 1-15% of strains were resistant to fluoroquinolones, 13-22% to aminoglycosides, 37% to cefazolin, 18% to chloramphenicol, 54% to polymyxin B, 51% to fusidic acid, and 45% to bacitracin. Five of the 85 patients (5.8%) had a poor clinical outcome with a visual loss of one or more lines of visual acuity.
CONCLUSION—Fluoroquinolones appear to be the therapy of choice for bacterial keratitis, but, based upon these in vitro studies, some strains may be resistant.

 PMID:11423460

  6. Renal profile in patients with orthopaedic trauma: a prospective study.

    PubMed

    Paul, Ashish; John, Bobby; Pawar, Basant; Sadiq, Shalinder

    2009-08-01

    This prospective study was undertaken to determine the incidence of acute renal failure (ARF) and to identify factors contributing to development of ARF in orthopaedic trauma patients. A total of 55 patients who presented over a period of one year with trauma to upper and lower limbs were studied. Patients with renal injury, chest or abdominal injury, isolated fractures of the hands, feet and axial skeleton involvement were excluded. Out of these, five developed acute renal failure, three recovered and two died. The overall incidence of ARF in this study was 9.1%. Patients with lower limb injuries are at higher risk of developing ARF. Mangled Extremity Severity Score (MESS) > or = 7, higher age, patient presenting with shock, increased myoglobin levels in urine and serum have been correlated with a greater risk of patients developing ARF and a higher mortality. This study attempts to determine the magnitude of crush injury causing renal failure and the incidence of renal failure in patients with injuries affecting the appendicular skeleton exclusively.

  7. The early growth and development study: a prospective adoption design.

    PubMed

    Leve, Leslie D; Neiderhiser, Jenae M; Ge, Xiaojia; Scaramella, Laura V; Conger, Rand D; Reid, John B; Shaw, Daniel S; Reiss, David

    2007-02-01

    The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children (N=359 triads) that was initiated in 2003. The primary study aims are to examine how family processes mediate or moderate the expression of genetic influences in order to aid in the identification of specific family processes that could serve as malleable targets for intervention. Participants in the study are recruited through adoption agencies located throughout the United States, following the birth of a child. Assessments occur at 6-month intervals until the child reaches 3 years of age. Data collection includes the following primary constructs: infant and toddler temperament, social behavior, and health; birth and adoptive parent personality characteristics, psychopathology, competence, stress, and substance use; adoptive parenting and marital relations; and prenatal exposure to drugs and maternal stress. Preliminary analyses suggest the representativeness of the sample and minimal confounding effects of current trends in adoption practices, including openness and selective placement. Future plans are described.

  8. A study of geothermal prospects in the western United States

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The commercial development potential of 13 underdeveloped geothermal prospects in the Western United States was examined, and the prospects were ranked in order of relative potential for development on the basis of investment considerations. The following were considered in the ranking: geotechnical and engineering data, energy market accessibility, administrative constraints, and environmental and socio-economic factors. The primary ranking criterion is the unit cost of energy production expected from each prospect. Secondary criteria are administrative constraints, environmental factors and the quality of the geotechnical data.

  9. Prospective study concerning 71 cases of caesarean scar endometriosis (CSE).

    PubMed

    Pas, Katarzyna; Joanna, Skręt-Magierło; Renata, Raś; Skręt, Andrzej; Barnaś, Edyta

    2017-04-11

    A prospective study was undertaken involving 71 patients with caesarean scar endometriosis (CSE) between the years 2007 and 2013. A prospective study enabled us to find out: mean age of patients with CSE; 34.0 years (range 22.0-48.0), time between CS and diagnosis of CSE; 12.0 months (range 19.0-39.0), duration between symptoms and surgery; 24.0 months (range 1.0-204.0), mean operation time; 40.0 min. (range 15.0-160.0), and mean lesion size; 54.4 ± 42.3 mm(3). In three patients (4.2%) a large deficit in the abdominal wall was closed by means of polypropylene mesh. One of them conceived a year later. Surgical excision is the only effective treatment in patients with CSE. Wide local excision with clear margins is the key to prevent recurrence. Repair of large post-excisional deficits with mesh may also be offered to woman planning their next pregnancy. Impact statement • What is already known on this subject? Endometriosis in the scar may occur after various abdominal surgeries, more frequently after caesarean sections. The excision of large nodules is connected with suboptimal cosmetic outcomes and the possibility of recurrence. • What the results of this study add? In this study including 71 patients with CSE, wide excision with electrocoagulatory was associated with a single recurrence in 12-month follow-up. In three patients (4.2%) large deficits in the abdominal wall were closed with the use of polypropylene mesh. One of them conceived a year later and had a successful pregnancy. • What the implications are of these findings for clinical practice and/or futher research? Surgical excision is the only effective treatment in patients with CSE. Wide local excision with clear margins is the key to preventing recurrence. Repair of large post excisional deficit with mesh may be offered also to woman planning pregnancy.

  10. Prospective study of nutritional support during pelvic irradiation

    SciTech Connect

    Kinsella, T.J.; Malcolm, A.W.; Bothe, A. Jr.; Valerio, D.; Blackburn, G.L.

    1981-04-01

    A prospective study of nutritional support during pelvic irradiation was carried out in 32 patients with a primary pelvic malignancy and prior weight loss. Both curative and palliative patients were eligible for the study. Seventeen patients were randomized to receive intravenous hyperalimentation (IVH) and fifteen patients served as controls who were maintained on their regular diet. Patients were stratified by percent body weight loss. Tolerance to therapy was assessed by evaluation of functional status and by using nutritional parameters of body weight change, change in serum protein levels, and response to delayed hypersensitivity skin tests. The curative IVH group tolerated therapy well by both functional and nutritional measurements. All curative IVH patients completed the planned radiation therapy without a treatment break and were fully active following treatment. Patients gained an average of 4.0 kg body weight during irradiation, which was significantly different from the curative control patients. They demonstrated a significant increase in serum transferrin reflecting an improvement in visceral protein. In addition, all showed a positive response to delayed hypersensitivity skin tests at the completion of irradiation. The palliative IVH patients often did poorly because of progression of disease and demonstrated only an elevation of serum transferrin during treatment. The results in the curative IVH group suggest a potential adjunctive role for intravenous hyperalimentation in the malnourished cancer patient undergoing pelvic irradiation. Clearly, further study of nutritional support during pelvic irradiation is needed using curative patients with a single tumor type and significant prior weight loss.

  11. New prospects for the study of leprosy in the laboratory

    PubMed Central

    Rees, R. J. W.

    1969-01-01

    Although Mycobacterium leprae was identified earlier than Myco. tuberculosis, it has still not been cultured in vitro and only in 1960 was an infection obtained in laboratory animals. However, important advances have been made in the field of experimental leprosy in the last decade due to the development of new techniques and models for studying Myco. leprae in vivo, thus overcoming the limitations imposed by a non-cultivable mycobacterium. Quantitative techniques using Myco. lepraemurium provided the first model for developing an indirect method for distinguishing dead (non-infectious) from living (infectious) bacilli, based on morphological differences in organisms stained by the Ziehl—Neelsen method. However, the most important advances resulted from the limited and localized growth of Myco. leprae when inoculated into the foot pads of mice and, later, the more substantial and generalized multiplication of Myco. leprae in immunologically deficient mice (thymectomized and irradiated with a dose of 900 r). Moreover, in the immunologically deficient animals, the infection eventually resulted in a disease replicating that of lepromatous type leprosy in man, including the involvement of peripheral nerves. The results from these studies and the future prospects for the study of leprosy in the laboratory are reviewed in this article. ImagesFIG. 5FIG. 6FIG. 4FIG. 7 PMID:4898388

  12. A Prospective Study of Herpes Zoster in Children

    PubMed Central

    Katakam, Bhumesh Kumar; Kiran, Geeta; Kumar, Udaya

    2016-01-01

    Background: Herpes zoster (HZ) is a dermatomal viral infection, caused by reactivation of varicella zoster virus (VZV) that persists in the posterior root ganglion. HZ is uncommonly reported in immunocompetent children. It may be due to intrauterine VZV infection or secondary to postnatal exposure to VZV at an early age. Aims: Our study was to review clinico-epidemiological data for HZ in children for early diagnosis and treatment to prevent complications. Materials and Methods: A prospective observational study was conducted from January 2013 to December 2014. Consecutive cases clinically diagnosed as HZ in the pediatric age group were taken up. Results: We report the clinico-epidemiological study of 26 cases of HZ, their benign course and recovery among children. Conclusions: HZ is a rare disease in childhood. Varicella in early childhood is a risk factor of HZ in immunocompromised and immunocompetent children. Childhood zoster occurs in either healthy or underlying immunodeficient children. The appearance of HZ in a young child does not always imply an underlying immunodeficiency or malignancy. But the identification of HZ with or without immunodeficiency is of prime importance from the treatment and prognostic point of view and should be considered in the differential diagnosis of vesicular eruptions. The prognosis is generally good in healthy children. PMID:27688444

  13. Structured Smoking Cessation Training for Medical Students: A Prospective Study

    PubMed Central

    Herold, Ronja; Schiekirka, Sarah; Brown, Jamie; Bobak, Alex; McEwen, Andy

    2016-01-01

    Introduction: Physician adherence to guideline recommendations regarding the provision of counseling and support for smokers willing to quit is low. A lack of training during undergraduate medical education has been identified as a potential cause. This prospective intervention study evaluated a novel teaching module for medical students. Methods: As part of a 6-week cardiovascular course, 125 fourth-year undergraduate medical students received a multimodal and interactive teaching module on smoking cessation, including online learning material, lectures, seminars, and practical skills training. Short- and medium-term effects on knowledge, skills, attitudes, and self-reported practice were measured using written examinations and an objective structured clinical examination at the end of the module and 6 months later. Results were compared to data obtained from a historical control cohort (n = 70) unexposed to the intervention. Results: At the 6-month follow-up, scores in the knowledge test were significantly higher in the intervention than the control group (61.1% vs. 51.7%; p < .001). A similar pattern was observed in the objective structured clinical examination (71.5% vs. 60.5%; p < .001). More students in the intervention than control group agreed that smoking was a chronic disease (83.1% vs. 68.1%; p = .045). The control group was more likely to report recording smoking status (p = .018), but no group difference was detected regarding the report of advising to quit (p = .154). Conclusions: A novel teaching module for undergraduate medical students produced a sustained learning outcome in terms of knowledge, skills, and attitudes but not self-reported practice. Implications: Studies across the world have identified considerable knowledge gaps and deficits in practical training with regard to smoking cessation counseling in undergraduate medical students. This paper describes a teaching intervention informed by current recommendations for the design of

  14. Criminal poisoning of commuters in Bangladesh: prospective and retrospective study.

    PubMed

    Majumder, M Mahbub Alam; Basher, Ariful; Faiz, M Abul; Kuch, Ulrich; Pogoda, Werner; Kauert, Gerold F; Toennes, Stefan W

    2008-08-25

    Travel-related poisoning is an emerging social and public health emergency in Bangladesh but its cause and significance have not been determined. To investigate this syndrome we performed a prospective clinical study and retrospective analysis of hospital records in a general medicine unit of a public tertiary care teaching hospital in Dhaka, Bangladesh, using toxicological analysis by fluorescence polarization immunoassay (FPIA) and liquid chromatography coupled to time-of-flight mass spectrometry (LC-TOF MS). The participants of the prospective study were 130 consecutive patients aged 16-80 years who were admitted with central nervous system depression (Glasgow Coma Score 3-14) after using public transportation, in the absence of other abnormalities, from January through June 2004, and a convenience sample of 15 such patients admitted during 3 days in May 2006. In 2004-2006, travel-related poisoning increased from 6.1 to 9.5% of all admissions (210-309 of 3266-3843 per year), representing 46.6-55.7% of all admitted poisoning cases. Incidents were associated with bus (76%), taxi, train, and air travel, or local markets; 98% of patients remembered buying or accepting food or drinks before losing consciousness. Direct financial damage (missing property) was diverse and frequently existential. Among 94 urine samples analyzed by FPIA, 74% tested positive for benzodiazepines. Among 15 urine samples analyzed by LC-TOF MS, lorazepam was detected in all; five also contained diazepam or metabolites; nitrazepam was present in three. FPIA results obtained for these 15 samples were below the recommended cut-off in eight (53%; lorazepam only). Our findings show that the massive medicosocial emergency of travel-related poisoning in Bangladesh is the result of drug-facilitated organized crime and that benzodiazepine drugs are used to commit these crimes, suggesting modifications to the local emergency management of the victims of this type of poisoning. They also highlight the

  15. A prospective study on postoperative pain after cataract surgery

    PubMed Central

    Porela-Tiihonen, Susanna; Kaarniranta, Kai; Kokki, Merja; Purhonen, Sinikka; Kokki, Hannu

    2013-01-01

    Purpose To evaluate postoperative pain and early recovery in cataract patients. Patients and methods A total of 201 patients who underwent elective first eye cataract extraction surgery were enrolled, and 196 were included in the final analysis. The study design was a single-center, prospective, follow-up study in a tertiary hospital in eastern Finland. Postoperative pain was evaluated with the Brief Pain Inventory at four time points: at baseline, and at 24 hours, 1 week, and 6 weeks postsurgery. Results Postoperative pain was relatively common during the first hours after surgery, as it was reported by 67 (34%) patients. After hospital discharge, the prevalence decreased; at 24 hours, 1 week, and 6 weeks, 18 (10%), 15 (9%) and 12 (7%) patients reported having ocular pain, respectively. Most patients with eye pain reported significant pain, with a score of ≥4 on a pain scale of 0–10, but few had taken analgesics for eye pain. Those who had used analgesics rated the analgesic efficacy of paracetamol and ibuprofen as good or excellent. Other ocular irritation symptoms were common after surgery; as a new postoperative symptom, foreign-body sensation was reported by 40 patients (22%), light sensitivity by 29 (16%), burning by 15 (8%), and itching by 15 (8%). Conclusion Moderate or severe postoperative pain was relatively common after cataract surgery. Thus, all patients undergoing cataract surgery should be provided appropriate counseling on pain and pain management after surgery. PMID:23885165

  16. A prospective study of radionuclide biliary scanning in acute pancreatitis.

    PubMed Central

    Neoptolemos, J. P.; Fossard, D. P.; Berry, J. M.

    1983-01-01

    Early surgery for biliary pancreatitis has resulted in a need for an accurate method of gallstone detection in acute pancreatitis. Fifty patients with acute pancreatitis were studied prospectively to assess the diagnostic value of Radionuclide Biliary Scanning (RBS) performed within 72 hours of an attack. To assess the general accuracy of RBS a further 154 patients with suspected acute cholecystitis or biliary colic were similarly studied. There were 34 patients with biliary pancreatitis and 18 (53%) had a positive scan (no gallbladder seen). There were 16 patients with non-biliary pancreatitis and 5 (31%) had a positive scan. All 51 patients with acute cholecystitis had a positive scan, as did 82% of the 51 patients with biliary colic. There were 52 patients with no biliary or pancreatic disease and none of these had a positive scan. RBS is highly accurate in confirming a diagnosis of acute cholecystitis or biliary colic. However, it cannot be relied on to differentiate between biliary and non-biliary pancreatitis and should certainly not be used as the basis for biliary surgery in these patients. PMID:6859781

  17. Prognostic factors of Bell's palsy: prospective patient collected observational study.

    PubMed

    Fujiwara, Takashi; Hato, Naohito; Gyo, Kiyofumi; Yanagihara, Naoaki

    2014-07-01

    The purpose of this study was to evaluate various parameters potentially influencing poor prognosis in Bell's palsy and to assess the predictive value for Bell's palsy. A single-center prospective patient collected observation and validation study was conducted. To evaluate the correlation between patient characteristics and poor prognosis, we performed univariate and multivariate analyzes of age, gender, side of palsy, diabetes mellitus, hypertension, and facial grading score 1 week after onset. To evaluate the accuracy of the facial grading score, we prepared a receiver operating characteristic (ROC) curve and calculated the area under the ROC curve (AUROC). We also calculated sensitivity, specificity, positive/negative likelihood ratio, and positive/negative predictive value. We included Bell's palsy patients who attended Ehime University Hospital within 1 week after onset between 1977 and 2011. We excluded patients who were less than 15 years old and lost-to-follow-up within 6 months. The main outcome was defined as non-recovery at 6 months after onset. In total, 679 adults with Bell's palsy were included. The facial grading score at 1 week showed a correlation with non-recovery in the multivariate analysis, although age, gender, side of palsy, diabetes mellitus, and hypertension did not. The AUROC of the facial grading score was 0.793. The Y-system score at 1 week moderate accurately predicted non-recovery at 6 months in Bell's palsy.

  18. A prospective study of marine phytoplankton and reported ...

    EPA Pesticide Factsheets

    BACKGROUND: Blooms of marine phytoplankton may adversely affect human health. The potential public health impact of low-level exposures is not well established, and few prospective cohort studies of recreational exposures to marine phytoplankton have been conducted.OBJECTIVE: We evaluated the association between phytoplankton cell counts and subsequent illness among recreational beachgoers.METHODS:We recruited beachgoers at Boquer6n Beach, Puerto Rico, during the summer of 2009. We conducted interviews at three time points to assess baseline health, water activities, and subsequent illness. Daily water samples were quantitatively assayed for phytoplankton cell count. Logistic regression models, adjusted for age and sex, were used to assess the association between exposure to three categories of phytoplankton concentration and subsequent illness.RESULTS: During 26 study days, 15,726 individuals successfully completed all three interviews. Daily total phytoplankton cell counts ranged from 346 to 2,012 cells/ml (median, 712 cells/ml). The category with the highest (≥75th percentile) total phytoplankton cell count was associated with eye irritation [adjusted odds ratio (OR) = 1.30; 95% confidence interval (Cl): 1.01, 1.66], rash (OR = 1.27; 95% Cl: 1.02, 1.57), and earache (OR = 1.25; 95% Cl: 0.88, 1.77). In phytoplankton group-specific analyses, the category with the highest Cyanobacteria counts was associated with respiratory illness (OR = 1.37; 95% Cl: 1.12, 1

  19. The Yugoslavia Prospective Study of environmental lead exposure.

    PubMed Central

    Factor-Litvak, P; Wasserman, G; Kline, J K; Graziano, J

    1999-01-01

    The Yugoslavia Prospective Study of environmental lead exposure has studied the associations between exposure to lead and pregnancy outcomes; childhood neuropsychological, behavioral, and physical development; and hematologic, renal, and cardiovascular function. The cohort comprises 577 children born to women recruited at midpregnancy in two towns in Kosovo, Yugoslavia; one town is the site of a lead smelter, refinery, and battery plant and the other is 25 miles away and relatively unexposed. A sample of these children has been followed at 6-month intervals through 7.5 years of age. Blood lead concentrations ranged from 1 to 70 microg/dl. Exposure to lead was not associated with adverse pregnancy outcomes. Exposure was associated with modest decrements in intelligence, small increases in blood pressure, higher risks of proteinuria, small increases in behavior problems, and perturbed hematopoiesis. Only at low level exposures (i.e., <16 microg/dl) were small associations with decreased height found. We discuss methodological problems that may hinder causal interpretation of these data, namely, use of blood lead concentration as an exposure measure, confounding, and town-specific associations. We conclude that while reported associations are small, collectively they lend support to the notion that lead is a toxicant with numerous adverse health effects. Images Figure 1 PMID:9872712

  20. Massage Therapy for Lyme Disease Symptoms: a Prospective Case Study

    PubMed Central

    Thomason, Meghan J.; Moyer, Christopher A.

    2012-01-01

    Introduction To study the effects of massage therapy (MT) on Lyme disease (LD) symptoms and affect. Methods A 21-year-old female college student previously diagnosed with LD was recruited for a prospective case study that incorporated alternating periods of treatment and nontreatment across 65 days. Her self-reported symptoms of pain, fatigue, and impairment of concentration were assessed by means of a daily diary with corresponding visual analog scales. Immediate effects of MT on affect were assessed by completion of the Positive and Negative Affect Scales before and after each treatment session. Results LD symptoms decreased during treatment periods and increased during nontreatment periods. Positive affect was increased at every MT session. Conclusions MT is a promising treatment for the symptoms pain, fatigue, and impaired concentration associated with LD. In addition, MT reliably increased positive affect. Massage therapists should consider using light-to-medium pressure MT for treatment of persons who present with a similar pattern of LD symptoms, and further research with this population is warranted. PMID:23429967

  1. Risk factors for intraoperative floppy iris syndrome: a prospective study.

    PubMed

    Chatziralli, I P; Peponis, V; Parikakis, E; Maniatea, A; Patsea, E; Mitropoulos, P

    2016-08-01

    PurposeTo evaluate risk factors for intraoperative floppy iris syndrome (IFIS) in patients undergoing phacoemulsification.MethodsParticipants in the study were 1274 consecutive patients, who underwent routine phacoemulsification cataract surgery. The following data were recorded and evaluated as possible risk factors: ophthalmological conditions, axial length of the eye, sociodemographic features, clinical data (hypertension and diabetes mellitus), medications being taken at the time of surgery, and duration of their intake. Cases were characterized intraoperatively as IFIS and non-IFIS. Univariate and multivariate logistic regression analysis were performed.ResultsIFIS was observed in 63/1274 eyes (4.9%, 95% CI: 3.9-6.7%). Current use of tamsulosin, alfuzosin, terazosin, benzodiazepines, quetiapine, and finasteride, as well as hypertension, were all independently associated with IFIS. Significant associations were noted for male sex, rivastigmine, and short axial length, which did not reach significance at the multivariate analysis. Duration of α-blockers intake was not found to be associated with IFIS.ConclusionApart from the well-established associations with α-blockers, this prospective study points to benzodiazepines, quetiapine, finasteride, and hypertension as potential risk factors for IFIS. Short axial length and rivastigmine were significantly associated with IFIS only at the univariate analysis.

  2. A prospective clinical study of polycarboxylate cement in periapical surgery

    PubMed Central

    Ortega-Sánchez, Bárbara; García-Mira, Berta; Maestre-Ferrín, Laura; Peñarrocha-Oltra, David; Gay-Escoda, Cosme

    2012-01-01

    Objective: To evaluate the clinical efficacy of polycarboxylate cement as retrograde filling material. Design: A prospective clinical study was made of 25 patients subjected to periapical surgery with ultrasound and magnifying loupes, in which polycarboxylate cement was used as retrograde filling material. Measurements were made of the area and diameter of the lesions pre- and postoperatively, and 6 and 12 months after the operation. The apical resection and retrograde filling areas were also measured, and the prognosis following surgery was recorded. Results: A total of 23 patients with 31 apicoectomized teeth were studied (2 patients being lost to follow-up). The mean area of the periapical lesions before surgery was 52.25 mm2, with a mean major diameter of 6.1 mm and a mean lesser diameter of 4.8 mm. The success rate after 12 months was 54.7%, according to the criteria of Von Arx and Kurt. The prognosis was poorer in females, in larger lesions, and in cases with larger retrograde filling areas. Conclusions: Polycarboxylate cement offers good results, with important bone regeneration after periapical surgery. Key words: Periapical surgery, endodontic treatment, polycarboxylate cement. PMID:22143701

  3. Wartenberg's migrant sensory neuritis: a prospective follow-up study.

    PubMed

    Stork, Abraham C J; van der Meulen, Marjon F G; van der Pol, W-Ludo; Vrancken, Alexander F J E; Franssen, Hessel; Notermans, Nicolette C

    2010-08-01

    Migrant sensory neuropathy (Wartenberg's migrant sensory neuritis) is characterized by sudden numbness in the distribution of one or multiple cutaneous nerves. To study disease course and outcome, we prospectively followed 12 patients who presented to our tertiary referral neuromuscular outpatient clinic between January 2003 and January 2004. Medical history, neurological, laboratory and electrophysiological examinations were obtained from all patients. All patients were reviewed a second time in 2007, and five had a follow-up electrophysiological examination. At the first visit, 50% described an episode of stretching preceding the sensory complaints. All but three described pain in the affected area before or concomitant with sensory loss. At clinical examination a median of six skin areas were affected, and in 75% this could be confirmed by nerve conduction studies in at least one nerve. Forty-two percent had involvement of the trigeminal nerve. After a mean disease duration of 7.5 years, three patients reported a complete disappearance of sensory complaints and five that the pain had disappeared, but numbness remained. Three patients still had both painful and numb sensory deficits. One patient developed a distal symmetric sensory polyneuropathy. In conclusion, Wartenberg's sensory neuritis is a distinct, exclusively sensory, neuropathy, marked by pain preceding numbness in affected nerves. An episode of stretching preceding pain is not necessary for the diagnosis. Wartenberg's sensory neuritis often retains its spotty, exclusively sensory characteristics after long term follow-up.

  4. Qingdao Port Cardiovascular Health Study: a prospective cohort study

    PubMed Central

    Spatz, Erica S; Jiang, Xianyan; Lu, Jiapeng; Masoudi, Frederick A; Spertus, John A; Wang, Yongfei; Li, Xi; Downing, Nicholas S; Nasir, Khurram; Du, Xue; Li, Jing; Krumholz, Harlan M; Liu, Xiancheng; Jiang, Lixin

    2015-01-01

    Purpose In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. Participants For this study, from 2000 through 2013, 32 404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221 923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records. Findings to date Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4–39.4%; diabetes: 3.3–8.9%; hyperlipidaemia: 5.0–33.6%; body mass index >28 m/kg2: 14.1–18.6%). Future Plans We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge

  5. The Limitations of a Prospective Study of Memories for Child Sexual Abuse

    ERIC Educational Resources Information Center

    Cheit, Ross E.

    2003-01-01

    Prospective studies have been held out as a kind of Holy Grail in research about remembering or forgetting child sexual abuse. They seem to hold the perfect answer to the verification problems that plague retrospective self-reports in the clinical literature. Prospective studies begin with verified cases of abuse. Then they require detective work…

  6. A Qualitative Case Study of Prospective Chemistry Teachers' Knowledge about Instructional Strategies: Introducing Particulate Theory

    ERIC Educational Resources Information Center

    Boz, Nihat; Boz, Yezdan

    2008-01-01

    The purpose of this study was to investigate prospective chemistry teachers' knowledge about instructional strategies, one component of pedagogical content knowledge about introducing particulate theory, as well as sources of this knowledge. Twenty-two prospective chemistry teachers participated in the study. Data were collected by the means of a…

  7. A Comparative Study of Problematic Internet Use and Loneliness among Turkish and Korean Prospective Teachers

    ERIC Educational Resources Information Center

    Tutgun, Aylin; Deniz, Levent; Moon, Man-Ki

    2011-01-01

    The main aim of this study is to compare the problematic internet use and its relation to loneliness among two nations' prospective teachers, Turkey and South Korea. Five hundred and ninety five prospective teachers from three universities, two from Turkey and one from South Korea participated in the study. Generalized Problematic Internet Use…

  8. An Instrument Development Study for Determining Prospective Science Teachers' Science-Specific Epistemological Beliefs

    ERIC Educational Resources Information Center

    Koksal, Mustafa Serdar; Ertekin, Pelin

    2016-01-01

    The study is focusing on development of an instrument to determine science-specific epistemological beliefs of prospective science teachers. The study involved 364 (male = 82, female = 282) prospective science teachers enrolled in a science teacher education program. The confirmatory factor analysis, reliability analysis and correlation analysis…

  9. Metabolic Bone Disease in Viral Cirrhosis: A Prospective Study

    PubMed Central

    Goubraim, Rabia; Kabbaj, Nawal; Salihoun, Mouna; Chaoui, Zakia; Nya, M'Hamed; Amrani, Naima

    2013-01-01

    Background/Aim. Metabolic Bone disorders are well-recognized extrahepatic complications of cirrhosis. The aim was to report their prevalence and the associated factors to their development in patients with viral cirrhosis. Patients and Methods. All consecutive patients with viral cirrhosis were prospectively enrolled. Parathyroid hormone, 25-hydroxyvitamin D, liver function, and phosphocalcic tests were measured in all patients. Bone mineral density was measured at the lumbar spine and total hip by dual-energy X-ray absorptiometry. Data were analyzed using SPSS software. Results. Forty-six cirrhotic patients were included with hepatitis C (87%) and hepatitis B (13%). The Child-Pugh score was grade A in 87% of cases and grade B in 13%. Thirty-seven patients had decreased bone mineral density with osteopenia in 24 patients and osteoporosis in 13 patients. Decreased 25-hydroxyvitamin D was found in 95.6% of cases. Bone disorders were significantly more frequent in old patients with low body mass index, long duration of liver disease, and low 25-hydroxyvitamin D level. None of these factors was an independent factor associated with bone disorders. Conclusion. Our study revealed a high prevalence of metabolic bone disorders among viral cirrhotic patients. Consequently, bone mineral density assessment should be performed systematically in all cirrhotic patients. PMID:27398385

  10. Neuropsychological correlates of stereotactic subcaudate tractotomy. A prospective study.

    PubMed

    Kartsounis, L D; Poynton, A; Bridges, P K; Bartlett, J R

    1991-12-01

    Stereotactic subcaudate tractotomy is a surgical procedure performed for the alleviation of intractable affective disorders. It involves the destruction of bifrontal pathways located beneath and in front of the head of the caudate nucleus. We report the first prospective study of the neuropsychological correlates of this operation in 23 patients. Tests of general intelligence, speed and attention, as well as a wide range of focal cognitive tests, including tasks which have been reported in the literature to be sensitive to frontal lobe dysfunction, were administered 1 wk before the operation, 2 wks after the operation and approximately 6 mths after the operation. The results indicated that this operation does not cause any significant, long-term adverse, cognitive deficits. In the post-operative assessment, however, patients show a significant deterioration in their performance on recognition memory tests and a large proportion of them present with a marked tendency to confabulate on recall tasks. In addition, their performance on some of the tasks which are considered to be sensitive to frontal lobe dysfunction is found to be significantly impaired. These deficits are interpreted to reflect frontal lobe dysfunction due to widespread post-operative oedema rather than damage to the subcaudate pathways. The potential for research on these transient effects of the operation for the advancement of our understanding of frontal lobe functions is discussed.

  11. Necrotizing fasciitis of the extremities: a prospective study.

    PubMed

    Espandar, Ramin; Sibdari, Siamak Yousef; Rafiee, Elham; Yazdanian, Shideh

    2011-11-01

    Necrotizing fasciitis is a rapidly progressive infection and is a necrosis of the fascia and surrounding tissues. Despite recent advances in its management, outcomes have not improved and mortality rate is still high. Between September 2007 and August 2009, we prospectively studied twenty-four histopathologically proven necrotizing fasciitis patients to assess the prognostic factors that indicate the outcome. Mortality rate was 20.8%. Twelve patients (50%) improved, while seven patients (29.2%) were complicated by limb loss. Mortality rates related to upper and lower limb involvement were similar (20% vs. 22.2%). The rates of gangrene and amputation in patients with diabetes mellitus were significantly higher than other comorbidities. Patients with gram-positive infections had significantly lower rates of amputation (15.4% vs. 54.5%, P = 0.04). Mean band cell count and serum potassium level were significantly higher in the nonsurvivors same as leukocyte count in the patients with gangrene, while serum sodium level was significantly lower in nonsurvivors. We conclude that hyponatremia, hyperkalemia, and increased band cells in the peripheral blood of patients may be useful parameters in distinguishing life-threatening necrotizing fasciitis; hence, we recommended lower threshold to amputation during surgery for this group of patients.

  12. Endoscopic vertical ramus osteotomy: a long-term prospective study.

    PubMed

    Papadaki, M E; Kaban, L B; Troulis, M J

    2014-03-01

    The purpose of this prospective study was to evaluate the outcomes of endoscopic vertical ramus osteotomy (EVRO) with rigid fixation for the treatment of mandibular prognathism or asymmetry. Inclusion criteria were age >15 years, adequate clinical and radiographic documentation, and minimum postoperative follow-up of 3 years. Exclusion criteria were refusal to consent, rheumatoid arthritis, steroid use, and smoking. Demographic data, pre-operative (T0), immediate postoperative (T1), and latest follow-up (T2) clinical examinations and cephalometric analysis, procedure data, complications, and length of hospital stay (LOS) were documented. Ten fulfilled the inclusion criteria. Diagnoses included mandibular hyperplasia (n = 5), stable condylar hyperplasia (n = 4), and mandibular asymmetry secondary to condylar resorption (n = 1). In total, 17 EVROs were performed. The mean operative time was 33 min per side. Mean mandibular setback was 4.7 mm. Mean LOS was 1.9 days. Latest follow-up ranged from 3 to 5 years. Skeletal stability was confirmed in nine patients. One patient exhibited recurrence of mandibular prognathism at 5 years due to late growth. No VII nerve deficits were encountered. Inferior alveolar nerve (IAN) paresthesia was noted in four patients, which resolved postoperatively. EVRO was fast and resulted in minimal blood loss, quick recovery, and skeletal stability.

  13. A Prospective Three Generational Study of Fathers’ Constructive Parenting

    PubMed Central

    Kerr, David C. R.; Capaldi, Deborah M.; Pears, Katherine C.; Owen, Lee D.

    2009-01-01

    This prospective, intergenerational study considered multiple influences on 102 fathers’ constructive parenting of 181 children. Fathers in the second generation (G2) were recruited as boys on the basis of neighborhood risk for delinquency and assessed through early adulthood. The fathers’ parents (G1) and the G2 mothers of G3 also participated. A multiagent, multimethod approach was used to measure G1 and G2 constructive parenting (monitoring, discipline, warmth, and involvement), G2 positive adolescent adjustment, and problem behavior in all 3 generations, including G3 difficult temperament and externalizing problems in early and middle childhood, respectively. Path modeling supported direct transmission of G1 constructive parenting of G2 in late childhood to G2 constructive parenting of G3 in middle childhood. Of note, G1 parenting indirectly influenced G2 parenting through G2 positive adjustment but not through G2 adolescent antisocial behavior. G1 parenting influenced G2 parenting in both early and middle childhood of G3. G2 parenting influenced G3 problem behavior but not vice versa. Intergenerational continuities in parenting persisted, even when additional influences were considered. Transmission pathways are not limited to life-course adversity. Rather, constructive parenting is maintained, in part, by engendering positive adjustment in offspring. PMID:19702390

  14. Telomere length and periodontal attachment loss: a prospective cohort study

    PubMed Central

    Thomson, WM; Zeng, J; Broadbent, JM; Foster Page, LA; Shalev, I; Moffitt, TE; Caspi, A; Williams, SM; Braithwaite, AW; Robertson, SP; Poulton, R

    2016-01-01

    Aim To examine the association between telomere erosion and periodontitis in a longstanding prospective cohort study of New Zealand adults. Specific hypotheses tested were: (1) that exposure to periodontitis at ages 26 and 38 was associated with accelerated leucocyte telomere erosion; and (2) that accelerated leucocyte telomere erosion was associated with higher rates of periodontitis by ages 26 and 38. Materials and Methods Periodontal attachment loss data were collected at ages 26 and 38. Blood samples taken at the same ages were analysed to obtain estimates of leucocyte telomere length and erosion over a 12-year period. Results Overall, mean telomere length reduced by 0.15 T/S ratio (adjusted) from age 26 to 38 among the 661 participants reported on here. During the same period, the mean attachment loss increased by 10%, after adjusting for sex, socio-economic status and smoking. Regression models showed that attachment loss did not predict telomere length, and that telomere erosion did not predict attachment loss. Conclusions Although both periodontitis and telomere length are age-dependent, they do not appear to be linked, suggesting that determination of leucocyte telomere length may not be a promising clinical approach at this age for identifying people who are at risk for periodontitis. PMID:26713854

  15. Natural history of human calicivirus infection: a prospective cohort study.

    PubMed

    Rockx, Barry; De Wit, Matty; Vennema, Harry; Vinjé, Jan; De Bruin, Erwin; Van Duynhoven, Yvonne; Koopmans, Marion

    2002-08-01

    We investigated the natural history of human Calicivirus infection in the community. Clinical information was obtained from 99 subjects infected with Norwalk-like viruses (NLV) and 40 subjects infected with Sapporo-like viruses (SLV) in a prospective, community-based cohort study. NLV infection was common in all age groups, whereas SLV infection was mainly restricted to children aged <5 years. Symptoms lasted for a median of 5 and 6 days for NLV and SLV infections, respectively. Disease was characterized by diarrhea during the first 5 days (87% of patients with NLV infection and 95% of patients with SLV infection) and vomiting on the first day (74% for NLV and 60% for SLV). Vomiting was less common in children aged <1 year (59% for NLV and 44% for SLV) than it was among children aged >/=1 year (>75% for NLV and >67% for SLV). Overall, NLV was detected in 26% of patients up to 3 weeks after the onset of illness. This proportion was highest (38%) for children aged <1 year. SLV shedding subsided after 14 days. These data show that the durations of disease and viral shedding of caliciviruses are longer than has been described elsewhere. Therefore, the impact of these infections may have been underestimated.

  16. Butorphanol in labour analgesia: A prospective cohort study

    PubMed Central

    Halder, Ajay; Agarwal, Rachana

    2013-01-01

    Objective Parenteral opioids can be administered with ease at a very low cost with high efficacy as labour analgesia. However, there are insufficient data available to accept the benefits of parenteral opioids over other proven methods of labour analgesia. Butorphanol, a new synthetic opioid, has emerged as a promising agent in terms of efficacy and a better safety profile. This study investigates the effect of butorphanol as a labour analgesia to gather further evidence of its safety and efficacy to pave the way for its widespread use in low resource settings. Material and Methods One hundred low risk term consenting pregnant women were recruited to take part in a prospective cohort study. Intramuscular injections of butorphanol tartrate 1 mg (Butrum 1/2mg, Aristo, Mumbai, India) were given in the active phase of labour and repeated two hourly. Pain relief was noted on a 10-point visual pain analogue scale (VPAS). Obstetric and neonatal outcome measures were mode of delivery, duration of labour, Apgar scores at 1 and 5 minutes and Neonatal Intensive Care Unit admissions. Collected data were analysed for statistically significant pain relief between pre- and post-administration VPAS scores and also for the incidence of adverse outcomes. Results Pain started to decrease significantly within 15 minutes of administration and reached the nadir (3.08 SD0.51) at the end of two hours. The pain remained below four on the VPAS until the end of six hours and was still significantly low after eight hours. The incidence of adverse outcomes was low in the present study. Conclusion Butorphanol is an effective parenteral opioid analgesic which can be administered with reasonable safety for the mother and the neonate. The study has the drawback of lack of control and small sample size. PMID:24592110

  17. Atypical antipsychotic drugs and pregnancy outcome: a prospective, cohort study.

    PubMed

    Habermann, Frank; Fritzsche, Juliane; Fuhlbrück, Frederike; Wacker, Evelin; Allignol, Arthur; Weber-Schoendorfer, Corinna; Meister, Reinhard; Schaefer, Christof

    2013-08-01

    Women of childbearing age are often affected with psychotic disorders, requiring the use of antipsychotic medication during pregnancy. In the present study, we prospectively followed the pregnancies of 561 women exposed to second-generation antipsychotic agents (SGAs; study cohort) and compared these to 284 pregnant women exposed to first-generation antipsychotic agents (FGAs; comparison cohort I) and to 1122 pregnant women using drugs known as not harmful to the unborn (comparison cohort II). Subjects were enrolled through the Institute's consultation service. Major malformation rates of SGA exposed were higher compared to comparison cohort II (adjusted odds ratio, 2.17; 95% confidence interval, 1.20-3.91), possibly reflecting a detection bias concerning atrial and ventricular septal defects. Postnatal disorders occurred significantly more often in infants prenatally exposed to SGAs (15.6%) and FGAs (21.6%) compared to 4.2% of comparison cohort II. Cumulative incidences of elective terminations of pregnancy were significantly higher in both the study cohort (17%) and comparison cohort I (21%) compared to comparison cohort II (3%), whereas the rates of spontaneous abortions did not differ. The numbers of stillbirths and neonatal deaths were within the reference range. Preterm birth and low birth weight were more common in infants exposed to FGAs. To conclude, our findings did not reveal a major teratogenic risk for SGAs, making the better studied drugs of this group a treatment option during pregnancy. Because neonates exposed to SGAs or FGAs in the last gestational week are at higher risk of postnatal disorders, delivery should be planned in clinics with neonatal intensive care units.

  18. A prospective study of patient safety incidents in gastrointestinal endoscopy

    PubMed Central

    Matharoo, Manmeet; Haycock, Adam; Sevdalis, Nick; Thomas-Gibson, Siwan

    2017-01-01

    Background and study aims Medical error occurs frequently with significant morbidity and mortality. This study aime to assess the frequency and type of endoscopy patient safety incidents (PSIs). Patients and methods A prospective observational study of PSIs in routine diagnostic and therapeutic endoscopy was undertaken in a secondary and tertiary care center. Observations were undertaken within the endoscopy suite across pre-procedure, intra-procedure and post-procedure phases of care. Experienced (Consultant-level) and trainee endoscopists from medical, surgical, and nursing specialities were included. PSIs were defined as any safety issue that had the potential to or directly adversely affected patient care: PSIs included near misses, complications, adverse events and “never events”. PSIs were reviewed by an expert panel and categorized for severity and nature via expert consensus. Results One hundred and forty procedures (92 diagnostic, 48 therapeutic) over 37 lists (experienced operators n = 25, trainees n = 12) were analyzed. One hundred forty PSIs were identified (median 1 per procedure, range 0 – 7). Eighty-six PSIs (61 %) occurred in 48 therapeutic procedures. Zero PSIs were detected in 13 diagnostic procedures. 21 (15 %) PSIs were categorized as severe and 12 (9 %) had the potential to be “never events,” including patient misidentification and wrong procedure. Forty PSIs (28 %) were of intermediate severity and 78 (56 %) were minor. Oxygen monitoring PSIs occurred most frequently. Conclusion This is the first study documenting the range and frequency of PSIs in endoscopy. Although many errors are minor without immediate consequence, further work should identify whether prevention of such recurrent errors affects the incidence of severe errors, thus improving safety and quality. PMID:28191498

  19. Community-acquired pneumonia. A prospective outpatient study.

    PubMed

    Bochud, P Y; Moser, F; Erard, P; Verdon, F; Studer, J P; Villard, G; Cosendai, A; Cotting, M; Heim, F; Tissot, J; Strub, Y; Pazeller, M; Saghafi, L; Wenger, A; Germann, D; Matter, L; Bille, J; Pfister, L; Francioli, P

    2001-03-01

    We initiated a prospective study with a group of practitioners to assess the etiology, clinical presentation, and outcome of community-acquired pneumonia in patients diagnosed in the outpatient setting. All patients with signs and symptoms suggestive of pneumonia and an infiltrate on chest X-ray underwent an extensive standard workup and were followed over 4 weeks. Over a 4-year period, 184 patients were eligible, of whom 170 (age range, 15-96 yr; median, 43 yr) were included and analyzed. In 78 (46%), no etiologic agent could be demonstrated. In the remaining 92 patients, 107 etiologic agents were implicated: 43 were due to "pyogenic" bacteria (39 Streptococcus pneumoniae, 3 Haemophilus spp., 1 Streptococcus spp.), 39 were due to "atypical" bacteria (24 Mycoplasma pneumoniae, 9 Chlamydia pneumoniae, 4 Coxiella burnetii, 2 Legionella spp.), and 25 were due to viruses (20 influenza viruses and 5 other respiratory viruses). There were only a few statistically significant clinical differences between the different etiologic categories (higher age and comorbidities in viral or in episodes of undetermined etiology, higher neutrophil counts in "pyogenic" episodes, more frequent bilateral and interstitial infiltrates in viral episodes). There were 2 deaths, both in patients with advanced age (83 and 86 years old), and several comorbidities. Only 14 patients (8.2%) required hospitalization. In 6 patients (3.4%), the pneumonia episode uncovered a local neoplasia. This study shows that most cases of community-acquired pneumonia have a favorable outcome and can be successfully managed in an outpatient setting. Moreover, in the absence of rapid and reliable clinical or laboratory tests to establish a definite etiologic diagnosis at presentation, the spectrum of the etiologic agents suggest that initial antibiotic therapy should cover both S. pneumoniae and atypical bacteria, as well as possible influenza viruses during the epidemic season.

  20. Liquid versus gel handrub formulation: a prospective intervention study

    PubMed Central

    Traore, Ousmane; Hugonnet, Stéphane; Lübbe, Jann; Griffiths, William; Pittet, Didier

    2007-01-01

    Introduction Hand hygiene is one of the cornerstones of the prevention of health care-associated infection, but health care worker (HCW) compliance with good practices remains low. Alcohol-based handrub is the new standard for hand hygiene action worldwide and usually requires a system change for its successful introduction in routine care. Product acceptability by HCWs is a crucial step in this process. Methods We conducted a prospective intervention study to compare the impact on HCW compliance of a liquid (study phase I) versus a gel (phase II) handrub formulation of the same product during daily patient care. All staff (102 HCWs) of the medical intensive care unit participated. Compliance with hand hygiene was monitored by a single observer. Skin tolerance and product acceptability were assessed using subjective and objective scoring systems, self-report questionnaires, and biometric measurements. Logistic regression was used to estimate the association between predictors and compliance with the handrub formulation as the main explanatory variable and to adjust for potential risk factors. Results Overall compliance (phases I and II) with hand hygiene practices among nurses, physicians, nursing assistants, and other HCWs was 39.1%, 27.1%, 31.1%, and 13.9%, respectively (p = 0.027). Easy access to handrub improved compliance (35.3% versus 50.6%, p = 0.035). Nurse status, working on morning shifts, use of the gel formulation, and availability of the alcohol-based handrub in the HCW's pocket were independently associated with higher compliance. Immediate accessibility was the strongest predictor. Based on self-assessment, observer assessment, and the measurement of epidermal water content, the gel performed significantly better than the liquid formulation. Conclusion Facilitated access to an alcohol-based gel formulation leads to improved compliance with hand hygiene and better skin condition in HCWs. PMID:17477858

  1. A prospective study of cardiorespiratory fitness and breast cancer mortality

    PubMed Central

    Peel, J. Brent; Sui, Xuemei; Adams, Swann A.; Hébert, James R.; Hardin, James W.; Blair, Steven N.

    2013-01-01

    Purpose Physical activity may protect against breast cancer. Few prospective studies have evaluated breast cancer mortality in relation to cardiorespiratory fitness, an objective marker of physiologic response to physical activity habits. Methods We examined the association between cardiorespiratory fitness and risk of death from breast cancer in the Aerobics Center Longitudinal Study. Women (N=14,811), aged 20 to 83 years with no prior breast cancer history, received a preventive medical examination at the Cooper Clinic in Dallas, TX, between 1970 and 2001. Mortality surveillance was completed through December 31, 2003. Cardiorespiratory fitness was quantified as maximal treadmill exercise test duration and was categorized for analysis as low (lowest 20% of exercise duration), moderate (middle 40%), and high (upper 40%). At baseline, all participants were able to complete the exercise test to at least 85% of their age-predicted maximal heart rate. Results A total of 68 breast cancer deaths occurred during follow-up (mean=16 years). Age-adjusted breast cancer mortality rates per 10,000 woman-years were 4.4, 3.2, and 1.8 for low, moderate, and high cardiorespiratory fitness groups, respectively (trend P = 0.008). After further controlling for body mass index, smoking, drinking, chronic conditions, abnormal exercise electrocardiogram responses, family history of breast cancer, oral contraceptive use, and estrogen use, hazard ratios (95% CI) for breast cancer mortality across incremental cardiorespiratory fitness categories were 1.00 (referent), 0.67 (0.35–1.26), 0.45 (0.22–0.95); trend P = 0.04. Conclusions These results indicate that cardiorespiratory fitness is associated with a reduced risk of dying from breast cancer in women. PMID:19276861

  2. Injury Rates in Iranian Taekwondo Athletes; a Prospective Study

    PubMed Central

    Ziaee, Vahid; Rahmani, Seyed-Hessam; Rostami, Mohsen

    2010-01-01

    Purpose Taekwondo, as the most popular martial art among Iranian sportsmen, might lead to injury for the athletes of this sport during competitions. We decided to report the incidence rate of injuries sustained by the athletes of this sport during national competitions. Methods All competitions of Iran national championship taekwondo league in 2006-2007 with 204 athletes were observed prospectively to detect the occurrence of injuries. The severity of injuries was classified into four groups (mild, moderate, severe, and critical) according to the involvement of medical care team in the contest, ability of the athletes to resume and duration of probable absence of injured athletes from future competitions and training sessions. Athlete-Exposure (A-E) was defined as the number of competitions multiplied by two. On this base, the rate of injury incidence per 1000 A-Es, the rate of injuries per time unit and the rate of injury occurred for each 100 athletes were considered as the major outcomes of this study. Results Of totally 1,338 A-Es, 93 injuries were recorded during the competitions. The rate of injury incidence was found to be 69.5 injuries per 1000 A-Es and the rate of injuries per minute of competitions was 0.023 which corresponded to 23.3 injuries per 1000 minutes of competitions. 45.6 injuries were occurred for each 100 athletes during the course of competitions. The most frequent injuries were mild (68.8%) and critical injuries (24.7%), followed by moderate and severe injuries; 4.3% and 2.1%, respectively. Conclusion The rate of injury we found was lower than that of western countries. In spite of finding the lower limbs as the most frequent place of injuries in other studies, we found the upper limbs as the most predisposed place of injuries which might be due to difference in the method of combat of Iranian athletes with other athletes. PMID:22375188

  3. Active Bleeding after Cardiac Surgery: A Prospective Observational Multicenter Study

    PubMed Central

    Fellahi, Jean-Luc; Bertet, Héléna; Faucanie, Marie; Amour, Julien; Blanloeil, Yvonnick; Lanquetot, Hervé; Ouattara, Alexandre; Picot, Marie Christine

    2016-01-01

    Main Objectives To estimate the incidence of active bleeding after cardiac surgery (AB) based on a definition directly related on blood flow from chest drainage; to describe the AB characteristics and its management; to identify factors of postoperative complications. Methods AB was defined as a blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or in case of reoperation for hemostasis during the first 12 postoperative hours. The definition was applied in a prospective longitudinal observational study involving 29 French centers; all adult patients undergoing cardiac surgery with cardiopulmonary bypass were included over a 3-month period. Perioperative data (including blood product administration) were collected. To study possible variation in clinical practice among centers, patients were classified into two groups according to the AB incidence of the center compared to the overall incidence: “Low incidence” if incidence is lower and “High incidence” if incidence is equal or greater than overall incidence. Logistic regression analysis was used to identify risk factors of postoperative complications. Results Among 4,904 patients, 129 experienced AB (2.6%), among them 52 reoperation. Postoperative bleeding loss was 1,000 [820;1,375] ml and 1,680 [1,280;2,300] ml at 6 and 24 hours respectively. Incidence of AB varied between centers (0 to 16%) but was independent of in-centre cardiac surgical experience. Comparisons between groups according to AB incidence showed differences in postoperative management. Body surface area, preoperative creatinine, emergency surgery, postoperative acidosis and red blood cell transfusion were risk factors of postoperative complication. Conclusions A blood loss > 1.5 ml/kg/h for 6 consecutive hours within the first 24 hours or early reoperation for hemostasis seems a relevant definition of AB. This definition, independent of transfusion, adjusted to body weight, may assess real time bleeding occurring

  4. Prospects: The Congressionally Mandated Study of Educational Growth and Opportunity. The Interim Report.

    ERIC Educational Resources Information Center

    Puma, Michael J.; And Others

    This publication is the first interim report from the Congressionally Mandated Study of Educational Growth and Opportunity (Prospects), and describes students' characteristics and the schools they attend. Prospects is designed to evaluate the short- and long-term consequences of Chapter 1 program participation by following for 5 years large…

  5. Prospective Elementary School Teachers' Views about Socioscientific Issues: A Concurrent Parallel Design Study

    ERIC Educational Resources Information Center

    Özden, Muhammet

    2015-01-01

    The purpose of this research is to examine the prospective elementary school teachers' perceptions on socioscientific issues. The research was conducted on prospective elementary school teachers studying at a university located in western Turkey. The researcher first taught the subjects of global warming and nuclear power plants from a perspective…

  6. A prospective study of adverse drug reactions in hospitalized children

    PubMed Central

    Martínez-Mir, Inocencia; García-López, Mercedes; Palop, Vicente; Ferrer, José M; Rubio, Elena; Morales-Olivas, Francisco J

    1999-01-01

    Aims There are few publications of adverse drug reactions (ADRs) among paediatric patients, though ADR incidence is usually stated to be higher during the first year of life and in male patients. We have carried out a prospective study to assess the extent, pattern and profile risk for ADRs in hospitalized patients between 1 and 24 months of age. Methods An intensive events monitoring scheme was used. A total of 512 successive admissions to two medical paediatric wards (47 beds) were analysed. The hospital records were screened daily during two periods (summer, 105 days and winter, 99 days), and adverse clinical events observed were recorded. Results A total of 282 events were detected; of these, 112 were considered to be manifestations of ADRs. The cumulative incidence was 16.6%, no differences being observed between periods. Although there were no differences between patients under and over 12 months of age, risk was found to be significantly higher among girls compared with boys (RR = 1.66, 95% CI 1.03–2.52). The gastro-intestinal system was most frequently affected. The therapeutic group most commonly implicated was anti-infective drugs and vaccines (41.5%). The ADRs were mild or moderate in over 90% of cases. A consistent relationship was noted between the number of drugs administered and the incidence of ADRs. Conclusions Hospitalized patients exhibited an ADR risk profile that included female sex and the number of drugs administered. No particular age predisposition was observed. The most commonly prescribed drugs are those most often implicated in ADRs in paediatric patients. PMID:10383547

  7. Critical Pertussis Illness in Children, A Multicenter Prospective Cohort Study

    PubMed Central

    Berger, John T.; Carcillo, Joseph A.; Shanley, Thomas P.; Wessel, David L.; Clark, Amy; Holubkov, Richard; Meert, Kathleen L.; Newth, Christopher J.L.; Berg, Robert A.; Heidemann, Sabrina; Harrison, Rick; Pollack, Murray; Dalton, Heidi; Harvill, Eric; Karanikas, Alexia; Liu, Teresa; Burr, Jeri S.; Doctor, Allan; Dean, J. Michael; Jenkins, Tammara L.; Nicholson, Carol E.

    2013-01-01

    Objective Pertussis persists in the United States despite high immunization rates. The present report characterizes the presentation and acute course of critical pertussis by quantifying demographic data, laboratory findings, clinical complications, and critical care therapies required among children requiring admission to the pediatric intensive care unit (PICU). Design Prospective cohort study. Setting Eight PICUs comprising the Eunice Kennedy Shriver National Institute for Child Health and Human Development Collaborative Pediatric Critical Care Research Network and 17 additional PICUs across the United States. Patients Eligible patients had laboratory confirmation of pertussis infection, were < 18 years of age, and died in the PICU or were admitted to the PICU for at least 24 hours between June 2008 and August 2011. Interventions None. Measurements and Main Results 127 patients were identified. Median age was 49 days, and 105 (83%) patients were < 3 months of age. Fifty-five (43%) required mechanical ventilation. Twelve (9.4%) died during initial hospitalization. Pulmonary hypertension was found in 16 patients (12.5%), and was present in 75% of patients who died, compared with 6% of survivors (p< 0.001). Median white blood cell count (WBC) was significantly higher in those requiring mechanical ventilation (p<0.001), those with pulmonary hypertension (p<0.001) and non-survivors (p<0.001). Age, sex and immunization status did not differ between survivors and non-survivors. Fourteen patients received leukoreduction therapy (exchange transfusion (12), leukopheresis (1) or both (1)). Survival benefit was not apparent. Conclusions Pulmonary hypertension may be associated with mortality in pertussis critical illness. Elevated WBC is associated with the need for mechanical ventilation, pulmonary hypertension, and mortality risk. Research is indicated to elucidate how pulmonary hypertension, immune responsiveness, and elevated WBC contribute to morbidity and mortality

  8. Prospective Study of Dental Intervention for Hematopoietic Malignancy

    PubMed Central

    Tsuji, K.; Akashi, M.; Furudoi, S.; Yakushijin, K.; Kawamoto, S.; Okamura, A.; Matsuoka, H.; Komori, T.

    2015-01-01

    Various chemotherapeutic agents used in patients with hematopoietic malignancy cause serious side effects, including myelosuppression and immunosuppression. Immunosuppression makes patients more susceptible to infection, resulting in an increased risk of infectious complications, including the development of severe septicemia that may be life-threatening. It is necessary for dental staff to be familiar with an appropriate protocol in such cases and to share information about the chemotherapy with a hematologist. To verify the effectiveness of our dental intervention protocol, we conducted a prospective study on the incidence of complications for each myelosuppressive grade of chemotherapy in patients with hematopoietic malignancy. We compared the incidence of complications between treatment P (patients who finished all the dental treatments according to the protocol) and treatment Q (patients who did not) per grade (A, B, C, D) and incidence of systemic or oral findings. We also compared the incidence of oral complication related to the residual teeth between first chemo (patients who were undergoing chemotherapy for the first time) and prior chemo (not the first time). There were significant differences in inflammatory complications between treatment P and treatment Q. We found that both systemic and oral inflammatory complications increased with higher-grade myelosuppressive chemotherapy. Additionally, there was a significant difference between the incidence of oral complications related to the residual teeth between first chemo and prior chemo. Complete implementation of the dental intervention protocol was associated with fewer oral and systemic infectious and inflammatory complications in patients with hematopoietic malignancies undergoing chemotherapy. The incidence of oral and systemic complications also increased with grade of chemotherapy. These results support the validity of our dental intervention protocol. We should pay close attention to the oral

  9. Trigeminocardiac reflex in neurosurgical practice: An observational prospective study

    PubMed Central

    Etezadi, Farhad; Orandi, Amir Ali; Orandi, Amir Hosein; Najafi, Atabak; Amirjamshidi, Abbas; Pourfakhr, Pejman; Khajavi, Mohammad Reza; Abbassioun, Kazem

    2013-01-01

    Background: Considering wide variations regarding the incidence of trigeminocardiac reflex (TCR) during cranial neurosurgical procedures, and paucity of reliable data, we intended to design a prospective study to determine the incidence of TCR in patients undergoing standard general anesthesia for surgery of supra/infra-tentorial cranial and skull base lesions. Methods: A total of 190 consecutive patients candidate for elective surgery of supra-tentorial, infra-tentorial, and skull base lesions were enrolled. All the patients were operated in the neurosurgical operating room of a university-affiliated teaching hospital. All surgeries were performed using sufficient depth of anesthesia achieved by titration of propofol–alfentanil mixture, adjusted according to target Cerebral State Index (CSI) values (40-60). All episodes of bradycardia and hypotension indicating the occurrence of TCR during the surgery (sudden decrease of more than 20% from the previous level) were recorded. Results: Four patients, two female and two male, developed episodes of TCR during surgery (4/190; 2.1%). Three patients showed one episode of TCR just at the end of operation when the skin sutures were applied while CSI values were 70-77 and in the last case, when small tumor samples were taken from just beneath the lateral wall of the cavernous sinus TCR episode was seen while the CSI value was 51. Conclusion: TCR is a rare phenomenon during brain surgeries when patient is anesthetized using standard techniques. Keeping the adequate depth of anesthesia using CSI monitoring method may be an advisable strategy during whole period of a neurosurgical procedure. PMID:24083052

  10. A one season prospective cohort study of volleyball injuries

    PubMed Central

    Verhagen, E; Van der Beek, A J; Bouter, L; Bahr, R; Mechelen, W

    2004-01-01

    Objective: To estimate the overall incidence of acute and overuse volleyball injuries, and to describe factors associated with ankle sprains. Methods: 486 players from the second and third Dutch national volleyball divisions participated in the study and were followed prospectively during a whole season. Three measurements were made during the season (baseline, follow up 1, and follow up 2), where all players completed a questionnaire on demographic variables (only at baseline), sports participation, use of preventive measures, and previous injuries. Volleyball exposure during training and matches was recorded for each individual player by the coach on a weekly exposure form. In case of injury the coach provided the injured player with an injury registration form, which had to be completed within one week after the onset of injury. Results: 100 injuries were reported, resulting in an overall injury incidence of 2.6 injuries/1000 hours. The incidence of acute injuries was 2.0/1000 hours. Ankle sprains (n = 41) accounted for most of the acute injuries, and 31 (75%) of all players with an ankle sprain reported a previous ankle sprain. Twenty five overuse injuries were reported. The overall incidence of overuse injuries was 0.6/1000 hours; the back and the shoulder were the most common sites. Conclusions: Ankle sprain is the most common injury in volleyball, accounting for 41% of all volleyball related injuries. Previous injury seems to be an important risk factor for an ankle sprain. Injury prevention programmes should focus on ankle sprains and concentrate on players with previous ankle sprains. PMID:15273190

  11. Central venous catheterization: a prospective, randomized, double-blind study.

    PubMed

    Mer, Mervyn; Duse, Adriano Gianmaria; Galpin, Jacqueline Suzanne; Richards, Guy Antony

    2009-02-01

    Central venous catheters (CVCs) are extensively used worldwide. Mechanical, infectious and thrombotic complications are well described with their use and may be associated with prolonged hospitalization, increased medical costs and mortality. CVCs account for an estimated 90% of all catheter-related bloodstream infections (CRBSI) and a host of risk factors for CVC-related infections have been documented. The duration of use of CVCs remains controversial and the length of time such devices can safely be left in place has not been fully and objectively addressed in the critically ill patient. Antimicrobial-impregnated catheters have been introduced in an attempt to limit catheter-related infection (CRI) and increase the time that CVCs can safely be left in situ. Recent meta-analyses concluded that antimicrobial-impregnated CVCs appear to be effective in reducing CRI. The authors conducted a prospective, randomized, double-blind study at Johannesburg Hospital over a 4-year period. The study entailed a comparison of standard triple-lumen versus antimicrobial impregnated CVCs on the rate of CRI. Our aim was to determine whether we could safely increase the duration of catheter insertion time from our standard practice of seven days to 14 days, to assess the influence of the antimicrobial impregnated catheter on the incidence of CRI, and to elucidate the epidemiology and risks of CRI. One hundred and eighteen critically ill patients were included in the study which spanned 34 951.5 catheter hours (3.99 catheter years). It was found that antimicrobial catheters did not provide any significant benefit over standard catheters, which the authors feel can safely be left in place for up to 14 days with appropriate infection control measures. The most common source of CRI was the skin. The administration of parenteral nutrition and the site of catheter insertion (internal jugular vein vs subclavian vein) were not noted to be risk factors for CRI. There was no clinical evidence

  12. Ultrasonography of Leprosy Neuropathy: A Longitudinal Prospective Study

    PubMed Central

    Frade, Marco Andrey Cipriani; Marques-Jr, Wilson; Foss, Norma Tiraboschi

    2016-01-01

    Background Previous studies have shown that leprosy multi-drug therapy (MDT) does not stop the progression of nerve function impairment. There are no prospective studies investigating the evolution of nerve anatomic abnormalities after treatment. We examined leprosy patients aiming to investigate the evolution of nerve ultrasonography (US) abnormalities and the risk factors for poor outcomes after MDT. Methodology/Principal findings We performed bilateral US of the ulnar (U), median (M) and common fibular (CF) nerves in 9 paucibacillary (PB) and 64 multibacillary (MB) patients before and after MDT. Forty-two patients had leprosy reactions (type 1, type 2, acute neuritis) during the study. We analyzed nerve maximum cross-sectional areas (CSA), echogenicity and Doppler signal. Poor outcomes included a post-treatment CSA above normal limits with a reduction of less than 30% (U, M) or 40% (CF) from the baseline, echogenicity abnormalities or intraneural Doppler in the post-treatment study. We found that PB and patients without reactions showed significant increases in CSA at CF, whereas MB and patients with reactions had CSA reduction in some nerves after treatment (p<0.05). Despite this reduction, we observed a greater frequency of poor CSA outcomes in the MB compared to the PB (77.8% and 40.6%; p>0.05) and in the patients with reactions compared to those without (66.7% and 38.7%; p<0.05). There was significantly higher odds ratio (7.75; 95%CI: 1.56–38.45) for poor CSA outcomes only for M nerve in patients with reactions. Poor echogenicity outcomes were more frequent in MB (59.4%) compared to PB (22.2%) (p<0.05). There was significant association between poor Doppler outcomes and neuritis. Gender, disease duration, and leprosy classification were not significant risk factors for poor outcomes in CSA, echogenicity or Doppler. Conclusions/Significance US nerve abnormalities can worsen after treatment despite the leprosy classification or the presence of reactions

  13. Injuries at a Canadian National Taekwondo Championships: a prospective study

    PubMed Central

    Kazemi, Mohsen; Pieter, Willy

    2004-01-01

    Background The purpose of this prospective study was to assess the injury rates in male and female adult Canadian Taekwondo athletes relative to total number of injuries, type and body part injured. Methods Subjects (219 males, 99 females) participated in the 1997 Canadian National Taekwondo Championships in Toronto, Canada. Injuries were recorded on an injury form to documents any injury seen and treatment provided by the health care team. These data were later used for this study. The injury form describes the athlete and nature, site, severity and mechanism of the injury. Results The overall rate of injuries was 62.9/1,000 athlete-exposures (A-E). The males (79.9/1,000 A-E) sustained significantly more injuries than the females (25.3/1,000 A-E). The lower extremities were the most commonly injured body region in the men (32.0 /1,000 A-E), followed by the head and neck (18.3/1,000 A-E). Injuries to the spine (neck, upper back, low back and coccyx) were the third most often injured body region in males (13.8/1,000 A-E). All injuries to the women were sustained to the lower extremities. The most common type of injury in women was the contusion (15.2/1,000 A-E). However, men's most common type of injury was the sprain (22.8/1,000 A-E) followed by joint dysfunction (13.7/1,000A-E). Concussions were only reported in males (6.9/1,000 A-E). Compared to international counterparts, the Canadian men and women recorded lower total injury rates. However, the males incurred more cerebral concussions than their American colleagues (4.7/1,000 A-E). Conclusions Similar to what was found in previous studies, the current investigation seems to suggest that areas of particular concern for preventive measures involve the head and neck as well as the lower extremities. This is the first paper to identify spinal joint dysfunction. PMID:15279679

  14. Prospective Multicenter Study of Children With Bronchiolitis Requiring Mechanical Ventilation

    PubMed Central

    Piedra, Pedro A.; Stevenson, Michelle D.; Sullivan, Ashley F.; Forgey, Tate F.; Clark, Sunday; Espinola, Janice A.; Camargo, Carlos A.

    2012-01-01

    OBJECTIVE: To identify factors associated with continuous positive airway pressure (CPAP) and/or intubation for children with bronchiolitis. METHODS: We performed a 16-center, prospective cohort study of hospitalized children aged <2 years with bronchiolitis. For 3 consecutive years from November 1 until March 31, beginning in 2007, researchers collected clinical data and a nasopharyngeal aspirate from study participants. We oversampled children from the ICU. Samples of nasopharyngeal aspirate were tested by polymerase chain reaction for 18 pathogens. RESULTS: There were 161 children who required CPAP and/or intubation. The median age of the overall cohort was 4 months; 59% were male; 61% white, 24% black, and 36% Hispanic. In the multivariable model predicting CPAP/intubation, the significant factors were: age <2 months (odds ratio [OR] 4.3; 95% confidence interval [CI] 1.7–11.5), maternal smoking during pregnancy (OR 1.4; 95% CI 1.1–1.9), birth weight <5 pounds (OR 1.7; 95% CI 1.0–2.6), breathing difficulty began <1 day before admission (OR 1.6; 95% CI 1.2–2.1), presence of apnea (OR 4.8; 95% CI 2.5–8.5), inadequate oral intake (OR 2.5; 95% CI 1.3–4.3), severe retractions (OR 11.1; 95% CI 2.4–33.0), and room air oxygen saturation <85% (OR 3.3; 95% CI 2.0–4.8). The optimism-corrected c-statistic for the final model was 0.80. CONCLUSIONS: In this multicenter study of children hospitalized with bronchiolitis, we identified several demographic, historical, and clinical factors that predicted the use of CPAP and/or intubation, including children born to mothers who smoked during pregnancy. We also identified a novel subgroup of children who required mechanical respiratory support <1 day after respiratory symptoms began. PMID:22869823

  15. Eye lens dosimetry in anesthesiology: a prospective study.

    PubMed

    Vaes, Bart; Van Keer, Karel; Struelens, Lara; Schoonjans, Werner; Nijs, Ivo; Vandevenne, Jan; Van Poucke, Sven

    2017-04-01

    The eye lens is one of the most sensitive organs for radiation injury and exposure might lead to radiation induced cataract. Eye lens dosimetry in anesthesiology has been published in few clinical trials and an active debate about the causality of radiation induced cataract is still ongoing. Recently, the International Commission on Radiological Protection (ICRP) recommended a reduction in the annual dose limit for occupational exposure for the lens of the eye from 150 to 20 mSv, averaged over a period of 5 years, with the dose in a single year not exceeding 50 mSv. This prospective study investigated eye lens dosimetry in anesthesiology practice during a routine year of professional activity. The radiation exposure measured represented the exposure in a normal working schedule of a random anesthesiologist during 1 month and this cumulative eye lens dose was extrapolated to 1 year. Next, eye lens doses were measured in anesthesiology during neuro-embolisation procedures, radiofrequency ablations or vertebroplasty/kyphoplasty procedures. The eye lens doses are measured in terms of the dose equivalent H p(3) with the Eye-D dosimeter (Radcard, Poland) close to the right eye (on the temple). In 16 anesthesiologists, the estimated annual eye lens doses range from a minimum of 0.4 mSv to a maximum of 3.5 mSv with an average dose of 1.33 mSv. Next, eye lens doses were measured for nine neuro-embolisation procedures, ten radiofrequency ablations and six vertebroplasty/kyphoplasty procedures. Average eye lens doses of 77 ± 76 µSv for neuro-embolisations, 38 ± 34 µSv for cardiac ablations and 40 ± 44 µSv for vertebro-/kyphoplasty procedures were recorded. The maximum doses were respectively 264, 97 and 122 µSv. This study demonstrated that the estimated annual eye lens dose is well below the revised ICRP's limit of 20 mSv/year. However, we demonstrated high maximum and average doses during neuro-embolisation, cardiac ablation and vertebro

  16. [The preclinical efficacy of emergency care. A prospective study].

    PubMed

    Hennes, H J; Reinhardt, T; Otto, S; Dick, W

    1993-07-01

    Quality assurance has become an important issue in emergency medicine. At present, no prospective studies are available that quantify the efficacy of interventions performed by emergency doctors. The development and implementation of a rapid, yet simple scoring system, allowing preclinical assessment of all emergency medicine patients, is required. Once the scoring system is implemented, evaluation of the prehospital intervention, based upon objective parameters, is possible. METHODS. The Mainz Emergency Evaluation Score (MEES) is based on seven parameters: level of consciousness, heart rate, heart rhythm, arterial blood pressure, respiratory rate, partial arterial oxygen saturation and pain. A coded value is assigned to each parameter, with the normal physiological condition securing a score of 4, while a life-threatening condition receives a value of 1. For the parameter of pain there is no life-threatening condition, so the lowest value allowed is 2 (Table 2). Addition of the respective values from the seven parameters yields the MEES value, which objectively reflects the patients' condition (minimum = 8, maximum = 28). Comparing the MEES value before (MEES1) and after the intervention (MEES2) allows an objective evaluation of the efficacy of the preclinical care (delta-MEES = MEES2-MEES1). A difference of > or = +2 is considered an improvement, +1, +/- 0, -1 are rated as unchanged and < or = -2 is considered a deterioration in the patients condition. For more detailed evaluation the patients were allocated to 16 diagnosis groups (Table 3). Statistical evaluation utilized analysis of variance, the rank sum test (Wilcoxon) and the correlation coefficient (Kendall-Tau). RESULTS. In 356 patients the condition of 187 (52%) patients improved during the preclinical treatment; the condition of 156 (44%) patients did not change. In 13 patients (3%) the condition became worse (Table 5, Fig. 2). Allocation to 16 diagnosis groups revealed that the improvement in the

  17. Prospective study on laser-assisted laparascopic partial nephrectomy

    NASA Astrophysics Data System (ADS)

    Sroka, Ronald; Hennig, Georg; Zilinberg, Katja; Khoder, Wael Y.

    2012-02-01

    margin, but could not measured so far. Based on this experiences a simple and easy to use instrument described serving also for suction and rinsing. Conclusion: This prospective in-vivo feasibility study shows that laser assisted partial nephrectomy seems to be a safe and promising medical technique which could be provided either during open surgery as well as laparascopically. This application showed good haemostasis and minimal parenchymal damage. Further investigations and development are needed for on-line detection of the remain coagulation margin. An optimised treatment equipment will support the applicability of laser assisted laparoscopic partial nephrectomy.

  18. Alcohol consumption and fecundability: prospective Danish cohort study

    PubMed Central

    Riis, Anders H; Wise, Lauren A; Hatch, Elizabeth E; Rothman, Kenneth J; Cueto, Heidi T; Sørensen, Henrik Toft

    2016-01-01

    Objective To investigate to what extent alcohol consumption affects female fecundability. Design Prospective cohort study. Setting Denmark, 1 June 2007 to 5 January 2016. Participants 6120 female Danish residents, aged 21-45 years, in a stable relationship with a male partner, who were trying to conceive and not receiving fertility treatment. Main outcome measures Alcohol consumption was self reported as beer (330 mL bottles), red or white wine (120 mL glasses), dessert wine (50 mL glasses), and spirits (20 mL) and categorized in standard servings per week (none, 1-3, 4-7, 8-13, and ≥14). Participants contributed menstrual cycles at risk until the report of pregnancy, start of fertility treatment, loss to follow-up, or end of observation (maximum 12 menstrual cycles). A proportional probability regression model was used to estimate fecundability ratios (cycle specific probability of conception among exposed women divided by that among unexposed women). Results 4210 (69%) participants achieved a pregnancy during follow-up. Median alcohol intake was 2.0 (interquartile range 0-3.5) servings per week. Compared with no alcohol consumption, the adjusted fecundability ratios for alcohol consumption of 1-3, 4-7, 8-13, and 14 or more servings per week were 0.97 (95% confidence interval 0.91 to 1.03), 1.01 (0.93 to 1.10), 1.01 (0.87 to 1.16) and 0.82 (0.60 to 1.12), respectively. Compared with no alcohol intake, the adjusted fecundability ratios for women who consumed only wine (≥3 servings), beer (≥3 servings), or spirits (≥2 servings) were 1.05 (0.91 to1.21), 0.92 (0.65 to 1.29), and 0.85 (0.61 to 1.17), respectively. The data did not distinguish between regular and binge drinking, which may be important if large amounts of alcohol are consumed during the fertile window. Conclusion Consumption of less than 14 servings of alcohol per week seemed to have no discernible effect on fertility. No appreciable difference in fecundability was observed by level of

  19. Safe total intrafascial laparoscopic (TAIL™) hysterectomy: a prospective cohort study

    PubMed Central

    Hohl, Michael K.

    2010-01-01

    This study directly compares total intrafascial laparoscopic (TAIL™) hysterectomy with vaginal (VH) and abdominal (AH) hysterectomy with regard to safety, operating time and time of convalescence. The study is a prospective cohort study (Canadian Task Force classification II-2), including data from patients of a single university-affiliated teaching institution, admitted between 1997 and 2008 for hysterectomy due to benign uterus pathology. Patient data were collected pre-, intra- and postoperatively and complications documented using a standardised data sheet of a Swiss obstetric and gynaecological study group (Arbeitsgemeinschaft Schweizerische Frauenkliniken, Amlikon/Switzerland). Classification of complications (major complications and minor complications) for all three operation techniques, evaluation of surgeons and comparison of operation times and days of hospitalisation were analysed. 3066 patients were included in this study. 993 patients underwent AH, 642 VH and 1,431 total intrafascial hysterectomy. No statistically significant difference for the operation times comparing the three groups can be demonstrated. The mean hospital stay in the TAIL™ hysterectomy, VH and AH groups is 5.8 ± 2.4, 8.8 ± 4.0 and 10.4 ± 3.9 days, respectively. The postoperative minor complications including infection rates are low in the TAIL™ hysterectomy group (3.8%) when compared with either the AH group (15.3%) or the VH group (11.2%), respectively. The total of minor complications is statistically significant lower for TAIL™ hysterectomy as for AH (O.R. 4.52, CI 3.25–6.31) or VH (O.R. 3.16, CI 2.16–4.62). Major haemorrhage with consecutive reoperation is observed statistically significantly more frequent in the AH group when compared to the TAIL™ hysterectomy group, with an O.R. of 6.13 (CI 3.05–12.62). Overall, major intra- and postoperative complications occur significant more frequently in the AH group (8.6%) when compared to the VH group (3

  20. Study protocol title: a prospective cohort study of low back pain

    PubMed Central

    2013-01-01

    Background Few prospective cohort studies of workplace low back pain (LBP) with quantified job physical exposure have been performed. There are few prospective epidemiological studies for LBP occupational risk factors and reported data generally have few adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study has been incepted to quantify risk factors for LBP and potentially develop improved methods for designing and analyzing jobs. Due to the subjectivity of LBP, six measures of LBP are captured: 1) any LBP, 2) LBP ≥ 5/10 pain rating, 3) LBP with medication use, 4) LBP with healthcare provider visits, 5) LBP necessitating modified work duties and 6) LBP with lost work time. Workers have thus far been enrolled from 30 different employment settings in 4 diverse US states and performed widely varying work. At baseline, workers undergo laptop-administered questionnaires, structured interviews, and two standardized physical examinations to ascertain demographics, medical history, psychosocial factors, hobbies and physical activities, and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of low back pain. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. The lifetime cumulative incidence of low back pain will also include those with a past history of low back pain. Incident cases will exclude prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion Data analysis of a prospective cohort study of low back pain is underway and has successfully enrolled over 800 workers to date. PMID:23497211

  1. Prospective Double-Blind Study of Zidovudine (AZT) in Early Stage HIV infection

    DTIC Science & Technology

    1988-05-01

    FRONT COVER FUNDING NO. 87PP7875 S L. TITLE: Prospective Double-Blind Study of Zidovudine (AZT) in Early Stage HIV Infection PRINCIPAL INVESTIGATOR...Prospective Double-Blind Study of Zidovudine (AZT) in Early State HIV Infection 12. PERSONAL AUTHOR(S) Shannon M. Harrison 13a. TYPE OF REPORT 113b...COSATI CODES 18. SUBJECT TERMS (Continue on reverse if necessary and identify by block number) FIELD GROUP SUBGROUP HIV , Zidovudine, Early, Infection 06

  2. Lifetime socioeconomic position and mortality: prospective observational study.

    PubMed Central

    Smith, G. D.; Hart, C.; Blane, D.; Gillis, C.; Hawthorne, V.

    1997-01-01

    OBJECTIVES: To assess the influence of socioeconomic position over a lifetime on risk factors for cardiovascular disease, on morbidity, and on mortality from various causes. DESIGN: Prospective observational study with 21 years of follow up. Social class was determined as manual or non-manual at three stages of participants' lives: from the social class of their father's job, the social class of their first job, and the social class of their job at the time of screening. A cumulative social class indicator was constructed, ranging from non-manual social class at all three stages of life to manual social class at all three stages. SETTING: 27 workplaces in the west of Scotland. PARTICIPANTS: 5766 men aged 35-64 at the time of examination. MAIN OUTCOME MEASURES: Prevalence and level of risk factors for cardiovascular disease; morbidity; and mortality from broad causes of death. RESULTS: From non-manual social class locations at all three life stages to manual at all stages there were strong positive trends for blood pressure, body mass index, current cigarette smoking, angina, and bronchitis. Inverse trends were seen for height, cholesterol concentration, lung function, and being an ex-smoker. 1580 men died during follow up. Age adjusted relative death rates in comparison with the men of non-manual social class locations at all three stages of life were 1.29 (95% confidence interval 1.08 to 1.56) in men of two non-manual and one manual social class; 1.45 (1.21 to 1.73) in men of two manual and one non-manual social class; and 1.71 (1.46 to 2.01) in men of manual social class at all three stages. Mortality from cardiovascular disease showed a similar graded association with cumulative social class. Mortality from cancer was mainly raised among men of manual social class at all three stages. Adjustment for a wide range of risk factors caused little attenuation in the association of cumulative social class with mortality from all causes and from cardiovascular disease

  3. The Examining of Prospective Teachers? Views about Renewable and Non-Renewable Energy Sources: A Case Study of Turkey

    ERIC Educational Resources Information Center

    Hasiloglu, Mehmet Akif

    2014-01-01

    The aim of this study is to determine prospective teachers? views about renewable and non-renewable energy sources. To collect data, a questionnaire with 5 open-ended questions was conveyed to 463 prospective teachers selected from Agri Ibrahim Cecen University. The results showed that almost three fourths of the prospective teachers tend to…

  4. The WISTAH hand study: A prospective cohort study of distal upper extremity musculoskeletal disorders

    PubMed Central

    2012-01-01

    Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain’s stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion A prospective cohort study of

  5. Developmental antecedents of partner abuse: a prospective-longitudinal study.

    PubMed

    Magdol, L; Moffitt, T E; Caspi, A; Silva, P A

    1998-08-01

    Prospective measures of risk factors for partner abuse were obtained from a large birth cohort in 4 domains: socioeconomic resources, family relations, educational achievements, and problem behaviors. Partner abuse outcomes were measured at age 21. Results showed that antecedents of abuse included risk factors from all 4 domains. Risk factors were similar for men and women. Some age 3 antecedents were significant, but the strongest correlations were from age 15. In multivariate analyses, the most consistent predictor was the presence of early problem behaviors. In a cross-validation tests, abuse was moderately predictable by the same antecedents, whether the outcome measure was self-report or reports from partners of sample members. Findings suggest that theories of partner abuse should account for developmental influences from multiple life domains and that primary prevention of partner abuse should begin in adolescence.

  6. Sleep attacks and antiparkinsonian drugs: a pilot prospective pharmacoepidemiologic study.

    PubMed

    Montastruc, J L; Brefel-Courbon, C; Senard, J M; Bagheri, H; Ferreira, J; Rascol, O; Lapeyre-Mestre, M

    2001-01-01

    A prospective survey was performed to characterize the prevalence of sleep attacks and to evaluate precipitating factors in a group of 236 patients with idiopathic Parkinson's disease. Sleep attacks were reported by 72 patients (30.5%). Multivariate analysis showed a marked association between the occurrence of sudden sleep episodes and first autonomic failure, followed by treatment with ropinirole and bromocriptine. The present work underlines the major contributing role of autonomic failure followed by dopamine agonists in the occurrence of such an event. Because a relationship between sleep attacks and not only ropinirole but also bromocriptine treatment was described, the present work suggests that sleep attacks are a common side effect of all dopamine agonists.

  7. PROSPECTIVE RANDOMIZED STUDY COMPARING TWO ANESTHETIC METHODS FOR SHOULDER SURGERY

    PubMed Central

    Ikemoto, Roberto Yukio; Murachovsky, Joel; Prata Nascimento, Luis Gustavo; Bueno, Rogerio Serpone; Oliveira Almeida, Luiz Henrique; Strose, Eric; de Mello, Sérgio Cabral; Saletti, Deise

    2015-01-01

    Objective: To evaluate the efficacy of suprascapular nerve block in combination with infusion of anesthetic into the subacromial space, compared with interscalene block. Methods: Forty-five patients with small or medium-sized isolated supraspinatus tendon lesions who underwent arthroscopic repair were prospectively and comparatively evaluated through random assignation to three groups of 15, each with a different combination of anesthetic methods. The efficacy of postoperative analgesia was measured using the visual analogue scale for pain and the analgesic, anti-inflammatory and opioid drug consumption. Inhalation anesthetic consumption during surgery was also compared between the groups. Results: The statistical analysis did not find any statistically significant differences among the groups regarding anesthetic consumption during surgery or postoperative analgesic efficacy during the first 48 hours. Conclusion: Suprascapular nerve block with infusion of anesthetic into the subacromial space is an excellent alternative to interscalene block, particularly in hospitals in which an electrical nerve stimulating device is unavailable. PMID:27022569

  8. Retrospective and prospective data collection compared in the Dutch End Of Life in Dementia (DEOLD) study.

    PubMed

    van der Steen, Jenny T; Ribbe, Miel W; Deliens, Luc; Gutschow, Giselka; Onwuteaka-Philipsen, Bregje D

    2014-01-01

    Studying end of life in dementia patients is challenging because of ill-defined prognoses and frequent inability to self-report. We aim to quantify and compare (1) feasibility and (2) sampling issues between prospective and retrospective data collection specific to end-of-life research in long-term care settings. The observational Dutch End of Life in Dementia study (DEOLD; 2007 to 2011) used both prospective data collection (28 facilities; 17 nursing home organizations/physician teams; questionnaires between January 2007 and July 2010, survival until July 2011) and retrospective data collection (exclusively after death; 6 facilities; 2 teams, questionnaires between November 2007 and March 2010). Prospective collection extended from the time of admission to the time after death or conclusion of the study. Prospectively, we recruited 372 families: 218 residents died (59%) and 184 (49%) had complete physician and family after-death assessments. Retrospectively, 119 decedents were enrolled, with 64 (54%) complete assessments. Cumulative data collection over all homes lasted 80 and 8 years, respectively. Per complete after-death assessments in a year, the prospective data collection involved 37.9 beds, whereas this was 7.9 for the retrospective data collection. Although age at death, sex, and survival curves were similar, prospectively, decedents' length of stay was shorter (10.3 vs. 31.4 mo), and fewer residents had advanced dementia (39% vs. 54%). Regarding feasibility, we conclude that prospective data collection is many fold more intensive and complex per complete after-death assessment. Regarding sampling, if not all are followed until death, it results in right censoring and in different, nonrepresentative samples of decedents compared with retrospective data collection. Future work may adjust or stratify for dementia severity and length of stay as key issues to promote comparability between studies.

  9. Antibiotic treatment of pneumonia and bronchiolitis. A prospective randomised study.

    PubMed Central

    Friis, B; Andersen, P; Brenøe, E; Hornsleth, A; Jensen, A; Knudsen, F U; Krasilnikoff, P A; Mordhorst, C H; Nielsen, S; Uldall, P

    1984-01-01

    Routine administration of antibiotics in the treatment of pneumonia and bronchiolitis in infants and small children was evaluated in an open randomised prospective trial. From 1979-82 136 children between the age of 1 month and 6 years were allocated to one of two treatment groups shortly after their admission to a paediatric ward. Group A patients were to be given antibiotics but those in group B were not. None of the children had received antibiotics before hospital admission. A viral infection was diagnosed in 38 of the 72 patients from group A and in 34 of the 64 patients from group B. Respiratory syncytial virus was detected in 84% of these patients. Samples of tracheal secretions showed no differences between the groups in respect of cytology and bacterial flora. Nor were there any significant differences in the course of acute disease, the frequency of fever relapse and pulmonary complications. Fifteen patients from group B were subsequently treated with antibiotics: two of these developed secondary purulent infections of the middle ear and one showed a slight pleural effusion. These results do not support the routine use of antibiotics in infants and small children admitted to hospital with pneumonia and bronchiolitis. PMID:6391389

  10. Bronchial colonisation in patients with lung cancer: a prospective study.

    PubMed

    Laroumagne, Sophie; Lepage, Benoît; Hermant, Christophe; Plat, Gavin; Phelippeau, Michael; Bigay-Game, Laurence; Lozano, Stéphanie; Guibert, Nicolas; Segonds, Christine; Mallard, Valérie; Augustin, Nathalie; Didier, Alain; Mazieres, Julien

    2013-07-01

    Bronchial colonisation is frequently reported in patients with lung cancer, and has a potential impact on therapeutic management and prognosis. We aimed to prospectively define the prevalence and nature of bronchial colonisation in patients at the time of diagnosing lung cancer. 210 consecutive patients with lung cancer underwent a flexible bronchoscopy for lung cancer. The type and frequency of bacterial, mycobacterial and fungal colonisation were analysed and correlated with the patients' and tumours' characteristics. Potential pathogens were found in 48.1% of samples: mainly the Gram-negative bacilli Escherichia coli (8.1%), Haemophilus influenzae (4.3%) and Enterobacter spp. (2.4%); Gram-positive cocci, Staphylococcus spp. (12.9%) and Streptococcus pneumoniae (3.3%); atypical mycobacteria (2.9%); Candida albicans (42.9%); and Aspergillus fumigatus (6.2%). Aged patients (p=0.02) with chronic obstructive pulmonary disease (p=0.008) were significantly more frequently colonised; however, tumour stage, atelectasis, bronchial stenosis and abnormalities of chest radiography were not associated with a higher rate of colonisation. Squamous cell carcinoma tended to be more frequently colonised than other histological subtypes. Airway colonisation was reported in almost half of patients presenting with lung cancer, mainly in fragile patients, and was significantly associated with worse survival (p=0.005). Analysing colonisation status of patients at the time of diagnosis may help improve the management of lung cancer.

  11. Diagnosing epilepsy in neurology clinics: a prospective study.

    PubMed

    Angus-Leppan, Heather

    2008-07-01

    The certainty of the initial diagnosis of epilepsy was assessed prospectively by one neurologist in outpatients. One hundred and fifty-eight consecutive referrals with loss of consciousness or possible epilepsy were seen. The relative contributions to the initial diagnosis from the referral letter, history taking in clinic, physical examination, and investigation were compared. There was a referring diagnosis in 28.5%. The neurologist reached a diagnosis in 87% of the 158 cases: in 43% epilepsy, 25% syncope, 12% non-epileptic seizures and in 7% other diagnoses. There was a low correlation between referral and specialist diagnosis. Physical examination did not change the diagnosis in any patient. Investigations changed the diagnosis in one patient. Neuro-imaging revealed a relevant abnormality in 12/43 (27.9%) scanned. The yield from EEG was 7/25 (28%), but the EEG changed the diagnosis in only one case. Cardiac testing confirmed the type of syncope in 2/47 (4.3%) of patients. Blood tests did not contribute to the diagnosis in any patient. The neurology consultation significantly increased diagnostic certainty. The diagnosis of epilepsy remains largely clinical. It is important that patients are aware of this prior to investigation.

  12. Prospective observational cohort studies for studying rare diseases: the European PedNet Haemophilia Registry.

    PubMed

    Fischer, K; Ljung, R; Platokouki, H; Liesner, R; Claeyssens, S; Smink, E; van den Berg, H M

    2014-07-01

    Haemophilia is a rare disease. To improve knowledge, prospective studies of large numbers of subjects are needed. To establish a large well-documented birth cohort of patients with haemophilia enabling studies on early presentation, side effects and outcome of treatment. Twenty-one haemophilia treatment centres have been collecting data on all children with haemophilia with FVIII/IX levels up to 25% born from 2000 onwards. Another eight centres collected data on severe haemophilia A only. At baseline, details on delivery and diagnosis, gene mutation, family history of haemophilia and inhibitors are collected. For the first 75 exposure days, date, reason, dose and product are recorded for each infusion. Clinically relevant inhibitors are defined as follows: at least two positive inhibitor titres and a FVIII/IX recovery <66% of expected. For inhibitor patients, results of all inhibitor- and recovery tests are collected. For continued treatment, data on bleeding, surgery, prophylaxis and clotting factor consumption are collected annually. Data are downloaded for analysis annually. In May 2013, a total of 1094 patients were included: 701 with severe, 146 with moderate and 247 with mild haemophilia. Gene defect data were available for 87.6% of patients with severe haemophilia A. The first analysis, performed in May 2011, lead to two landmark publications. The outcome of this large collaborative research confirms its value for the improvement of haemophilia care. High-quality prospective observational cohorts form an ideal source to study natural history and treatment in rare diseases such as haemophilia.

  13. Adverse Consequences of School Mobility for Children in Foster Care: A Prospective Longitudinal Study

    ERIC Educational Resources Information Center

    Pears, Katherine C.; Kim, Hyoun K.; Buchanan, Rohanna; Fisher, Philip A.

    2015-01-01

    Few prospective studies have examined school mobility in children in foster care. This study described the school moves of 86 such children and 55 community comparison children (primarily Caucasian), living in a medium-sized metropolitan area in the Pacific Northwest who were approximately 3 to 6 years old at the study start. Additionally, the…

  14. Comparing Science Process Skills of Prospective Science Teachers: A Cross-Sectional Study

    ERIC Educational Resources Information Center

    Farsakoglu, Omer Faruk; Sahin, Cigdem; Karsli, Fethiye

    2012-01-01

    This study was conducted with the purpose of examining how Prospective Science Teachers' (PST) Science Process Skills (SPS) develop according to different grades. In this study, a cross-sectional research approach in the form of a case study was used. The sample group consisted of a total number of 102 undergraduate students who were selected from…

  15. Seizures in a Pediatric Intensive Care Unit: A Prospective Study

    PubMed Central

    Yazici, Mutlu Uysal; Ayar, Ganime; Karalok, Zeynep Selen; Arhan, Ebru Petek

    2016-01-01

    Background: The aim of the research is to determine the etiology and clinical features of seizures in critically ill children admitted to a pediatric intensive care unit (PICU). Methods: A total of 203 children were admitted from June 2013 to November 2013; 45 patients were eligible. Age ranged from 2 months to 19 years. Seizures were organized as epileptic or acute symptomatic. Pediatric risk of mortality score III, Glasgow coma scale, risk factors, coexistent diagnosis, medications administered before admission, type and duration of seizures, drugs used, requirement and duration of mechanical ventilation, length of stay and neuroimaging findings were collected as demographic data prospectively. Results: The male–female ratio was 0.8. Mean age was 5.4. The most common causes of seizures were acute symptomatic. Most frequent coexistent diagnosis was infectious diseases, and 53.3% had recurrent seizures. Medications were administered to 51.1% of the patients before admission. Seizures were focal in 21 (46.7%), generalized in 11 (24.4%) and 13 (28.9%) had status epilepticus. Intravenous midazolam was first-line therapy in 48.9%. Acute symptomatic seizures were usually new-onset, and duration was shorter. Epileptic seizures tended to be recurrent and were likely to progress to status epilepticus. However, type of seizures did not change severity of the disease. Also, laboratory test results, medications administered before admission, requirement and duration of ventilation, mortality and length of stay were not significant between epileptic/acute symptomatic patients. Conclusion: Seizures in critically ill children, which may evolve into status epilepticus, is an important condition that requires attention regardless of cause. Intensified educational programs for PICU physicians and international guidelines are necessary for a more efficient approach to children with seizures. PMID:26892503

  16. Toward Fully Automated Multicriterial Plan Generation: A Prospective Clinical Study

    SciTech Connect

    Voet, Peter W.J.; Dirkx, Maarten L.P.; Breedveld, Sebastiaan; Fransen, Dennie; Levendag, Peter C.; Heijmen, Ben J.M.

    2013-03-01

    Purpose: To prospectively compare plans generated with iCycle, an in-house-developed algorithm for fully automated multicriterial intensity modulated radiation therapy (IMRT) beam profile and beam orientation optimization, with plans manually generated by dosimetrists using the clinical treatment planning system. Methods and Materials: For 20 randomly selected head-and-neck cancer patients with various tumor locations (of whom 13 received sequential boost treatments), we offered the treating physician the choice between an automatically generated iCycle plan and a manually optimized plan using standard clinical procedures. Although iCycle used a fixed “wish list” with hard constraints and prioritized objectives, the dosimetrists manually selected the beam configuration and fine tuned the constraints and objectives for each IMRT plan. Dosimetrists were not informed in advance whether a competing iCycle plan was made. The 2 plans were simultaneously presented to the physician, who then selected the plan to be used for treatment. For the patient group, differences in planning target volume coverage and sparing of critical tissues were quantified. Results: In 32 of 33 plan comparisons, the physician selected the iCycle plan for treatment. This highly consistent preference for the automatically generated plans was mainly caused by the improved sparing for the large majority of critical structures. With iCycle, the normal tissue complication probabilities for the parotid and submandibular glands were reduced by 2.4% ± 4.9% (maximum, 18.5%, P=.001) and 6.5% ± 8.3% (maximum, 27%, P=.005), respectively. The reduction in the mean oral cavity dose was 2.8 ± 2.8 Gy (maximum, 8.1 Gy, P=.005). For the swallowing muscles, the esophagus and larynx, the mean dose reduction was 3.3 ± 1.1 Gy (maximum, 9.2 Gy, P<.001). For 15 of the 20 patients, target coverage was also improved. Conclusions: In 97% of cases, automatically generated plans were selected for treatment because of

  17. Testosterone deficiency and quality of life in Australasian testicular cancer survivors: a prospective cohort study.

    PubMed

    O'Carrigan, B; Fournier, M; Olver, I N; Stockler, M R; Whitford, H; Toner, G C; Thomson, D B; Davis, I D; Hanning, F; Singhal, N; Underhill, C; Clingan, P; McDonald, A; Boland, A; Grimison, P

    2014-08-01

    This is the first prospective study in a contemporary Australian/New Zealand population to determine the prevalence of testosterone deficiency in testicular cancer survivors at 12 months from treatment, and any association with poorer quality of life. Hormone assays from 54 evaluable patients in a prospective cohort study revealed biochemical hypogonadism in 18 patients (33%) and low-normal testosterone in 13 patients (24%). We found no association between testosterone levels and quality of life (all P > 0.05). Hypogonadal patients should be considered for testosterone replacement to prevent long-term morbidity.

  18. Development of Visual Motion Perception for Prospective Control: Brain and Behavioral Studies in Infants

    PubMed Central

    Agyei, Seth B.; van der Weel, F. R. (Ruud); van der Meer, Audrey L. H.

    2016-01-01

    During infancy, smart perceptual mechanisms develop allowing infants to judge time-space motion dynamics more efficiently with age and locomotor experience. This emerging capacity may be vital to enable preparedness for upcoming events and to be able to navigate in a changing environment. Little is known about brain changes that support the development of prospective control and about processes, such as preterm birth, that may compromise it. As a function of perception of visual motion, this paper will describe behavioral and brain studies with young infants investigating the development of visual perception for prospective control. By means of the three visual motion paradigms of occlusion, looming, and optic flow, our research shows the importance of including behavioral data when studying the neural correlates of prospective control. PMID:26903908

  19. Asthma and Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Prospective Cohort Study

    ERIC Educational Resources Information Center

    Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

    2013-01-01

    Background: Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early…

  20. A Study on Teaching Gases to Prospective Primary Science Teachers through Problem-Based Learning

    ERIC Educational Resources Information Center

    Senocak, Erdal; Taskesenligil, Yavuz; Sozbilir, Mustafa

    2007-01-01

    The aim of this study was to compare the achievement of prospective primary science teachers in a problem-based curriculum with those in a conventional primary science teacher preparation program with regard to success in learning about gases and developing positive attitudes towards chemistry. The subjects of the study were 101 first year…

  1. Sustained Effects of Ecstasy on the Human Brain: A Prospective Neuroimaging Study in Novel Users

    ERIC Educational Resources Information Center

    de Win, Maartje M. L.; Jager, Gerry; Booij, Jan; Reneman, Liesbeth; Schilt, Thelma; Lavini, Christina; Olabarriaga, Silvia D.; den Heeten, Gerard J.; van den Brink, Wim

    2008-01-01

    Previous studies have suggested toxic effects of recreational ecstasy use on the serotonin system of the brain. However, it cannot be excluded that observed differences between users and non-users are the cause rather than the consequence of ecstasy use. As part of the Netherlands XTC Toxicity (NeXT) study, we prospectively assessed sustained…

  2. A 10-Year Prospective Study of Prodromal Patterns for Bipolar Disorder among Amish Youth

    ERIC Educational Resources Information Center

    Shaw, Jon A.; Egeland, Janice A.; Endicott, Jean; Allen, Cleona R.; Hostetter, Abram M.

    2005-01-01

    Objective: Prospective study of well children at risk of bipolarity to identify the frequency and pattern of potentially prodromal symptoms/behaviors for bipolar disorder type I (BPI) disorder. Method: A total of 110 at-risk children with a BPI parent and 112 children with well parents were studied. Ten-year data collection used structured and…

  3. Predictors of Cerebral Palsy in Very Preterm Infants: The EPIPAGE Prospective Population-Based Cohort Study

    ERIC Educational Resources Information Center

    Beaino, Ghada; Khoshnood, Babak; Kaminski, Monique; Pierrat, Veronique; Marret, Stephane; Matis, Jacqueline; Ledesert, Bernard; Thiriez, Gerard; Fresson, Jeanne; Roze, Jean-Christophe; Zupan-Simunek, Veronique; Arnaud, Catherine; Burguet, Antoine; Larroque, Beatrice; Breart, Gerard; Ancel, Pierre-Yves

    2010-01-01

    Aim: The aim of this study was to assess the independent role of cerebral lesions on ultrasound scan, and several other neonatal and obstetric factors, as potential predictors of cerebral palsy (CP) in a large population-based cohort of very preterm infants. Method: As part of EPIPAGE, a population-based prospective cohort study, perinatal data…

  4. Prediction of Participation and Sensory Modulation of Late Preterm Infants at 12 Months: A Prospective Study

    ERIC Educational Resources Information Center

    Bart, O.; Shayevits, S.; Gabis, L. V.; Morag, I.

    2011-01-01

    The aim of the study was to prospectively assess the differences in participation and sensory modulation between late preterm infants (LPI) and term babies, and to predict it by LPI characteristics. The study population includes 124 late preterm infants at gestational age between 34 and 35 6/7 weeks who were born at the same medical center. The…

  5. Involvement in Bullying and Suicide-Related Behavior at 11 Years: A Prospective Birth Cohort Study

    ERIC Educational Resources Information Center

    Winsper, Catherine; Lereya, Tanya; Zanarini, Mary; Wolke, Dieter

    2012-01-01

    Objective: To study the prospective link between involvement in bullying (bully, victim, bully/victim), and subsequent suicide ideation and suicidal/self-injurious behavior, in preadolescent children in the United Kingdom. Method: A total of 6,043 children in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort were assessed to…

  6. A Pilot Study of the Challenges and Prospects of Continuous Assessment Implementation in Nigeria

    ERIC Educational Resources Information Center

    Owolabi, Henry O.; Onuka, Adams O. U.

    2010-01-01

    This study obtained basic information from teachers and students on the challenges and prospects of implementing continuous assessment (CA) in the Nigerian school system. Secondary Schools in Ilorin, the capital city of Kwara State, located in the central region of Nigeria were sampled for use in the study. It employed survey research design…

  7. Prenatal, Perinatal, and Neonatal Risk Factors for Specific Language Impairment: A Prospective Pregnancy Cohort Study

    ERIC Educational Resources Information Center

    Whitehouse, Andrew J. O.; Shelton, W. M. R.; Ing, Caleb; Newnham, John P.

    2014-01-01

    Purpose: Although genetic factors are known to play a causal role in specific language impairment (SLI), environmental factors may also be important. This study examined whether there are prenatal, perinatal, and neonatal factors that are associated with childhood SLI. Method: Participants were members of the Raine Study, a prospective cohort…

  8. Behavior Problems and Placement Change in a National Child Welfare Sample: A Prospective Study

    ERIC Educational Resources Information Center

    Aarons, Gregory A.; James, Sigrid; Monn, Amy R.; Raghavan, Ramesh; Wells, Rebecca S.; Leslie, Laurel K.

    2010-01-01

    Objective: There is ongoing debate regarding the impact of youth behavior problems on placement change in child welfare compared to the impact of placement change on behavior problems. Existing studies provide support for both perspectives. The purpose of this study was to prospectively examine the relations of behavior problems and placement…

  9. Drug Exposure Opportunities and Use Patterns among College Students: Results of a Longitudinal Prospective Cohort Study

    ERIC Educational Resources Information Center

    Arria, Amelia M.; Caldeira, Kimberly M.; O'Grady, Kevin E.; Vincent, Kathryn B.; Fitzelle, Dawn B.; Johnson, Erin P.; Wish, Eric D.

    2008-01-01

    Underage drinking and drug use among college students are major public health concerns, yet few studies have examined these behaviors and their associated risk factors and consequences prospectively. This paper describes the sampling and recruitment methods of a longitudinal study of 1253 college students at a large, mid-Atlantic university.…

  10. Peer Victimization in Childhood and Internalizing Problems in Adolescence: A Prospective Longitudinal Study

    ERIC Educational Resources Information Center

    Zwierzynska, Karolina; Wolke, Dieter; Lereya, Tanya S.

    2013-01-01

    Traumatic childhood experiences have been found to predict later internalizing problems. This prospective longitudinal study investigated whether repeated and intentional harm doing by peers (peer victimization) in childhood predicts internalizing symptoms in early adolescence. 3,692 children from the Avon Longitudinal Study of Parents and…

  11. Recurrence Risk after a First Remote Symptomatic Unprovoked Seizure in Childhood: A Prospective Study

    ERIC Educational Resources Information Center

    Ramos-Lizana, J.; Aguirre-Rodriguez, J.; Aguilera-Lopez, P.; Cassinello-Garcia, E.

    2009-01-01

    The aim of this study was to assess recurrence risk after a first remote symptomatic unprovoked seizure in childhood. All consecutive patients younger than 14 years with a first remote symptomatic unprovoked seizure who were seen at our hospital between 1994 and 2006 were included in the study and prospectively followed. Only two patients received…

  12. Exposure to Intimate Partner Violence, Peer Relations, and Risk for Internalizing Behaviors: A Prospective Longitudinal Study

    ERIC Educational Resources Information Center

    Camacho, Kathleen; Ehrensaft, Miriam K.; Cohen, Patricia

    2012-01-01

    The present study examines the quality of peer relations as a mediator between exposure to IPV (intimate partner violence) and internalizing behaviors in a sample of 129 preadolescents and adolescents (ages 10-18), who were interviewed via telephone as part of a multigenerational, prospective, longitudinal study. Relational victimization is also…

  13. Trait Anger, Anger Expression, and Suicide Attempts among Adolescents and Young Adults: A Prospective Study

    ERIC Educational Resources Information Center

    Daniel, Stephanie S.; Goldston, David B.; Erkanli, Alaattin; Franklin, Joseph C.; Mayfield, Andrew M.

    2009-01-01

    Previous studies of the relationship between anger, anger expression, and suicidal behavior have been largely cross-sectional and have yielded mixed findings. In a prospective, naturalistic study, we examined how trait anger and anger expression influenced the likelihood of suicide attempts among 180 adolescents followed for up to 13.3 years after…

  14. A prospective study of impaired fasting glucose and type 2 diabetes in China: The Kailuan study.

    PubMed

    Vaidya, Anand; Cui, Liufu; Sun, Lixia; Lu, Bing; Chen, Shuohua; Liu, Xing; Zhou, Yong; Liu, Xiurong; Xie, Xiaobing; Hu, Frank B; Wu, Shouling; Gao, Xiang

    2016-11-01

    The worldwide prevalence and incidence of diabetes and obesity are increasing in pandemic proportions. This is particularly relevant for China, where an extremely large population is growing, aging, and urbanizing. We thus conducted a prospective study to examine the prevalence and incidence of impaired fasting glucose (IFG) and diabetes, the rate at which fasting blood glucose rises, and the major modifiable risk factors associated with these outcomes in a large Chinese population from the Kailuan prospective study.A prospective cohort included 100,279 Chinese participants, aged 18 years or more, who had available information on fasting blood glucose concentrations at the start of the study (2006). Examination surveys were conducted every 2 years in 2008 and 2010. For the analyses of incident diabetes, we included 76,869 participants who were free of diabetes, cardiovascular disease, and cancer at the baseline and participants in the 2008 and/or 2010 follow-up. Diabetes was defined by a fasting blood glucose concentration ≥7 mmol/L, self-reported history, or active treatment with insulin or any oral hypoglycemic agent. IFG was defined by a fasting blood glucose concentration between 5.6 and 6.9 mmol/L.During the 4-year study, the prevalence of diabetes and IFG rose from 6.6% to 7.7%, and 17.3% to 22.6%, respectively. There were 17,811 incident cases of IFG and 4867 incident cases of diabetes. The age-standardized incident rate of IFG and diabetes were 62.6/1000 person-years (51.2/1000 person-years in women and 73.8/1000 person-years in men) and 10.0/1000 person-years (7.8/1000 person-years in women and 12.1/1000 person-years in men), respectively. We observed steady increases in fasting blood glucose with body anthropometrics and in every defined category of body mass index, including in those traditionally considered to be well within the "normal" range.In this large longitudinal study of Chinese adults, we observed a high prevalence and incidence of IFG

  15. Defining safe criteria to diagnose miscarriage: prospective observational multicentre study

    PubMed Central

    Preisler, Jessica; Kopeika, Julia; Ismail, Laure; Vathanan, Veluppillai; Farren, Jessica; Abdallah, Yazan; Battacharjee, Parijat; Van Holsbeke, Caroline; Bottomley, Cecilia; Gould, Deborah; Johnson, Susanne; Stalder, Catriona; Van Calster, Ben; Hamilton, Judith; Timmerman, Dirk

    2015-01-01

    Objectives To validate recent guidance changes by establishing the performance of cut-off values for embryo crown-rump length and mean gestational sac diameter to diagnose miscarriage with high levels of certainty. Secondary aims were to examine the influence of gestational age on interpretation of mean gestational sac diameter and crown-rump length values, determine the optimal intervals between scans and findings on repeat scans that definitively diagnose pregnancy failure.) Design Prospective multicentre observational trial. Setting Seven hospital based early pregnancy assessment units in the United Kingdom. Participants 2845 women with intrauterine pregnancies of unknown viability included if transvaginal ultrasonography showed an intrauterine pregnancy of uncertain viability. In three hospitals this was initially defined as an empty gestational sac <20 mm mean diameter with or without a visible yolk sac but no embryo, or an embryo with crown-rump length <6 mm with no heartbeat. Following amended guidance in December 2011 this definition changed to a gestational sac size <25 mm or embryo crown-rump length <7 mm. At one unit the definition was extended throughout to include a mean gestational sac diameter <30 mm or embryo crown-rump length <8 mm. Main outcome measures Mean gestational sac diameter, crown-rump length, and presence or absence of embryo heart activity at initial and repeat transvaginal ultrasonography around 7-14 days later. The final outcome was pregnancy viability at 11-14 weeks’ gestation. Results The following indicated a miscarriage at initial scan: mean gestational sac diameter ≥25 mm with an empty sac (364/364 specificity: 100%, 95% confidence interval 99.0% to 100%), embryo with crown-rump length ≥7 mm without visible embryo heart activity (110/110 specificity: 100%, 96.7% to 100%), mean gestational sac diameter ≥18 mm for gestational sacs without an embryo presenting after 70 days’ gestation (907/907 specificity: 100%, 99.6% to

  16. Prospective studies on children with sex chromosome aneuploidy

    SciTech Connect

    Ratcliffe, S.G.; Paul, N.

    1986-01-01

    This book contains 11 selections. Some of the titles are: Growth and Development from Early to Midadolescence of Children with X and Y Chromosome Aneuploidy: The Toronto Study; Sex Chromomal Aneuploidy: Perspective and Longitudinal Studies; Psychologic Study of XYY and XXY Men; and Cellular and Molecular Studies in Human Chromosomal Diseases.

  17. Organisational justice and mental health: a systematic review of prospective studies.

    PubMed

    Ndjaboué, Ruth; Brisson, Chantal; Vézina, Michel

    2012-10-01

    The models most commonly used, to study the effects of psychosocial work factors on workers' health, are the demand-control-support (DCS) model and Effort-Reward Imbalance (ERI) model. An emerging body of research has identified Organisational Justice as another model that can help to explain deleterious health effects. This review aimed: (1) to identify prospective studies of the associations between organisational justice and mental health in industrialised countries from 1990 to 2010; (2) to evaluate the extent to which organisational justice has an effect on mental health independently of the DCS and ERI models; and (3) to discuss theoretical and empirical overlap and differences with previous models. The studies had to present associations between organisational justice and a mental health outcome, be prospective, and be entirely available in English or in French. Duplicated papers were excluded. Eleven prospective studies were selected for this review. They provide evidence that procedural justice and relational justice are associated with mental health. These associations remained significant even after controlling for the DCS and ERI models. There is a lack of prospective studies on distributive and informational justice. In conclusion, procedural and relational justice can be considered a different and complementary model to the DCS and ERI models. Future studies should evaluate the effect of change in exposure to organisational justice on employees' mental health over time.

  18. Chronic Stress is Prospectively Associated with Sleep in Midlife Women: The SWAN Sleep Study

    PubMed Central

    Hall, Martica H.; Casement, Melynda D.; Troxel, Wendy M.; Matthews, Karen A.; Bromberger, Joyce T.; Kravitz, Howard M.; Krafty, Robert T.; Buysse, Daniel J.

    2015-01-01

    Study Objectives: Evaluate whether levels of upsetting life events measured over a 9-y period prospectively predict subjective and objective sleep outcomes in midlife women. Design: Prospective cohort study. Setting: Four sites across the United States. Participants: 330 women (46–57 y of age) enrolled in the Study of Women's Health Across the Nation (SWAN) Sleep Study. Interventions: N/A. Measurements and Results: Upsetting life events were assessed annually for up to 9 y. Trajectory analysis applied to life events data quantitatively identified three distinct chronic stress groups: low stress, moderate stress, and high stress. Sleep was assessed by self-report and in-home polysomnography (PSG) during the ninth year of the study. Multivariate analyses tested the prospective association between chronic stress group and sleep, adjusting for race, baseline sleep complaints, marital status, body mass index, symptoms of depression, and acute life events at the time of the Sleep Study. Women characterized by high chronic stress had lower subjective sleep quality, were more likely to report insomnia, and exhibited increased PSG-assessed wake after sleep onset (WASO) relative to women with low to moderate chronic stress profiles. The effect of chronic stress group on WASO persisted in the subsample of participants without baseline sleep complaints. Conclusions: Chronic stress is prospectively associated with sleep disturbance in midlife women, even after adjusting for acute stressors at the time of the sleep study and other factors known to disrupt sleep. These results are consistent with current models of stress that emphasize the cumulative effect of stressors on health over time. Citation: Hall MH, Casement MD, Troxel WM, Matthews KA, Bromberger JT, Kravitz HM, Krafty RT, Buysse DJ. Chronic stress is prospectively associated with sleep in midlife women: the SWAN Sleep Study. SLEEP 2015;38(10):1645–1654. PMID:26039965

  19. The Short-Term Impact of Involuntary Migration in China's Three Gorges: A Prospective Study

    ERIC Educational Resources Information Center

    Hwang, Sean-Shong; Cao, Yue; Xi, Juan

    2011-01-01

    The aim of this study is to measure the short-term impact of involuntary migration resulting from China's Three Gorges Dam project on the 1.3 million persons being displaced. We focus on the social, economic, and mental and physical health impact using three sets of indicators. Using a prospective research design, we gathered information about…

  20. A Study of Prospective Turkish Science Teachers' Knowledge at the Popular Biotechnological Issues

    ERIC Educational Resources Information Center

    Darcin, Emine Selcen; Turkmen, Lutfullah

    2006-01-01

    The purpose of this study was to determine the knowledge level of popular biotechnological issues of prospective Turkish science teachers. A questionnaire was administered during 2005-2006 academic year to 194 students in the Department of Science Education of a university in Turkey. The questionnaire covered six biotechnological issues such as…

  1. Predicting Dyslexia in a Transparent Orthography from Grade 1 Literacy Skills: A Prospective Cohort Study

    ERIC Educational Resources Information Center

    Bigozzi, Lucia; Tarchi, Christian; Pinto, Giuliana; Accorti Gamannossi, Beatrice

    2016-01-01

    We conducted this prospective cohort study to explore the predictability of dyslexia from 1st-grade literacy skills in Italian students. We followed 407 Italian students in primary school from the 1st through the 3rd grades. Students were diagnosed with dyslexia in the 3rd grade. We retrospectively tested participants' 1st-grade performance in…

  2. What They Notice in Video: A Study of Prospective Secondary Mathematics Teachers Learning to Teach

    ERIC Educational Resources Information Center

    Roller, Sarah A.

    2016-01-01

    Most teacher preparation programs have embraced the use of video as an effective methodology for developing teachers' noticing skills. This study focused on learning about what secondary mathematics prospective teachers (PSTs) were able to notice when viewing video of their own co-teaching, particularly in a microteaching setting that consisted of…

  3. Predicting Changes in Eating Disorder Symptoms among Adolescents in China: An 18-Month Prospective Study

    ERIC Educational Resources Information Center

    Jackson, Todd; Chen, Hong

    2008-01-01

    This 18-month prospective study investigated factors that contributed to changes in eating disorder symptoms among adolescents living in the People's Republic of China. Five hundred forty-one Chinese middle school and high school students (182 boys, 359 girls) completed measures of eating disorder symptoms; body dissatisfaction; appearance ideal…

  4. How Can Perceived Autonomy Support Influence Enrollment in Elective Physical Education? A Prospective Study

    ERIC Educational Resources Information Center

    Shen, Bo

    2010-01-01

    This prospective study was designed to investigate the influence of high students' perceived teacher autonomy support in mandatory physical education on their intention and actual enrollment in elective physical education. Participants included 545 ninth-grade students enrolled in three suburban high schools in a major midwestern metropolitan…

  5. A prospective study of marine phytoplankton and reported illness among recreational beachgoers in Puerto Rico, 2009

    EPA Science Inventory

    BACKGROUND: Blooms of marine phytoplankton may adversely affect human health. The potential public health impact of low-level exposures is not well established, and few prospective cohort studies of recreational exposures to marine phytoplankton have been conducted.OBJECTIVE: We ...

  6. A Case Study of Two Groups of Elementary Prospective Teachers' Experiences in Distinct Mathematics Content Courses

    ERIC Educational Resources Information Center

    Auslander, Susan Swars; Smith, Stephanie Z.; Smith, Marvin E.; Hart, Lynn C.; Carothers, Jody

    2016-01-01

    This multiple case study examined two groups of elementary prospective teachers (n=12) completing distinct mathematics content courses. Data were collected via two belief surveys, one content knowledge assessment, and individual interviews. The findings revealed differences in specialized content knowledge and mathematical beliefs between the two…

  7. Prospective Elementary Teachers' Division of Fractions Understanding: A Mixed Methods Study

    ERIC Educational Resources Information Center

    Redmond, Adrienne

    2009-01-01

    This sequential explanatory mixed methods study explored 34 prospective elementary teachers understanding of division of fractions at the beginning and end of their final mathematics methods course. Participants' beliefs on the teaching and learning of division with fractions were also explored. At the beginning of the course, the participants had…

  8. Does Attention Constrain Developmental Trajectories in Fragile X Syndrome? A 3-Year Prospective Longitudinal Study

    ERIC Educational Resources Information Center

    Cornish, Kim; Cole, Victoria; Longhi, Elena; Karmiloff-Smith, Annette; Scerif, Gaia

    2012-01-01

    Basic attentional processes and their impact on developmental trajectories in fragile X syndrome were assessed in a 3-year prospective study. Although fragile X syndrome is a monogenic X-linked disorder, there is striking variability in outcomes even in young boys with the condition. Attention is a key factor constraining interactions with the…

  9. Psychological and Behavioral Risk Factors for Obesity Onset in Adolescent Girls: A Prospective Study

    ERIC Educational Resources Information Center

    Stice, Eric; Presnell, Katherine; Shaw, Heather; Rohde, Paul

    2005-01-01

    Because little is known about risk factors for obesity, the authors tested whether certain psychological and behavioral variables predicted future onset of obesity. The authors used data from a prospective study of 496 adolescent girls who completed a baseline assessment at age 11-15 years and 4 annual follow-ups. Self-reported dietary restraint,…

  10. The Interpersonal Antecedents of Supportive Parenting: A Prospective, Longitudinal Study from Infancy to Adulthood

    ERIC Educational Resources Information Center

    Raby, K. Lee; Lawler, Jamie M.; Shlafer, Rebecca J.; Hesemeyer, Paloma S.; Collins, W. Andrew; Sroufe, L. Alan

    2015-01-01

    This study drew on prospective, longitudinal data to test the hypothesis that the intergenerational transmission of positive parenting is mediated by competence in subsequent relationships with peers and romantic partners. Interview-based ratings of supportive parenting were completed with a sample of 113 individuals (46% male) followed from birth…

  11. A Prospective Cohort Study Comparing Workload in Children with and without Developmental Coordination Disorder

    ERIC Educational Resources Information Center

    Rivilis, Irina; Liu, Jian; Cairney, John; Hay, John A.; Klentrou, Panagiota; Faught, Brent E.

    2012-01-01

    The purpose of this prospective cohort study was to assess how cardiorespiratory fitness (CRF) of children with probable developmental coordination disorder (DCD) changes over a period of 4.7 years relative to a group of typically developing controls. A school-based sample of children in a large region of Ontario, Canada with 75 out of a possible…

  12. Do Specific Types of Networking Predict Specific Mobility Outcomes? A Two-Year Prospective Study

    ERIC Educational Resources Information Center

    Wolff, Hans-Georg; Moser, Klaus

    2010-01-01

    Previous research has established a general relation between networking and career outcomes, as postulated by theories on protean careers and career self management. We suggest that specific facets of networking behavior differentially affect specific career mobility outcomes over time. In a 2-year prospective study, we examined the impact of six…

  13. Clinical Observed Performance Evaluation: A Prospective Study in Final Year Students of Surgery

    ERIC Educational Resources Information Center

    Markey, G. C.; Browne, K.; Hunter, K.; Hill, A. D.

    2011-01-01

    We report a prospective study of clinical observed performance evaluation (COPE) for 197 medical students in the pre-qualification year of clinical education. Psychometric quality was the main endpoint. Students were assessed in groups of 5 in 40-min patient encounters, with each student the focus of evaluation for 8 min. Each student had a series…

  14. Father Locus of Control and Child Emotional and Behavioral Outcomes: A Prospective Study

    ERIC Educational Resources Information Center

    Tone, Erin B.; Goodfellow, Stephanie; Nowicki, Stephen, Jr.

    2012-01-01

    In a prospective longitudinal study the authors examined the associations between parent locus of control of reinforcement (LOCR), measured before the birth of a child, and behavioral-emotional outcomes in that child at age 7 years. A total of 307 couples completed questionnaires regarding their emotional status and LOCR at their first prenatal…

  15. A One Year Prospective Study of Neurogenic Stuttering Following Stroke: Incidence and Co-Occurring Disorders

    ERIC Educational Resources Information Center

    Theys, C.; van Wieringen, A.; Sunaert, S.; Thijs, V.; De Nil, L. F.

    2011-01-01

    In this prospective study, data on incidence, stuttering characteristics, co-occurring speech disorders, and recovery of neurogenic stuttering in a large sample of stroke participants were assessed. Following stroke onset, 17 of 319 participants (5.3%; 95% CI, 3.2-8.3) met the criteria for neurogenic stuttering. Stuttering persisted in at least…

  16. Prospective Predictors of Body Dissatisfaction in Adolescent Girls and Boys: A Five-Year Longitudinal Study

    ERIC Educational Resources Information Center

    Paxton, Susan J.; Eisenberg, Marla E.; Neumark-Sztainer, Dianne

    2006-01-01

    This study investigated prospective risk factors for increases in body dissatisfaction in adolescent girls and boys in the Eating Among Teens Project. At the time of first assessment (Time 1), participants were a cohort of early adolescent girls (N = 440) and boys (N = 366) and a cohort of middle adolescent girls (N = 946) and boys (N = 764).…

  17. A Prospective Study of Mexican American Adolescents' Academic Success: Considering Family and Individual Factors

    ERIC Educational Resources Information Center

    Roosa, Mark W.; O'Donnell, Megan; Cham, Heining; Gonzales, Nancy A.; Zeiders, Katherine H.; Tein, Jenn-Yun; Knight, George P.; Umana-Taylor, Adriana

    2012-01-01

    Mexican American youth are at greater risk of school failure than their peers. To identify factors that may contribute to academic success in this population, this study examined the prospective relationships from 5th grade to 7th grade of family (i.e., human capital [a parent with at least a high school education], residential stability,…

  18. How Can We Get the Information about Democracy? The Example of Social Studies Prospective Teachers

    ERIC Educational Resources Information Center

    Tonga, Deniz

    2014-01-01

    In this research, the information about democracy, which social studies prospective teachers have, and interpretation of the information sources are aimed. The research was planned as a survey research methodology and the participants were determined with criterion sampling method. The data were collected through developed open-ended questions…

  19. Beliefs of Applied Studio Faculty on Desirable Traits of Prospective Music Education Majors: A Pilot Study

    ERIC Educational Resources Information Center

    Royston, Natalie Steele; Springer, D. Gregory

    2015-01-01

    The purpose of this pilot study was to examine the beliefs of applied music faculty on desirable traits of prospective music education majors. Researcher-designed surveys were sent electronically to applied music faculty at 12 National Association of Schools of Music-accredited institutions randomly selected from each of the four major divisions…

  20. The Effects of Divorce and Parental Conflict on Children's Adjustment: A Prospective Study.

    ERIC Educational Resources Information Center

    Shaw, Daniel

    Replicating the methodology used by Block, Block, and Gjerde (1986), a prospective, longitudinal examination was made of relations between divorce and children's adjustment. Data from the New York Longitudinal Study (NYLS), originally collected by Thomas, Chess, and Birch (1963, 1968, 1977, 1983, 1984) was analyzed. The NYLS assessed children's…

  1. Predictors and Health-Related Outcomes of Positive Body Image in Adolescent Girls: A Prospective Study

    ERIC Educational Resources Information Center

    Andrew, Rachel; Tiggemann, Marika; Clark, Levina

    2016-01-01

    This study aimed to investigate prospective predictors and health-related outcomes of positive body image in adolescent girls. In so doing, the modified acceptance model of intuitive eating was also examined longitudinally. A sample of 298 girls aged 12 to 16 years completed a questionnaire containing measures of body appreciation, potential…

  2. Sociocultural and Individual Psychological Predictors of Body Image in Young Girls: A Prospective Study

    ERIC Educational Resources Information Center

    Clark, Levina; Tiggemann, Marika

    2008-01-01

    This study investigated the prospective predictors of body image in 9- to 12-year-old girls. Participants were 150 girls in Grades 4-6 with a mean age of 10.3 years. Girls completed questionnaire measures of media and peer influences (television/magazine exposure, peer appearance conversations), individual psychological variables (appearance…

  3. The "Prospects" Study of Educational Growth and Opportunity: Implications for Policy and Practice.

    ERIC Educational Resources Information Center

    Puma, Michael J.

    This paper examines results from the Prospects study--a research agenda that explored the federal Title I program's impact on the academic and socio-emotional development of disadvantaged children. The document focuses on the program's strengths and limitations, offering a brief review of educational research and highlighting what may or may not…

  4. Cognitive Coping Strategies and Stress in Parents of Children with Down Syndrome: A Prospective Study

    ERIC Educational Resources Information Center

    van der Veek, Shelley M. C.; Kraaij, Vivian; Garnefski, Nadia

    2009-01-01

    The purpose of this study was to explore the cross-sectional and prospective relationships between cognitive coping strategies and parental stress in parents of children with Down syndrome. A total of 621 participants filled out questionnaires, including the Cognitive Emotion Regulation Questionnaire to measure cognitive coping and the Nijmeegse…

  5. Prediction of Women's Utilization of Resistance Strategies in a Sexual Assault Situation: A Prospective Study

    ERIC Educational Resources Information Center

    Gidycz, Christine A.; Van Wynsberghe, Amy; Edwards, Katie M.

    2008-01-01

    The present study prospectively explored the predictors of resistance strategies to a sexual assault situation. Participants were assessed at the beginning of an academic quarter on a number of variables, including past history of sexual victimization, perceived risk of sexual victimization, and intentions to use specific types of resistance…

  6. Keeping Friends Safe: A Prospective Study Examining Early Adolescent's Confidence and Support Networks

    ERIC Educational Resources Information Center

    Buckley, L.; Chapman, R. L.; Sheehan, M.; Cunningham, L.

    2012-01-01

    There is a continued need to consider ways to prevent early adolescent engagement in a variety of harmful risk-taking behaviours for example, violence, road-related risks and alcohol use. The current prospective study examined adolescents' reports of intervening to try and stop friends' engagement in such behaviours among 207 early adolescents…

  7. A Prospective Study on Changes of Cognitions, Interpersonal Influences, and Physical Activity in Taiwanese Youth

    ERIC Educational Resources Information Center

    Wu, Tsu-Yin; Jwo, Jun-Ling

    2005-01-01

    The decline of physical activity during adolescence is not well understood. This prospective study followed 969 Taiwanese students from eighth to ninth grade and examined their physical activity-related cognitions, interpersonal influences, and behavior of physical activity across the grade transition. Gender differences were found in the effects…

  8. Risk and Protective Factors Predictive of Adolescent Pregnancy: A Longitudinal, Prospective Study

    ERIC Educational Resources Information Center

    East, Patricia L.; Khoo, Siek Toon; Reyes, Barbara T.

    2006-01-01

    One hundred twenty-eight Latina and African American girls from high-risk environments (e.g., poverty, family history of teen parenting, etc.) were studied from age 13 through age 19 to prospectively identify the protective factors that might guard against teenage pregnancy. Results indicated that involved and strict parenting during early…

  9. A Case Study: Employment Prospects for Female Technology Graduates.

    ERIC Educational Resources Information Center

    Frey, Dewayne L.

    1978-01-01

    Findings from a three-year study to determine the ratio of male and female graduates employed in industrial-related jobs after completing industrial technology programs at Black Hawk College, Moline, Illinois, show no significant difference in the employability rate. Several factors may limit the study validity. (MF)

  10. Estrogen Metabolism and Prostate Cancer Risk: A Prospective Study

    DTIC Science & Technology

    2006-05-01

    Trained interviewers collected extensive data on demographics and other study variables during in person interviews. Waist circumference was...controls, prostate cancer cases were more likely to be slightly younger, to have higher values of waist circumference and BMI and to be Afro...control comparison showed significant differences exclusively for waist circumference , which did not represent outcome variables in the present study

  11. Procedures for assessing psychological predictors of injuries in circus artists: a pilot prospective study

    PubMed Central

    2014-01-01

    Background Research on psychological risk factors for injury has focused on stable traits. Our objective was to test the feasibility of a prospective longitudinal study designed to examine labile psychological states as risk factors of injury. Methods We measured psychological traits at baseline (mood, ways of coping and anxiety), and psychological states every day (1-item questions on anxiety, sleep, fatigue, soreness, self-confidence) before performances in Cirque du Soleil artists of the show “O”. Additional questions were added once per week to better assess anxiety (20-item) and mood. Questionnaires were provided in English, French, Russian and Japanese. Injury and exposure data were extracted from electronic records that are kept as part of routine business practices. Results The 43.9% (36/82) recruitment rate was more than expected. Most artists completed the baseline questionnaires in 15 min, a weekly questionnaire in <2 min and a daily questionnaire in <1 min. We improved the formatting of some questions during the study, and adapted the wording of other questions to improve clarity. There were no dropouts during the entire study, suggesting the questionnaires were appropriate in content and length. Results for sample size calculations depend on the number of artists followed and the minimal important difference in injury rates, but in general, preclude a purely prospective study with daily data collection because of the long follow-up required. However, a prospective nested case-crossover design with data collection bi-weekly and at the time of injury appears feasible. Conclusion A prospective study collecting psychological state data from subjects who train and work regularly together is feasible, but sample size calculations suggest that the optimal study design would use prospective nested case-crossover methodology. PMID:24920527

  12. Quasi-Prospective Study of Breast Cancer and Diet

    DTIC Science & Technology

    2001-08-01

    This study aims to refine estimates of the effect of diet on breast cancer. Besides diet we will measure adult weight history and physical activity ...through the clinical systems is on-going. Study results will increase our understanding of the effects of diet, adult weight gain, and physical activity on...fruits, vegetables, and grains that may be protective. High weight gain and physical inactivity, both potentially related to increased risk, also will

  13. [Plant hydroponics and its application prospect in medicinal plants study].

    PubMed

    Zeng, Yan; Guo, Lan-Ping; Huang, Lu-Qi; Sun, Yu-Zhang

    2007-03-01

    This article introduced the theorem and method of hydroponics. Some examples of studies in agriculture and forestry were presented, the effects of elements, environmental stress and hormones on physiology of medicinal plants by using hydroponics were analyzed. It also introduced the feasibility and advantage of hydroponics in intermediate propagation and allelopathy of medicinal plant. And finally it made the conclusion that the way of hydroponics would be widely used in medicinal plant study.

  14. Mortality in Autism: A Prospective Longitudinal Community-Based Study

    ERIC Educational Resources Information Center

    Gillberg, Christopher; Billstedt, Eva; Sundh, Valter; Gillberg, I. Carina

    2010-01-01

    The purposes of the present study were to establish the mortality rate in a representative group of individuals (n = 120) born in the years 1962-1984, diagnosed with autism/atypical autism in childhood and followed up at young adult age (greater than or equal to 18 years of age), and examine the risk factors and causes of death. The study group,…

  15. An Ecological Approach to Prospective and Retrospective Timing of Long Durations: A Study Involving Gamers

    PubMed Central

    Tobin, Simon; Bisson, Nicolas; Grondin, Simon

    2010-01-01

    To date, most studies comparing prospective and retrospective timing have failed to use long durations and tasks with a certain degree of ecological validity. The present study assessed the effect of the timing paradigm on playing video games in a “naturalistic environment” (gaming centers). In addition, as it involved gamers, it provided an opportunity to examine the effect of gaming profile on time estimation. A total of 116 participants were asked to estimate prospectively or retrospectively a video game session lasting 12, 35 or 58 minutes. The results indicate that time is perceived as longer in the prospective paradigm than in the retrospective one, although the variability of estimates is the same. Moreover, the 12-minute session was perceived as longer, proportionally, than the 35- and 58-minute sessions. The study also revealed that the number of hours participants spent playing video games per week was a significant predictor of time estimates. To account for the main findings, the differences between prospective and retrospective timing are discussed in quantitative terms using a proposed theoretical framework, which states that both paradigms use the same cognitive processes, but in different proportions. Finally, the hypothesis that gamers play more because they underestimate time is also discussed. PMID:20174648

  16. Melissa officinalis L: A Review Study With an Antioxidant Prospective.

    PubMed

    Miraj, Sepide; Rafieian-Kopaei; Kiani, Sara

    2016-09-11

    Melissa officinalis is a plant cultivated in some parts of Iran. The leaves of lemon balm, Melissa officinalis L (Lamiaceae), are used in Iranian folk medicine for their digestive, carminative, antispasmodic, sedative, analgesic, tonic, and diuretic properties, as well as for functional gastrointestinal disorders. This review article was aimed not only to introduce Melissa officinalis (its growth condition, its chemical compounds, and its traditional usages) but also to overview its antioxidant properties in detail. This review was carried out by searching studies in PubMed, Medline, Web of Science, and IranMedex databases up to 2016. The search terms used were "Melissa officinalis L," "antioxidant properties," oxidative stress," "oxidative damage", "ROS." Articles whose full texts were not available were excluded from the study. In this study, firstly, traditional usage of this herb was reviewed, including antimicrobial activity (antiparasitic, antibacterial, antiviral, etc), antispasmodic, and insomnia properties. Then, its antioxidant properties were overviewed. Various studies have shown that Melissa officinalis L possesses high amount of antioxidant activity through its chemical compounds including high amount of flavonoids, rosmaric acid, gallic acid, phenolic contents. Many studies confirmed the antioxidative effects of Melissa officinalis; thus, its effect in preventing and treating oxidative stress-related diseases might be reliable.

  17. Prospects for the study of evolution in the deep biosphere.

    PubMed

    Biddle, Jennifer F; Sylvan, Jason B; Brazelton, William J; Tully, Benjamin J; Edwards, Katrina J; Moyer, Craig L; Heidelberg, John F; Nelson, William C

    2011-01-01

    Since the days of Darwin, scientists have used the framework of the theory of evolution to explore the interconnectedness of life on Earth and adaptation of organisms to the ever-changing environment. The advent of molecular biology has advanced and accelerated the study of evolution by allowing direct examination of the genetic material that ultimately determines the phenotypes upon which selection acts. The study of evolution has been furthered through examination of microbial evolution, with large population numbers, short generation times, and easily extractable DNA. Such work has spawned the study of microbial biogeography, with the realization that concepts developed in population genetics may be applicable to microbial genomes (Martiny et al., 2006; Manhes and Velicer, 2011). Microbial biogeography and adaptation has been examined in many different environments. Here we argue that the deep biosphere is a unique environment for the study of evolution and list specific factors that can be considered and where the studies may be performed. This publication is the result of the NSF-funded Center for Dark Energy Biosphere Investigations (C-DEBI) theme team on Evolution (www.darkenergybiosphere.org).

  18. Prospects for the Study of Evolution in the Deep Biosphere

    PubMed Central

    Biddle, Jennifer F.; Sylvan, Jason B.; Brazelton, William J.; Tully, Benjamin J.; Edwards, Katrina J.; Moyer, Craig L.; Heidelberg, John F.; Nelson, William C.

    2012-01-01

    Since the days of Darwin, scientists have used the framework of the theory of evolution to explore the interconnectedness of life on Earth and adaptation of organisms to the ever-changing environment. The advent of molecular biology has advanced and accelerated the study of evolution by allowing direct examination of the genetic material that ultimately determines the phenotypes upon which selection acts. The study of evolution has been furthered through examination of microbial evolution, with large population numbers, short generation times, and easily extractable DNA. Such work has spawned the study of microbial biogeography, with the realization that concepts developed in population genetics may be applicable to microbial genomes (Martiny et al., 2006; Manhes and Velicer, 2011). Microbial biogeography and adaptation has been examined in many different environments. Here we argue that the deep biosphere is a unique environment for the study of evolution and list specific factors that can be considered and where the studies may be performed. This publication is the result of the NSF-funded Center for Dark Energy Biosphere Investigations (C-DEBI) theme team on Evolution (www.darkenergybiosphere.org). PMID:22319515

  19. Prospects for HERMES-spin structure studies at HERA

    SciTech Connect

    Jackson, H.E.

    1994-12-31

    HERMES (HERA Measurement of Spin), is a second generation experiment to study the spin structure of the nucleon by using polarized internal gas targets in the HERA 35-GeV electron storage ring. Scattered electrons and coincident hadrons will be detected in an open geometry spectrometer which will include particle identification. Measurements are planned for each of the inclusive structure functions, g{sub 1},(x), g{sub 2}(x), b{sub 1}(x) and A(x), as well as the study of semi-inclusive pion and kaon asymmetries. Targets of hydrogen, deuterium and {sup 3}He will be studied. The accuracy of data for the inclusive structure functions will equal or exceed that of current experiments. The semi-inclusive asymmetries will provide a unique and sensitive probe of the flavor dependence of quark helicity distributions and properties of the quark sea. Monte Carlo simulations of HERMES data for experiment asymmetries and polarized structure functions are discussed.

  20. Do affective attitudes predict organ donor registration? A prospective study.

    PubMed

    Shepherd, Lee; O'Carroll, Ronan E

    2014-10-01

    This study assessed whether people's affective attitudes predicted organ donor registration at a later time. People who were not registered as an organ donor prior to completing the study (N = 150) first rated their affective attitudes towards organ donation. We then measured whether they clicked on a hyperlink to register as an organ donor. Believing that the body should be kept whole for burial (bodily integrity) was the only affective attitude to predict this organ donation behaviour. Future campaigns should target this concern in order to increase organ donor registration and the availability of donor organs.

  1. Shyness Predicts Depressive Symptoms among Adolescents : A Prospective Study

    ERIC Educational Resources Information Center

    Murberg, Terje A.

    2009-01-01

    This study examines the relation between shyness, social support and depressive symptoms in a sample of 259 students (aged 14-16 years) in two secondary schools. Results at both time-points showed positive associations of depressive symptoms with shyness and with being female and negative associations of depressive symptoms with social support and…

  2. Attempts to Prevent Falls and Injury: A Prospective Community Study.

    ERIC Educational Resources Information Center

    Reinsch, Sibylle; And Others

    1992-01-01

    At 16 senior centers, studied effectiveness of exercise and cognitive-behavioral programs, compared to discussion control program, in reducing falls and injuries among 230 older adults. After one year of programs, observed no significant difference in time to first fall among groups. Secondary outcome measures such as strength, balance, fear of…

  3. Preschool Predictors of Childhood Anxiety Disorders: A Prospective Community Study

    ERIC Educational Resources Information Center

    Wichstrøm, Lars; Belsky, Jay; Berg-Nielsen, Turid Suzanne

    2013-01-01

    Background: Anxiety disorders are often present at preschool age. Research on older children and studies contrasting preschoolers with high versus low behavioral inhibition (BI) highlight several risk factors, but these have not been investigated in community samples of young children. Child, parent, and peer factors at age 4 were therefore…

  4. Type A Behavior, Life Change, and Illness: A Prospective Study.

    ERIC Educational Resources Information Center

    Rhodewalt, Frederick; And Others

    The Type A disease association may be obscured by the failure of epidemiological studies to take into account the person by situation nature of the Type A construct. Past research suggests that it is not coping with demand that is stressful for Type As, but rather the perception that the job or life event is less than completely controllable that…

  5. Baseline Factors Predictive of SLT Response: A Prospective Study.

    PubMed

    Bruen, Robin; Lesk, Mark R; Harasymowycz, Paul

    2012-01-01

    Purpose. To study the response to Selective Laser Trabeculoplasty (SLT) according to baseline medical treatment, angle pigmentation, age, diagnosis (open-angle glaucoma or ocular hypertension), and baseline intraocular pressure (IOP). Methods. 74 eyes of 74 patients were enrolled in this study. Baseline characteristics were recorded for each patient. IOP in the treated and fellow eyes was measured at baseline, and 1 month, 6 months, and 12 months following SLT. IOP changes in the different groups were compared using two-way ANOVA and Pearson's correlation. Results. The mean age of our cohort was 71 ± 10 years. The mean baseline IOP was 21.5 ± 5 mmHg, and the mean change in IOP from baseline in the treated eye at one year was -4.67 ± 3.40 mmHg. Higher baseline IOP was highly correlated with greater absolute IOP decrease. Prostaglandin analogue use at baseline was shown to be associated with a statistically decreased IOP-lowering response following SLT when corrected for baseline IOP. No significant differences in IOP response were found when comparing groups stratified for age, angle pigmentation, phakic status, gender, or diagnosis. Discussion. The results of this study confirm the finding that higher baseline IOP is a predictor of greater IOP response following SLT, and that pretreatment with prostaglandin analogue therapy is associated with a decreased IOP-lowering response following SLT. The study is limited by the small number of eyes with data available for complete case analysis.

  6. Living with diabetes: rationale, study design and baseline characteristics for an Australian prospective cohort study

    PubMed Central

    2012-01-01

    Background Diabetes mellitus is a major global public health threat. In Australia, as elsewhere, it is responsible for a sizeable portion of the overall burden of disease, and significant costs. The psychological and social impact of diabetes on individuals with the disease can be severe, and if not adequately addressed, can lead to the worsening of the overall disease picture. The Living With Diabetes Study aims to contribute to a holistic understanding of the psychological and social aspects of diabetes mellitus. Methods/Design The Living With Diabetes Study is a 5-year prospective cohort study, based in Queensland, Australia. The first wave of data, which was collected via a mailed self-report survey, was gathered in 2008, with annual collections thereafter. Measurements include: demographic, lifestyle, health and disease characteristics; quality of life (EQ-5D, ADDQoL); emotional well-being (CES-D, LOT-R, ESSI); disease self-management (PAM); and health-care utilisation and patient-assessed quality of care (PACIC). 29% of the 14,439 adults who were invited to participate in the study agreed to do so, yielding a sample size of 3,951 people. Discussion The data collected by the Living With Diabetes Study provides a good representation of Australians with diabetes to follow over time in order to better understand the natural course of the illness. The study has potential to further illuminate, and give a comprehensive picture of the psychosocial implications of living with diabetes. Data collection is ongoing. PMID:22216947

  7. Hypokalaemic Periodic Paralysis– A Prospective Study of the Underlying Etiologies

    PubMed Central

    Jandhyala, Surya Narayana; Belle, Jayaprakash; Rau, N.R; Shetty, Ranjan

    2015-01-01

    Background Hypokalaemic periodic paralysis (HPP) is a rare muscular disorder characterised by episodic weakness associated with hypokalaemia. The disease can either be inherited or acquired and misdiagnosis of the disease is quite common. Most of the data available on the disease is from the western world. Studies reporting aetiological, clinical and metabolic profiles of Indian population are sparse. Hence we tried to provide insights of the disease among the Indian population. Aim To study the aetiological, clinical and metabolic profile of patients diagnosed with Hypokalaemic Periodic Paralysis (HPP). Materials and Methods This is an observational and analytical study on HPP diagnosed patients, during September 2011 to September 2014 in Kasturba Hospital, Manipal. A total of 23 patients were studied. Detailed history, clinical evaluation and metabolic workup for secondary causes of HPP were analysed. Results Of the 23 patients, 57% had primary HPP while 43% had secondary HPP. The group of patients with primary HPP comprised of 92% males and 8% females with mean age of 28 years and the mean duration of symptoms of 18 hours. The group with secondary HPP comprised of 70% males and 30% females with mean age of 38.7 years and the mean duration of symptoms of 60 hours. The secondary causes of HPP were thyrotoxicosis (50%), infective diarrhea (20%), Crohn’s disease (10%), renal tubular acidosis (RTA) Type I (10%) and Conn’s syndrome (10%). Conclusion In our study primary HPP was found to be more common than secondary HPP. Males were predominantly affected in both groups. HPP should be ruled out before starting therapy for Guillain-Barré Syndrome (GBS). PMID:26500936

  8. A Study on Prospective Science Teachers' Knowledge and Achievement Levels in Mathematical Logic in Electricity-Related Subjects

    ERIC Educational Resources Information Center

    Yilmaz, Ismail

    2012-01-01

    The purpose of this case study is to reveal prospective science teachers' knowledge and achievement levels in electricity-related subjects. The data for the study were collected from 44 prospective teachers using three measurement tools. The data were then analyzed using software developed for the Probability and Possibility Calculation Statistics…

  9. A Study on Prospective Teachers' Self-Efficacy Beliefs Regarding the Implementation of Constructivist Approach (A Case of Konya)

    ERIC Educational Resources Information Center

    Ektem, Isil Sönmez

    2016-01-01

    The purpose of this study was to reveal prospective teachers' perceptions and views about the implementation of the constructivist approach. The study was conducted on 528 prospective teachers in their 4th year at Necmettin Erbakan University Ahmet Kelesoglu Education Faculty and Selcuk University Faculty of Science and Faculty of Letters in the…

  10. 75 FR 72816 - Public Input for the Study Regarding the Oversight of Existing and Prospective Carbon Markets

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-26

    ... COMMISSION Public Input for the Study Regarding the Oversight of Existing and Prospective Carbon Markets... Commission (the ``CFTC''), to conduct a study on the oversight of existing and prospective carbon markets to ensure an efficient, secure, and transparent carbon market, including oversight of spot markets...

  11. The Prospective and Retrospective Memory Questionnaire: a population-based random sampling study.

    PubMed

    Piauilino, D C; Bueno, O F A; Tufik, S; Bittencourt, L R; Santos-Silva, R; Hachul, H; Gorenstein, C; Pompéia, S

    2010-05-01

    The Prospective and Retrospective Memory Questionnaire (PRMQ) has been shown to have acceptable reliability and factorial, predictive, and concurrent validity. However, the PRMQ has never been administered to a probability sample survey representative of all ages in adulthood, nor have previous studies controlled for factors that are known to influence metamemory, such as affective status. Here, the PRMQ was applied in a survey adopting a probabilistic three-stage cluster sample representative of the population of Sao Paulo, Brazil, according to gender, age (20-80 years), and economic status (n=1042). After excluding participants who had conditions that impair memory (depression, anxiety, used psychotropics, and/or had neurological/psychiatric disorders), in the remaining 664 individuals we (a) used confirmatory factor analyses to test competing models of the latent structure of the PRMQ, and (b) studied effects of gender, age, schooling, and economic status on prospective and retrospective memory complaints. The model with the best fit confirmed the same tripartite structure (general memory factor and two orthogonal prospective and retrospective memory factors) previously reported. Women complained more of general memory slips, especially those in the first 5 years after menopause, and there were more complaints of prospective than retrospective memory, except in participants with lower family income.

  12. Mineral resources of the Prospect Mountain Wilderness Study Area, Carbon County, Wyoming

    SciTech Connect

    du Bray, E.A.; Bankey, V.; Hill, R.H.; Ryan, G.S.

    1989-01-01

    The Prospect Mountain Wilderness Study Area is about 20 mi east-southeast of Encampment in Carbon County, Wyoming. This study area is underlain by middle Proterozoic gabbro, granite, and hornblende gneiss, which is locally cut by pegmatite dikes. There are no identified resources and no potential for undiscovered energy resources in this study area. Resource potential for all undiscovered metallic commodities and for industrial mineral is low.

  13. Studies of compact objects with Einstein - Review and prospects

    NASA Technical Reports Server (NTRS)

    Grindlay, Jonathan E.

    1990-01-01

    X-ray images and spectra of a wide range of systems containing compact objects were obtained with the Einstein X-ray Observatory. Accreting white dwarfs, neutron stars and black holes were observed in binary systems in the Galaxy, and new constraints were derived for their formation, nature and evolution. Massive black holes were studied in active galactic nuclei, and X-ray spectra (and evolution) of AGN have led to a new model for the diffuse X-ray background.

  14. A Prospective Study of Anterior Segment Ocular Parameters in Anisometropia

    PubMed Central

    Rohatgi, Jolly; Kumar, Vinod

    2017-01-01

    Purpose The aim of this study was to investigate the differences in anterior segment ocular parameters in anisometropia >1 D. Methods This study included 202 eyes of 101 subjects ranging from 10 to 40 years of age with anisometropia of 1 D or more. The subjects were divided into groups according to anisomyopia, anisoastigmatism, and anisohypermetropia. After providing informed consent, each patient underwent a detailed ophthalmological examination including cycloplegic refraction, best-corrected visual acuity, cover test, axial length (AL) measurement using A-scan ultrasound biometer, keratometry, anterior chamber depth, and central corneal thickness measurement. For each participant, the eye with greater refractive error was compared to the fellow eye via paired t-tests. Correlations between parameters were studied using the Pearson correlation coefficient. Results The average age of subjects was 21.7 ± 9.3 years. Of 101 subjects, 31 had anisomyopia; 42 had anisohypermetropia; and 28 had anisoastigmatism. A predisposition toward greater myopia in right eyes was noted in anisomyopia (24 of 31 subjects, 77%). The inter-ocular acuity difference was significant in all three groups (p < 0.01). As the degree of anisometropia increased, there was significant positive correlation in the difference in AL in myopes (r = 0.863, p < 0.01) and hypermetropes (r = 0.669, p < 0.01) and the difference in corneal curvature in anisoastigmatism (r = 0.564, p = 0.002) and hypermetropes (r = 0.376, p = 0.014). A significant positive correlation was also present between the anterior chamber depth difference and refractive difference in hypermetropes (r = 0.359, p = 0.020). Conclusions This study showed that anisomyopia is correlated only with anterior chamber differences. Anisohypermetropia is correlated with AL differences as well as corneal curvature difference and anterior chamber depth difference. The amount of anisoastigmatism correlates only with corneal curvature difference

  15. Subclinical thyroid dysfunction and cardiovascular outcomes among prospective cohort studies.

    PubMed

    Gencer, Baris; Collet, Tinh-Hai; Virgini, Vanessa; Auer, Reto; Rodondi, Nicolas

    2013-03-01

    The association between subclinical thyroid dysfunction and cardiovascular outcomes has been recently clarified with the publication of three individual participant data (IPD) analyses from the Thyroid Studies Collaboration. We identified original cohort studies with a systematic review and pooled individual data from over 70'000 participants to obtain a more precise estimate of the risks of cardiovascular outcomes associated with subclinical thyroid dysfunction. Subclinical hypothyroidism and subclinical hyperthyroidism, defined as normal thyroxine (FT4) levels with increased or decreased Thyroid-Stimulating Hormones (TSH or thyrotropin) respectively, are associated with increased risk of cardiovascular outcomes compared to euthyroid state, particularly in those with a more pronounced thyroid dysfunction. Specifically, subclinical hypothyroidism is associated with an increased risk of coronary heart disease (CHD) events, CHD mortality and heart failure (HF) events in individuals with higher TSH levels, particularly in those with TSH levels ≥10.0 mIU/L. Conversely, subclinical hyperthyroidism is associated with an increased risk of total mortality, CHD mortality, HF and atrial fibrillation, particularly in those with suppressed TSH levels <0.10 mIU/L. Pending ongoing randomized controlled trials, these observational findings allow identifying potential TSH thresholds for thyroid medication initiation based on risk of clinical outcomes, although clinical decision based solely on observational data need caution. The impact of thyroid replacement among the elderly with subclinical hypothyroidism is currently studied in a multicenter international randomized controlled trial (Thyroid Hormone Replacement for Subclinical Hypothyroidism Trial, TRUST trial).

  16. Prospective study of swimmer's itch incidence and severity.

    PubMed

    Verbrugge, Lois M; Rainey, Jeanette J; Reimink, Ronald L; Blankespoor, Harvey D

    2004-08-01

    This epidemiologic study reports incidence, severity, and risk factors of swimmer's itch (cercarial dermatitis). Daily diaries about water exposures and swimmer's itch symptoms were completed by 40 riparian households at Douglas Lake, Michigan, for July 2000. Minutes spent in the water, minutes in shallow water, location, time of day, preventive action, age, and gender were recorded for all residents and guests. Incidence of swimmer's itch was 6.8 episodes per 100 water-exposure days. Probability of an episode increased with more days of water use and at locations with onshore winds. Episode severity increased with more time in the water and at the same locations. Age and gender had no effect on incidence or severity. In sum, onset and severity of swimmer's itch are affected by how people interact with the lake, not by their demographic features. More studies of human incidence and severity are needed to convince public health agencies to address this problem at recreational lakes. Study designs that combine epidemiologic and biological data will simultaneously inform public health education and biological control programs.

  17. Prospects for Chronological Studies of Martian Rocks and Soils

    NASA Technical Reports Server (NTRS)

    Nyquist, L. E.; Shih, C-Y.; Reese, Y. D.

    2008-01-01

    Chronological information about Martian processes comes from two sources: Crater-frequency studies and laboratory studies of Martian meteorites. Each has limitations that could be overcome by studies of returned Martian rocks and soils. Chronology of Martian volcanism: The currently accepted chronology of Martian volcanic surfaces relies on crater counts for different Martian stratigraphic units [1]. However, there is a large inherent uncertainty for intermediate ages near 2 Ga ago. The effect of differing preferences for Martian cratering chronologies [1] is shown in Fig. 1. Stoeffler and Ryder [2] summarized lunar chronology, upon which Martian cratering chronology is based. Fig. 2 shows a curve fit to their data, and compares to it a corresponding lunar curve from [3]. The radiometric ages of some lunar and Martian meteorites as well as the crater-count delimiters for Martian epochs [4] also are shown for comparison to the craterfrequency curves. Scaling the Stoeffler-Ryder curve by a Mars/Moon factor of 1.55 [5] places Martian shergottite ages into the Early Amazonian to late Hesperian epochs, whereas using the lunar curve of [3] and a Mars/Moon factor 1 consigns the shergottites to the Middle-to-Late Amazonian, a less probable result. The problem is worsened if a continually decreasing cratering rate since 3 Ga ago is accepted [6]. We prefer the adjusted St ffler-Ryder curve because it gives better agreement with the meteorite ages (Fig.

  18. Weight cycling and mortality in a large prospective US study.

    PubMed

    Stevens, Victoria L; Jacobs, Eric J; Sun, Juzhong; Patel, Alpa V; McCullough, Marjorie L; Teras, Lauren R; Gapstur, Susan M

    2012-04-15

    Weight cycling has been associated with an increased risk of death in some studies, but few studies differentiated weight cycling initiated by intentional weight loss from that initiated by illness. The association of weight cycling with death was examined among 55,983 men and 66,655 women in the Cancer Prevention Study II Nutrition Cohort from 1992 to 2008. A weight cycle was defined as an intentional loss of 10 or more pounds (≥4.5 kg) followed by regain of that weight, and the lifetime number of weight cycles was reported on a questionnaire administered at enrollment in 1992. A total of 15,138 men and 10,087 women died during follow-up, which ended in 2008. Hazard ratios and 95% confidence intervals were estimated using Cox proportional hazards regression models. When the models were adjusted for age only, weight cycling was positively associated with mortality (P for trend < 0.0001). However, after adjustment for body mass index and other risk factors, low numbers of weight cycles (1-4 cycles) were associated with slightly lower mortality rates (hazard ratio (HR) = 0.93, 95% confidence interval (CI): 0.89, 0.97 in men and HR = 0.93, 95% CI: 0.89, 0.98 in women), whereas high numbers of weight cycles (≥20 cycles) were not associated with mortality (HR = 1.03, 95% CI: 0.89, 1.19 in men and HR = 0.99, 95% CI: 0.88, 1.12 in women). These results do not support an increased risk of mortality associated with weight cycling.

  19. Prospective, Controlled Study of Acyclovir Pharmacokinetics in Obese Patients.

    PubMed

    Turner, R Brigg; Cumpston, Aaron; Sweet, Michael; Briggs, Frank; Slain, Douglas; Wen, Sijin; Craig, Michael; Hamadani, Mehdi; Petros, William

    2016-01-11

    The current recommendations for intravenous (i.v.) acyclovir dosing in obese patients suggest using ideal body weight (IBW) rather than total body weight (TBW). To our knowledge, no pharmacokinetic analysis has validated this recommendation. This single-dose pharmacokinetic study was conducted in an inpatient oncology population. Enrollment was conducted by 1:1 matching of obese patients (>190% of IBW) to normal-weight patients (80 to 120% of IBW). All patients received a single dose of i.v. acyclovir, 5 mg/kg, infused over 60 min. Consistent with current recommendations, IBW was used for obese patients and TBW for normal-weight patients. Serial plasma concentrations were obtained and compared. Seven obese and seven normal-weight patients were enrolled, with mean body mass indexes of 45.0 and 22.5 kg/m(2), respectively. Systemic clearance was substantially higher in the obese than normal-weight patients (mean, 19.4 ± 5.3 versus 14.3 ± 5.4 liters/h; P = 0.047). Area under the concentration-time curve was lower in the obese patients (15.2 ± 2.9 versus 24.0 ± 9.4 mg · h/liter; P = 0.011), as was maximum concentration (5.8 ± 0.9 versus 8.2 ± 1.3 mg/liter; P = 0.031). Utilization of IBW for dose calculation of i.v. acyclovir in obese patients leads to lower systemic exposure than dosing by TBW in normal-weight patients. While not directly evaluated in this study, utilization of an adjusted body weight for dose determination appears to more closely approximate the exposure seen in normal-weight patients. (This study has been registered at ClinicalTrials.gov under registration no. NCT01714180.).

  20. [Ashy dermatosis (erithema dyschromicum perstans): prospective study of 23 patients].

    PubMed

    Navarro Jiménez, B R; Sánchez Navarro, L M

    1988-01-01

    During the period between january 1984 to july 1987 in the Hospital Unit "Presidente Juárez" ISSSTE, Oaxaca (Mexico), for the first time was given dermatology consult to 2,683 patients among them, 23 who had ashy dermatosis (Erithema dyschromicum perstans), a study was done for the present time and the future of the same, discarding it as possible cause of that nosological entity: treponemal disease, parasitic, infectious, hepatic and renal. It is commented in relation with the ashy dermatosis and lichen planus, the clinicals variants and the possible sun etiology.

  1. Guideline adaptation and implementation planning: a prospective observational study

    PubMed Central

    2013-01-01

    Background Adaptation of high-quality practice guidelines for local use has been advanced as an efficient means to improve acceptability and applicability of evidence-informed care. In a pan-Canadian study, we examined how cancer care groups adapted pre-existing guidelines to their unique context and began implementation planning. Methods Using a mixed-methods, case-study design, five cases were purposefully sampled from self-identified groups and followed as they used a structured method and resources for guideline adaptation. Cases received the ADAPTE Collaboration toolkit, facilitation, methodological and logistical support, resources and assistance as required. Documentary and primary data collection methods captured individual case experience, including monthly summaries of meeting and field notes, email/telephone correspondence, and project records. Site visits, process audits, interviews, and a final evaluation forum with all cases contributed to a comprehensive account of participant experience. Results Study cases took 12 to >24 months to complete guideline adaptation. Although participants appreciated the structure, most found the ADAPTE method complex and lacking practical aspects. They needed assistance establishing individual guideline mandate and infrastructure, articulating health questions, executing search strategies, appraising evidence, and achieving consensus. Facilitation was described as a multi-faceted process, a team effort, and an essential ingredient for guideline adaptation. While front-line care providers implicitly identified implementation issues during adaptation, they identified a need to add an explicit implementation planning component. Conclusions Guideline adaptation is a positive initial step toward evidence-informed care, but adaptation (vs. ‘de novo’ development) did not meet expectations for reducing time or resource commitments. Undertaking adaptation is as much about the process (engagement and capacity building) as it

  2. Prospects for studying penguin decays in LHCb experiments

    SciTech Connect

    Barsuk, S. Ya. Pakhlova, G. V. Belyaev, I. M.

    2006-04-15

    Investigation of loop penguin decays of beauty hadrons seems promising in testing the predictions of the Standard Model of electroweak and strong interactions and in seeking new phenomena beyond the Standard Model. The possibility of studying the radiative penguin decays B{sup 0} {sup {yields}} K*{sup 0}{gamma}, B{sup 0}{sub s} {sup {yields}} {phi}{gamma}, and B{sup 0} {sup {yields}} {omega}{gamma} and the gluonic penguin decays B{sup 0} {sup {yields}} {phi}K{sup 0}{sub S} and B{sup 0}{sub s} {sup {yields}} {phi}{phi} in LHCb experiments is discussed.

  3. Reliability of solar keratosis clinical diagnosis: A prospective study.

    PubMed

    Buinauskaite, Evelina; Makstiene, Jurgita; Buinauskiene, Jurate; Valiukeviciene, Skaidra

    2015-05-01

    Usually solar keratoses (SK) are diagnosed clinically. However other diseases may clinically present as erythematous macules, papules or patches on sun-exposed areas; therefore the histopathology remains the gold standard diagnostic tool. Our study, which assessed the efficacy of photodynamic therapy (PDT), showed that one in 20 clinically diagnosed SK lesions grade I-II identified by board-certified dermatologists were rosacea and only one in 40 were malignant lesions. These findings should be considered by clinicians who treat clinically diagnosed grade I-II SK without response to treatment or diagnose the recurrence of SK after PDT.

  4. Coffee Consumption and Risk of Gastric Cancer: A Large Updated Meta-Analysis of Prospective Studies

    PubMed Central

    Xie, Feiyue; Wang, Dan; Huang, Zhifang; Guo, Yajun

    2014-01-01

    The potential role of coffee consumption in the development of various types of cancer has been extensively investigated in epidemiologic studies. How coffee consumption may modulate risk of gastric cancer, however, remains a subject open for investigation. To better quantify this relation, we quantitatively summarized evidence from prospective studies. Eligible studies were identified on PubMed databases. The summary risk estimates were obtained using the random-effects model. Subgroup, sensitivity and dose-response analyses were conducted. The present meta-analysis included 12 prospective cohort studies. A pooled analysis of these studies suggested that coffee consumption (highest vs. lowest consumption) was not associated with risk of gastric cancer (RR = 1.12, 95% CI = 0.93–1.36). In the subgroup analysis, significant increased risk was detected in the U.S. studies (RR = 1.36, 95% CI = 1.06–1.74) and in the studies with <10 years of follow-up (RR = 1.24, 95% CI = 1.00–1.54), and the greatest increase in risk was observed in those studies without adjustment for smoking (RR = 1.48, 95% CI = 1.13–1.93). There was some evidence of publication bias (P for Egger’s test = 0.03). Cumulative evidence from prospective studies suggests that coffee consumption is not associated with risk of gastric cancer. The observed positive results may be confounded by smoking and need further investigation. PMID:25237829

  5. Coffee consumption and risk of gastric cancer: a large updated meta-analysis of prospective studies.

    PubMed

    Xie, Feiyue; Wang, Dan; Huang, Zhifang; Guo, Yajun

    2014-09-18

    The potential role of coffee consumption in the development of various types of cancer has been extensively investigated in epidemiologic studies. How coffee consumption may modulate risk of gastric cancer, however, remains a subject open for investigation. To better quantify this relation, we quantitatively summarized evidence from prospective studies. Eligible studies were identified on PubMed and Embase databases. The summary risk estimates were obtained using the random-effects model. Subgroup, sensitivity and dose-response analyses were conducted. The present meta-analysis included 12 prospective cohort studies. A pooled analysis of these studies suggested that coffee consumption (highest vs. lowest consumption) was not associated with risk of gastric cancer (RR = 1.12, 95% CI = 0.93-1.36). In the subgroup analysis, significant increased risk was detected in the U.S. studies (RR = 1.36, 95% CI = 1.06-1.74) and in the studies with <10 years of follow-up (RR = 1.24, 95% CI = 1.00-1.54), and the greatest increase in risk was observed in those studies without adjustment for smoking (RR = 1.48, 95% CI = 1.13-1.93). There was some evidence of publication bias (P for Egger's test = 0.03). Cumulative evidence from prospective studies suggests that coffee consumption is not associated with risk of gastric cancer. The observed positive results may be confounded by smoking and need further investigation.

  6. A Prospective Study of Soft Tissue Tumors Histocytopathology Correlation

    PubMed Central

    Soni, Priyanka Bhatia; Verma, Anand Kumar; Chandoke, Raj Kumar; Nigam, Jitendra Singh

    2014-01-01

    Background. Soft tissue tumors are defined as nonepithelial extraskeletal tissue of the body exclusive of the reticuloendothelial system, glia, and supporting tissue of various parenchymal organs. The absence of recognizable tissue architectural patterns in cytological preparation makes diagnosis by FNAC more difficult. Aims. To assess the utility of FNAC in diagnosing soft tissue tumors and to determine their patterns compared with with the respective histopathology results. Materials and Methods. 150 cases of soft tissue tumors were included in this study for cytologic and histologic correlation. FNAC air dried smears were stained with Giemsa stain and 95% ethanol fixed smears were stained with Papanicolaou stain. The smears were studied for cytological diagnosis and were categorized as benign, suspicious of malignancy, and malignant along with specific subtyping of the lesion. All diagnostic FNAC results were compared for diagnostic concordance using histology results as the “gold standard.” Results. The sensitivity, specificity, positive predictive value, negative predictive value, and efficiency were 70%, 100%, 97.90%, 100%, and 98%, respectively. P value was <0.0001 which shows statistically extreme significant correlation. Conclusion. FNAC is a very important preliminary diagnostic tool in palpable soft tissue lumps with high degree of correlation with the final histopathology report. PMID:24876987

  7. Prospects for Pulsar Studies with the GLAST Large Area Telescope

    NASA Technical Reports Server (NTRS)

    Harding, Alice K.

    2007-01-01

    The Large Area Telescope (LAT) on the Gamma-ray Large Area Space Telescope (GLAST), due to launch in November 2007, will have unprecedented sensitivity and energy resolution for gamma-rays in the range of 30 MeV to 200 GeV. GLAST is therefore expected to provide major advances in the understanding of high-energy emission from rotation-powered pulsars. As the only presently known galactic GeV source class; pulsars will be one of the most important sources for study with GLAST. The main science goals of the LAT for pulsar studies include an increase in the number of detected radio-loud and radio-quiet gamma-ray pulsars, including millisecond pulsars, giving much better statistics for elucidating population characteristics, measurement of the high-energy spectrum and the shape of spectral cutoffs and determining pulse profiles for a variety of pulsars of different age. Further, measurement of phase-resolved spectra and energy dependent pulse profiles of the brighter pulsars should allow detailed tests of magnetospheric particle acceleration and radiation mechanisms, by comparing data with theoretical models that have been developed. Additionally, the LAT will have the sensitivity to allow blind pulsation searches of nearly all unidentified EGRET sources, to possibly uncover more radio-quiet Geminga-like pulsars.

  8. Prospects for Pulsar Studies with the GLAST Large Area Telescope

    NASA Technical Reports Server (NTRS)

    Harding, Alice K.

    2006-01-01

    The Large Area Telescope (LAT) on the Gamma-ray Large Area Space Telescope (GLAST) will have unprecedented sensitivity and energy resolution for gamma-rays in the range of 30 MeV to 200 GeV. GLAST is therefore expected to provide major advances in the understanding of high-energy emission from rotation-powered pulsars. As the only presently known galactic GeV source class, pulsars will be one of the most important sources for study with GLAST. The main science goals of the LAT for pulsar studies include an increase in the number of detected radio-loud and radio-quiet gamma ray pulsars, including millisecond pulsars, giving much better statistics for elucidating population characteristics, measurement of the high-energy spectrum and the shape of spectral cutoffs and determining pulse profiles for a variety of pulsars of different age. Further, measurement of phase-resolved spectra and energy dependent pulse profiles of the brighter pulsars should allow detailed tests of magnetospheric particle acceleration and radiation mechanisms, by comparing data with theoretical models that have been developed. Additionally, the LAT will have the sensitivity to allow blind pulsation searches of nearly all unidentified EGRET sources, to possibly uncover more radio-quiet Geminga-like pulsars.

  9. Prospects for Pulsar Studies with the GLAST Large Area Telescope

    NASA Technical Reports Server (NTRS)

    Harding, Alice K.

    2007-01-01

    The Large Area Telescope (LAT) on the Gamma-ray Large Area Space Telescope (GLAST), due to launch in November 2007, will have unprecedented sensitivity and energy resolution for gamma-rays in the range of 30 MeV to 200 GeV. GLAST is therefore expected to provide major advances in the understanding of high-energy emission from rotation-powered p ulsars. As the only presently known galactic GeV source class, pulsar s will be one of the most important sources for study with GLAST. The main science goals of the LAT for pulsar studies include an increase in the number of detected radio-loud and radio-quiet gamma-ray pulsar s, including millisecond pulsars, giving much better statistics for e lucidating population characteristics, measurement of the high-energy spectrum and the shape of spectral cutoffs and determining pulse profiles for a variety of pulsars of different age. Further, measurement of phase-resolved spectra and energy dependent pulse profiles of the brighter pulsars should allow detailed tests of magnetospheric partic le acceleration and radiation mechanisms, by comparing data with theo retical models that have been developed. Additionally, the LAT will have the sensitivity to allow blind pulsation searches of nearly all un identified EGRET sources, to possibly uncover more radio-quiet Geming a-like pulsars.

  10. Childhood social hardships and fertility: A prospective cohort study

    PubMed Central

    Harville, Emily W.; Boynton-Jarrett, Renée

    2013-01-01

    Purpose To examine the effect of lifetime social hardships on fertility. Methods Using the British National Child Development Study, a longitudinal cohort study, the impact of exposure to childhood hardships on becoming pregnant, reported infertility, and time to pregnancy was investigated. 6477 women reported on whether they had become pregnant by age 41, and 5198 women had data on at least one pregnancy. Factor analysis was used to identify six types of childhood hardships (as reported by parent, child, social worker, or teacher); retrospective report of child abuse was also examined. Logistic regression and discrete failure-time analysis was used to adjust for potential confounders. Results Never-married women were more likely to have become pregnant at some point if they had experienced more childhood hardships. Retrospectively reported child abuse was associated with an increased likelihood of having been told one was unable to have children. Among ever-married women, childhood hardships were associated with reduced fecundability, but the association was weakened by adjustment for adult social class. Conclusions The relationship between childhood adversity and adult fertility is complex. Future research should investigate pathways between characteristics of adversities and fertility. PMID:24404568

  11. Impact of childhood trauma on postpartum depression: a prospective study.

    PubMed

    De Venter, Maud; Smets, Jorien; Raes, Filip; Wouters, Kristien; Franck, Erik; Hanssens, Myriam; Jacquemyn, Yves; Sabbe, Bernard G C; Van Den Eede, Filip

    2016-04-01

    Studies on the impact of childhood trauma on postpartum depression show inconsistencies and methodological limitations. The present study examines the effect of childhood trauma on depression 12 and 24 weeks after childbirth, while controlling for history of depression, depression symptoms during pregnancy and type D personality. During the third trimester of pregnancy, 210 women completed self-report questionnaires assessing depression (current and/or past episodes), childhood trauma and type D personality, of whom 187 participated in the postpartum follow-up, with depression symptoms being reassessed at 12 and 24 weeks after delivery with three depression outcome measures. Eventually, 183 participants were retained for analysis. Results indicated no predictive value of childhood trauma on postpartum depression in the univariate analyses, nor after controlling for previous depression, depression symptoms during pregnancy and type D personality. However, past depression and depression symptoms during pregnancy did independently and convincingly predict postpartum depression, especially at 12 weeks and to a lesser extent at 24 weeks following childbirth. Overall, we found no significant association between childhood trauma and postpartum depression. Past depression and depression symptoms during pregnancy are more relevant factors to assess before childbirth.

  12. Precision of maxillary repositioning during orthognathic surgery: a prospective study.

    PubMed

    Bouchard, Carl; Landry, Pierre-Éric

    2013-05-01

    The purpose of this study was to evaluate the accuracy of surgical splints and an external reference point to reposition the maxilla during orthognathic surgery. Before surgery, a radiological marker was inserted inside the orthodontic bracket of the first right maxillary molar. A surgical splint was utilized to reposition the maxilla in the sagittal and coronal planes after the osteotomy. The vertical position was established by measuring the distance between a Kirschner wire inserted at bony nasion and the orthodontic wire. Preoperative and postoperative cephalometric radiographs were obtained and manually traced. The radiological marker and the tip of the right maxillary incisor were used as specific landmarks. Their displacement on the pre- and postoperative radiographs was measured. The actual surgical movement of the maxilla was compared to the initial surgical planning. 23 patients met the inclusion criteria to participate in the study. The mean difference between the planned and executed movements of the maxilla was 0.1mm (p=0.71). The difference was not statistically significant for any given movements of the maxilla. The use of surgical splints made from model surgery combined with an external reference point at bony nasion is accurate methods for repositioning the maxilla during orthognathic surgery.

  13. Radiofrequency ablation of spinal osteoid osteoma: a prospective study.

    PubMed

    Faddoul, Joe; Faddoul, Yara; Kobaiter-Maarrawi, Sandra; Moussa, Ronald; Rizk, Tony; Nohra, Georges; Okais, Nabil; Samaha, Elie; Maarrawi, Joseph

    2017-03-01

    OBJECTIVE Surgery has been considered the standard treatment for spinal osteoid osteomas that are refractory to analgesic agents. Radiofrequency ablation (RFA) is a less invasive technique with established efficiency for the treatment of peripheral osteoid osteomas. The main objectives of this study are to evaluate the safety of RFA based on the results of a previous experimental study in rats conducted in the authors' laboratory and to identify its short- and long-term efficiency in the treatment of spinal osteoid osteomas. METHODS Between March 2009 and July 2016, 8 consecutive patients with spinal osteoid osteomas were enrolled in the study and underwent 9 CT-guided RFA procedures. All patients presented with spinal pain (median preoperative visual analog scale [VAS] score 7.55, range 6-8.8) predominantly during the night, and they all had normal neurological examination results before the procedure. Pain (according to the VAS score) and neurological status were reassessed immediately before discharge, with further follow-up at 1, 6, and 12 months after the procedure. At the final follow-up, VAS score, neurological examination, patient satisfaction, and a radiological control (CT scan) were documented (median 48 months, range 12-84 months). VAS scores before and after the procedure were compared during the 3 days before surgery (D0), on the day of the surgery, Day 1 (D1), and at the final follow-up. RESULTS No neurological deficit was documented following the procedure or at the final follow-up. A statistically significant reduction in the VAS score was observed on Day 1 (mean 2.56 ± 0.68, p = 0.005) compared with D0. At the final follow-up, all patients reported a VAS score of 0 and a satisfaction rate of 100%. Only 1 patient had recurrent symptoms (pain, VAS score 8.1) 6 months after the initial RFA. A second procedure was performed, and the patient was subsequently symptom free at the final follow-up. CT scanning performed in all patients (12-84 months post

  14. A prospective study of behavioral and emotional symptoms in preschoolers.

    PubMed

    Klein, Annette M; Otto, Yvonne; Fuchs, Sandra; Reibiger, Ina; von Klitzing, Kai

    2015-03-01

    A substantial number of preschool children exhibit psychological symptoms that have an impact on their own and their families' lives. The aim of the current study was to investigate the prevalence, stability and increase/decrease in emotional and behavioral symptoms and the resultant impairment at two assessment points at preschool age. The sample consisted of 1,034 children drawn from the general population with a mean age of 51 months at t1 and 72 months at t2. Parents completed the Strengths and Difficulties Questionnaire extended version (Goodman, J Child Psychol Psychiatry 38(5):581-586, 1997; Goodman, J Child Psychol Psychiatry 40(5):791-799, 1999). At t1, 6.9 % of the preschoolers had a total difficulties and 6.8 % a total impact score within the abnormal range. At t2, these scores were 5.7 and 6.2 %, respectively. We found moderate stability of symptoms. From t1 to t2, emotional symptoms and prosocial behavior significantly increased, while hyperactivity, conduct problems, peer problems and total difficulties decreased. The mean total impact score did not change. Boys showed higher levels of symptoms (except emotional symptoms) and impact, and lower prosocial behavior, than girls. Moreover, there was a significant time × gender interaction, with girls showing a larger decrease in hyperactivity/inattention and in total difficulties than boys. The stepwise multiple regression analysis revealed that the total impact score at baseline, male gender, conduct problems, hyperactivity and peer problems significantly contributed to the explained variance of the total impact score at follow-up. This is one of very few studies to examine the stability and change of psychological symptoms in a large community sample of preschoolers, assessed twice during preschool age.

  15. Seroprevalence of Pertussis in Senegal: A Prospective Study

    PubMed Central

    Gaayeb, Lobna; Sarr, Jean Biram; Ndiath, Mamadou O.; Hanon, Jean-Baptiste; Debrie, Anne-Sophie; Seck, Modou; Schacht, Anne-Marie; Remoué, Franck; Hermann, Emmanuel; Riveau, Gilles

    2012-01-01

    Background Pertussis, also known as whooping cough, is a vaccine-preventable respiratory disease caused by Bordetella pertussis infection, against which Senegalese children are immunized with the diphtheria-tetanus-whole cell pertussis vaccine (DTwP). Seroepidemiology of pertussis has been widely described in industrialized countries, but rare are the studies referring to it in developing countries. Methods We conducted a longitudinal survey in Northern Senegal to investigate the epidemiology of B. pertussis by evaluating the IgG antibody (Ab) response against pertussis toxin (PT). A cohort of 410 children aged 1 to 9 from five villages in the Middle Senegal River Valley were followed-up for 18 months. During that period, five visits were made to assess the immunological status of the children. Principal Findings PT-specific IgG responses were significantly different according to age. Until the age of 3, there was a decrease in the Ab response, which then increased in the older groups. Assessment of IgG antibodies to PT (IgG-PT) suggested evidence of recent exposures to the pathogen. Surprisingly, in one of the five villages the average Ab response to PT was very low at all ages during the first 6 months of the study. At the third visit, IgG-PT concentrations peaked to very high levels, to slightly decline at the end of the survey. This indicates an outbreak of B. pertussis, whereas in the other villages a pertussis endemic profile could be observed. Conclusions Pertussis is endemic in Northern Senegal despite the introduction of vaccination. The circulation of the bacteria seems to differ between geographic locations and over time. A more complete understanding of the epidemiology of pertussis and its environmental determinants could provide information to adapt vaccination programs. PMID:23119090

  16. Work schedules and fatigue: a prospective cohort study

    PubMed Central

    Jansen, N; van Amelsvoort, L G P M; Kristensen, T; van den Brandt, P A; Kant, I.

    2003-01-01

    Aims: (1) To describe the prevalence of fatigue among employees in different work schedules (day work, three-shift, five-shift, and irregular shift work); (2) to investigate whether different work schedules are related to increasing fatigue over time, while taking into account job title and job characteristics; and (3) to study fatigue among shift workers changing to day work. Methods: Data from nine consecutive four-monthly self administered questionnaires from the Maastricht Cohort Study on Fatigue at work (n = 12 095) were used with 32 months of follow up. Day and shift workers were matched on job title. Results: The prevalence of fatigue was 18.1% in day workers, 28.6% in three-shift, 23.7% in five-shift, and 19.1% in irregular shift workers. For three-shift and five-shift workers substantial higher fatigue levels were observed compared to day workers at baseline measurement. In the course of fatigue over the 32 months of follow up there were only small and insignificant differences between employees in different work schedules. However, among employees fatigued at baseline, fatigue levels decreased faster over time among five-shift workers compared to fatigued day workers. Shift workers changing to day work reported substantially higher fatigue levels prior to change, compared to those remaining in shift work. Conclusions: Substantial differences in fatigue existed between day and shift workers. However, as no considerable differences in the course of fatigue were found, these differences have probably developed within a limited time span after starting in a shift work job. Further, evidence was found that fatigue could be an important reason for quitting shift work and moving to day work. Finally, in the relation between work schedules and fatigue, perceived job characteristics might play an important role. PMID:12782747

  17. The Early Growth and Development Study: A Prospective Adoption Study from Birth Through Middle Childhood

    PubMed Central

    Leve, Leslie D.; Neiderhiser, Jenae M.; Shaw, Daniel S.; Ganiban, Jody; Natsuaki, Misaki N.; Reiss, David

    2013-01-01

    The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children recruited in two cohorts (N = 561 triads). The primary study aims are to examine how family, peer, and contextual processes affect children’s adjustment, and to examine their interplay (mediation, moderation) with genetic influences. Participants were recruited through adoption agencies located throughout the United States following the birth of a child. Assessments are ongoing, in 9-month intervals until the child reaches 3 years of age and in one-year intervals thereafter through age 9. Data collection includes the following primary constructs: child temperament, social behavior, school performance, mental health, and health; birth and adoptive parent personality characteristics, mental health, competence, stress, health, context, substance use, parenting, and marital relations; and pregnancy use of drugs and maternal stress during pregnancy. DNA and salivary cortisol samples have also been collected. Analyses have indicated evidence for genotype-environment interactions during early childhood. Study procedures, sample representativeness (including tests of potential confounds in the adoption design), and an overview of findings to date are summarized, and future plans are described. PMID:23218244

  18. The Early Growth and Development Study: a prospective adoption study from birth through middle childhood.

    PubMed

    Leve, Leslie D; Neiderhiser, Jenae M; Shaw, Daniel S; Ganiban, Jody; Natsuaki, Misaki N; Reiss, David

    2013-02-01

    The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children recruited in two cohorts (N = 561 triads). The primary study aims are to examine how family, peer, and contextual processes affect children's adjustment, and to examine their interplay (mediation, moderation) with genetic influences. Participants were recruited through adoption agencies located throughout the United States following the birth of a child. Assessments are ongoing, in 9-month intervals until the child reaches 3 years of age and in 1-year intervals thereafter through age 9. Data collection includes the following primary constructs: child temperament, social behavior, school performance, mental health, and health; birth and adoptive parent personality characteristics, mental health, competence, stress, health, context, substance use, parenting, and marital relations; and pregnancy use of drugs and maternal stress during pregnancy. DNA and salivary cortisol samples have also been collected. Analyses have indicated evidence for genotype-environment interactions during early childhood. Study procedures, sample representativeness (including tests of potential confounds in the adoption design), and an overview of findings to date are summarized, and future plans are described.

  19. Dieting and food craving. A descriptive, quasi-prospective study.

    PubMed

    Massey, Anna; Hill, Andrew J

    2012-06-01

    Evidence linking food restriction and food craving is equivocal. This study investigated whether dieting was associated with a greater frequency of food craving. Dieting to lose weight was distinguished from watching so as not to gain weight. Participants were 129 women (mean age=41 yrs): 52 were currently dieting to lose weight, 40 were watching their weight, and 37 were non-dieters. They completed a food craving record after every food craving, a food diary, and a daily mood assessment over 7-days. Of the 393 craving incidents recorded, dieters experienced significantly more food cravings than non-dieters, with watchers intermediate. Chocolate was the most craved food (37% of cravings) but neither the types of food, the proportion of cravings leading to eating (∼70%), the situations in which cravings occurred, nor the time since the last eating episode differed between groups. Compared with non-dieters, dieters experienced stronger cravings that were more difficult to resist, and for foods they were restricting eating. Watchers showed similarities in experience both to dieters (low hunger) and non-dieters (lower craving intensity). These results support an association between dieting and food craving, the usefulness of distinguishing dieting to lose weight and watching, and suggest a need for further experimental investigation of actual food restriction on food craving experiences.

  20. A prospective natural history study of Mucopolysaccharidosis Type IIIA

    PubMed Central

    Shapiro, Elsa G.; Nestrasil, Igor; Delaney, Kathleen A.; Rudser, Kyle; Kovac, Victor; Nair, Nitin; Richard, Charles W.; Haslett, Patrick; Whitley, Chester B.

    2015-01-01

    Objectives To characterize the clinical course of mucopolysaccharidosis type IIIA (MPS IIIA), and identified potential endpoints for future treatment trials. Study design Children with a confirmed diagnosis of MPS IIIA, functioning above a developmental age of 1 year, were followed for up to 2 years. Cognitive status and brain atrophy were assessed by standardized tests and volumetric MRI, respectively. Liver and spleen volumes, CSF and urine biomarker levels were measured. Results Twenty-five children, from 1.1 to 18.4 years old, were enrolled, and 24 followed for at least 12 months. 19 exhibited a rapidly progressing form of MPS IIIA (RP), and 5, a more slowly progressing form (SP). Children with RP plateaued in development by 30 months, followed by rapid regression after 40 to 50 months. Cognitive developmental quotients (DQ) in patients with RP showed consistent steep declines associated with progressive cortical gray matter atrophy. Children with SP had a similar but more prolonged course. Liver and spleen volumes were approximately double normal size, and CSF and urine HS levels were elevated and relatively constant over time. Conclusions DQ and cortical gray matter volumes are sensitive markers of disease progression in MPS IIIA, and may have utility as clinical endpoints in treatment trials. For optimal outcomes, treatment may need to be instituted in children before the onset of steep cognitive decline and brain atrophy. PMID:26787381

  1. A prospective study of acute idiopathic neuropathy. II. Antecedent events.

    PubMed

    Winer, J B; Hughes, R A; Anderson, M J; Jones, D M; Kangro, H; Watkins, R P

    1988-05-01

    The incidence of antecedent events and serological evidence of preceding infection were studied in 100 patients with acute idiopathic neuropathy and age and sex matched control subjects in South-East England. Symptoms of respiratory infections occurred within one month before onset of neuropathic symptoms in 38% of patients and 12% of controls (p less than 0.001) and symptoms of gastrointestinal infections in 17% of patients and 3% of controls (p less than 0.005). Immunisations, insect bites and animal contact were equally common in the patient and control subjects. Eight per cent of patients had undergone an operation within the preceding 3 months. Six per cent of patients had co-existing "autoimmune" diseases. Serological evidence of recent infection was identified in 31% of patients. Campylobacter jejuni (14%) and cytomegalovirus (11%) were both significantly more frequently demonstrated in patients than controls. Serological evidence of recent infection with mycoplasma (1%), Epstein Barr virus (1-2%) and parvovirus B19 (4%) was also identified in the patients but not more frequently than in the controls. Possible explanations for the association of these agents with acute idiopathic neuropathy include possession of antigens shared with myelin and inhibition of suppressor mechanisms.

  2. Prospective study of enteropathogens in two communities of Misiones, Argentina.

    PubMed

    Vergara, M; Quiroga, M; Grenon, S; Pegels, E; Oviedo, P; Deschutter, J; Rivas, M; Binsztein, N; Claramount, R

    1996-01-01

    Children under five years of age, from two communities of different socio-economic strata (97 from Zaiman and 55 from Las Dolores) were examined epidemiologically during 2 years, by means of quarterly visits of the working team, who carried out the collection of faecal samples. During the study, one or more enteropathogens were identified in 73.9% of samples in children from Zaiman and in 58.3% of the samples from Las Dolores, being associated to diarrhoea in 70.5% and to asymptomatic infections in 65.7%. The number of diarrheic episodes was higher in Zaiman (15.45%) than in Las Dolores (12.35%), being more frequent in the spring-summer seasons. In Zaiman, the bacterial enteropathogen proportion was relevantly higher (p < 0.005) in children with diarrhoea, whereas the presence of parasites was more frequent in asymptomatic children (p < 0.01). Rotavirus had an even distribution within diarrheic and asymptomatic children. In Las Dolores, no relevant differences were found in the detection of enteroparasites between diarrheic and asymptomatic children. Mixed infections were detected; enterotoxigenic Escherichia coli (ETEC)-rotavirus and ETEC-parasites being the most frequent ones. ETEC was involved in 85% of these infections. These data, together with the high enteropathogen carriage, suggest an elevated level of environmental contamination. The latter plays an important role in diarrheic diseases, and added to the most extreme poverty, it affects children's lives.

  3. A prospective study of human polyomavirus infection in pregnancy.

    PubMed

    Coleman, D V; Wolfendale, M R; Daniel, R A; Dhanjal, N K; Gardner, S D; Gibson, P E; Field, A M

    1980-07-01

    Urine samples from 1,235 pregnant women were examined by light microscopy for cytologic evidence of virus infection. Smears of urine sediment from 40 women (3.2%) were observed to contain inclusion-bearing cells; polyomavirus infection was confirmed by virologic methods in 24 (60%). A polyomavirus was isolated from 12 women. Five isolates were identified as JC virus and one as BK virus. Another isolate designated AS virus appeared to be unique. Serologic studies on the 40 women were consistent with a high frequency of reactivation of JC virus, and virus excretion was related to gestation. The evidence suggests that selective excretion of JC virus may occur in pregnancy. Among 390 pregnant women without inclusion-bearing cells in their urine, 78 (20%) had a high or rising titer of serum antibody to JC or BK virus or both, a result suggesting virus reactivation, but virus excretion was not detected. In contrast to other reports, no evidence was found for transmission of BK virus to the fetus.

  4. Team perfectionism and team performance: a prospective study.

    PubMed

    Hill, Andrew P; Stoeber, Joachim; Brown, Anna; Appleton, Paul R

    2014-06-01

    Perfectionism is a personality characteristic that has been found to predict sports performance in athletes. To date, however, research has exclusively examined this relationship at an individual level (i.e., athletes' perfectionism predicting their personal performance). The current study extends this research to team sports by examining whether, when manifested at the team level, perfectionism predicts team performance. A sample of 231 competitive rowers from 36 boats completed measures of self-oriented, team-oriented, and team-prescribed perfectionism before competing against one another in a 4-day rowing competition. Strong within-boat similarities in the levels of team members' team-oriented perfectionism supported the existence of collective team-oriented perfectionism at the boat level. Two-level latent growth curve modeling of day-by-day boat performance showed that team-oriented perfectionism positively predicted the position of the boat in midcompetition and the linear improvement in position. The findings suggest that imposing perfectionistic standards on team members may drive teams to greater levels of performance.

  5. A prospective study of selenium status and breast cancer risk

    SciTech Connect

    Hunter, D.J.; Stampfer, M.J.; Colditz, G.A.; Speizer, F.E.; Willett, W.C. ); Morris, J.S. )

    1990-09-05

    Low dietary intake of selenium has been proposed as a risk factor for breast cancer. To address this hypothesis, the authors collected toenail clippings from 62,641 women in the Nurses' Health Study cohort who were free from cancer in 1982 and 1983. The selenium concentration in nails has been shown to reflect dietary intake of selenium. During 53 months of follow-up, 434 cases of breast cancer were diagnosed among women who had submitted a set of toenail clippings, and they matched one control free from breast and other cancers to each case. The mean selenium level in toenails in the cases was almost identical to that of the controls. After controlling for known breast cancer risk factors, the relative risk for women in the highest quintile of selenium as compared with the lowest quintile was 1.10 and there was not trend across quintiles. Results were similar for both premenopausal and postmenopausal women. Although these data do not exclude a possible influence of selenium intake before adulthood on subsequent risk of breast cancer, selenium intake later in life is not likely to be an important factor in the etiology of breast cancer.

  6. Snake poisoning in rural Zimbabwe--a prospective study.

    PubMed

    Nhachi, C F; Kasilo, O M

    1994-01-01

    Over a period of 2 years (January 1991 to December 1992) 274 cases of snake bite were admitted to hospital in the eight provinces of Zimbabwe. Of these patients, 54% were males and 88% belonged to the 6-40-year age group. Five deaths (1.8% of the total cases) were reported. The majority of snake bites (63%) occurred at night (between 6.30 p.m. and midnight) and over 74% took place during the hot rainy season, i.e. between November and April. In over 58% of the cases the victim accidentally stepped on the snake, the snake being cobra in 37%, puff adder in 20% and the black and green mamba in 18% of the cases. Most of the bites occurred on the leg, below the knee. Treatment of snake envenomation consisted mainly of the administration of antibiotics (151 cases), analgesics (144 cases), antivenom tropical snake polyvalent (ATT) (89 cases), antitoxoid tetanus (TT) (61 cases), antihistamines (47 cases) and traditional medicines (43 cases). This study indicates that snake envenomation in rural Zimbabwe is common but fatalities are relatively rare.

  7. Yoga therapy for breast cancer patients: a prospective cohort study.

    PubMed

    Sudarshan, Monisha; Petrucci, Andrea; Dumitra, Sinziana; Duplisea, Jodie; Wexler, Sharon; Meterissian, Sarkis

    2013-11-01

    We sought to study the impact of yoga therapy on anxiety, depression and physical health in breast cancer patients. Stage I-III post-operative breast cancer patients were recruited with twelve 1-h weekly yoga sessions completed with an experienced yoga instructor. Before and after each module completion, assessments were obtained with the Hospital Anxiety and Depression scale (HADS), the Dallas pain scale and shoulder flexibility measurements. Fourteen patients completed the entire yoga session with 42.8% having a total mastectomy and 15.4% having breast reconstruction. Both right and left shoulder abduction flexibility significantly improved (p = 0.004; p = 0.015 respectively) as well as left shoulder flexion (p = 0.046). An improvement trend in scores for the HADS and Dallas questionnaires pre- and post-intervention was found, although it was not statistically significant. Our data indicates an improvement in physical function in addition to a consistent amelioration in anxiety, depression and pain symptoms after a yoga intervention.

  8. Spinal alignment evolution with age: A prospective gait analysis study

    PubMed Central

    Pesenti, Sébastien; Blondel, Benjamin; Peltier, Emilie; Viehweger, Elke; Pomero, Vincent; Authier, Guillaume; Fuentes, Stéphane; Jouve, Jean-Luc

    2017-01-01

    AIM To describe, using gait analysis, the development of spinal motion in the growing child. METHODS Thirty-six healthy children aged from 3 to 16 years old were included in this study for a gait analysis (9 m-walk). Various kinematic parameters were recorded and analyzed such as thoracic angle (TA), lumbar angle (LA) and sagittal vertical axis (SVA). The kinetic parameters were the net reaction moments (N.m/kg) at the thoracolumbar and lumbosacral junctions. RESULTS TA and LA curves were not statistically correlated to the age (respectively, P = 0.32 and P = 0.41). SVA increased significantly with age (P < 0.001). Moments in sagittal plane at the lumbosacral junction were statistically correlated to the age (P = 0.003), underlining the fact that sagittal mechanical constraints at the lumbosacral junction increase with age. Moments in transversal plane at the thoracolumbar and lumbosacral junctions were statistically correlated to the age (P = 0.0002 and P = 0.0006), revealing that transversal mechanical constraints decrease with age. CONCLUSION The kinetic analysis showed that during growth, a decrease of torsional constraint occurs while an increase of sagittal constraint is observed. These changes in spine biomechanics are related to the crucial role of the trunk for bipedalism acquisition, allowing stabilization despite lower limbs immaturity. With the acquisition of mature gait, the spine will mainly undergo constraints in the sagittal plane. PMID:28361018

  9. Therapeutic horticulture in clinical depression: a prospective study.

    PubMed

    Gonzalez, Marianne Thorsen; Hartig, Terry; Patil, Grete Grindal; Martinsen, Egil W; Kirkevold, Marit

    2009-01-01

    Clinically depressed persons suffer from impaired mood and distortion of cognition. This study assessed changes in depression severity and perceived attentional capacity of clinically depressed adults (N=18) during a 12-week therapeutic horticulture program. The Beck Depression Inventory (BDI) and Attentional Function Index (AFI) were administered at baseline, twice during (4 and 8 weeks), and immediately after the intervention (12 weeks), and at a 3-month follow-up. Experiences of being away and fascination related to the intervention were measured at 4, 8, and 12 weeks. The mean BDI score declined 9.7 points from pretest (27.3) to posttest (p < .001) and were clinically relevant (deltaBDI > or =6) for 72% of the cases. The mean AFI score increased 10.2 points from pretest (68.8) to posttest (p = .06). The greatest change in BDI and AFI scores occurred in the initial weeks of the intervention. The reduction in BDI scores remained significant and clinically relevant at the 3-month follow-up (N=16). The decline in depression severity during the intervention correlated strongly with the degree to which the participants found that it captured their attention. Therapeutic horticulture may decrease depression severity and improve perceived attentional capacity by engaging effortless attention and interrupting rumination.

  10. Predictors and health-related outcomes of positive body image in adolescent girls: A prospective study.

    PubMed

    Andrew, Rachel; Tiggemann, Marika; Clark, Levina

    2016-03-01

    This study aimed to investigate prospective predictors and health-related outcomes of positive body image in adolescent girls. In so doing, the modified acceptance model of intuitive eating was also examined longitudinally. A sample of 298 girls aged 12 to 16 years completed a questionnaire containing measures of body appreciation, potential predictors, and a range of health outcomes, at 2 time points separated by 1 year. Longitudinal change regression models showed that perceived body acceptance by others (positively), self-objectification and social comparison (negatively), and body appreciation (positively) prospectively predicted intuitive eating 1 year later, consistent with the acceptance model of intuitive eating. Perceived body acceptance by others was the only proposed predictor to prospectively predict an increase in body appreciation over time. Time 1 body appreciation prospectively predicted a decrease in dieting, alcohol, and cigarette use, and an increase in physical activity 1 year later. In particular, girls with low body appreciation were more likely than girls with high body appreciation to take up alcohol and cigarette use between time points. The results highlight body appreciation as an important target for interventions designed to prevent or delay the uptake of alcohol and cigarette consumption among girls. More broadly, they suggest that a positive body image can confer considerable benefit for adolescent girls.

  11. Hospitalization and Survival in Patients Using Epoprostenol for Injection in the PROSPECT Observational Study

    PubMed Central

    Frantz, Robert P.; Schilz, Robert J.; Chakinala, Murali M.; Badesch, David B.; Frost, Adaani E.; McLaughlin, Vallerie V.; Barst, Robyn J.; Rosenberg, Daniel M.; Miller, Dave P.; Hartline, Brian K.; Benton, Wade W.

    2015-01-01

    BACKGROUND: Few studies have prospectively reported outcomes in patients with pulmonary arterial hypertension (PAH) treated with epoprostenol in the modern-day era of oral therapy and combination treatments. The Registry to Prospectively Describe Use of Epoprostenol for Injection (Veletri, prolonged room temperature stable-epoprostenol [RTS-Epo]) in Patients with Pulmonary Arterial Hypertension (PROSPECT) was established to prospectively describe the course of PAH in patients prescribed RTS-Epo. METHODS: PROSPECT is a multicenter, US-based drug registry of primarily group 1 patients with PAH treated with RTS-Epo who were parenteral-naive or parenteral-transitioned at enrollment. Patients were followed until discontinuation of RTS-Epo, withdrawal, loss to follow-up, death, or end of study (maximum 1 year). One-year freedom from hospitalization (FH) and survival estimates were summarized by prostacyclin history (parenteral-naive or parenteral-transitioned), sex, and chronic renal insufficiency (CRI). RESULTS: A total of 336 patients were included. The overall 1-year FH estimate was 51.0% ± 2.8% and was lower in parenteral-naive patients than parenteral-transitioned patients (42.8% ± 4.3% vs 57.1% ± 3.7%, respectively; P = .002). FH estimates were lower in male patients than female patients (38.3% ± 5.9% vs 54.6% ± 3.2%, respectively; P < .015) and in patients with CRI than patients without CRI (17.0% ± 8.4% vs 53.7% ± 2.9%, respectively; P < .001). The overall 1-year survival estimate was 84.0% ± 2.1%. Survival was poorer in parenteral-naive patients, male patients, and patients with CRI. CONCLUSIONS: Risk of hospitalization and mortality remain high in patients with PAH. In particular, patients who are parenteral-naive at initiation of RTS-Epo therapy, male patients, and patients with CRI require close monitoring and aggressive clinical management. PMID:25320967

  12. A prospective study of Astra single tooth implants.

    PubMed

    Palmer, R M; Smith, B J; Palmer, P J; Floyd, P D

    1997-06-01

    A new design of single tooth implant (AstraTech, Molndal Sweden) featuring a microthreaded conical neck and TiO blast surface was evaluated clinically and radiographically after 2 years in function. Fifteen patients (age range 16 to 48) with missing maxillary anterior teeth (6 central incisors, 8 laterals, 1 bicuspid) had 4, 13 mm and 11, 15 mm implants placed under local anaesthesia and left for a period of 6 months before exposure and abutment connection/crown fabrication. All patients were seen at 4 to 6 monthly intervals for hygienist maintenance. Radiographs using Rinn holders and a long cone technique were taken at the crown insertion and after 1 year (14 subjects) and 2 years (12 subjects). All implants were successfully integrated at stage 2, and no implants have been lost. The internal conical seal design of the abutment/implant interface facilitated connection and there were no cases of abutment screw loosening. No soft tissue problems were observed, and the gingival morphology/health was well maintained. One crown was recemented after 18 months in function, and 1 crown was replaced because of a fracture to the porcelain incisal edge. At crown insertion, the mean bone level was 0.46 to 0.48 mm apical to the top of the implant and there were no statistically significant changes in the bone level over the 2 years of the study. In conclusion, the single tooth Astra implants were highly successful and bone changes within the first 2 years of function were comparable with other systems reporting high long-term success rates.

  13. Asthma and pregnancy: a prospective study of 198 pregnancies.

    PubMed Central

    Stenius-Aarniala, B; Piirilä, P; Teramo, K

    1988-01-01

    A study was designed to investigate whether asthma, when carefully managed, is associated with an increased risk of complications in connection with pregnancy. One hundred and eighty one asthmatic women were monitored during 198 pregnancies. Antiasthmatic treatment consisted of inhaled beta 2 adrenergic drugs, beclomethasone, sodium cromoglycate, oral theophylline, and systemic corticosteroids as needed. Postpartum information on asthmatic symptoms and infant feeding was collected by means of a questionnaire. A control group of 198 non-asthmatic pregnant women was matched for age and parity. Atopic women had less severe asthma than non-atopic women. During pregnancy 40% of the patients were managed with the same antiasthmatic medication as before pregnancy; 18% needed less and 42% more medication. Pre-eclampsia occurred more often in asthmatic than control subjects, especially in patients with severe asthma. Hypoglycaemia occurred more often in infants of mothers with severe asthma than in infants of mothers with less severe disease. Theophylline medication at term did not influence labour or delivery. Asthma caused no emergencies during labour. Among the asthmatic subjects 28% of babies were delivered by caesarean section compared with 17% in the control group. There was no difference between asthmatic and control subjects with regard to length of gestation, birth weight, incidence of perinatal deaths, low Apgar scores, neonatal respiratory difficulties, hyperbilirubinaemia, or malformations. It is concluded that severe asthma or systemic corticosteroid treatment (or both) during pregnancy seems to increase the incidence of mild pre-eclampsia in the mother and hypoglycaemia in the infant. The findings suggest that careful supervision of asthma during pregnancy and labour by obstetricians and chest physicians working in close collaboration should prevent most of the serious obstetric and neonatal complications of asthma in pregnancy reported by previous authors

  14. A prospective study of parainfluenza virus type 4 infections in children attending daycare.

    PubMed

    Fairchok, Mary P; Martin, Emily T; Kuypers, Jane; Englund, Janet A

    2011-08-01

    Studies of parainfluenza virus type 4 (PIV-4) have been limited by difficulty in culturing. We prospectively studied a cohort of 225 young children attending daycare followed for 165 child-years, using polymerase chain reaction to detect 12 viruses, including PIV-4. PIV-4 was second only to PIV-3, occurring in 9 of 87 (10%) PIV+ illnesses. PIV-4 illnesses were not more severe and not associated with a specific clinical syndrome.

  15. Hearing impairment and risk of Alzheimer's disease: a meta-analysis of prospective cohort studies.

    PubMed

    Zheng, Yuqiu; Fan, Shengnuo; Liao, Wang; Fang, Wenli; Xiao, Songhua; Liu, Jun

    2017-02-01

    Observational studies suggested an association between hearing impairment and cognitive disorders. However, whether hearing impairment is an independent risk factor or a harbinger of Alzheimer's disease remains controversial. Our goal was to assess the association between hearing impairment (HI) and the risk of Alzheimer's disease (AD) by conducting a meta-analysis of prospective cohort studies. We comprehensively searched the PubMed, Embase, Web of Science and Cochrane Library databases on January 19, 2016 to incorporate all the prospective cohort studies meeting the inclusion criteria to perform a systematic review and meta-analysis. Four prospective cohort studies with comparison between hearing impairment and normal hearing were incorporated, with 7461 participants. The outcomes of three studies were the incidence of Alzheimer's disease and the outcome of the fourth study was the incidence of mild cognitive impairment. The overall combined relative risk of people with hearing impairment to develop Alzheimer's disease was 4.87 (95% CI 0.90-26.35; p = 0.066), compared with the control group. Since both Alzheimer's disease and mild cognitive impairment are cognitive disorders, we incorporated all the four studies and the overall combined relative risk was 2.82 (95% CI 1.47-5.42; p = 0.002), indicating that the difference was significant. This meta-analysis suggests that hearing impairment significantly increases the risk of cognitive disorders and future well-designed prospective cohort studies are awaited to confirm the association between hearing impairment and risk of Alzheimer's disease.

  16. Coordination and management of multicenter clinical studies in trauma: Experience from the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) Study

    PubMed Central

    Rahbar, Mohammad H.; Fox, Erin E.; del Junco, Deborah J.; Cotton, Bryan A.; Podbielski, Jeanette M.; Matijevic, Nena; Cohen, Mitchell J.; Schreiber, Martin A.; Zhang, Jiajie; Mirhaji, Parsa; Duran, Sarah; Reynolds, Robert J.; Benjamin-Garner, Ruby; Holcomb, John B.

    2011-01-01

    Aim Early death due to hemorrhage is a major consequence of traumatic injury. Transfusion practices differ among hospitals and it is unknown which transfusion practices improve survival. This report describes the experience of the PRospective Observational Multicenter Major Trauma Transfusion (PROMMTT) Study Data Coordination Center in designing and coordinating a study to examine transfusion practices at ten Level 1 trauma centers in the U.S. Methods PROMMTT was a multisite prospective observational study of severely injured transfused trauma patients. The clinical sites collected real-time information on the timing and amounts of blood product infusions as well as colloids and crystalloids, vital signs, initial diagnostic and clinical laboratory tests, life saving interventions and other clinical care data. Results Between July 2009 and October 2010, PROMMTT screened 12,561 trauma admissions and enrolled 1,245 patients who received one or more blood transfusions within 6 hours of ED admission. A total of 297 massive transfusions were observed over the course of the study at a combined rate of 5.0 massive transfusion patients/week. Conclusion PROMMTT is the first multisite study to collect real-time prospective data on trauma patients requiring transfusion. Support from the Department of Defense and collaborative expertise from the ten participating centers helped to demonstrate the feasibility of prospective trauma transfusion studies. The observational data collected from this study will be an invaluable resource for research in trauma surgery and it will guide the design and conduct of future randomized trials. PMID:22001613

  17. Coffee consumption and risk of prostate cancer: a meta-analysis of prospective cohort studies.

    PubMed

    Cao, Shiyi; Liu, Ling; Yin, Xiaoxu; Wang, Yunxia; Liu, Junan; Lu, Zuxun

    2014-02-01

    Observational studies and animal evidence suggest an association between coffee consumption and the risk of prostate cancer. However, the results are inconsistent. We evaluated the association by conducting a meta-analysis of prospective cohort studies. PubMed and Embase were searched through June 2013 to identify studies that met predetermined inclusion criterion. A random-effects model was used to calculate the pooled risk estimates. Ten prospective cohort studies involving 8973 patients with prostate cancer and 206 096 participants were included in this systematic review. Compared with individuals who seldom or never drink coffee, the pooled relative risk of prostate cancer was 0.88 (95% confidence interval: 0.82-0.95) for regular coffee drinkers. Exclusion of any single study did not materially alter the combined risk estimate. Visual inspection of a funnel plot and Begg's and Egger's tests did not indicate evidence of publication bias. In summary, integrated evidence from prospective cohort studies supports the hypothesis that coffee consumption may decrease the risk of prostate cancer.

  18. Australian snowboard injury data base study. A four-year prospective study.

    PubMed

    Bladin, C; Giddings, P; Robinson, M

    1993-01-01

    Information on the rate and spectrum of snowboarding injuries is limited. This 4-year prospective study at 3 major Australian ski resorts assesses incidence and patterns of snowboarding injuries, particularly in relation to skill level and footwear. Ski injury data were collected for the same period. In a predominantly male study population (men:women, 3:1), 276 snowboarding injuries were reported; 58% occurred in novices. Fifty-seven percent of injuries were in the lower limbs, 30% in the upper limbs. The most common injuries were sprains (53%), fractures (24%), and contusions (12%). Comparing skiers' versus snowboarders' injuries, snowboarders had 2.4 times as many fractures, particularly to the upper limbs (21% versus 35% of upper limb injuries), fewer knee injuries (23% versus 44% of lower limb injuries), but more ankle injuries (23% versus 6% of lower limb injuries). Ankle injuries were more common with soft-shell boots, worn most by intermediate and advanced riders. Knee injuries and distal tibial fractures were more common with hard-shell boots, worn most by novices. Overall, novices had more upper limb fractures and knee injuries; intermediate and advanced riders had more ankle injuries. Falls were the principal mode of injury. To prevent injury, beginners should use "hybrid" or soft-shell boots and take lessons.

  19. Psychological Factors Associated with Development of TMD: the OPPERA Prospective Cohort Study

    PubMed Central

    Fillingim, Roger B.; Ohrbach, Richard; Greenspan, Joel D.; Knott, Charles; Diatchenko, Luda; Dubner, Ronald; Bair, Eric; Baraian, Cristina; Mack, Nicole; Slade, Gary D.; Maixner, William

    2013-01-01

    Case-control studies have consistently associated psychological factors with chronic pain in general and with temporomandibular disorders (TMD) specifically. However, only a handful of prospective studies has explored whether pre-existing psychological characteristics represent risk factors for first-onset TMD. The current findings derive from the prospective cohort study of the Orofacial Pain Prospective Evaluation and Risk Assessment (OPPERA) cooperative agreement. For this study, 3,263 TMD-free participants completed a battery of psychological instruments assessing general psychological adjustment and personality, affective distress, psychosocial stress, somatic symptoms, and pain coping and catastrophizing. Study participants were then followed prospectively for an average of 2.8 years to ascertain cases of first-onset of TMD, and 2,737 provided follow-up data and were considered in the analyses of TMD onset. In bivariate and demographically-adjusted analyses, several psychological variables predicted increased risk of first-onset TMD, including reported somatic symptoms, psychosocial stress, and affective distress. Principal component analysis of 26 psychological scores was used to identify latent constructs, revealing four components: stress and negative affectivity, global psychological and somatic symptoms, passive pain coping, and active pain coping. In multivariable analyses, global psychological and somatic symptoms emerged as the most robust risk factor for incident TMD. These findings provide evidence that measures of psychological functioning can predict first-onset of TMD. Future analyses in the OPPERA cohort will determine whether these psychological factors interact with other variables to increase risk for TMD onset and persistence. PMID:24275225

  20. Rates and predictors of remission in young women with specific phobia: a prospective community study.

    PubMed

    Trumpf, Julia; Becker, Eni S; Vriends, Noortje; Meyer, Andrea H; Margraf, Jürgen

    2009-10-01

    This prospective study reports rates and predictors of remission in young women with specific phobia. Data came from a prospective community study, in which German women (aged 18-25 years) completed an extended version of the Anxiety Disorders Interview Schedule (ADIS-IV-L) at two time points. Of the 137 women with specific phobia at baseline, 41.6% were partially remitted and an additional 19.0% were fully remitted at follow-up, defined as absence of any specific fears. A remitting course of specific phobia was predicted by residual protective factors at baseline, especially participants' positive mental health and life satisfaction. Baseline levels of stress, coping skills, cognitive factors, psychopathology, and specific phobia characteristics did not predict remission. Results show that specific phobia in young women rarely takes a stable course at the full diagnostic threshold. The factors that influence remission of specific phobia are different from those that predict the incidence.

  1. Higher Cognitive Performance Is Prospectively Associated with Healthy Dietary Choices: The Maine Syracuse Longitudinal Study

    PubMed Central

    Crichton, G.E.; Elias, M.F.; Davey, A.; Alkerwi, A.; Dore, G.A.

    2015-01-01

    OBJECTIVES Few studies have examined whether cognitive function predicts dietary intake. The majority of research has focused on how diet can influence cognitive performance or risk for cognitive impairment in later life. The aim of this study was to examine prospective relationships between cognitive performance and dietary intake in participants of the Maine-Syracuse Longitudinal Study. DESIGN A prospective study with neuropsychological testing at baseline and nutritional assessments measured a mean of 18 years later. SETTING Community-dwelling individuals residing in central New York state. PARTICIPANTS 333 participants free of dementia and stroke. MEASUREMENTS The Wechsler Adult Intelligence Scale (WAIS) was assessed at baseline and dietary intake was measured using the Nutrition and Health Questionnaire. RESULTS Higher WAIS Scores at baseline were prospectively associated with higher intakes of vegetables, meats, nuts and legumes, and fish, but inversely associated with consumption of total grains and carbonated soft drinks. After adjustment for sample selection, socioeconomic indicators, lifestyle factors (smoking and physical activity), and cardiovascular risk factors, the relations between higher cognitive performance and greater consumption of vegetables, meat, and fish, and lower consumption of grains remained significant. CONCLUSION These data suggest that cognition early in life may influence dietary choices later in life. PMID:26878011

  2. Prospective study of relations between cortical Lewy bodies, poor eyesight, and hallucinations in Alzheimer's disease.

    PubMed

    McShane, R; Gedling, K; Reading, M; McDonald, B; Esiri, M M; Hope, T

    1995-08-01

    The presence of hallucinations is included in some, but not all, of the sets of clinical diagnostic criteria that have been proposed for dementia associated with cortical Lewy bodies. These criteria were developed from retrospective casenote analyses. This prospective, longitudinal study suggests that, in patients with Alzheimer's disease, cortical Lewy bodies are associated with more persistent and severe hallucinations, independently of any association with severity of cognitive decline. Poor eyesight contributes to the severity but not the persistence of the hallucinations.

  3. Analytical Components of the Benefits and Costs of the Clean Air Act 1990-2020, the Second Prospective Study

    EPA Pesticide Factsheets

    The major analytical components of the Second Prospective Study are shown on this page. For other major components of the study, supporting technical reports are available which provide additional technical information.

  4. Community paediatric respiratory infection surveillance study protocol: a feasibility, prospective inception cohort study

    PubMed Central

    Anderson, Emma C; Ingle, Suzanne Marie; Muir, Peter; Beck, Charles; Finn, Adam; Leeming, John Peter; Cabral, Christie; Kesten, Joanna May; Hay, Alastair D

    2016-01-01

    Introduction Paediatric respiratory tract infections (RTIs) are common reasons for primary care consultations and antibiotic prescribing. Locally relevant syndromic and microbiological surveillance information has the potential to improve the care of children with RTIs by normalising illness (parents) and reducing uncertainty (clinicians). Currently, most RTI studies are conducted at the point of healthcare service consultation, leaving the community burden, microbiology, symptom duration and proportion consulting largely unknown. This study seeks to establish the feasibility of (mainly online) participant recruitment and retention, and the acceptability/comparability of parent versus nurse-collected microbiological sampling, to inform the design of a future surveillance intervention study. Evidence regarding consultation rates and symptom duration is also sought. Methods and analysis A community-based, feasibility prospective inception cohort study, recruiting children aged ≥3 months and <16 years and their parents via general practitioner surgery invitation letter, aiming to collect data on 300 incident RTIs by July 2016. Following informed consent, parents provide baseline (demographic) data online, and respond to weekly emails to confirm the absence/presence of new RTI symptoms. Once symptomatic, parents provide daily data online (RTI symptoms, school/day-care attendance, time off work, health service use, medication), and a research nurse visits to collect clinical examination data and microbiological (nasal and saliva) swabs. Parents are invited to provide symptomatic (at nurse visit, but without nurse assistance) and asymptomatic (alone) swabs on recovery. A review of primary care medical notes will gather medical history, health service utilisation, referral and antibiotic prescribing rates. Feasibility will be assessed using recruitment and retention rates, data completeness; and acceptability by quantitative survey and qualitative interviews

  5. The Western Sydney Stroke Risk in the Elderly Study. A 5-year prospective study.

    PubMed

    Gliksman, M D; Lazarus, R; Wilson, A; Leeder, S R; Koutts, J

    1994-01-01

    Aging of the Australian population, as in other developed nations, will ensure that stroke remains one of the most important causes of death and disability. The Stroke Risk in the Elderly (SITE) study aims to measure prospectively the independent contribution of dietary, sociodemographic, blood lipid, blood pressure, and hemostatic factors to risk of stroke and other cardiovascular outcomes. The target population included all independently living men and women aged 65 years and over, residents in several retirement villages in western metropolitan Sydney, New South Wales, Australia. The study cohort consists of 225 men and 787 women, selected as a convenience sample from all eligible residents in the local government areas (LGAs) adjacent to Westmead Hospital. Participants attended a baseline session to complete dietary, life-style, medical, and sociodemographic questionnaires. Anthropomorphic variables and blood pressure were measured. Blood was taken for measurement of serum lipid, glucose, and hemostatic factors. Questionnaire results were compared with an age/sex-stratified, randomly selected sample drawn from the community (in the same LGAs), in order to quantify potential sampling and selection biases. The study cohort will be followed for a minimum of 5 years. The attendance rate of eligible residents for a baseline medical, dietary, life-style, and sociodemographic assessment was 72% for males and 69% for females. The study cohort was older, better educated, less ethnically diverse, and among women, less likely to have ever been married compared to people aged over 65 years in the comparison group. The baseline results suggest that hemostatic factors may be of importance in assessing risk of cardiovascular disease, (CVD), particularly in older men.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Use and Safety of Anthroposophic Medications for Acute Respiratory and Ear Infections: A Prospective Cohort Study

    PubMed Central

    Hamre, Harald J.; Glockmann, Anja; Fischer, Michael; Riley, David S.; Baars, Erik; Kiene, Helmut

    2007-01-01

    Objective Anthroposophic medications (AMED) are widely used, but safety data on AMED from large prospective studies are sparse. The objective of this analysis was to determine the frequency of adverse drug reactions (ADR) to AMED in outpatients using AMED for acute respiratory and ear infections. Methods A prospective four-week observational cohort study was conducted in 21 primary care practices in Europe and the U.S.A. The cohort comprised 715 consecutive outpatients aged ≥1 month, treated by anthroposophic physicians for acute otitis and respiratory infections. Physicians’ prescription data and patient reports of adverse events were analyzed. Main outcome measures were use of AMED and ADR to AMED. Results Two patients had confirmed ADR to AMED: 1) swelling and redness at the injection site after subcutaneous injections of Prunus spinosa 5%, 2) sleeplessness after intake of Pneumodoron® 2 liquid. These ADR lasted one and two days respectively; both subsided after dose reduction; none were unexpected; none were serious. The frequency of confirmed ADR to AMED was 0.61% (2/327) of all different AMED used, 0.28% (2/715) of patients, and 0.004% (3/73,443) of applications. Conclusion In this prospective study, anthroposophic medications used by primary care patients with acute respiratory or ear infections were well tolerated. PMID:21901075

  7. Incidence of adverse cutaneous drug reactions in 22,866 Chinese inpatients: a prospective study.

    PubMed

    Tian, Xiao-Yin; Liu, Bing; Shi, Hao; Zhao, Zi-Ran; Zhou, Xi-Ping; Zhang, Tao; Sun, Qiu-Ning; Zuo, Ya-Gang

    2015-11-01

    Cutaneous adverse drug reactions (ADRs) are common. However, no prospective study assessing cutaneous ADRs is available for Chinese populations. This study aimed to assess the incidence, manifestations, causative drugs, and other factors related to cutaneous ADRs. A total of 22,866 inpatients were surveyed prospectively from January to April 2012 at the Peking Union Medical College Hospital. Only cutaneous ADRs induced by systemic drugs were considered. Fifty cases were confirmed as cutaneous ADRs, for an estimated incidence of 2.2 per 1000 during this period (95 % confidence interval 1.6-2.8). Cases of cutaneous ADRs comprised 69 % females, while 63 % of all inpatients were female (χ (2) = 0.641, P = 0.427). The department of infectious diseases was the most frequently involved department. Morbilliform exanthema (40 %) was the most frequent cutaneous ADR, followed by urticaria (23.1 %). Anti-infection drugs (36.9 %) caused most cases of cutaneous ADRs, followed by iodinated contrast media (ICM, 18.5 %) and non-steroidal anti-inflammatory drugs (NSAIDs, 18.5 %). The most frequently associated disorders were cancer (24 %), infection (22 %), cardiovascular and cerebrovascular diseases (20 %), and autoimmune diseases (18 %). In this first prospective study assessing the incidence of cutaneous ADRs in China, anti-infection drugs were the most commonly involved drugs, followed by ICM and NSAIDs. No evidence of increased cutaneous ADR incidence in AIDS or SLE patients was observed. Our findings indicate that cancer and its treatments were often related to cutaneous ADRs in China.

  8. Independent and combined relationship of habitual unhealthy eating behaviors with depressive symptoms: A prospective study

    PubMed Central

    Huang, Cong; Momma, Haruki; Cui, Yufei; Chujo, Masahiko; Otomo, Atsushi; Sugiyama, Shota; Ren, Zhongyu; Niu, Kaijun; Nagatomi, Ryoichi

    2016-01-01

    Background Unhealthy eating has been found to be associated with the prevalence of depressive symptoms. However, prospective evidence of the combined effects of unhealthy eating and depressive symptoms has not been reported. This study aimed to elucidate the prospective relationship between habitual unhealthy eating habits and depressive symptoms. Methods A 2-year prospective cohort study of 376 Japanese adults aged 24–83 years without depressive symptoms at baseline was conducted. Information about participants' eating behaviors was obtained via a self-administered questionnaire, in which skipping breakfast, eating dinner shortly before bedtime, and snacking after dinner were recorded. Depressive symptoms were assessed using the Japanese version of the Zung Self-rating Depression Scale. Results The 2-year incidence of depressive symptoms was found to be 23.7% (89/376). Covariate-adjusted multivariate Poisson regression analyses showed that habitual snacking after dinner was significantly associated with the incidence of depressive symptoms (relative risk [RR] 1.77; 95% confidence interval [CI], 1.00–3.14, p = 0.049), whereas no relationship was found between skipping breakfast or eating dinner shortly before bedtime and depressive symptoms. On the other hand, there was an interaction effect of snacking after dinner and dinner before bedtime on depressive symptoms (p for the interaction = 0.044). Participants with more than two unhealthy eating behaviors had a higher incidence of depressive symptoms compared to those with fewer than two unhealthy eating behaviors (RR 1.71; 95% CI, 1.06–2.77, p = 0.028). Conclusions This prospective study is the first to reveal the combined relationship between unhealthy eating and the incidence of depressive symptoms. PMID:28135197

  9. Antecedents of Intact Cognition and Dementia at Age 90: A Prospective Study

    PubMed Central

    Vaillant, George E.; Okereke, Olivia I; Mukamal, Kenneth; Waldinger, Robert J.

    2014-01-01

    Objectives To examine the possible antecedents of both dementia and sustained intact cognition at age 90 among men who underwent a prospective, multidisciplinary assessment from age 19 to 90, with little attrition. Methods A prospective 20-year reassessment of the 196 (out of 268) former Harvard College sophomores who survived until age 70. Begun in 1939 the Study gathered measurements of childhood environment, dominant personality traits, and objective mental and physical health over time, smoking in pack years, alcohol abuse and depression. Questionnaires were obtained every two years and physical exams every five years. Cognitive status was assessed at ages 80, 85 and 90. Results Despite addressing a wide variety health, behavioral and social factors over the lifespan, we observed few predictors with strong association with either intact cognition at age 90 (n = 40) or dementia (n = 44). Univariate analysis revealed seven suggestive predictors of intact cognition at age 90 or of dementia: warm childhood relationship with mother, exercise at age 60, high maternal education, young age of mother at subject’s birth, low BMI, good physical health at 60, and late retirement. Only the first 3 variables: warm childhood relationship with mother, exercise at age 60, and high maternal education remained significant with logistic regression. Conclusions In this prospective study of long-lived, highly educated men several well-known putative predictors of AD did not distinguish those who over the next 20 years developed dementia from those with unimpaired cognition until age 90. PMID:24733646

  10. Are Prospective Elementary School Teachers' Social Studies Teaching Efficacy Beliefs Related to Their Learning Approaches in a Social Studies Teaching Methods Course?

    ERIC Educational Resources Information Center

    Dündar, Sahin

    2015-01-01

    This study aimed to contribute to the growing literature on learning approaches and teacher self-efficacy beliefs by examining associations between prospective elementary school teachers' learning approaches in a social studies teaching methods course and their social studies teaching efficacy beliefs. One hundred ninety-two prospective elementary…

  11. Suicide prevention by lithium SUPLI--challenges of a multi-center prospective study.

    PubMed

    Lauterbach, Erik; Ahrens, Bernd; Felber, Werner; Oerlinghausen, Bruno Muller; Kilb, Birgit; Bischof, Gerd; Heuser, Isabella; Werner, Petra; Hawellek, Barbara; Maier, Wolfgang; Lewitzka, Ute; Pogarell, Oliver; Hegerl, Ulrich; Bronisch, Thomas; Richter, Kneginja; Niklewski, Günther; Broocks, Andreas; Hohagen, Fritz

    2005-01-01

    Several studies have shown that there is a significantly increased risk of suicide related mortality in patients with a positive history of suicide attempts. The SUPLI-Study is the first prospective, randomized, double blind, placebo controlled multi-center trial focusing on the proposed suicide preventive effects of lithium in patients with suicidal behavior but not suffering from bipolar disorder or recurrent major depressive disorder. Patients with a recent history of a suicide attempt are treated with lithium versus placebo during a 12 month period. The hypothesis is that lithium treatment will lead to a 50% reduction of suicidal behavior. The protocol of the study and preliminary results are presented.

  12. Aetiology of community acquired pneumonia in Valencia, Spain: a multicentre prospective study.

    PubMed Central

    Blanquer, J; Blanquer, R; Borrás, R; Nauffal, D; Morales, P; Menéndez, R; Subías, I; Herrero, L; Redón, J; Pascual, J

    1991-01-01

    A year long multicentre prospective study was carried out in the Valencia region of Spain, to determine the cause of community acquired pneumonia. The study was based on 510 of 833 patients with pneumonia. Of these, 462 were admitted to hospital, where 31 patients died. A cause was established in only 281 cases--208 of bacterial, 60 of viral, and 13 of mixed infection. The most common microorganisms were Streptococcus pneumoniae (14.5%), Legionella sp (14%), Influenza virus (8%), and Mycoplasma pneumoniae (4%). There was a higher incidence of Legionella sp than in other studies. PMID:1908605

  13. Chlamydia pneumoniae IgG titres and coronary heart disease: prospective study and meta-analysis

    PubMed Central

    Danesh, John; Whincup, Peter; Walker, Mary; Lennon, Lucy; Thomson, Andrew; Appleby, Paul; Wong, Yuk-ki; Bernardes-Silva, Martine; Ward, Michael

    2000-01-01

    Objective To examine the association between coronary heart disease and serum markers of chronic Chlamydia pneumoniae infection. Design “Nested” case-control analysis in a prospective cohort study and an updated meta-analysis of previous relevant studies. Setting General practices in 18 towns in Britain. Participants Of the 5661 men aged 40-59 who provided blood samples during 1978-80, 496 men who died from coronary heart disease or had non-fatal myocardial infarction and 989 men who had not developed coronary heart disease by 1996 were included. Main outcome measures IgG serum antibodies to C pneumoniae in baseline samples; details of fatal and non-fatal coronary heart disease from medical records and death certificates. Results 200 (40%) of the 496 men with coronary heart disease were in the top third of C pneumoniae titres compared with 329 (33%) of the 989 controls. The corresponding odds ratio for coronary heart disease was 1.66 (95% confidence interval 1.25 to 2.21), which fell to 1.22 (0.82 to 1.82) after adjustment for smoking and indicators of socioeconomic status. No strong associations were observed between C pneumoniae IgG titres and blood lipid concentrations, blood pressure, or plasma homocysteine concentration. In aggregate, the present study and 14 other prospective studies of C pneumoniae IgG titres included 3169 cases, yielding a combined odds ratio of 1.15 (0.97 to 1.36), with no significant heterogeneity among the separate studies (χ2=10.5, df=14; P>0.1). Conclusion This study, together with a meta-analysis of previous prospective studies, reliably excludes the existence of any strong association between C pneumoniae IgG titres and incident coronary heart disease. Further studies are required, however, to confirm or refute any modest association that may exist, particularly at younger ages. PMID:10903653

  14. Metacognitive beliefs and rumination as predictors of anger: A prospective study.

    PubMed

    Caselli, Gabriele; Offredi, Alessia; Martino, Francesca; Varalli, Davide; Ruggiero, Giovanni M; Sassaroli, Sandra; Spada, Marcantonio M; Wells, Adrian

    2017-02-23

    The metacognitive approach conceptualizes the relationship between anger and rumination as driven by metacognitive beliefs, which are information individuals hold about their own cognition and about coping strategies that impact on it. The present study aimed to test the prospective predictive impact of metacognitive beliefs and rumination on anger in a community sample. Seventy-six participants were recruited and engaged in a 2-week anger, rumination, and metacognitive beliefs monitoring protocol. A multi-wave panel design was employed to test whether metacognitive beliefs and rumination have a prospective impact on anger. Metacognitive beliefs and rumination were found to have a significant prospective impact on anger that was independent from the number of triggering events. Metacognitive beliefs about the need to control thoughts were shown to have a direct impact on subsequent anger, independently from rumination. These findings provide support for the potential value for applying metacognitive theory and therapy to anger-related problems. Aggr. Behav. 9999:1-9, 2017. © 2017 Wiley Periodicals, Inc.

  15. Pharmacovigilance study of Ayurvedic medicine in Ayurvedic Teaching Hospital: A prospective survey study

    PubMed Central

    Ajanal, Manjunath N.; Nayak, Shradda U.; Kadam, Avinash P.; Prasad, B. S.

    2015-01-01

    Introduction: Though Ayurveda is practiced in the Indian subcontinent since centuries, there is a paucity of systematic documentation related to the occurrence of adverse drug reactions (ADR) and other issues regarding the safety of Ayurveda medicines. Aim: To monitor and analyze the pattern and frequency of ADR to Ayurvedic medicines in an Ayurvedic hospital setup. Materials and Methods: In this prospective study, ADR monitoring was done in KLE Ayurveda Secondary Care Hospital, Belgaum, Karnataka, India by spontaneous and intensive monitoring technique for a span of 1-year (June 2010 to May 2011). Data pertaining to patient demography, drug and reaction characteristics, organ system involved and reaction outcomes were collected and evaluated. The reaction severity and predisposing factors were also assessed. Results: In a span of one year, 84 adverse drug events were reported out of which 52 confirmed as ADR. The overall incidence of ADR in the patient population was 1.14%, out of which 23 (44.23%) were related to Panchakarma (detoxification process), 13 (25.00%) related to the herbal formulations and 06 (11.53%) were of Rasa Aushadhi (mineral or herbo-mineral formulations). The commonly affected organ systems were gastrointestinal system 24 (46.15%) and skin 15 (28.84%). The majority of the reactions were moderate 30 (57.69%) to mild 20 (38.46%) in severity. Most patients recovered from the incidence. Conclusion: The present work has documented the incidence and characteristic of ADR to Ayurvedic medicine in a typical Ayurveda hospital setup. This will help in developing various strategies for boosting pharmacovigilance in Ayurveda, thereby ensuring safer use of Ayurveda medicines. PMID:27011712

  16. Prospective research on musculoskeletal disorders in office workers (PROMO): study protocol

    PubMed Central

    IJmker, Stefan; Blatter, Birgitte M; van der Beek, Allard J; van Mechelen, Willem; Bongers, Paulien M

    2006-01-01

    Background This article describes the background and study design of the PROMO study (Prospective Research on Musculoskeletal disorders in Office workers). Few longitudinal studies have been performed to investigate the risk factors responsible for the incidence of hand, arm, shoulder and neck symptoms among office workers, given the observation that a large group of office workers might be at risk worldwide. Therefore, the PROMO study was designed. The main aim is to quantify the contribution of exposure to occupational computer use to the incidence of hand, arm, shoulder and neck symptoms. The results of this study might lead to more effective and/or cost-efficient preventive interventions among office workers. Methods/Design A prospective cohort study is conducted, with a follow-up of 24 months. In total, 1821 participants filled out the first questionnaire (response rate of 74%). Data on exposure and outcome is collected using web-based self-reports. Outcome assessment takes place every three months during the follow-up period. Data on computer use are collected at baseline and continuously during follow-up using a software program. Discussion The advantages of the PROMO study include the long follow-up period, the repeated measurement of both exposure and outcome, and the objective measurement of the duration of computer use. In the PROMO study, hypotheses stemming from lab-based and field-based research will be investigated. PMID:16822300

  17. Electroencephalographic source imaging: a prospective study of 152 operated epileptic patients

    PubMed Central

    Brodbeck, Verena; Spinelli, Laurent; Lascano, Agustina M.; Wissmeier, Michael; Vargas, Maria-Isabel; Vulliemoz, Serge; Pollo, Claudio; Schaller, Karl; Michel, Christoph M.

    2011-01-01

    Electroencephalography is mandatory to determine the epilepsy syndrome. However, for the precise localization of the irritative zone in patients with focal epilepsy, costly and sometimes cumbersome imaging techniques are used. Recent small studies using electric source imaging suggest that electroencephalography itself could be used to localize the focus. However, a large prospective validation study is missing. This study presents a cohort of 152 operated patients where electric source imaging was applied as part of the pre-surgical work-up allowing a comparison with the results from other methods. Patients (n = 152) with >1 year postoperative follow-up were studied prospectively. The sensitivity and specificity of each imaging method was defined by comparing the localization of the source maximum with the resected zone and surgical outcome. Electric source imaging had a sensitivity of 84% and a specificity of 88% if the electroencephalogram was recorded with a large number of electrodes (128–256 channels) and the individual magnetic resonance image was used as head model. These values compared favourably with those of structural magnetic resonance imaging (76% sensitivity, 53% specificity), positron emission tomography (69% sensitivity, 44% specificity) and ictal/interictal single-photon emission-computed tomography (58% sensitivity, 47% specificity). The sensitivity and specificity of electric source imaging decreased to 57% and 59%, respectively, with low number of electrodes (<32 channels) and a template head model. This study demonstrated the validity and clinical utility of electric source imaging in a large prospective study. Given the low cost and high flexibility of electroencephalographic systems even with high channel counts, we conclude that electric source imaging is a highly valuable tool in pre-surgical epilepsy evaluation. PMID:21975586

  18. Growth, characterization, and properties of metastable and modulated semiconductor structures - Prospects for future studies

    NASA Technical Reports Server (NTRS)

    Grunthaner, F. J.; Madhukar, A.

    1983-01-01

    The general field of preparation and study of metastable and modulated semiconductor structures has progressed rapidly in recent years. This short overview offers an assessment of the progress and current understanding in the areas of fabrication, characterization, and utilization of these new material systems. The discussion includes the more prominent growth techniques, theoretical and experimental analysis of growth kinetics, and an overview of structural, chemical, electronic, and optical characterization. The probable application of these structures for the technological development of new device structures and concepts is considered. The discussion particularly emphasizes the prospects for future studies in view of the specific current understanding.

  19. Impact of Anti-Inflammatory Drugs on Pyogenic Vertebral Osteomyelitis: A Prospective Cohort Study

    PubMed Central

    Jean, Maxime; Bouchand, Frédérique; Davido, Benjamin; Descatha, Alexis; Duran, Clara; Gras, Guillaume; Perronne, Christian; Mulleman, Denis; Salomon, Jérôme; Bernard, Louis

    2016-01-01

    Objective. Pyogenic vertebral osteomyelitis (PVO) are frequently misdiagnosed and patients often receive anti-inflammatory drugs for their back pain. We studied the impact of these medications. Methods. We performed a prospective study enrolling patients with PVO and categorized them depending on their drugs intake. Then, we compared diagnosis delay, clinical presentation at hospitalization, incidence of complications, and cure rate. Results. In total, 79 patients were included. Multivariate analysis found no correlation between anti-inflammatory drug intake and diagnosis delay, clinical presentation, complications, or outcome. Conclusion. Anti-inflammatory drugs intake does not affect diagnostic delay, severity at diagnosis, or complications of PVO. PMID:27833642

  20. Characteristics of Abductive Inquiry in Earth and Space Science: An Undergraduate Teacher Prospective Case Study

    NASA Astrophysics Data System (ADS)

    Ramalis, T. R.; Liliasari; Herdiwidjaya, D.

    2016-08-01

    The purpose this case study was to describe characteristic features learning activities in the domain of earth and space science. Context of this study is earth and space learning activities on three groups of student teachers prospective, respectively on the subject of the shape and size of Earth, land and sea breeze, and moon's orbit. The analysis is conducted qualitatively from activity data and analyze students doing project work, student worksheets, group project report documents, note and audio recordings of discussion. Research findings identified the type of abduction: theoretical models abduction, factual abduction, and law abduction during the learning process. Implications for science inquiry learning as well as relevant research were suggested.

  1. Dietary fiber intake and mortality among survivors of myocardial infarction: prospective cohort study

    PubMed Central

    Flint, Alan; Pai, Jennifer K; Forman, John P; Hu, Frank B; Willett, Walter C; Rexrode, Kathryn M; Mukamal, Kenneth J; Rimm, Eric B

    2014-01-01

    Objective To evaluate the associations of dietary fiber after myocardial infarction (MI) and changes in dietary fiber intake from before to after MI with all cause and cardiovascular mortality. Design Prospective cohort study. Setting Two large prospective cohort studies of US women and men with repeated dietary measurements: the Nurses’ Health Study and the Health Professionals Follow-Up Study. Participants 2258 women and 1840 men who were free of cardiovascular disease, stroke, or cancer at enrollment, survived a first MI during follow-up, were free of stroke at the time of initial onset of MI, and provided food frequency questionnaires pre-MI and at least one post-MI. Main outcome measures Associations of dietary fiber post-MI and changes from before to after MI with all cause and cardiovascular mortality using Cox proportional hazards models, adjusting for drug use, medical history, and lifestyle factors. Results Higher post-MI fiber intake was significantly associated with lower all cause mortality (comparing extreme fifths, pooled hazard ratio 0.75, 95% confidence interval 0.58 to 0.97). Greater intake of cereal fiber was more strongly associated with all cause mortality (pooled hazard ratio 0.73, 0.58 to 0.91) than were other sources of dietary fiber. Increased fiber intake from before to after MI was significantly associated with lower all cause mortality (pooled hazard ratio 0.69, 0.55 to 0.87). Conclusions In this prospective study of patients who survived MI, a greater intake of dietary fiber after MI, especially cereal fiber, was inversely associated with all cause mortality. In addition, increasing consumption of fiber from before to after MI was significantly associated with lower all cause and cardiovascular mortality. PMID:24782515

  2. Height and Risk of Hip Fracture: A Meta-Analysis of Prospective Cohort Studies

    PubMed Central

    Xiao, Zhihong; Ren, Dong; Feng, Wei; Chen, Yan; Kan, Wusheng

    2016-01-01

    The association between height and risk of hip fracture has been investigated in several studies, but the evidence is inconclusive. We therefore conducted this meta-analysis of prospective cohort studies to explore whether an association exists between height and risk of hip fracture. We searched PubMed and EMBASE, Web of Science, and the Cochrane Library for studies of height and risk of hip fracture up to February 16, 2016. The random-effects model was used to combine results from individual studies. Seven prospective cohort studies, with 7,478 incident hip fracture cases and 907,913 participants, were included for analysis. The pooled relative risk (RR) was 1.65 (95% confidence interval (CI): 1.26–2.16) comparing the highest with the lowest category of height. Result from dose-response analysis suggested a linear association between height and hip fracture risk (P-nonlinearity = 0.0378). The present evidence suggests that height is positively associated with increased risk of hip fracture. Further well-designed cohort studies are needed to confirm the present findings in other ethnicities. PMID:27818998

  3. Relationship between young peoples' sedentary behaviour and biomedical health indicators: a systematic review of prospective studies.

    PubMed

    Chinapaw, M J M; Proper, K I; Brug, J; van Mechelen, W; Singh, A S

    2011-07-01

    The aim of this systematic review was to describe the prospective relationship between childhood sedentary behaviour and health indicators. We identified prospective studies from searches in PubMed, EMBASE, PsycInfo and Cochrane, from January 1989 through April 2010. Two reviewers independently screened the titles and abstracts for eligibility, rated the methodological quality of the studies, and extracted data. We identified 31 papers, examining 27 different cohorts. The quality score of the studies ranged from 38 to 88%. Nine studies were scored as high quality. According to the best evidence synthesis we found insufficient evidence for a longitudinal positive relationship between 'sedentary time'- mainly TV viewing - and body mass index (BMI) and more specific indicators of fat mass. One high quality and two low quality studies found a significant inverse relationship between sedentary time - mainly TV viewing - and aerobic fitness, leading to moderate evidence for this inverse relationship. There was insufficient evidence for a longitudinal relationship between sedentary time and blood pressure, blood lipids or bone mass. Our systematic review suggests that there is moderate evidence for a longitudinal inverse relationship between screen time and aerobic fitness during childhood. Thus there is evidence to limit screen time in young people in order to prevent low levels of fitness. The possible detrimental health effects of prolonged or excessive sitting on other health indicators needs further study.

  4. Natural History of Spinocerebellar Ataxia Type 31: a 4-Year Prospective Study.

    PubMed

    Nakamura, Katsuya; Yoshida, Kunihiro; Matsushima, Akira; Shimizu, Yusaku; Sato, Shunichi; Yahikozawa, Hiroyuki; Ohara, Shinji; Yazawa, Masanobu; Ushiyama, Masao; Sato, Mitsuto; Morita, Hiroshi; Inoue, Atsushi; Ikeda, Shu-Ichi

    2017-04-01

    Spinocerebellar ataxia type 31 (SCA31) is known as a late-onset, relatively pure cerebellar form of ataxia, but a longitudinal prospective study on the natural history of SCA31 has not been done yet. In this prospective cohort study, we enrolled 44 patients (mean ± standard deviation 73.6 ± 8.5 years) with genetically confirmed SCA31 from 10 ataxia referral centers in the Nagano area, Japan. Patients were evaluated every year for 4 years using the Scale for the Assessment and Rating of Ataxia (SARA) and the Barthel Index (BI). Of the 176 follow-up visits (91.5%), 161 were completed in this study. Five patients (11.4%) died during the follow-up period, and two patients (4.5%) were lost to follow-up. The annual progression of the SARA score was 0.8 ± 0.1 points/year and that of the BI was -2.3 ± 0.4 points/year (mean ± standard error). Shorter disease duration at baseline was associated with faster progression of the SARA score. Our study indicated the averaged clinical course of SCA31 as follows: the patients develop ataxic symptoms at 58.5 ± 10.3 years, become wheelchair bound at 79.4 ± 1.7 years, and died at 88.5 ± 0.7 years. Our prospective dataset provides important information for clinical trials of forthcoming disease-modifying therapies for cerebellar ataxia. It also represents a useful resource for SCA31 patients and their family members in genetic counseling sessions.

  5. Increased Cardiovascular Events and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients: 1 Year Prospective Single Centre Study

    PubMed Central

    Ruscitti, Piero; Cipriani, Paola; Masedu, Francesco; Romano, Silvio; Berardicurti, Onorina; Liakouli, Vasiliki; Carubbi, Francesco; Di Benedetto, Paola; Alvaro, Saverio; Penco, Maria; Valenti, Marco; Giacomelli, Roberto

    2017-01-01

    Objectives Several studies showed the close relationship between Rheumatoid Arthritis (RA) and cerebro-cardiovascular events (CVEs) and subclinical atherosclerosis. In this study, we investigated the occurrence of CVEs and subclinical atherosclerosis during the course of RA and we evaluated the possible role of both traditional cardiovascular (CV) and disease related risk factors to predict the occurrence of new CVEs and the onset of subclinical atherosclerosis. Methods We designed a single centre, bias-adjusted, prospective, observational study to investigate, in a homogeneous subset of RA patients, the occurrence of new onset of CVEs and subclinical atherosclerosis. Statistical analyses were performed to evaluate the role of traditional CV and disease-related risk factors to predict the occurrence of new CVEs and subclinical atherosclerosis. Results We enrolled 347 RA patients prospectively followed for 12 months. An increased percentage of patients experienced CVEs, developed subclinical atherosclerosis and was affected by systemic arterial hypertension (SAH), type 2 diabetes mellitus and metabolic syndrome (MS), at the end of follow up. Our analysis showed that the insurgence of both SAH and MS, during the follow up, the older age, the CVE familiarity and the lack of clinical response, were associated with a significantly increased risk to experience CVEs and to develop subclinical atherosclerosis. Conclusions Our study quantifies the increased expected risk for CVEs in a cohort of RA patients prospectively followed for 1 year. The occurrence of both new CVEs and subclinical atherosclerosis in RA patients may be explained by inflammatory burden as well as traditional CV risk factors. PMID:28103312

  6. A one-year prospective study of refractory status epilepticus in Modena, Italy.

    PubMed

    Giovannini, Giada; Monti, Giulia; Polisi, Michela M; Mirandola, Laura; Marudi, Andrea; Pinelli, Giovanni; Valzania, Franco; Girardis, Massimo; Nichelli, Paolo F; Meletti, Stefano

    2015-08-01

    Refractory status epilepticus (RSE) is a particular critical condition characterized by seizures that continue despite the use of first- and second-line therapies and by high mortality. To date, only one prospective study investigated clinical features and prognostic factors in RSE. In this study, we performed a one-year prospective survey to identify clinical features, outcomes, and variables associated with the development of RSE in the adolescent and adult population of Modena, northern Italy. We observed 83 episodes of SE in 83 patients. In 31% of the cases, third-line therapy (anesthetic drug) was needed. Among this group, 14% resolved and were classified as RSE, while, in 17%, seizures recurred at withdrawal of anesthetics and were classified as super-RSE. The development of RSE/super-RSE was associated with a stuporous/comatose state at presentation and with the absence of a previous history of epilepsy. Refractory status epilepticus/super-refractory status epilepticus showed a worse outcome compared with responsive SE: 54% versus 21% for 30-day mortality; 19% versus 56% for a return to baseline condition. This prospective study confirms stupor/coma at onset as a relevant clinical factor associated with SE refractoriness. We observed a rate of RSE comparable with previous reports, with high mortality and morbidity. Mortality in the observed RSE was higher than in previous studies; this result is probably related to the low rate of a previous epilepsy history in our population that reflects a high incidence of acute symptomatic etiologies, especially the inclusion of patients with postanoxic SE who have a bad prognosis per se. This article is part of a Special Issue entitled "Status Epilepticus".

  7. Calcium intake and risk of cardiovascular disease: a review of prospective studies and randomized clinical trials.

    PubMed

    Wang, Lu; Manson, JoAnn E; Sesso, Howard D

    2012-04-01

    The potential effects of inadequate or excessive calcium supply on cardiovascular disease (CVD) are receiving growing attention. We review experimental, epidemiologic, and clinical evidence regarding the role of calcium intake in the development of CVD in adults. In vitro and in vivo laboratory studies have shown that calcium may affect the risk of developing CVD through multiple mechanisms including blood cholesterol, insulin secretion and sensitivity, vasodilation, inflammatory profile, thrombosis, obesity, and vascular calcification. A number of prospective epidemiologic studies have examined the relationship between dietary calcium intake and CVD incidence or mortality in middle-aged and older adults. The results were inconsistent, and the pooled data do not strongly support a significant effect of greater dietary calcium intake on the risk of coronary artery disease (CAD) or stroke. Only a few prospective studies have examined calcium supplement use in association with risk of CVD. The pooled data show no significant benefits of calcium supplement use in reducing the risk of CAD or stroke. No randomized clinical trial has specifically tested the effect of calcium supplementation on CVD as its primary endpoint. Secondary analyses in existing trials to date suggest a neutral effect of calcium (with or without vitamin D) supplements on CVD events, but do not allow for a definitive conclusion. A large percentage of Americans, particularly older adults, fail to meet the US recommendations for optimal calcium intake and are encouraged to increase daily calcium consumption. More prospective cohort studies and large-scale randomized trials are needed to further evaluate the risks or benefits of calcium supplementation on CVD endpoints as the primary pre-specified outcome.

  8. Paris Prospective Study III: a study of novel heart rate parameters, baroreflex sensitivity and risk of sudden death.

    PubMed

    Empana, Jean-Philippe; Bean, Kathy; Guibout, Catherine; Thomas, Frédérique; Bingham, Annie; Pannier, Bruno; Boutouyrie, Pierre; Jouven, Xavier

    2011-11-01

    Resting heart rate has been related to the risk of cardiovascular disease and sudden death in several large prospective studies. To investigate prospectively the association of novel heart rate parameters and of carotid artery stiffness with sudden death and other cardiovascular disease. The Paris Prospective Study III (PPS3) is a new, ongoing French prospective study. From June 2008 to December 2011, 10,000 men and women aged 50-75 years who will have a preventive medical check-up at the Centre d'Investigations Préventives et Cliniques in Paris (France), will be enrolled in the study, after signing an informed consent. In addition to the general health examination, each subject's heart rhythm will be recorded during the course of the health check-up (approximately 2(1/2) h) and an echo-tracking of the right carotid bulb will be performed by trained technicians. A bio bank and DNA bank will be established for further biomarker and genetic analyses. The occurrence of cardiovascular disease including acute coronary syndrome, stroke, peripheral artery disease and sudden death, and of mortality, of the participants will be followed up during 20 years. With an estimated mean annual rate of sudden death of 0.1% and its increasing incidence rate with age, between 250 and 300 sudden deaths are expected. This unique study should provide new insights into the regulation of heart rate and blood pressure and should enable to identify novel heart rate parameters that are associated with sudden death.

  9. Dietary fiber intake and total mortality: a meta-analysis of prospective cohort studies.

    PubMed

    Kim, Youngyo; Je, Youjin

    2014-09-15

    Greater intake of dietary fiber has been associated with lower risk of several chronic diseases. Some observational studies have examined the association between dietary fiber intake and total mortality, but the results were inconclusive. We conducted a meta-analysis of data from prospective cohort studies to quantitatively assess the association. Eligible studies were identified by searching the PubMed and Embase databases for all articles published through November 30, 2013, and by reviewing the reference lists of retrieved articles. Study-specific estimates adjusting for potential confounders were combined to calculate a pooled relative risk and 95% confidence interval using a random-effects model. Seven prospective cohort studies of dietary fiber intake and total mortality, including 62,314 deaths among 908,135 participants, were identified. The pooled adjusted relative risk of total mortality for the highest category of dietary fiber intake versus the lowest was 0.77 (95% confidence interval: 0.74, 0.80). In a dose-response meta-analysis, the pooled adjusted relative risk for a 10-g/day increment of dietary fiber intake was 0.89 (95% confidence interval: 0.85, 0 92). By source of fiber, cereal and, to a lesser extent, vegetable fiber were significantly associated with lower total mortality, while fruit fiber showed no association. In conclusion, high dietary fiber intake may reduce the risk of total mortality.

  10. Comparative Study for Efficacy and Safety of Adenoidectomy according to the Surgical Method: A Prospective Multicenter Study

    PubMed Central

    Lee, Woo Hyun; Kim, Dong-Kyu; Kim, Sung Wan; Kim, Young Hyo; Nam, Jung Gwon; Park, Seok-Won; Park, Chan-Soon; Bae, Woo Yong; Yeo, Nam-Kyung; Won, Tae-Bin; Lee, Seung Hoon; Lee, Tae-Hoon; Lee, Hyoung Joo; Kim, Sang-Wook; Jeong, Sung-Wook; Choi, Jeong-Seok; Han, Doo Hee; Choi, Ji Ho

    2015-01-01

    Background/Objective There have been several operative techniques for adenoidectomy and their efficacy and morbidity are different according to the technique. This prospective multicenter study was aimed to compare the efficacy and morbidity of coblation adenoidectomy (CA) with those of power-assisted adenoidectomy. Study Design Prospective multi-institutional study. Methods Children who underwent CA, power-assisted adenoidectomy with cauterization (PAA+C) or without cauterization (PAA-C) due to adenoid hypertrophy were enrolled from 13 hospitals between July 2013 and June 2014. Mean operation time, degree of intraoperative bleeding and postoperative bleeding rate were evaluated. Results A total of 388 children (mean age ± standard deviation = 6.6 ± 2.5 years; 245 males and 143 females) were included. According to the adenoidectomy technique, the children were classified into 3 groups: (1) CA (n = 116); (2) PAA+C (n = 153); and (3) PAA-C (n = 119). Significant differences were not found in age and sex among three groups. In the CA group, mean operation time was significantly shorter (P < 0.001) and degree of intraoperative bleeding was significantly less (P < 0.001) compared to PAA+C or PAA-C group. Delayed postoperative bleeding rate of PAA-C group was significantly higher than that of CA or PAA+C group (P = 0.016). Conclusions This prospective multicenter study showed that CA was superior to PAA in terms of mean operation time and degree of intraoperative bleeding. PMID:26267337

  11. Predicting mortality with biomarkers: a population-based prospective cohort study for elderly Costa Ricans

    PubMed Central

    2012-01-01

    Background Little is known about adult health and mortality relationships outside high-income nations, partly because few datasets have contained biomarker data in representative populations. Our objective is to determine the prognostic value of biomarkers with respect to total and cardiovascular mortality in an elderly population of a middle-income country, as well as the extent to which they mediate the effects of age and sex on mortality. Methods This is a prospective population-based study in a nationally representative sample of elderly Costa Ricans. Baseline interviews occurred mostly in 2005 and mortality follow-up went through December 2010. Sample size after excluding observations with missing values: 2,313 individuals and 564 deaths. Main outcome: prospective death rate ratios for 22 baseline biomarkers, which were estimated with hazard regression models. Results Biomarkers significantly predict future death above and beyond demographic and self-reported health conditions. The studied biomarkers account for almost half of the effect of age on mortality. However, the sex gap in mortality became several times wider after controlling for biomarkers. The most powerful predictors were simple physical tests: handgrip strength, pulmonary peak flow, and walking speed. Three blood tests also predicted prospective mortality: C-reactive protein (CRP), glycated hemoglobin (HbA1c), and dehydroepiandrosterone sulfate (DHEAS). Strikingly, high blood pressure (BP) and high total cholesterol showed little or no predictive power. Anthropometric measures also failed to show significant mortality effects. Conclusions This study adds to the growing evidence that blood markers for CRP, HbA1c, and DHEAS, along with organ-specific functional reserve indicators (handgrip, walking speed, and pulmonary peak flow), are valuable tools for identifying vulnerable elderly. The results also highlight the need to better understand an anomaly noted previously in other settings: despite the

  12. Medial tibial pain. A prospective study of its cause among military recruits.

    PubMed

    Milgrom, C; Giladi, M; Stein, M; Kashtan, H; Margulies, J; Chisin, R; Steinberg, R; Swissa, A; Aharonson, Z

    1986-12-01

    In a prospective study of 295 infantry recruits during 14 weeks of basic training, 41% had medial tibial pain. Routine scintigraphic evaluation in cases of medial tibial bone pain showed that 63% had abnormalities. A stress fracture was found in 46%. Only two patients had periostitis. None had ischemic medial compartment syndrome. Physical examination could not differentiate between cases with medial tibial bone pain secondary to stress fractures and those with scintigraphically normal tibias. When both pain and swelling were localized in the middle one-third of the tibia, the lesion most likely proved to be a stress fracture.

  13. Computed tomography versus ultrasound of the adrenal gland: a prospective study

    SciTech Connect

    Abrams, H.L.; Siegelman, S.S.; Adams, D.F.; Sanders, R.; Finberg, H.J.; Hessel, S.J.; McNeil, B.J.

    1982-04-01

    A prospective study of the accuracy of computed tomography (CT) and ultrasound was undertaken in 112 consecutive patients with suspected adrenal disease. CT had a sensitivity of 84% (47/56), a specificity of 98% (55/56), and an accuracy of 90%. Ultrasound had a sensitivity of 79% (22/28), a specificity of 61% (14/23), and an overall accuracy of 70%. When patients with Cushing disease and adrenal hyperplasia were excluded, and only masses such as pheochromocytoma, adenoma, and carcinoma were considered, the sensitivity of both CT and ultrasound was increased. Receiver operating characteristic (ROC) curves differed for CT and ultrasound, and strongly supported the diagnostic superiority of CT.

  14. Stress responses after pediatric bone marrow transplantation: preliminary results of a prospective longitudinal study.

    PubMed

    Stuber, M L; Nader, K; Yasuda, P; Pynoos, R S; Cohen, S

    1991-11-01

    This paper reports the preliminary findings of a longitudinal prospective study of young children undergoing bone marrow transplantation. Symptoms of post-traumatic stress were seen in these children up to 12 months after transplant. The bone marrow transplantation survivors demonstrated more denial and avoidance and fewer arousal symptoms than has been noted in children traumatized by a violent life threat, such as a sniper attack. These data suggest the use of post-traumatic stress as a model in understanding some of the symptoms of pediatric bone marrow transplantation survivors and may be applicable to other children exposed to the double life threat of serious illness and intensive medical intervention.

  15. Cholesterol and breast cancer risk: a systematic review and meta-analysis of prospective studies.

    PubMed

    Touvier, Mathilde; Fassier, Philippine; His, Mathilde; Norat, Teresa; Chan, Doris S M; Blacher, Jacques; Hercberg, Serge; Galan, Pilar; Druesne-Pecollo, Nathalie; Latino-Martel, Paule

    2015-08-14

    The objective of the present study was to conduct the first systematic review and meta-analysis of prospective studies investigating the associations between total cholesterol (TC), HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C) levels and the risk of breast cancer. Relevant studies were identified in PubMed (up to January 2014). Inclusion criteria were original peer-reviewed publications with a prospective design. Random-effects models were used to estimate summary hazard ratios (HR) and 95% CI. Distinction was made between studies that did or did not exclude cancer cases diagnosed during the first years of follow-up, thereby eliminating potential preclinical bias. Overall, the summary HR for the association between TC and breast cancer risk was 0.97 (95% CI 0.94, 1.00; dose-response per 1 mmol/l increment, thirteen studies), and that between HDL-C and breast cancer risk was 0.86 (95% CI 0.69, 1.09; dose-response per 1 mmol/l increment, six studies), with high heterogeneity (I2= 67 and 47%, respectively). For studies that eliminated preclinical bias, an inverse association was observed between the risk of breast cancer and TC (dose-response HR 0.94 (95% CI 0.89, 0.99), seven studies, I2= 78%; highest v. lowest HR 0.82 (95% CI 0.66, 1.02), nine studies, I2= 81%) and HDL-C (dose-response HR 0.81 (95% CI 0.65, 1.02), five studies, I2= 30 %; highest v. lowest HR 0.82 (95% CI 0.69, 0.98), five studies, I2= 0%). There was no association observed between LDL-C and the risk of breast cancer (four studies). The present meta-analysis confirms the evidence of a modest but statistically significant inverse association between TC and more specifically HDL-C and the risk of breast cancer, supported by mechanistic plausibility from experimental studies. Further large prospective studies that adequately control for preclinical bias are needed to confirm the results on the role of cholesterol level and its fractions in the aetiology of breast cancer.

  16. PEDIATRIC DELIRIUM AND ASSOCIATED RISK FACTORS: A SINGLE-CENTER PROSPECTIVE OBSERVATIONAL STUDY

    PubMed Central

    Gerber, Linda M.; Sun, Xuming; Kearney, Julia; Patel, Anita; Greenwald, Bruce

    2016-01-01

    Objective To describe a single-institution pilot study regarding prevalence and risk factors for delirium in critically ill children. Design A prospective observational study, with secondary analysis of data collected during the validation of a pediatric delirium screening tool, the Cornell Assessment of Pediatric Delirium (CAPD). Setting This study took place in the pediatric intensive care unit (PICU) at an urban academic medical center. Patients 99 consecutive patients, ages newborn to 21 years. Intervention Subjects underwent a psychiatric evaluation for delirium based on the DSM-IV criteria. Measurements and Main Results Prevalence of delirium in this sample was 21%. In multivariate analysis, risk factors associated with the diagnosis of delirium were presence of developmental delay, need for mechanical ventilation, and age 2-5 years. Conclusions In our institution, pediatric delirium is a prevalent problem, with identifiable risk factors. Further large-scale prospective studies are required to explore multi-institutional prevalence, modifiable risk factors, therapeutic interventions, and effect on long-term outcomes. PMID:25647240

  17. Calcium intake and hip fracture risk: a meta-analysis of prospective cohort studies

    PubMed Central

    Wang, Dong; Chen, Xiao-Hu; Fu, Guo; Gu, Li-Qiang; Zhu, Qing-Tang; Liu, Xiao-Lin; Qi, Jian; Xiang, Jian-Ping

    2015-01-01

    It has been suggested that the amount of calcium intake may influence hip fracture incidence. However, the results of the researches in this regard are inconsistent. We performed this meta-analysis to estimate the association between calcium intake and hip fracture risk. Prospective cohort studies on calcium intake and hip fracture risk were identified by searching databases from the period 1960 to 2014. Results from individual studies were synthetically combined using STATA 11 software. The results indicated that a total of 8 prospective cohort studies were included in our meta-analysis, involving 2,435 cases and 267,759 participants. The combined relative risk (RR) of hip fracture for highest compared with lowest amount calcium intake was 0.97 (95% confidence interval [CI]: 0.89-1.07). Little evidence of publication bias was found. In conclusion, this meta-analysis provides evidence of no association between calcium intake and hip fracture risk. However, this finding is based on only a limited number of included studies. PMID:26550430

  18. Workplace Exercise for Control of Occupational Neck/Shoulder Disorders: A Review of Prospective Studies

    PubMed Central

    Lowe, Brian D; Dick, Robert B

    2014-01-01

    A review was conducted of prospective studies (1997–2014) examining the efficacy of exercise as a workplace intervention to control neck/shoulder pain, symptoms, and disability. The review identified 38 relevant studies – 20 were classified with positive effects, 13 with null effects, and 5 as inconclusive. Of the positive studies, 12 were consistent with Level I evidence, 3 with Level II evidence, and 5 with Level IV evidence. Specific resistance training (SRT) exercise appeared to be associated with more positive studies (eight Level I studies) than other exercise modalities such as general resistance training, general physical exercise, stretching, and movement awareness exercises. Studies of longer trial duration tended toward more null findings and lower program compliance. Evidence for a primary preventive effect of workplace exercise is minimal. The findings of this review suggest that workplace exercise can be effective as tertiary prevention and therapeutic relief of neck/shoulder symptoms, at least over the shorter term. PMID:25780338

  19. General health status and incidence of first-onset temporomandibular disorder: OPPERA prospective cohort study

    PubMed Central

    Sanders, Anne E.; Slade, Gary D.; Bair, Eric; Fillingim, Roger B.; Knott, Charles; Dubner, Ronald; Greenspan, Joel D.; Maixner, William; Ohrbach, Richard

    2013-01-01

    Temporomandibular disorders (TMD) overlap with other health conditions but no study has examined which of these conditions increase the risk of developing first-onset TMD. The authors prospectively evaluated the relationship between health status at enrollment and subsequent incidence of TMD in 2,722 men and women. Participants aged 18–44 years had no history of TMD and were clinically free of TMD when enrolled in 2006–08 at four U.S. study sites in the OPPERA prospective cohort study. First-onset examiner-classified TMD developed in 260 people over a median 2.8 years of follow-up. Cox regression estimated the association between health conditions and TMD incidence while accounting for potential confounders. Incidence of first-onset TMD was 50% higher for people with lower back pain (adjusted hazard ratio [AHR] = 1.50, 95% confidence limits [95% CL]: 1.08, 2.10) and 75% higher for people with genital pain symptoms (AHR = 1.75 [95% CL: 1.04, 2.93]) than people without a history of these pain disorders. Digit ratio, a marker of intra-uterine exposure to sex hormones, was significantly associated with TMD incidence. Other independent predictors of first-onset TMD were sleep disturbance and cigarette smoking. These findings reveal multiple-influences of health status on incidence of first-onset TMD. PMID:24275223

  20. Sexual orientation disparities in weight status in adolescence: findings from a prospective study.

    PubMed

    Austin, S Bryn; Ziyadeh, Najat J; Corliss, Heather L; Haines, Jess; Rockett, Helaine R; Wypij, David; Field, Alison E

    2009-09-01

    A growing number of studies among adult women have documented disparities in overweight adversely affecting lesbian and bisexual women, but few studies have examined sexual orientation-related patterns in weight status among men or adolescents. We examined sexual orientation group trends in BMI (kg/m(2)), BMI Z-scores, and overweight using 56,990 observations from 13,785 adolescent females and males in the Growing Up Today Study (GUTS), a large prospective cohort of US youth. Participants provided self-reported information from six waves of questionnaire data collection from 1998 to 2005. Gender-stratified linear regression models were used to estimate BMI and BMI Z-scores and modified Poisson regression models to estimate risk ratios for overweight, controlling for age and race/ethnicity, with heterosexuals as the referent group. Among females, we observed fairly consistently elevated BMI in all sexual orientation minority groups relative to heterosexual peers. In contrast, among males we documented a sexual-orientation-by-age interaction indicating steeper increases in BMI with age from early-to-late adolescence in heterosexuals relative to sexual orientation minorities. Additional prospective research is needed to understand the determinants of observed sexual orientation disparities and to inform appropriate preventive and treatment interventions. The long-term health consequences of overweight are well-documented and over time are likely to exact a high toll on populations with elevated rates.

  1. Complications from submental endotracheal intubation: a prospective study and literature review.

    PubMed

    de Toledo, Guilherme Lacerda; Bueno, Sebastião Cristian; Mesquita, Ricardo Alves; Amaral, Márcio Bruno Figueiredo

    2013-06-01

    Submental endotracheal intubation, as compared to the use of tracheotomy, is an alternative for the surgical management of maxillofacial trauma, as described by Altemir FH (The submental route for endotracheal intubation: a new technique. J Maxillofac Surg 1986; 14: 64). Although the submental endotracheal intubation is a useful technique, a wide range of complications have been reported in the literature. The core aim of this article is to present additional data from 17 patients who have undergone submental endotracheal intubation and who have received at least 6 months of postoperative follow up. A prospective study was carried out on patients who suffered maxillofacial trauma between 2008 and 2011. Age, gender, etiology of trauma, fracture type, complications, and follow up were evaluated. Case series, as well as retrospective and prospective studies regarding submental endotracheal intubation in maxillofacial trauma, were also reviewed. This study demonstrated a low rate of complications in submental endotracheal intubation and no increase in operative time within the evaluated sample. The submental endotracheal intubation may be considered a simple, secure, and effective technique for operative airway control in major maxillofacial traumas.

  2. A prospective study on hyponatraemia in medical cancer patients: epidemiology, aetiology and differential diagnosis.

    PubMed

    Berghmans, T; Paesmans, M; Body, J J

    2000-05-01

    The frequency of hyponatraemia varies from less than 1% to more than 40% in series reported from general hospitals. We performed a prospective study to evaluate its incidence and to determine the types of hyponatraemia in a dedicated cancer hospital. All patients admitted to the Department of Medicine were prospectively studied over 11 months. Hyponatraemia was defined as a serum Na level < or =130 mEq/l. Urine and blood samples were collected at baseline, and all consecutive hyponatraemic episodes were studied. One hundred and six patients developed 123 episodes of hyponatraemia. The observed incidence of hyponatraemia was 3.7%. Sodium depletion and syndrome of inappropriate antidiuretic hormone secretion (SIADH) each accounted for almost one third of all aetiologies. Serum urea and uric acid, urinary Na and fractional excretions of Na and urea were most useful for the differential diagnosis. The percentage of deaths observed in the hyponatraemic group, 19.5%, was higher than in the whole cancer population (6.3%) although no death was apparently due directly to hyponatraemia. Hyponatraemia is regularly diagnosed in cancer patients, but it was related to SIADH in only about one third of the cases. A higher mortality was observed in hyponatraemic patients than in normonatraemic patients.

  3. Dietary and circulating lycopene and stroke risk: a meta-analysis of prospective studies

    PubMed Central

    LI, Xinli; XU, Jiuhong

    2014-01-01

    Epidemiological studies support a protective role of lycopene against stroke occurrence or mortality, but the results have been conflicting. We conducted a meta-analysis to assess the relationship between dietary or circulating lycopene and stroke risk (including stroke occurrence or mortality). Relevant papers were collected by screening the PubMed database through October 2013. Only prospective studies providing relative risk estimates with 95% confidence intervals for the association between lycopene and stroke were included. A random-effects model was used to calculate the pooled estimate. Subgroup analysis was conducted to investigate the effects of various factors on the final results. The pooled analysis of seven prospective studies, with 116,127 participants and 1,989 cases, demonstrated that lycopene decreased stroke risk by 19.3% (RR = 0.807, 95% CI = 0.680–0.957) after adjusting for confounding factors. No heterogeneity was observed (p = 0.234, I2 = 25.5%). Circulating lycopene, not dietary lycopene, was associated with a statistically significant decrease in stroke risk (RR = 0.693, 95% CI = 0.503–0.954). Lycopene could protect European, or males against stroke risk. Duration of follow-up had no effect on the final results. There was no evidence of publication bias. Lycopene, especially circulating lycopene, is negatively associated with stroke risk. PMID:24848940

  4. Coffee consumption and risk of gastric and pancreatic cancer--a prospective cohort study.

    PubMed

    Bidel, Siamak; Hu, Gang; Jousilahti, Pekka; Pukkala, Eero; Hakulinen, Timo; Tuomilehto, Jaakko

    2013-04-01

    Only few prospective studies have examined the association between coffee consumption and risk of gastric and pancreatic cancer. This study is designed to evaluate this relationship among Finns, whose coffee consumption is the highest in the world. A total of 60,041 Finnish men and women who were 26-74 years of age and without history of any cancer at baseline were included in the present analyses. Coffee consumption and other study parameters were determined at baseline using standardized measurements. Participants were prospectively followed up for onset of gastric and/or pancreatic cancer, emigration, death or until June 30, 2006. During a mean follow-up period of 18 years, 299 cases of gastric cancer and 235 cases of pancreatic cancer were found. There was a nonsignificant inverse association between coffee consumption and risk of gastric cancer among men but not in the women. The multivariate-adjusted hazard ratio of stomach and pancreatic cancer incidence for ≥ 10 cups of coffee per day compared with nondrinkers were 0.75 (95% CI, 0.40-1.41) (P for trend = 0.19) and 0.82 (95% CI, 0.38-1.76) (P for trend = 0.95) for the combined population of men and women, respectively. We did not find a significant association between coffee consumption and the risk of gastric and/or pancreatic cancers.

  5. Incidence of Neuralgic Amyotrophy (Parsonage Turner Syndrome) in a Primary Care Setting - A Prospective Cohort Study

    PubMed Central

    van Alfen, Nens; van Eijk, Jeroen J. J.; Ennik, Tessa; Flynn, Sean O.; Nobacht, Inge E. G.; Groothuis, Jan T.; Pillen, Sigrid; van de Laar, Floris A.

    2015-01-01

    Objective Neuralgic amyotrophy is considered a rare peripheral nervous system disorder but in practice seems grossly under recognized, which negatively affects care for these patients. In this study we prospectively counted the one-year incidence rate of classic neuralgic amyotrophy in a primary care setting. Methods In a prospective cohort study during the year 2012 we registered all new cases of neck, shoulder or arm complaints from two large primary care centers serving a population of 14,118. Prior to study, general practitioners received a short training on how to diagnose classic neuralgic amyotrophy. Neuralgic amyotrophy was defined according to published criteria irrespective of family history. Only patients with a classic phenotype were counted as definite cases. After inclusion, patients with suspected neuralgic amyotrophy who had not yet seen a neurologist were offered neurologic evaluation for diagnostic confirmation. Results Of the 492 patients identified with new onset neck, shoulder or arm complaints, 34 were suspected of having neuralgic amyotrophy. After neurologic evaluation the diagnosis was confirmed in 14 patients. This amounts to a one-year incidence rate for classic neuralgic amyotrophy of 1 per 1000. Conclusions Our findings suggest that neuralgic amyotrophy is 30-50 times more common than previously thought. Unawareness of the disorder and its clinical presentation seems the most likely explanation for this difference. An incidence rate of 1 per 1000 and the long-term sequelae many patients suffer warrant more vigilance in diagnosing the disorder, to pave the way for timely treatment and prevent complications. PMID:26016482

  6. Four case studies of prospective science teachers' beliefs concerning constructivist teaching practices

    NASA Astrophysics Data System (ADS)

    Haney, Jodi J.; McArthur, Julia

    2002-11-01

    To gain a better understanding of the emerging constructivist beliefs and classroom practices, case studies were constructed for four prospective teachers who were purposely selected as a result of their scores on the Classroom Learning Environment Survey (CLES) (Taylor, Fraser, & White, A classroom environment questionnaire for science educators interested in the constructivist reform of school science. Paper presented at the annual meeting of the National Association for Research in Science Teaching, Anaheim, CA, 1994). The case studies provided insight into two primary questions (1) what are the beliefs of the prospective science teacher regarding constructivist teaching practices and (2) are these beliefs consistent with subsequent classroom practice? The components of constructivist teaching by Taylor, Fraser, and White (1994) were used as a theoretical framework in conjunction with Ajzen and Fishbein's components of the Theory of Planned Behavior (Ajzen, 1985). Data collection consisted of document analysis, classroom observation, and interviews. Data were analyzed using the constant comparative method. Findings from the case studies suggest that at least two kinds of beliefs were in operation: central beliefs and peripheral beliefs. The central beliefs were defined as those dictating subsequent teaching behaviors; whereas the peripheral beliefs were those that were stated but not operationalized.

  7. Extension of the modified Poisson regression model to prospective studies with correlated binary data.

    PubMed

    Zou, G Y; Donner, Allan

    2013-12-01

    The Poisson regression model using a sandwich variance estimator has become a viable alternative to the logistic regression model for the analysis of prospective studies with independent binary outcomes. The primary advantage of this approach is that it readily provides covariate-adjusted risk ratios and associated standard errors. In this article, the model is extended to studies with correlated binary outcomes as arise in longitudinal or cluster randomization studies. The key step involves a cluster-level grouping strategy for the computation of the middle term in the sandwich estimator. For a single binary exposure variable without covariate adjustment, this approach results in risk ratio estimates and standard errors that are identical to those found in the survey sampling literature. Simulation results suggest that it is reliable for studies with correlated binary data, provided the total number of clusters is at least 50. Data from observational and cluster randomized studies are used to illustrate the methods.

  8. Active Commuting Throughout Adolescence and Central Fatness before Adulthood: Prospective Birth Cohort Study

    PubMed Central

    Martinez-Gomez, David; Mielke, Gregore I.; Menezes, Ana M.; Gonçalves, Helen; Barros, Fernando C.; Hallal, Pedro C.

    2014-01-01

    Background Active commuting is a good opportunity to accumulate physical activity (PA) across the lifespan that potentially might influence central body fat. We aimed to examine the prospective associations of active commuting at 11, 15 and 18 years of age with central body fat at 18 years. Methods Participants were part of a large birth cohort study in Pelotas, Brazil (n = 3,649 participants). Active commuting, leisure-time PA and income were self-reported at 11, 15 and 18 years. Waist circumference and trunk fat mass were collected at 18 years with the use of a 3-dimensional photonic scanner and dual-energy X-ray absorptiometry, respectively. Results Active commuting at 11 years was not prospectively associated with central body fat. However, we found that active commuting at 15 and 18 years were prospectively and cross-sectionally associated with central body fat variables, respectively, in boys but not in girls. Also, boys in the highest tertile of accumulated active commuting (i.e., average of active commuting at 11, 13 and 18 years) were associated with −2.09 cm (95%CI: −3.24; −0.94) of waist circumference and −1.11 kg (95%CI: −1.74; −0.48) of trunk fat mass compared to boys in the lowest tertile. Analyses on changes in tertiles of active commuting from 11 and 15 years to 18 years with central body fat variables at 18 years showed that boys who remained consistently in the highest tertile or moved to a higher tertile had lower levels of central body fat compared to those consistently in the lowest tertile. Conclusions Active commuting throughout adolescence in boys, especially during middle and late adolescence, is associated with lower levels in central fatness before adulthood. PMID:24791780

  9. A Prospective Study of Periodontal Disease and Risk of Rheumatoid Arthritis

    PubMed Central

    Arkema, Elizabeth V.; Karlson, Elizabeth W.; Costenbader, Karen H.

    2010-01-01

    Objectives To test for an association between periodontal disease (PD) and incident rheumatoid arthritis (RA) in a large prospective cohort. Methods We conducted a prospective analysis of history of periodontal surgery, tooth loss and risk of RA among 81,132 women in the Nurses’ Health Study prospective cohort. Periodontal surgery and tooth loss were used as proxies for history of PD. There were 292 incident RA cases diagnosed from 1992 to 2004. Information on periodontal surgery and tooth loss in the past two years was collected by questionnaire in 1992. Cox proportional hazards models were used to assess relationships between periodontal surgery, tooth loss and RA risk adjusting for age, smoking, number of natural teeth, BMI, parity, breastfeeding, postmenopausal status, postmenopausal hormone use, father’s occupation and alcohol intake. Results Compared with those who reported no history of periodontal surgery or tooth loss, women with periodontal surgery or tooth loss did not have a significantly elevated risk of RA in multivariable-adjusted models (RR=1.24; 95% CI (0.83, 1.83) and RR=1.18; 95% CI (0.47, 2.95), respectively). In analyses stratified by ever and never smokers, ever smokers with periodontal surgery had an increased risk that was also non-significant. Those with severe PD (both history of periodontal surgery and tooth loss) did not have a significant increased risk. Conclusion In this large cohort of U.S. women, there is no evidence of an increased risk of later onset RA among those with a history of periodontal surgery and/or tooth loss. PMID:20595268

  10. Processed meat and colorectal cancer: a quantitative review of prospective epidemiologic studies.

    PubMed

    Alexander, Dominik D; Miller, Arthur J; Cushing, Colleen A; Lowe, Kimberly A

    2010-09-01

    A tremendous amount of scientific interest has been generated regarding processed meat consumption and cancer risk. Therefore, to estimate the association between processed meat intake and colorectal cancer (CRC), a meta-analysis of prospective studies was conducted. Twenty-eight prospective studies of processed meat and CRC were identified, of which 20 represented independent nonoverlapping study populations. Summary relative risk estimates (SRREs) for high versus low intake and dose-response relationships were calculated. The SRRE for high (vs. low) processed meat intake and CRC was 1.16 [95% confidence interval (CI): 1.10-1.23] for all studies. Summary associations were modified considerably by sex; the SRRE for men was 1.23 (95% CI: 1.07-1.42) and the SRRE for women was 1.05 (95% CI: 0.94-1.16), based on nine and 13 studies, respectively. Sensitivity analyses did not indicate appreciable statistical variation by tumor site, processed meat groups, or study location. The SRRE for each 30-gram increment of processed meat and CRC was 1.10 (95% CI: 1.05-1.15) based on nine studies, and the SRRE for each incremental serving of processed meat per week was 1.03 (95% CI: 1.01-1.05) based on six studies. Overall, summary associations were weak in magnitude (i.e. most less than 1.20), processed meat definitions and analytical comparisons were highly variable across studies, and isolating the independent effects of processed meat intake is difficult, given the likely influence of confounding by other dietary and lifestyle factors. Therefore, the currently available epidemiologic evidence is not sufficient to support a clear and unequivocal independent positive association between processed meat consumption and CRC.

  11. Assessing the long-term probabilistic volcanic hazard for tephra fallout in Reykjavik, Iceland: a preliminary multi-source analysis

    NASA Astrophysics Data System (ADS)

    Tonini, Roberto; Barsotti, Sara; Sandri, Laura; Tumi Guðmundsson, Magnús

    2015-04-01

    from all the PVHAs can be combined at the end. This will allow to: 1) possibly add the contribution of new volcanic systems, 2) compare and hierarchically rank the tephra fallout risk among both all the considered volcanoes and, possibly, other kinds of risk, and 3) quantitatively assess the overall tephra fallout hazard over the target area. As practical application, we selected a first subset consisting of the five most hazardous volcanic systems for tephra fallout that could affect the selected target area. These are the ones with the highest number of eruptions in the last 1100 years (Katla, Hekla, Grímsvötn) and the ones located closest to the target area (Reykjanes and Snæfellsjökull). PVHA is computed using the PyBetVH tool (an improvement of the Bayesian Event Tree for Volcanic Hazard -BET_VH- model) and tephra dispersal is modelled by means of VOL-CALPUFF numerical code. Katla volcanic system is used as pilot case study because of its eruptive history and behaviour are well known and documented. We found that some considerations and results derived from the study of Katla could be general and applied to the other considered volcanoes and, more in general, to other Icelandic volcanic systems. The work was financially supported by the European Science Foundation (ESF), in the framework of the Research Networking Programme MeMoVolc.

  12. Psychosocial characteristics of candidates for the prospective evaluation of radial keratotomy (PERK) study.

    PubMed

    Bourque, L B; Rubenstein, R; Cosand, B; Waring, G O; Moffitt, S; Gelender, H; Laibson, P R; Lindstrom, R L; McDonald, M; Myers, W D

    1984-08-01

    The National Eye Institute Prospective Evaluation of Radial Keratotomy (PERK) Study is a multicenter clinical trial for the evaluation of radial keratotomy. This article describes the questionnaire data collected on PERK patients and compares them with a similar group of myopic persons studied during the Rand Health Insurance Experiment (heretofore referred to as the Rand study). The PERK patients are young, white myopes who dislike being dependent on corrective lenses but perceive themselves to be more visually impaired than do comparable Rand study myopes. Most female subjects and a plurality of the male subjects have tried contact lenses and quit wearing them mainly because use of the lenses was inconvenient or bothersome. There is no evidence that patients are psychologically or socially deviant. Both male and female subjects expressed a fear of being without vision and cited impatience with the lenses as their major motivation for wanting surgery.

  13. Prospective noninterventional study on peripheral blood stem cell mobilization in patients with relapsed lymphomas.

    PubMed

    van Gorkom, Gwendolyn; Finel, Herve; Giebel, Sebastian; Pohlreich, David; Shimoni, Avichai; Ringhoffer, Mark; Sucak, Gülsan; Schaap, Nicolaas; Dreger, Peter; Sureda, Anna; Schouten, Harry C

    2016-09-10

    High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) to rescue hematopoiesis is considered standard care for patients with a relapsed chemosensitive lymphoma, but diagnosis of lymphoma has been a risk factor for poor mobilization in several studies. The aim of this prospective noninterventional clinical audit was to review the mobilization strategies used by EBMT centers in relapsed lymphoma and to evaluate their efficacy. Between 2010 and 2014, 275 patients with relapsed lymphoma from 30 EBMT centers were prospectively registered. Almost all patients were mobilized with chemotherapy plus G-CSF (96%), but there was a large variation in chemotherapy schedules. Thirty (11%) of them were poor mobilizers (<2 × 10(6) CD 34+ cells/kg body weight) at the first mobilization. Poor mobilization was not associated with gender, age, bone marrow involvement at diagnosis, primary diagnosis, number of previous chemotherapy lines, previous radiotherapy or mobilization with G-CSF alone. The use of high dose cyclophosphamide alone was associated with mobilization failure (P = 0.0006), whereas the use of a platinum-containing regimen was associated with a good mobilization outcome (P = 0.013). Because failure rate is low, we can conclude from this study that PBSC mobilization failure in relapsed lymphomas is not an important problem in the EBMT centers.

  14. Weekly miscarriage rates in a community-based prospective cohort study in rural western Kenya

    PubMed Central

    Dellicour, Stephanie; Aol, George; Ouma, Peter; Yan, Nicole; Bigogo, Godfrey; Hamel, Mary J; Burton, Deron C; Oneko, Martina; Breiman, Robert F; Slutsker, Laurence; Feikin, Daniel; Kariuki, Simon; Odhiambo, Frank; Stergachis, Andreas; Laserson, Kayla F; ter Kuile, Feiko O; Desai, Meghna

    2016-01-01

    Objective Information on adverse pregnancy outcomes is important to monitor the impact of public health interventions. Miscarriage is a challenging end point to ascertain and there is scarce information on its rate in low-income countries. The objective was to estimate the background rate and cumulative probability of miscarriage in rural western Kenya. Design This was a population-based prospective cohort. Participants and setting Women of childbearing age were followed prospectively to identify pregnancies and ascertain their outcomes in Siaya County, western Kenya. The cohort study was carried out in 33 adjacent villages under health and demographic surveillance. Outcome measure Miscarriage. Results Between 2011 and 2013, among 5536 women of childbearing age, 1453 pregnancies were detected and 1134 were included in the analysis. The cumulative probability was 18.9%. The weekly miscarriage rate declined steadily with increasing gestation until approximately 20 weeks. Known risk factors for miscarriage such as maternal age, gravidity, occupation, household wealth and HIV infection were confirmed. Conclusions This is the first report of weekly miscarriage rates in a rural African setting in the context of high HIV and malaria prevalence. Future studies should consider the involvement of community health workers to identify the pregnancy cohort of early gestation for better data on the actual number of pregnancies and the assessment of miscarriage. PMID:27084287

  15. Negative cognitive styles synergistically predict suicidal ideation in bipolar spectrum disorders: a 3-year prospective study.

    PubMed

    Stange, Jonathan P; Hamilton, Jessica L; Burke, Taylor A; Kleiman, Evan M; O'Garro-Moore, Jared K; Seligman, Nicole D; Abramson, Lyn Y; Alloy, Lauren B

    2015-03-30

    Rates of suicidal ideation and behavior are extremely high in bipolar spectrum disorders (BSDs). However, relatively little work has evaluated potentially synergistic relationships between cognitive and emotion-regulatory processes proposed by theoretical models of suicidality in BSDs. The present study evaluated whether negative cognitive style and subtypes of rumination would exacerbate the impact of self-criticism on suicidal ideation in a prospective study of individuals with BSDs. Seventy-two young adults with BSDs (bipolar II, bipolar NOS, or cyclothymia) completed diagnostic interviews and trait measures of self-criticism, negative cognitive style, and brooding and reflective rumination at a baseline assessment. The occurrence of suicidal ideation was assessed as part of diagnostic interviews completed every 4 months for an average of 3 years of follow-up. Negative cognitive style and reflective rumination strengthened the association between self-criticism and the prospective occurrence of suicidal ideation across follow-up. Individuals with high levels of self-criticism in conjunction with negative cognitive style or reflective rumination were most likely to experience the onset of suicidal ideation. Self-criticism may work synergistically with negative cognitive style and rumination to confer risk for suicidal ideation in bipolar spectrum disorders. These results support theoretical models of suicidality in BSDs and indicate that evaluating and understanding negative cognitive styles may help to identify individuals who are at risk of suicide.

  16. Prospective cohort study of factors influencing the relative weights of the placenta and the newborn infant.

    PubMed Central

    Williams, L. A.; Evans, S. F.; Newnham, J. P.

    1997-01-01

    OBJECTIVES: To determine the demographic, environmental, and medical factors that influence the relative weights of the newborn infant and the placenta and compare this ratio with other factors known to predispose to adult ill health. DESIGN: Prospective cohort study. SETTING: The tertiary referral centre for perinatal care in Perth, Western Australia. SUBJECTS: 2507 pregnant women who delivered a single live infant at term. MAIN OUTCOME MEASURES: Placental weight, birth weight, and the ratio of placental weight to birth weight. RESULTS: By multiple regression analysis the placental weight to birthweight ratio was significantly and positively associated with gestational age, female sex, Asian parentage, increasing maternal body mass index, increased maternal weight at booking, lower socioeconomic status, maternal anaemia, and increasing number of cigarettes smoked daily. There were no consistent relations between the placental weight to birthweight ratio and measures of newborn size. CONCLUSIONS: The ratio of placental weight to birth weight is not an accurate marker of fetal growth. In its role as a predictor of adult disease the ratio may be acting as a surrogate for other factors which are already known to influence health and may act before or after birth. Determining the role that relative growth rates of the fetus and placenta have in predisposing to adult disease requires prospective study to account for the many confounding variables which complicate this hypothesis. PMID:9224128

  17. Prospective effect of job strain on general and central obesity in the Whitehall II Study.

    PubMed

    Brunner, Eric J; Chandola, Tarani; Marmot, Michael G

    2007-04-01

    Positive energy balance is the major cause of obesity, and chronic stress may be a contributory factor. The authors examined cumulative work stress, using the Job Strain Questionnaire on four occasions, as a predictor of obesity in a prospective 19-year study of 6,895 men and 3,413 women (aged 35-55 years) in the Whitehall II cohort in London, United Kingdom (baseline: 1985-1988). A dose-response relation was found between work stress and risk of general obesity (body mass index > or =30 kg/m(2)) and central obesity (waist circumference >102 cm in men, >88 cm in women) that was largely independent of covariates. The imputed odds ratios of body mass index obesity for one, two, and three or more reports of work stress adjusted for age, sex, and social position were 1.17, 1.24, and 1.73 (trend p < 0.01), respectively. For waist obesity, the corresponding findings were 1.17, 1.41, and 1.61 (trend p < 0.01). Work stress effect was modestly attenuated after exclusion of obese individuals at baseline and further adjustments for smoking; intakes of dietary fiber, fruits and vegetables, and alcohol; and levels of physical activity during follow-up. This study provides prospective, population-based evidence that chronic work stress predicts general and central obesity.

  18. Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men.

    PubMed Central

    Karasek, R; Baker, D; Marxer, F; Ahlbom, A; Theorell, T

    1981-01-01

    The association between specific job characteristics and subsequent cardiovascular disease was tested using a large random sample of the male working Swedish population. The prospective development of coronary heart disease (CHD) symptoms and signs was analyzed using a multivariate logistic regression technique. Additionally, a case-controlled study was used to analyze all cardiovascular-cerebrovascular (CHD-CVD) deaths during a six-year follow-up. The indicator of CHD symptoms and signs was validated in a six-year prospective study of CHD deaths (standardized mortality ratio 5.0; p less than or equal to .001). A hectic and psychologically demanding job increases the risk of developing CHD symptoms and signs (standardized odds ratio 1.29, p less than 0.25) and premature CHD-CVD death (relative risk 4.0, p less than .01). Low decision latitude-expressed as low intellectual discretion and low personal schedule freedom-is also associated with increased risk of cardiovascular disease. Low intellectual discretion predicts the development of CHD symptoms and signs (SOR 1.44, p less than .01), while low personal schedule freedom among the majority of workers with the minimum statutory education increases the risk of CHD-CVD death (RR 6.6, p less than .0002). The associations exist after controlling for age, education, smoking, and overweight. PMID:7246835

  19. Adverse Drug Reactions in a Complementary Medicine Hospital: A Prospective, Intensified Surveillance Study

    PubMed Central

    Süsskind, M.; Thürmann, P. A.; Lüke, C.; Jeschke, E.; Tabali, M.; Matthes, H.; Ostermann, T.

    2012-01-01

    Background. Anthroposophic medicine is one of the widely used approaches of complementary and alternative medicine. However, few prospective studies have generated safety data on its use. Objectives. We aimed to assess adverse drug reactions (ADRs) caused by anthroposophical medicines (AMEDs) in the anthroposophical Community Hospital Havelhoehe, GERMANY. Study Design and Methods. Between May and November 2007, patients of six medical wards were prospectively assessed for ADRs. Suspected ADRs occurring during hospitalization were documented and classified in terms of organ manifestation (WHO SOC-code), causality (according to the Uppsala Monitoring Centre WHO criteria), and severity. Only those ADRs with a severity of grade 2 and higher according to the CTCAE classification system are described here. Results. Of the 3,813 patients hospitalized, 174 patients (4.6%) experienced 211 ADRs (CTCAE grade 2/3 n = 191, 90.5%, CTCAE grade 4/5 n = 20, 9.5%) of which 57 ADRs (27.0%) were serious. The median age of patients with ADRs (62.1% females) was 72.0 (IQR: 61.0; 80.0). Six patients (0.2%) experienced six ADRs (2.8% of ADRs) caused by eight suspected AMEDs, all of which were mild reactions (grade 2). Conclusion. Our data show that ADRs caused by AMEDs occur rarely and are limited to mild symptoms. PMID:22315630

  20. Chemotherapy-induced nausea and vomiting in breast cancer patients: a prospective observational study.

    PubMed

    Booth, Christopher M; Clemons, Mark; Dranitsaris, George; Joy, Anil; Young, Scott; Callaghan, Walter; Trudeau, Maureen; Petrella, Teresa

    2007-09-01

    Despite advances in the prevention and treatment of emesis, nausea and vomiting are still considered by patients to be among the most severe and feared adverse effects of chemotherapy for breast cancer. There is, however, a paucity of prospective data documenting the prevalence and severity of emesis in patients with breast cancer in the era of modern antiemetics. This prospective multicenter study evaluated chemotherapy-induced nausea and vomiting (CINV) in patients with breast cancer. Patients were given a daily diary to record the frequency and severity of nausea and vomiting during the first 5 days following chemotherapy. Data were collected until either the cessation of chemotherapy or the administration of a maximum of 6 cycles of treatment. Data are available from 143 patients who received a total of 766 cycles of chemotherapy. Prevalence rates of any nausea or any vomiting were, respectively, 37% and 13% at 24 hours and 70% and 15% during days 2-5. Severe emesis was reported by fewer than 10% of patients. Risk factors associated with CINV included age younger than 40 years, nausea expectation, not eating before treatment, and low alcohol use. The prevalence of severe CINV for breast cancer was relatively low compared with the prevalence reported in the literature. As a result of the observational design of this study, the results may better reflect the "true" prevalence of nausea and vomiting than do estimates from previously reported randomized controlled trials. Several patient characteristics that predict which patients are at increased risk of developing severe symptoms were identified.

  1. Predicting remembering and forgetting of autobiographical memories in children and adults: a 4-year prospective study.

    PubMed

    Bauer, Patricia J; Larkina, Marina

    2016-11-01

    Preservation and loss to forgetting of autobiographical memories is a focus in both the adult and developmental literatures. In both, there are comparative arguments regarding rates of forgetting. Children are assumed to forget autobiographical memories more rapidly than adults, and younger children are assumed to forget more rapidly than older children. Yet few studies can directly inform these comparisons: few feature children and adults, and few prospectively track the survival of specific autobiographical memories over time. In a 4-year prospective study, we obtained autobiographical memories from children 4, 6, and 8 years, and adults. We tested recall of different subsets of the events after 1, 2, and 3 years. Accelerated rates of forgetting were apparent among all child groups relative to adults; within the child groups, 4- and 6-year-olds had accelerated forgetting relative to 8-year-olds. The differences were especially pronounced in open-ended recall. The thematic coherence of initial memory reports also was a significant predictor of the survival of specific memories. The pattern of findings is consistent with suggestions that the adult distribution of autobiographical memories is achieved as the quality of memory traces increases (here measured by thematic coherence) and the rate of forgetting decreases.

  2. Risk Factors for Erosion of Artificial Urinary Sphincters: A Multicenter Prospective Study

    PubMed Central

    Brant, William O.; Erickson, Bradley A.; Elliott, Sean P.; Powell, Christopher; Alsikafi, Nejd; McClung, Christopher; Myers, Jeremy B.; Voelzke, Bryan B.; Smith, Thomas G.; Broghammer, Joshua A.

    2015-01-01

    OBJECTIVE To evaluate the short- to medium-term outcomes after artificial urinary sphincter (AUS) placement from a large, multi-institutional, prospective, follow-up study. We hypothesize that along with radiation, patients with any history of a direct surgery to the urethra will have higher rates of eventual AUS explantation for erosion and/or infection. MATERIALS AND METHODS A prospective outcome analysis was performed on 386 patients treated with AUS placement from April 2009 to December 2012 at 8 institutions with at least 3 months of follow-up. Charts were analyzed for preoperative risk factors and postoperative complications requiring explantation. RESULTS Approximately 50% of patients were considered high risk. High risk was defined as patients having undergone radiation therapy, urethroplasty, multiple treatments for bladder neck contracture or urethral stricture, urethral stent placement, or a history of erosion or infection in a previous AUS. A total of 31 explantations (8.03%) were performed during the follow-up period. Overall explantation rates were higher in those with prior radiation and prior UroLume. Men with prior AUS infection or erosion also had a trend for higher rates of subsequent explantation. Men receiving 3.5-cm cuffs had significantly higher explantation rates than those receiving larger cuffs. CONCLUSION This outcomes study confirms that urethral risk factors, including radiation history, prior AUS erosion, and a history of urethral stent placement, increase the risk of AUS explantation in short-term follow-up. PMID:25109562

  3. Combined dementia-risk biomarkers in Parkinson's disease: a prospective longitudinal study.

    PubMed

    Compta, Yaroslau; Pereira, Joana B; Ríos, Jose; Ibarretxe-Bilbao, Naroa; Junqué, Carme; Bargalló, Núria; Cámara, Ana; Buongiorno, Mariateresa; Fernández, Manel; Pont-Sunyer, Claustre; Martí, Maria J

    2013-08-01

    Neuropsychological (mostly posterior-cortical) deficits, quantitative magnetic resonance imaging (MRI) atrophy patterns, and low cerebrospinal fluid (CSF) levels of amyloid-β have been separately related to worsening cognition in Parkinson's disease (PD). However, these biomarkers have not been longitudinally assessed in combination as PD-dementia predictors. In this prospective longitudinal study, 27 non-demented PD patients underwent CSF, neuropsychological and 3-T brain-MRI studies at baseline and were re-assessed 18 months later in terms of progression to dementia (primary outcome) and longitudinal neuropsychological and cortical thickness changes (secondary outcomes). At follow-up 11 patients (41%) had progressed to dementia. Lower CSF amyloid-β, worse verbal learning, semantic fluency and visuoperceptual scores, and thinner superior-frontal/anterior cingulate and precentral regions were significant baseline dementia predictors in binary logistic regressions as quantitative and/or dichotomised traits. All participants without baseline biomarker abnormalities remained non-demented whereas all with abnormalities in each biomarker type progressed to dementia, with intermediate risk for those showing abnormalities in a single to two biomarker types (p = 0.006). Both the dementia-outcome and low baseline CSF amyloid-β were prospectively associated with limbic and posterior-cortical neuropsychological decline and frontal, limbic and posterior-cortical thinning from baseline to follow-up. These findings suggest that the combination of CSF amyloid-β, neuropsychological and cortical thickness biomarkers might provide a basis for dementia-risk stratification and progression monitoring in PD.

  4. Prospective performance evaluation of selected common virtual screening tools. Case study: Cyclooxygenase (COX) 1 and 2

    PubMed Central

    Kaserer, Teresa; Temml, Veronika; Kutil, Zsofia; Vanek, Tomas; Landa, Premysl; Schuster, Daniela

    2015-01-01

    Computational methods can be applied in drug development for the identification of novel lead candidates, but also for the prediction of pharmacokinetic properties and potential adverse effects, thereby aiding to prioritize and identify the most promising compounds. In principle, several techniques are available for this purpose, however, which one is the most suitable for a specific research objective still requires further investigation. Within this study, the performance of several programs, representing common virtual screening methods, was compared in a prospective manner. First, we selected top-ranked virtual screening hits from the three methods pharmacophore modeling, shape-based modeling, and docking. For comparison, these hits were then additionally predicted by external pharmacophore- and 2D similarity-based bioactivity profiling tools. Subsequently, the biological activities of the selected hits were assessed in vitro, which allowed for evaluating and comparing the prospective performance of the applied tools. Although all methods performed well, considerable differences were observed concerning hit rates, true positive and true negative hits, and hitlist composition. Our results suggest that a rational selection of the applied method represents a powerful strategy to maximize the success of a research project, tightly linked to its aims. We employed cyclooxygenase as application example, however, the focus of this study lied on highlighting the differences in the virtual screening tool performances and not in the identification of novel COX-inhibitors. PMID:25916906

  5. A Prospective Study on Time to Recovery in 254 Injured Novice Runners

    PubMed Central

    Nielsen, Rasmus Oestergaard; Rønnow, Lotte; Rasmussen, Sten; Lind, Martin

    2014-01-01

    Objectives Describe the diagnoses and the time to recovery of running-related injuries in novice runners. Design Prospective cohort study on injured runners. Method This paper is a secondary data analysis of a 933-person cohort study (DANO-RUN) aimed at characterizing risk factors for injury in novice runners. Among those sustaining running-related injuries, the types of injuries and time to recovery is described in the present paper. All injured runners were diagnosed after a thorough clinical examination and then followed prospectively during their recovery. If they recovered completely from injury, time to recovery of each injury was registered. Results A total of 254 runners were injured. The proportion of runners diagnosed with medial tibial stress syndrome was 15%, 10% for patellofemoral pain, 9% for medial meniscal injury, 7% for Achilles tendinopathy and 5% for plantar fasciitis. Among the 220 runners (87%) recovering from their injury, the median time to recovery was 71 days (minimum  = 9 days, maximum  = 617 days). Conclusions Medial tibial stress syndrome was the most common injury followed by patellofemoral pain, medial meniscal injury and Achilles tendinopathy. Half of the injured runners were unable to run 2×500 meters without pain after 10 weeks. Almost 5% of the injured runners received surgical treatment. PMID:24923269

  6. Micronutrient Levels and Supplement Intake in Pregnancy after Bariatric Surgery: A Prospective Cohort Study

    PubMed Central

    Devlieger, Roland; Guelinckx, Isabelle; Jans, Goele; Voets, Willy; Vanholsbeke, Caroline; Vansant, Greet

    2014-01-01

    Background Studies report frequent micronutrient deficiencies after bariatric surgery, but less is known about micronutrient levels of pregnant women after bariatric surgery. Objective To prospectively evaluate micronutrient levels and supplement intake in pregnancy following bariatric surgery. Design A multicenter prospective cohort study including women with restrictive or malabsorptive types of bariatric surgery. Nutritional deficiencies, together with supplement intake, were screened during pregnancy. Results The total population included 18 women in the restrictive and 31 in the malabsorptive group. Most micronutrients were depleted and declined significantly during pregnancy. The proportion of women with low vitamin A and B-1 levels increased to respectively 58 and 17% at delivery (P = 0.005 and 0.002). The proportion of women with vitamin D deficiency decreased from 14% at trimester 1 to 6% at delivery (P = 0.030). Mild anemia was found in respectively 22 and 40% of the women at trimester 1 and delivery. In the first trimester, most women took a multivitamin (57.1%). In the second and third trimester, the majority took additional supplements (69.4 and 73.5%). No associations were found between supplement intake and micronutrient deficiencies. Conclusion Pregnant women with bariatric surgery show frequent low micronutrient levels. Supplementation partially normalizes low levels of micronutrients. PMID:25470614

  7. Prospective study of obesity, hypertension, high cholesterol, and risk of restless legs syndrome.

    PubMed

    De Vito, Katerina; Li, Yanping; Batool-Anwar, Salma; Ning, Yi; Han, Jiali; Gao, Xiang

    2014-07-01

    Because previous cross-sectional studies suggest an association between metabolic disorders and restless legs syndrome (RLS), we prospectively evaluated whether obesity, hypercholesterolemia, and hypertension were associated with increased risk of RLS. Our study consisted of 42,728 female participants from the Nurses' Health Study II and 12,812 male participants from the Health Professionals Follow-up Study, free of RLS at baseline (2002 for men and 2005 for women), and free of diabetes and arthritis through follow-up (2002-2008 for men and 2005-2009 for women). RLS symptoms were assessed using the International RLS Study Group's standardized questionnaire. We considered RLS symptoms a "case" if the symptoms occurred ≥5 times/month and met International RLS Study Group criteria. We found that obesity was associated with an increased risk RLS among both men and women (P difference for sex >0.5). The pooled multivariate-adjusted odds ratio (OR) for RLS was 1.57 (95% confidence interval [CI]: 1.33-1.85; P trend <0.0001) for body mass index >30 versus ≤23 kg/m(2) and 1.56 (95% CI: 1.29-1.89; P trend = 0.0001) comparing two extreme waist circumference quintiles, adjusting for age, ethnicity, smoking, physical activity, use of antidepressant, and other covariates. A similar significant association was found for high cholesterol; the pooled adjusted OR for total serum cholesterol >240 versus <159 mg/dL was 1.33 (95% CI: 1.11-1.60; P trend = 0.002). There was no significant association between hypertension and RLS risk (adjusted OR: 0.90; 95% CI: 0.79-1.02). In this large, prospective study, we found that obesity and high cholesterol, but not high blood pressure, were significantly associated with an increased risk of developing RLS. © 2014 International Parkinson and Movement Disorder Society.

  8. Travel style is a major risk factor for diarrhoea in India: a prospective cohort study.

    PubMed

    Schindler, V M; Jaeger, V K; Held, L; Hatz, C; Bühler, S

    2015-07-01

    Although some studies suggested specific foods/beverages as risk factors for travellers' diarrhoea (TD), details of transmission remain unclear. We assessed the influence of travel style (luxury/middle-class versus backpacking) on TD risk. TD attack rates were compared in a prospective study among travellers to India at the University of Zurich's Travel Clinic. Information on consumption of foods/beverages was collected. Seventy-one luxury/middle-class travellers and 21 backpackers completed the study; overall 37% suffered from TD (62% backpackers, 30% luxury/middle-class travellers, OR 4.43, p 0.022). Travel style rather than the consumption of specific foods/beverages appears to be a risk factor for TD development.

  9. [Design and implementation of the ELSA-Brasil biobank: a prospective study in a Brazilian population].

    PubMed

    Pereira, Alexandre C; Bensenor, Isabela M; Fedeli, Ligia M; Castilhos, Cristina; Vidigal, Pedro G; Maniero, Viviane; Leite, Claudia M; Pimentel, Robercia A; Duncan, Bruce B; Mill, Jose Geraldo; Lotufo, Paulo A

    2013-06-01

    The Brazilian Longitudinal Study for Adult Health (ELSA-Brasil) is a multicenter prospective cohort of civil servants designed to assess the determinants of chronic diseases, especially cardiovascular diseases and type 2 diabetes. The present article describes the main design and implementation points of the ELSA-Brasil biobank project. Economic, political, logistical and technological aspects of this study are characterized. Additionally, it discusses the final biorepository protocol and the facilities implemented to achieve this objective. The design and implementation process of the ELSA-Brasil biobank took three years to be performed. Both the central and local biobanks were built according to the best biorepository techniques, using different technological solutions for the distinct needs expected in this study.

  10. Prospective randomized clinical study of arterial pumps used for routine on pump coronary bypass grafting.

    PubMed

    Keyser, Andreas; Hilker, Michael K; Diez, Claudius; Philipp, Alois; Foltan, Maik; Schmid, Christof

    2011-05-01

    In a number of studies, centrifugal blood pumps--in comparison with roller pumps--have been shown to attenuate trauma to blood components. Nevertheless, the impact of these results on the postoperative course needs to be discussed controversially. In a prospective randomized study, 240 consecutive adult patients underwent elective myocardial revascularization with cardiopulmonary bypass employing five different pumps (Roller, Avecor, Sarns, Rotaflow, Bio-Medicus). We analyzed clinical course, blood loss, damage of blood components, and impairment of the hemostatic system. The study population was homogenous with respect to age, gender, myocardial function, and operative data. No differences were found with respect to time of ventilation, duration of intensive care stay, hospitalization, and laboratory data. The choice of arterial pump during standard extracorporeal bypass for elective coronary artery bypass grafting is no matter of concern.

  11. Evaluation of thyroid hormones in children receiving carbamazepine or valproate: a prospective study.

    PubMed

    Kafadar, İhsan; Kılıç, Betül Aydın; Arapoglu, Mujde; Yalçın, Koray; Dalgıç, Nazan

    2015-01-01

    The aim of this study was to determine the alterations in thyroid function during carbamazepine or valproate monotherapy in a prospective study. Forty patients treated with valproate, 33 patients treated with carbamazepine, and 36 control patients, all aged between 2 and 18 years, were enrolled in our study. Serum levels of thyroid hormones were measured before the beginning of the antiepileptic therapy and at 6 and 12 months of treatment. Carbamazepine-treated patients showed mean serum thyroid hormone levels significantly lower than baseline evaluation and the control group. Thyroid-stimulating hormone levels at 6 and 12 months were not significantly different in carbamazepine treated patients. Serum hormone levels did not change during valproate treatment. Thyroid-stimulating hormone levels were significantly higher at the 12th month of valproate treatment. Our data suggest that although carbamazepine causes significant alterations in thyroid hormone levels, these changes do not lead to clinical symptoms at the follow-up period of 12 months.

  12. A prospective study of atopic dermatitis managed without topical corticosteroids for a 6-month period

    PubMed Central

    Fukaya, Mototsugu; Sato, Kenji; Yamada, Takahiro; Sato, Mitsuko; Fujisawa, Shigeki; Minaguchi, Satoko; Kimata, Hajime; Dozono, Haruhiko

    2016-01-01

    Topical corticosteroids (TCS) are regarded as the mainstay treatment for atopic dermatitis (AD). As AD has a tendency to heal naturally, the long-term efficacy of TCS in AD management should be compared with the outcomes seen in patients with AD not using TCS. However, there are few long-term studies that consider patients with AD not using TCS. We designed a prospective multicenter cohort study to assess the clinical outcomes in patients with AD who did not use TCS for 6 months and then compared our results with an earlier study by Furue et al which considered AD patients using TCS over 6 months. Our patients’ clinical improvement was comparable with the patients described in Furue’s research. In light of this, it is reasonable for physicians to manage AD patients who decline TCS, as the expected long-term prognosis is similar whether they use TCS or not. PMID:27445501

  13. Adverse Consequences of School Mobility for Children in Foster Care: A Prospective Longitudinal Study

    PubMed Central

    Pears, Katherine C.; Kim, Hyoun K.; Buchanan, Rohanna; Fisher, Philip A.

    2015-01-01

    Few prospective studies have examined school mobility in children in foster care. This study described the school moves of 86 such children and 55 community comparison children (primarily Caucasian), living in a medium-sized metropolitan area in the Pacific Northwest who were approximately 3-6-years-old at the study start. Additionally, the effects of moves from kindergarten through Grade 2 on academic and social emotional competence in Grades 3 through 5 were examined. A greater number of early school moves was associated with poorer later social emotional competence and partially mediated the effects of maltreatment and out-of-home placement on social emotional competence. This was only the case for children with poorer early learning skills in kindergarten. Implications for preventive intervention are discussed. PMID:25906815

  14. Comparison between lengthening over nail and conventional Ilizarov lengthening: a prospective randomized clinical study.

    PubMed

    El-Husseini, Timour F; Ghaly, Nabil A M; Mahran, Mahmoud A; Al Kersh, Mohamed Ahmed; Emara, Khaled M

    2013-08-01

    The aim of this study is to compare lengthening over an intramedullary nail to the conventional Ilizarov method with regard to percentage length increase, external fixation index, consolidation index and incidence of complications. This is a prospective randomized controlled study. Thirty-one limbs in 28 patients were included in the study; 15 were lengthened over an intramedullary nail, and 16 limbs were lengthened conventionally. The mean duration of external fixation in the lengthening over nail group was 52.2 days compared to 180.4 days in the conventional group. There was higher incidence of complications in the conventional method group. In comparison with conventional Ilizarov lengthening, lengthening over an intramedullary nail offers a shorter period of external fixation and fewer complications overall, but there is a high incidence of deep intramedullary infection which is serious.

  15. Teaching corner: the prospective case study : a pedagogical innovation for teaching global health ethics.

    PubMed

    Stewart, Kearsley A

    2015-03-01

    Over the past decade, global health has emerged as one of the fastest growing academic programs in the United States. Ethics training is cited widely as an essential feature of U.S. global health programs, but generally it is not deeply integrated into the global health teaching and training curricula. A discussion about the pedagogy of teaching global health ethics is long overdue; to date, only a few papers specifically engage with pedagogy rather than competencies or content. This paper explores the value of case study pedagogy for a full-semester graduate course in global health ethics at an American university. I address some of the pedagogical challenges of teaching global health ethics through my innovative use of case study methodology-the "prospective case study" (PSC).

  16. Lumbar myelography with iohexol and metrizamide: a comparative multicenter prospective study

    SciTech Connect

    Kieffer, S.A.; Binet, E.F.; Davis, D.O.; Gabrielsen, T.O.; Kido, D.K.; Latchaw, R.E.; Turski, P.A.; Shaw, D.D.

    1984-06-01

    Diagnostic quality of radiographs and adverse reactions associated with the use of metrizamide and iohexol as contrast agents in lumbar myelography were compared in a prospective randomized double blind study in 350 patients at seven centers. Overall quality of radiographic visualization was graded good or excellent in 95% of 175 metrizamide studies and in 98% of 175 iohexol studies. Ninety-three patients examined using metrizamide (53%) and 130 patients examined using iohexol (74%) experienced no discomfort during or after myelography. Postmyelographic headache was associated with 38% of metrizamide examinations and 21% of iohexol examinations. Nausea and vomiting were also more common with metrizamide. Five patients examined using metrizamide (3%) experienced transient confusion and disorientation following lumbar myelography. No such reactions were observed following iohexol myelography.

  17. Menstrual Cycle Irregularity and Metabolic Disorders: A Population-Based Prospective Study

    PubMed Central

    Rostami Dovom, Marzieh; Ramezani Tehrani, Fahimeh; Djalalinia, Shirin; Cheraghi, Leila; Behboudi Gandavani, Samira; Azizi, Fereidoun

    2016-01-01

    The regularity of menstrual cycles is considered an indicator of women’s reproductive health. Previous studies with a cross-sectional design have documented the relationship between menstrual cycle irregularities, insulin-resistance and the future risks for metabolic disorders. Limited data documented by prospective studies can lead to premature conclusions regarding the relationship between menstrual cycle irregularities and other conditions influencing women’s health. The present study therefore, using a prospective design aimed to assess the risk of metabolic disorders in women with a history of irregular menstrual cycles, was based on the data gathered from the Tehran Lipid and Glucose study (TLGS) an ongoing prospective cohort study initiated in 1999. Participants of the current study were 2128 women, aged between 18–49 years, followed for 15 years. Based on their menstrual cycles, the women were divided into two groups: (i) women with regular menstrual cycles (n = 1749), and (ii) those with irregular menstrual cycles (n = 379). The proportional COX regression model was used to compare hazard ratios (HRs) between the groups for the proposed events, including diabetes mellitus (DM), pre-diabetes (pre-DM), hypertension (HTN), pre-hypertension (pre-HTN) and dyslipidemia. It was found that during a 15-year follow up, there were 123 cases of DM, 456 cases of pre-DM, 290 cases of HTN, 481 cases of pre-HTN, and 402 cases of dyslipidemia. Compared to those with regular cycles, women with irregular menstrual cycles were found to have an increased risk for DM2 (age adjusted Hazard Ratios (HRs), 2.01; 95% confidence intervals (CI:1.59–3.50), the increased risk for DM, associated with irregular cycles remained significant after the adjustment for Body Mass Index (BMI), fasting blood sugar (FBS), family history of diabetes, and parity (HRS, 1.73; 95% CI: 1.14–2.64). There was no significant difference in the increased risk for pre-DM between the groups (age

  18. Comparison of the Level of Using Metacognitive Strategies during Study between High Achieving and Low Achieving Prospective Teachers

    ERIC Educational Resources Information Center

    Doganay, Ahmet; Demir, Ozden

    2011-01-01

    The main purpose of this study is to compare the level of using metacognitive strategies during study between high achieving and low achieving prospective classroom teachers. This study was designed as a mixed method study. Metacognitive Learning Strategies Scale developed by Namlu (2004) was used to measure the use of metacognitive strategies…

  19. Integrating Prospective Longitudinal Data: Modeling Personality and Health in the Terman Life Cycle and Hawaii Longitudinal Studies

    ERIC Educational Resources Information Center

    Kern, Margaret L.; Hampson, Sarah E.; Goldberg, Lewis R.; Friedman, Howard S.

    2014-01-01

    The present study used a collaborative framework to integrate 2 long-term prospective studies: the Terman Life Cycle Study and the Hawaii Personality and Health Longitudinal Study. Within a 5-factor personality-trait framework, teacher assessments of child personality were rationally and empirically aligned to establish similar factor structures…

  20. Economic Consequences Incurred by Living Kidney Donors: A Canadian Multi-Center Prospective Study

    PubMed Central

    Klarenbach, S; Gill, J S; Knoll, G; Caulfield, T; Boudville, N; Prasad, G V R; Karpinski, M; Storsley, L; Treleaven, D; Arnold, J; Cuerden, M; Jacobs, P; Garg, A X

    2014-01-01

    Some living kidney donors incur economic consequences as a result of donation; however, these costs are poorly quantified. We developed a framework to comprehensively assess economic consequences from the donor perspective including out-of-pocket cost, lost wages and home productivity loss. We prospectively enrolled 100 living kidney donors from seven Canadian centers between 2004 and 2008 and collected and valued economic consequences ($CAD 2008) at 3 months and 1 year after donation. Almost all (96%) donors experienced economic consequences, with 94% reporting travel costs and 47% reporting lost pay. The average and median costs of lost pay were $2144 (SD 4167) and $0 (25th–75th percentile 0, 2794), respectively. For other expenses (travel, accommodation, medication and medical), mean and median costs were $1780 (SD 2504) and $821 (25th–75th percentile 242, 2271), respectively. From the donor perspective, mean cost was $3268 (SD 4704); one-third of donors incurred cost >$3000, and 15% >$8000. The majority of donors (83%) reported inability to perform usual household activities for an average duration of 33 days; 8% reported out-of-pocket costs for assistance with these activities. The economic impact of living kidney donation for some individuals is large. We advocate for programs to reimburse living donors for their legitimate costs. In a prospective costing study, the authors find that economic consequences incurred by living kidney donors are frequent and nontrivial, and a notable proportion of donors experience significant costs. PMID:24597854

  1. Does menopausal transition really influence mental health? Findings from the prospective long‐term Zurich study

    PubMed Central

    Rössler, Wulf; Ajdacic‐Gross, Vladeta; Riecher‐Rössler, Anita; Angst, Jules; Hengartner, Michael P.

    2016-01-01

    In the prospective long‐term Zurich study, we re‐examined the hypothesized association between mental health problems in women and the transition through menopausal stages. One hundred sixty‐eight women from a population‐based Swiss community cohort were prospectively followed up from age 21 to 50. At age 50, the occurrence of hot flushes/night sweats and sleep disturbances was significantly more frequent in peri‐ and post‐menopausal women. Irritability/nervousness was increased only in peri‐menopausal women, but that association was accounted for by neuroticism trait scores at age 30. Transitions to peri‐ or post‐menopause were not related to changes in either the prevalence rates of DSM major depressive episode or anxiety disorders, or the course of psychopathological syndromes as assessed by the Symptom Checklist 90 ‐ Revised. The null associations held when adjusting for duration of reproductive period or age at menopause. Preceding mental health problems between ages 21 and 41, increased neuroticism trait scores at age 30, and concurrent psychosocial distress were significantly related to mental health problems occurring between ages 41 and 50. Depending upon the cut‐off point that was chosen, the arbitrary dichotomization of a continuous depression outcome produced spurious associations with the menopausal transition. We conclude that mental health problems between ages 41 and 50 are probably not directly related to the menopausal transition, and that previously reported associations could be false positives due to inadequate dichotomizations, reporting bias, undisclosed multiple adjustments or overfitting. PMID:27265705

  2. Living kidney donors--a prospective study of quality of life before and after kidney donation.

    PubMed

    Garcia, Márcia Fátima Faraldo Martinez; Andrade, Luis Gustavo M; Carvalho, Maria Fernanda C

    2013-01-01

    Although the safety of living kidney donation has been well established, prospective studies examining the physical and psychosocial aspects of the donor's quality of life are still scarce. Thus, the purpose of this prospective work was to assess the quality of life of 50 consecutive donors before and after kidney transplantation. All donors were asked to respond to both a donor questionnaire and the short-form 36-item health survey (SF-36). Interviews were individually conducted before, three months after, and over one yr after transplantation. Donation was considered a positive experience by all patients and had no impact on any physical or psychosocial aspect of the donor's life. Improved self-esteem and better quality of life after donation were reported in 52% of the cases. All donors would donate again and encouraged donation. SF-36 data indicated improvement in post-donation mental and physical scores among living donors closely related to recipient. Overall, most donors had a positive experience, felt no changes in quality of life, experienced enhanced self-esteem, would donate again, and recommended donation.

  3. Differential effects of emotional cues on components of prospective memory: an ERP study

    PubMed Central

    Cona, Giorgia; Kliegel, Matthias; Bisiacchi, Patrizia S.

    2015-01-01

    So far, little is known about the neurocognitive mechanisms associated with emotion effects on prospective memory (PM) performance. Thus, this study aimed at disentangling possible mechanisms for the effects of emotional valence of PM cues on the distinct phases composing PM by investigating event-related potentials (ERPs). Participants were engaged in an ongoing N-back task while being required to perform a PM task. The emotional valence of both the ongoing pictures and the PM cues was manipulated (pleasant, neutral, unpleasant). ERPs were recorded during the PM phases, such as encoding, maintenance, and retrieval of the intention. A recognition task including PM cues and ongoing stimuli was also performed at the end of the sessions. ERP results suggest that emotional PM cues not only trigger an automatic, bottom-up, capture of attention, but also boost a greater allocation of top-down processes. These processes seem to be recruited to hold attention toward the emotional stimuli and to retrieve the intention from memory, likely because of the motivational significance of the emotional stimuli. Moreover, pleasant PM cues seemed to modulate especially the prospective component, as revealed by changes in the amplitude of the ERP correlates of strategic monitoring as a function of the relevance of the valence for the PM task. Unpleasant pictures seemed to modulate especially the retrospective component, as revealed by the largest old/new effect being elicited by unpleasant PM pictures in the recognition task. PMID:25674061

  4. Forensic age diagnostics using projection radiography of the clavicle: a prospective multi-center validation study.

    PubMed

    Wittschieber, Daniel; Ottow, Christian; Schulz, Ronald; Püschel, Klaus; Bajanowski, Thomas; Ramsthaler, Frank; Pfeiffer, Heidi; Vieth, Volker; Schmidt, Sven; Schmeling, Andreas

    2016-01-01

    The radiological investigation of the ossification stage of the medial clavicular epiphysis represents the crucial tool for assessing whether a living individual has completed the age of 18 years. However, exposure to radiation cannot always be accepted due to legal reasons and radiation-free methods still lack reference data or are not available. Therefore, this study examines the role of pre-existing radiographic material of the clavicles, making it necessary to prospectively validate the established five-stage classification system for evaluating the clavicular ossification process as well as to enlarge the so far very limited pool of available reference data. Accordingly, standard posterior-anterior projection radiographs of 836 sternoclavicular joints prospectively obtained during 418 forensic autopsies (age range 15-30 years) were analyzed. Stage III was first found at ages 16 and 15 (males/females), stage IV at ages 22 and 21 (males/females), and stage V at age 26 in both sexes. The presented results principally corroborate the previous reference data from 2004, suggesting reliability of the five-stage classification system. In conclusion, chest radiographs may still be useful for forensic age diagnostics in living individuals but only in certain cases. In age estimations which can be planned in advance, projection radiography of the clavicle must still be considered obsolete.

  5. Prospective memory performance in traumatic brain injury patients: a study of implementation intentions.

    PubMed

    Mioni, Giovanna; Rendell, Peter G; Terrett, Gill; Stablum, Franca

    2015-04-01

    Traumatic brain injury (TBI) patients often present with prospective memory (PM) dysfunction. Forgetting to complete tasks may result in a loss of independence, limited employment prospects and anxiety, therefore, it is important to develop programs to improve PM performance in TBI patients. A strategy which may improve PM performance is implementation intentions. It involves making explicit plans specifying when, where and how one will perform a task in the future. In the present study, a group of 36 TBI patients and a group of 34 controls performed Virtual Week using either implementation intentions or no strategy. The results showed that the PM performance of TBI patients was less accurate than controls, in particular when the PM cue was time-based. No effect of implementation intentions was observed for TBI patients, however, controls improved their PM performance when the task was time-based. The findings suggest that strategies to improve PM in this clinical group are likely to be more complex than those that benefit healthy adults and may involve targeting phases of the PM process other than, or in addition to, the intention formation phase.

  6. Coronary artery disease in patients with cerebrovascular disease: a prospective study

    SciTech Connect

    Rokey, R.; Rolak, L.A.; Harati, Y.; Kutka, N.; Verani, M.S.

    1984-07-01

    Coronary artery disease is the cause of death in most patients who have transient ischemic attacks or stroke. Evaluation for this condition is not routinely performed in such patients, and no prospective studies have been reported. We prospectively examined 50 consecutive patients with transient ischemic attacks or mild stroke to determine the prevalence and importance of coronary artery disease. All patients were examined by a cardiologist and underwent both exercise thallium-201 scintigraphy and exercise radionuclide ventriculography. Sixteen patients were suspected to have coronary artery disease on the basis of clinical evaluation. In 15 of these the was confirmed by the nuclear scans. The remaining 34 patients had no clinical evidence of heart disease, yet 14 had abnormal cardiac scans. Twenty of 22 patients with abnormal scans who underwent cardiac catheterization had significant coronary artery disease or a cardiomyopathy. The discovery of heart disease altered clinical management in 13 patients. Overall, 29 of 50 patients had significant coronary artery disease, compared with a 7% prevalence of the condition in other patients of similar age at the same institution.

  7. Prospective Validation of the Predictive Power of the Hematopoietic Cell Transplantation Comorbidity Index: A CIBMTR® Study

    PubMed Central

    Sorror, Mohamed L.; Logan, Brent R.; Zhu, Xiaochun; Rizzo, J. Douglas; Cooke, Kenneth R.; McCarthy, Philip L; Ho, Vincent T.; Horowitz, Mary M.; Pasquini, Marcelo C.

    2015-01-01

    Prospective validation of the hematopoietic cell transplantation-comorbidity index (HCT-CI) using contemporary patients treated with HCT across the Unites States is necessary to confirm its widespread applicability. We performed a prospective observational study including all patients (8115 recipients of allogeneic and 11,652 recipients of autologous HCT) who underwent first HCT that was reported to the CIBMTR between 2007 and 2009. In proportional hazards models, increased HCT-CI scores were independently associated with increases in hazard ratios for NRM (p<0.0001) and overall mortality (p<0.0001) among recipients of allogeneic HCT. HCT-CI Scores of ≥3 were uniformly associated with higher risks for outcomes in both allogeneic and autologous HCT, and all subgroups regardless of diagnoses, age, and conditioning intensity. Recipients of allogeneic HCT with scores of 1–2 who were aged <18 or were treated with lower intensity conditioning regimens had similar outcomes compared to those with score 0. Higher risks for overall mortality, but not for NRM, were observed among recipients of autologous HCT with scores of 1–2 versus 0. Our results confirm the validity the HCT-CI in both allogeneic and autologous HCT. The index should be used as a valid standard-of-care health measure in counseling patients for HCT, in clinical trial design, and in adjusting outcome analyses. PMID:25862591

  8. Sociocultural and individual psychological predictors of body image in young girls: a prospective study.

    PubMed

    Clark, Levina; Tiggemann, Marika

    2008-07-01

    This study investigated the prospective predictors of body image in 9- to 12-year-old girls. Participants were 150 girls in Grades 4-6 with a mean age of 10.3 years. Girls completed questionnaire measures of media and peer influences (television/magazine exposure, peer appearance conversations), individual psychological variables (appearance schemas, internalization of appearance ideals, autonomy), and body image (figure discrepancy and body esteem) at Time 1 and 1 year later at Time 2. Linear panel analyses showed that after controlling for Time 1 levels of body image, none of the Time 1 sociocultural variables predicted body image variables at Time 2. Body mass index (BMI; a biological variable) and psychological variables, however, did offer significant prospective prediction. Specifically, higher BMI, higher appearance schemas, higher internalization of appearance ideals, and lower autonomy predicted worsening body image 1 year later. Thus, higher weight and certain psychological characteristics were temporally antecedent to body image concerns. It was concluded that both biological and individual psychological variables play a role in the development of body image in children. Individual psychological variables, in particular, may provide useful targets in prevention and intervention programs addressing body image in 9- to 12-year-old girls.

  9. PROSPECTIVE ASSOCIATIONS OF DEPRESSIVE RUMINATION AND SOCIAL PROBLEM SOLVING WITH DEPRESSION: A 6-MONTH LONGITUDINAL STUDY(.).

    PubMed

    Hasegawa, Akira; Hattori, Yosuke; Nishimura, Haruki; Tanno, Yoshihiko

    2015-06-01

    The main purpose of this study was to examine whether depressive rumination and social problem solving are prospectively associated with depressive symptoms. Nonclinical university students (N = 161, 64 men, 97 women; M age = 19.7 yr., SD = 3.6, range = 18-61) recruited from three universities in Japan completed the Beck Depression Inventory-Second Edition (BDI-II), the Ruminative Responses Scale, Social Problem-Solving Inventory-Revised Short Version (SPSI-R:S), and the Means-Ends Problem-Solving Procedure at baseline, and the BDI-II again at 6 mo. later. A stepwise multiple regression analysis with the BDI-II and all subscales of the rumination and social problem solving measures as independent variables indicated that only the BDI-II scores and the Impulsivity/carelessness style subscale of the SPSI-R:S at Time 1 were significantly associated with BDI-II scores at Time 2 (β = 0.73, 0.12, respectively; independent variables accounted for 58.8% of the variance). These findings suggest that in Japan an impulsive and careless problem-solving style was prospectively associated with depressive symptomatology 6 mo. later, as contrasted with previous findings of a cycle of rumination and avoidance problem-solving style.

  10. A Prospective Cohort Study on Radiation-induced Hypothyroidism: Development of an NTCP Model

    SciTech Connect

    Boomsma, Marjolein J.; Bijl, Hendrik P.; Christianen, Miranda E.M.C.; Beetz, Ivo; Chouvalova, Olga; Steenbakkers, Roel J.H.M.; Laan, Bernard F.A.M. van der; Oosting, Sjoukje F.; Schilstra, Cornelis; Langendijk, Johannes A.

    2012-11-01

    Purpose: To establish a multivariate normal tissue complication probability (NTCP) model for radiation-induced hypothyroidism. Methods and Materials: The thyroid-stimulating hormone (TSH) level of 105 patients treated with (chemo-) radiation therapy for head-and-neck cancer was prospectively measured during a median follow-up of 2.5 years. Hypothyroidism was defined as elevated serum TSH with decreased or normal free thyroxin (T4). A multivariate logistic regression model with bootstrapping was used to determine the most important prognostic variables for radiation-induced hypothyroidism. Results: Thirty-five patients (33%) developed primary hypothyroidism within 2 years after radiation therapy. An NTCP model based on 2 variables, including the mean thyroid gland dose and the thyroid gland volume, was most predictive for radiation-induced hypothyroidism. NTCP values increased with higher mean thyroid gland dose (odds ratio [OR]: 1.064/Gy) and decreased with higher thyroid gland volume (OR: 0.826/cm{sup 3}). Model performance was good with an area under the curve (AUC) of 0.85. Conclusions: This is the first prospective study resulting in an NTCP model for radiation-induced hypothyroidism. The probability of hypothyroidism rises with increasing dose to the thyroid gland, whereas it reduces with increasing thyroid gland volume.

  11. Injury profile in junior tennis players: a prospective two year study.

    PubMed

    Hjelm, Nina; Werner, Suzanne; Renstrom, Per

    2010-06-01

    The aim of this study was to prospectively make a survey of injuries in junior players from a Swedish local tennis club during a 2-year period in relation to gender, anatomic location, month of the year when injured, injury type and injury severity. All 12-18 years old members in a tennis club playing more than twice weekly were asked to participate. Fifty-five junior tennis players, 35 boys and 20 girls accepted to participate. All tennis-related injuries were prospectively registered and evaluated. Time of exposure for playing tennis was recorded. Thirty-nine players sustained 100 injuries, 73 in boys and 27 in girls. Injury incidence for boys was 1.7 injuries/1000 h of tennis playing time and for girls 0.6 injuries/1000 h. Ankle sprains, low back pain and knee injuries were the most common ones. Sixty-five percent were new injuries, and the majority of these injuries were located at the knee joint followed by the ankle joint, while most of the recurrent injuries were found in the lumbar spine. Boys suffered mainly from low back pain and ankle injuries and girls from low back pain and knee injuries. Forty-three percent of the injuries caused absence from tennis for more than 4 weeks and 31% more than 1 week.

  12. Pregnancy outcome in women with multiple sclerosis: results from a prospective nationwide study in Finland.

    PubMed

    Jalkanen, A; Alanen, A; Airas, L

    2010-08-01

    The majority of individuals obtaining the diagnosis of multiple sclerosis are women of childbearing age. They are naturally concerned as to how multiple sclerosis affects the course of pregnancy and the developing foetus. The objective of this study was to prospectively evaluate the incidence of pregnancy complications and delivery risks, and to follow the natural course of multiple sclerosis during and after pregnancy in a cohort of Finnish patients with multiple sclerosis. Sixty-one patients with multiple sclerosis who became pregnant during the years 2003-2005 were prospectively followed-up from early pregnancy until 6 months postpartum. Multiple sclerosis relapses, Expanded Disability Status Scale rates and obstetric details were recorded. The results were compared with the statistics obtained from Finnish Medical Birth Register from the year 2004. We found that patients with multiple sclerosis were no more likely to experience pregnancy complications than Finnish pregnant women generally, but they had a greater likelihood for a need of artificial insemination (4.9% vs. 0.9%; p = 0.0009). Subjects with multiple sclerosis were more likely to undergo assisted vaginal delivery than the at-large cohort (16.4% vs. 6.5%; p = 0.0017). We conclude that pregnancy does not seem to pose a woman with multiple sclerosis to a greater risk for pregnancy complications when compared with women in general. The potential need for instrumental delivery should, however, be taken into account when planning the delivery of a mother with multiple sclerosis.

  13. Bacterial meningitis in diabetes patients: a population-based prospective study

    PubMed Central

    van Veen, Kiril E. B.; Brouwer, Matthijs C.; van der Ende, Arie; van de Beek, Diederik

    2016-01-01

    Diabetes mellitus is associated with increased infection rates. We studied clinical features and outcome of community-acquired bacterial meningitis in diabetes patients. Patients were selected from a nationwide, prospective cohort on community-acquired bacterial meningitis performed from March 2006 to October 2014. Data on patient history, symptoms and signs on admission, treatment, and outcome were prospectively collected. A total of 183 of 1447 episodes (13%) occurred in diabetes patients. The incidence of bacterial meningitis in diabetes patients was 3.15 per 100,000 patients per year and the risk of acquiring bacterial meningitis was 2.2-fold higher for diabetes patients. S. pneumoniae was the causative organism in 139 of 183 episodes (76%) and L. monocytogenes in 11 of 183 episodes (6%). Outcome was unfavourable in 82 of 183 episodes (45%) and in 43 of 183 episodes (23%) the patient died. Diabetes was associated with death with an odds ratio of 1.63 (95% CI 1.12–2.37, P = 0.011), which remained after adjusting for known predictors of death in a multivariable analysis (OR 1.98 [95% CI 1.13–3.48], P = 0.017). In conclusion, diabetes is associated with a 2-fold higher risk of acquiring bacterial meningitis. Diabetes is a strong independent risk factor for death in community-acquired adult bacterial meningitis. PMID:27845429

  14. Lifestyle Factors and Risk of Restless Legs Syndrome: Prospective Cohort Study

    PubMed Central

    Batool-Anwar, Salma; Li, Yanping; De Vito, Katerina; Malhotra, Atul; Winkelman, John; Gao, Xiang

    2016-01-01

    Study Objectives: To examine the association between modifiable lifestyle factors, and the risk of developing restless legs syndrome (RLS). Methods: This is a Prospective Cohort study of population including 12,812 men participating in Health Professionals Follow-up Study and 42,728 women participating in the Nurses' Health study II. The participants were free of RLS at baseline (2002 for the HPFS and 2005 for the NHS II) and free of diabetes and arthritis through follow-up. RLS was assessed via a set of questions recommended by International Restless Legs Syndrome Study group. The Information was collected on height, weight, level of physical activity, dietary intake, and smoking status via questionnaires. Results: During 4–6 years of follow-up, we identified 1,538 incident RLS cases. Participants with normal weight, and who were physically active, non-smoker, and had some alcohol consumption had a lower risk of developing RLS. When we combined the effects of these four factors together, we observed a dose response relationship between the increased number of healthy lifestyle factors and a low risk of RLS: after adjusting for potential confounders the pooled odds ratio was 0.67 (95% CI: 0.47–0.97) for 4 vs.0 healthy factors (p trend < 0.001). In contrast, we did not observe significant associations between caffeine consumption or diet quality as assessed by the Alternate Healthy Eating Index, and altered RLS risk in men and women. Conclusions: Several modifiable lifestyle factors may play an important role in RLS risk. Citation: Batool-Anwar S, Li Y, De Vito K, Malhotra A, Winkelman J, Gao X. Lifestyle factors and risk of restless legs syndrome: prospective cohort study. J Clin Sleep Med 2016;12(2):187–194. PMID:26446243

  15. Early intervention in 208 Swedish preschoolers with autism spectrum disorder. A prospective naturalistic study.

    PubMed

    Fernell, Elisabeth; Hedvall, Åsa; Westerlund, Joakim; Höglund Carlsson, Lotta; Eriksson, Mats; Barnevik Olsson, Martina; Holm, Anette; Norrelgen, Fritjof; Kjellmer, Liselotte; Gillberg, Christopher

    2011-01-01

    Early intervention has been reported to improve outcome in children with autism spectrum disorders (ASDs). Several studies in the field have been randomized controlled trials (RCTs). The aim of this study was to assess ASD outcome in a large naturalistic study. Two hundred and eight children, aged 20-54 months, with a clinical diagnosis of ASD were given intervention and monitored prospectively in a naturalistic fashion over a period of 2 years. The toddlers were considered representative of all but the most severely multiple disabled preschool children with ASD in Stockholm county. They fell into three cognitive subgroups: one with learning disability, one with developmental delay, and one with normal intellectual functioning. Data on intervention type and intensity were gathered prospectively in a systematic fashion. Intervention was classified into intensive applied behaviour analysis (ABA) and non-intensive, targeted interventions, also based on ABA principles. Children were comprehensively assessed by a research team before the onset of intervention, and then, again, 2 years later. Change in Vineland adaptive behaviour scales composite scores from intake (T1) to leaving the study (T2) was set as the primary outcome variable. The research team remained blind to the type and intensity of interventions provided. One hundred and ninety-eight (95%) of the original samples stayed in the study throughout the whole 2-year period and 192 children had a complete Vineland composite score results both at T1 and T2. Vineland composite scores increased over the 2-year period. This increase was accounted for by the subgroup with normal cognitive functioning. There was no significant difference between the intensive and non-intensive groups. Individual variation was considerable, but no child in the study was "problem-free" at follow-up. Our data do not support that children with ASD generally benefit more from the most intensive ABA intervention programs than from less

  16. A prospective study of impaired fasting glucose and type 2 diabetes in China

    PubMed Central

    Vaidya, Anand; Cui, Liufu; Sun, Lixia; Lu, Bing; Chen, Shuohua; Liu, Xing; Zhou, Yong; Liu, Xiurong; Xie, Xiaobing; Hu, Frank B.; Wu, Shouling; Gao, Xiang

    2016-01-01

    Abstract The worldwide prevalence and incidence of diabetes and obesity are increasing in pandemic proportions. This is particularly relevant for China, where an extremely large population is growing, aging, and urbanizing. We thus conducted a prospective study to examine the prevalence and incidence of impaired fasting glucose (IFG) and diabetes, the rate at which fasting blood glucose rises, and the major modifiable risk factors associated with these outcomes in a large Chinese population from the Kailuan prospective study. A prospective cohort included 100,279 Chinese participants, aged 18 years or more, who had available information on fasting blood glucose concentrations at the start of the study (2006). Examination surveys were conducted every 2 years in 2008 and 2010. For the analyses of incident diabetes, we included 76,869 participants who were free of diabetes, cardiovascular disease, and cancer at the baseline and participants in the 2008 and/or 2010 follow-up. Diabetes was defined by a fasting blood glucose concentration ≥7 mmol/L, self-reported history, or active treatment with insulin or any oral hypoglycemic agent. IFG was defined by a fasting blood glucose concentration between 5.6 and 6.9 mmol/L. During the 4-year study, the prevalence of diabetes and IFG rose from 6.6% to 7.7%, and 17.3% to 22.6%, respectively. There were 17,811 incident cases of IFG and 4867 incident cases of diabetes. The age-standardized incident rate of IFG and diabetes were 62.6/1000 person-years (51.2/1000 person-years in women and 73.8/1000 person-years in men) and 10.0/1000 person-years (7.8/1000 person-years in women and 12.1/1000 person-years in men), respectively. We observed steady increases in fasting blood glucose with body anthropometrics and in every defined category of body mass index, including in those traditionally considered to be well within the “normal” range. In this large longitudinal study of Chinese adults, we observed a high prevalence and

  17. Sedentary Behavior and Incident Cancer: A Meta-Analysis of Prospective Studies

    PubMed Central

    Shen, Dong; Mao, Weidong; Liu, Tao; Lin, Qingfeng; Lu, Xiangdong; Wang, Qiong; Lin, Feng; Ekelund, Ulf; Wijndaele, Katrien

    2014-01-01

    Background Sedentary behavior is ubiquitous in modern adults' daily lives and it has been suggested to be associated with incident cancer. However, the results have been inconsistent. In this study, we performed a systematic review and meta-analysis of prospective cohort studies to clarify the association between sedentary behavior and incident cancer. Method PubMed and Embase databases were searched up to March 2014. All prospective cohort studies on the association between sedentary behavior and incident cancer were included. The summary relative risks (RRs) with 95% confidence intervals (CIs) were estimated using random effect model. Results A total of 17 prospective studies from 14 articles, including a total of 857,581 participants and 18,553 cases, were included in the analysis for sedentary behavior and risk of incident cancer. The overall meta-analysis suggested that sedentary behavior increased risk of cancer (RR = 1.20, 95%CI = 1.12–1.28), with no evidence of heterogeneity between studies (I2 = 7.3%, P = 0.368). Subgroup analyses demonstrated that there were statistical associations between sedentary behavior and some cancer types (endometrial cancer: RR = 1.28, 95% CI = 1.08–1.53; colorectal cancer: RR = 1.30, 95%CI = 1.12–1.49; breast cancer: RR = 1.17, 95%CI = 1.03–1.33; lung cancer: RR = 1.27, 95%CI = 1.06–1.52). However, there was no association of sedentary behavior with ovarian cancer (RR = 1.26, 95%CI = 0.87–1.82), renal cell carcinoma (RR = 1.11, 95%CI = 0.87–1.41) or non-Hodgkin lymphoid neoplasms (RR = 1.09, 95%CI = 0.82–1.43). Conclusion The present meta-analysis suggested that prolonged sedentary behavior was independently associated with an increased risk of incident endometrial, colorectal, breast, and lung cancers, but not with ovarian cancer, renal cell carcinoma or non-Hodgkin lymphoid neoplasms. PMID:25153314

  18. The New Zealand Blood Donors' Health Study: baseline findings of a large prospective cohort study of injury

    PubMed Central

    Ameratunga, S; Norton, R; Whitlock, G; MacMahon, S; Coggan, C; Jackson, R; Langley, J; Parag, V; Smith, D; Woodfield, D

    2002-01-01

    Introduction: Cohort studies have contributed important scientific knowledge regarding the determinants of chronic diseases. Despite the need for etiologic investigations, this design has been infrequently used in injury prevention research. Objectives: To describe the baseline findings of the New Zealand Blood Donors' Health Study, a large prospective study designed to investigate relationships between lifestyle, psychosocial factors, and serious injury due to road crashes, falls, self harm, assault, work, sport, and recreation. Methods: Participants were recruited from fixed and mobile collection sites of a voluntary non-profit blood donor program. Baseline exposure data (for example risk taking behaviors, alcohol and marijuana use, sleep habits, and depression) were collected using a self administered questionnaire. Outcome data regarding serious injury will be collected prospectively through computerized record linkage of participants' unique identifiers to national morbidity and mortality databases. Results: In total, 22 389 participants enrolled in the study (81% response rate). The diverse study population included 36% aged 16–24 years, 20% rural residents, and large variability in exposures of interest. For example, in the 12 months before recruitment, 21% had driven a motor vehicle when they considered themselves over the legal limit for alcohol, and 11% had been convicted of traffic violations (excluding parking infringements). Twelve per cent had seriously considered attempting suicide sometime in their life. Conclusions: This is the first, large scale cohort study investigating determinants of serious injury in New Zealand and among the largest worldwide. Preliminary findings from prospective analyses that can inform injury prevention policy are expected within five years. PMID:11928979

  19. Evaluating Long-term Outcomes of NHS Stop Smoking Services (ELONS): a prospective cohort study.

    PubMed Central

    Dobbie, Fiona; Hiscock, Rosemary; Leonardi-Bee, Jo; Murray, Susan; Shahab, Lion; Aveyard, Paul; Coleman, Tim; McEwen, Andy; McRobbie, Hayden; Purves, Richard; Bauld, Linda

    2015-01-01

    BACKGROUND NHS Stop Smoking Services (SSSs) provide free at the point of use treatment for smokers who would like to stop. Since their inception in 1999 they have evolved to offer a variety of support options. Given the changes that have happened in the provision of services and the ongoing need for evidence on effectiveness, the Evaluating Long-term Outcomes for NHS Stop Smoking Services (ELONS) study was commissioned. OBJECTIVES The main aim of the study was to explore the factors that determine longer-term abstinence from smoking following intervention by SSSs. There were also a number of additional objectives. DESIGN The ELONS study was an observational study with two main stages: secondary analysis of routine data collected by SSSs and a prospective cohort study of service clients. The prospective study had additional elements on client satisfaction, well-being and longer-term nicotine replacement therapy (NRT) use. SETTING The setting for the study was SSSs in England. For the secondary analysis, routine data from 49 services were obtained. For the prospective study and its added elements, nine services were involved. The target population was clients of these services. PARTICIPANTS There were 202,804 cases included in secondary analysis and 3075 in the prospective study. INTERVENTIONS A combination of behavioural support and stop smoking medication delivered by SSS practitioners. MAIN OUTCOME MEASURES Abstinence from smoking at 4 and 52 weeks after setting a quit date, validated by a carbon monoxide (CO) breath test. RESULTS Just over 4 in 10 smokers (41%) recruited to the prospective study were biochemically validated as abstinent from smoking at 4 weeks (which was broadly comparable with findings from the secondary analysis of routine service data, where self-reported 4-week quit rates were 48%, falling to 34% when biochemical validation had occurred). At the 1-year follow-up, 8% of prospective study clients were CO validated as abstinent from smoking

  20. Protocol for a prospective, multicentre registry study of stenting for symptomatic intracranial artery stenosis in China

    PubMed Central

    Wang, Yilong; Miao, Zhongrong; Wang, Yongjun; Zhao, Xingquan; Gao, Peiyi; Liu, Liping; Wang, Feng; Liu, Yajie; Ma, Ning; Xu, Ziqi; Mo,, Dapeng; Gao, Feng

    2014-01-01

    Introduction The SAMMPRIS trial suggested that aggressive treatment was superior to endovascular stenting in patients with severe symptomatic intracranial atherosclerotic stenosis (ICAS) due to high complication rates in patients in the stenting group. Given that 12.2% patients failed aggressive medical therapy in the SAMMPRIS study, it is imperative to perform a multicentre prospective registry study of stenting for patients with ICAS in China. This study aims to evaluate the safety and efficacy of endovascular stenting for patients with symptomatic intracranial artery stenosis and poor collaterals in China and to identify the characteristics of the population that would benefit the most from endovascular stenting in Chinese patients. Methods and analysis This multicentre prospective registry study will involve 20 stroke centres in China, and plans to recruit 300 patients into the registry. Patients with ≥70% stenosis and symptomatic intracranial atherosclerotic disease caused by hypoperfusion combined with poor collaterals who met the inclusion criteria and exclusion criteria would be enrolled for this study. The primary outcome is the target vessel stroke event (including haemorrhagic or ischaemic stroke) or death within 30 days after stenting. The secondary outcomes include the successful recanalisation rate, the incidence of recurrent ischaemic stroke in the territory of the stented artery between 30 days and 1 year postoperatively, the restenosis rate and health-related quality of life. Ethics and dissemination The protocol is approved by the ethics committee at the coordinating centre and by the local institutional review board at each participating centre. Findings will be shared with participating hospitals, policymakers and the academic community to promote quality monitoring, quality improvement and the efficient allocation and use of cerebral catheterisation and intracranial artery stenting in China. Trial registration number http

  1. Arthroscopic anatomical double bundle anterior cruciate ligament reconstruction: A prospective longitudinal study

    PubMed Central

    Devgan, Ashish; Singh, Amanpreet; Gogna, Paritosh; Singla, Rohit; Magu, Narender Kumar; Mukhopadhyay, Reetadyuti

    2015-01-01

    Background: Single bundle anterior cruciate ligament (ACL) reconstruction has been the current standard of treatment for ACL deficiency. However, a significant subset of patients continue to report residual symptoms of instability with a poor pivot control. Cadaveric biomechanical studies have shown double bundle (DB) ACL reconstructions to restore the knee kinematics better. This study evaluates the outcome of DB ACL reconstruction. Materials and Methods: 30 consecutive patients who underwent anatomic DB ACL reconstruction were included in this prospective longitudinal study. There were all males with a mean age of 25 ± 7.45 years. All patients were prospectively evaluated using GeNouRoB (GNRB) arthrometer, functional knee scores (International Knee Documentation Committee [IKDC] and Lysholm) and postoperative magnetic resonance imaging (MRI) for comparing the graft orientation and footprint of the reconstructed ACL with that of the normal knee. Results: The average followup was 36.2 months. At the time of final followup the mean Lysholm score was 93.13 ± 3.31. As per the objective IKDC score, 26 patients (86.6%) were in Group A while 4 patients (13.3%) were in Group B. The mean differential anterior tibial translation by GNRB, arthrometer was 1.07 ± 0.8 mm (range 0.1-2.3 mm). All cases had a negative pivot shift test. MRI scans of operated and the contralateral normal knee showed the mean sagittal ACL tibial angle coronal ACL tibial angle and tibial ACL footprint to be in accordance with the values of the contralateral, normal knee. Conclusion: The study demonstrates that DB ACL reconstruction restores the ACL anatomically in terms of size and angle of orientation. However, long term studies are needed to further substantiate its role in decreasing the incidence of early osteoarthritic changes compared to the conventional single bundle reconstructions. PMID:26015600

  2. Epidemiology and treatment outcome of head injury in children: A prospective study

    PubMed Central

    Nnadi, M. O. N.; Bankole, O. B.; Fente, B. G.

    2014-01-01

    Summary: Head injury in children is a major concern all over the world. The increasing level of poverty in the world is exposing more children to trauma situations. The future consequences of trauma in these children are enormous, hence prevention they say, is better than cure. Aim of the Study: The study was designed to determine the etiological pattern, age group affectation and treatment outcome in children managed for head injury in our center. Methods: It was a prospective, descriptive and cross-sectional study of children with head injuries managed in our center from July 2010 to December 2013. Data were collected using structured proforma that was part of our prospective Data Bank approved by our hospital Research and Ethics Committee. Data were collected in accident and emergency unit, Intensive Care Unit, wards and out-patient clinic. The data was analyzed using Epi Info 7 software. Results: Total of 76 children managed by the unit and followed-up to a minimum of 3 months qualified for the study. There were 42 males. The age ranged from 7 months to 18 years with a mean of 8.66 years. There were 30 adolescent/teenagers. Road traffic accident formed 63.15%. Pedestrian accident was more among preschool and school children. Thirty-seven patients had mild head injury. Sixty-six patients were managed conservatively. The commonest posttraumatic effect was seizure (15.79%). Good functional outcome (≥4) was seen in 92.1%. Mode of accident and severity of injury affected the outcome. Conclusions: The etiologies of traumatic brain injury, from our study, were age dependent with falls commonest in toddlers and pedestrian accident commonest in pre-school and school ages. The outcome of treatment was related to severity of injury. PMID:25624926

  3. Survival of immediately versus delayed loaded short implants: A prospective case series study

    PubMed Central

    Alvira-González, Joaquin; Díaz-Campos, Erick; Sánchez-Garcés, Maria-Angeles

    2015-01-01

    Background To assess and compare survival rates of immediately and delayed loaded short implants (7 mm) in free ends of a partially edentulous jaw with moderate-severe alveolar bone resorption. Material and Methods 24 patients with atrophic edentulous free-ends were included in this prospective study. Four study groups were monitored monthly and their behavior was evaluated: bridges supported only by short implants and mixed short and long implant bridge groups, both with immediate and delayed loading. Failures, bone loss, probing depth and bleeding on probing were evaluated. Results 54 Mk III Shorty TiU and 15 Brånemark System®MK III TiU implants with a length longer than 7mm were included in the study. Twenty-eight implants were inserted following the immediate loading protocol and 26 according a two-stage procedure, depending on the torque value. The cumulative survival rate of short implants was 87% (n=54) after a mean time of 47.72 months (range 33-62 months), showing statistically significant differences related to loading protocol (p=0.047). Short implants immediately loaded had a higher long-term survival rate (96.4%) compared to the other study group (76.9%). Besides, short implants splinted to longer immediately loaded implants presented the highest survival rate (100%). Twenty-five (53.19%) short implants showed a bone loss of less than one millimeter after the follow-up period. Statistically significant differences were found between bleeding on probing, presence of plaque or suppuration and a higher bone loss in both loading protocols (p=0.001). Conclusions Immediate loading of short implants placed on free ends can be considered an option in the treatment protocol of patients with severe bone resorption especially if implants are splinted to others of greater length. Key words: Dental implants, short implants, immediate loading, prospective study, TiUnite surface. PMID:26034926

  4. Accelerator mass spectrometry-enabled studies: current status and future prospects

    PubMed Central

    Arjomand, Ali

    2010-01-01

    Accelerator mass spectrometry is a detection platform with exceptional sensitivity compared with other bioanalytical platforms. Accelerator mass spectrometry (AMS) is widely used in archeology for radiocarbon dating applications. Early exploration of the biological and pharmaceutical applications of AMS began in the early 1990s. AMS has since demonstrated unique problem-solving ability in nutrition science, toxicology and pharmacology. AMS has also enabled the development of new applications, such as Phase 0 microdosing. Recent development of AMS-enabled applications has transformed this novelty research instrument to a valuable tool within the pharmaceutical industry. Although there is now greater awareness of AMS technology, recognition and appreciation of the range of AMS-enabled applications is still lacking, including study-design strategies. This review aims to provide further insight into the wide range of AMS-enabled applications. Examples of studies conducted over the past two decades will be presented, as well as prospects for the future of AMS. PMID:20440378

  5. Transmission of enteric disease associated with wastewater irrigation: A prospective epidemiological study

    SciTech Connect

    Shuval, H.I.; Wax, Y.; Yekutiel, P.; Fattal, B.

    1989-01-01

    A prospective epidemiological study of possible enteric disease transmission by aerosolized pathogens from sprinkler irrigation of partially treated waste water in 20 kibbutzim (collective agricultural settlements) in Israel between March 1981 and February 1982 was conducted. Medical data were collected from the patients' files and daily logs of physicians and nurses at each kibbutzim clinic (total population 10,231). Episodes of enteric disease were similar in the kibbutzim most exposed to wastewater aerosols (11.6 per 100 person-year) and the kibbutzim not exposed to wastewater in any form (11.0 per 100 person-year). No excess of enteric disease was seen among waste water contract workers or their families as compared with the unexposed. No negative health effects were detected in the study which involved a large population, including many young children exposed to treated waste water aerosols generated at distances of 300-600 miles.

  6. Does attention constrain developmental trajectories in fragile x syndrome? A 3-year prospective longitudinal study.

    PubMed

    Cornish, Kim; Cole, Victoria; Longhi, Elena; Karmiloff-Smith, Annette; Scerif, Gaia

    2012-03-01

    Basic attentional processes and their impact on developmental trajectories in fragile X syndrome were assessed in a 3-year prospective study. Although fragile X syndrome is a monogenic X-linked disorder, there is striking variability in outcomes even in young boys with the condition. Attention is a key factor constraining interactions with the environment, so it is a perfect candidate to predict trajectories in cognitive and behavioral outcomes. In this study, 48 boys with fragile X syndrome were assessed 3 times over 24 months. Although nonverbal IQ declined, there were significant improvements in nonverbal growth scores and in cognitive attention. In contrast, behavioral difficulties (i.e., autistic symptomatology, hyperactivity-inattention) remained stable over this time frame. Attentional markers in the visual and auditory modalities predicted intellectual abilities and classroom behavior, whereas auditory markers alone predicted autistic symptomatology.

  7. A prospective study of religiousness and psychological distress among female survivors of Hurricanes Katrina and Rita.

    PubMed

    Chan, Christian S; Rhodes, Jean E; Pérez, John E

    2012-03-01

    This prospective study examined the pathways by which religious involvement affected the post-disaster psychological functioning of women who survived Hurricanes Katrina and Rita. The participants were 386 low-income, predominantly Black, single mothers. The women were enrolled in the study before the hurricane, providing a rare opportunity to document changes in mental health from before to after the storm, and to assess the protective role of religious involvement over time. Results of structural equation modeling indicated that, controlling for level of exposure to the hurricanes, pre-disaster physical health, age, and number of children, pre-disaster religiousness predicted higher levels of post-disaster (1) social resources and (2) optimism and sense of purpose. The latter, but not the former, was associated with better post-disaster psychological outcome. Mediation analysis confirmed the mediating role of optimism and sense of purpose.

  8. Accelerator mass spectrometry-enabled studies: current status and future prospects.

    PubMed

    Arjomand, Ali

    2010-03-01

    Accelerator mass spectrometry is a detection platform with exceptional sensitivity compared with other bioanalytical platforms. Accelerator mass spectrometry (AMS) is widely used in archeology for radiocarbon dating applications. Early exploration of the biological and pharmaceutical applications of AMS began in the early 1990s. AMS has since demonstrated unique problem-solving ability in nutrition science, toxicology and pharmacology. AMS has also enabled the development of new applications, such as Phase 0 microdosing. Recent development of AMS-enabled applications has transformed this novelty research instrument to a valuable tool within the pharmaceutical industry. Although there is now greater awareness of AMS technology, recognition and appreciation of the range of AMS-enabled applications is still lacking, including study-design strategies. This review aims to provide further insight into the wide range of AMS-enabled applications. Examples of studies conducted over the past two decades will be presented, as well as prospects for the future of AMS.

  9. Paranoid delusions and threatening hallucinations: a prospective study of sleep paralysis experiences.

    PubMed

    Cheyne, J Allan; Girard, Todd A

    2007-12-01

    Previously we reported a three-factor structure for hallucinations accompanying sleep paralysis (SP). These earlier analyses were, however, based on retrospective accounts. In a prospective study, 383 individuals reported individual episodes online providing further evidence for the three-factor structure as well as clearer conceptually meaningful relations among factors than retrospective studies. In addition, reports of individual episodes permitted a more fine-grained analysis of the internal structure of factors to assess predictions based on the hypothesis that a sensed or felt presence (FP) is a core experience affecting other SP hallucinations. Results were generally consistent with this hypothesis. In particular, associations among, and temporal stability of, sensory hallucinations were largely explained by their common association with FP. The findings are consistent with REM initiation of a threat activated vigilance system with pervasive effects on the SP experience and suggest a potential model for the thematic organization of nightmares and dreams more generally.

  10. Prospective clinical study of press-ceramic overlap and full veneer restorations: 7-year results.

    PubMed

    Guess, Petra C; Selz, Christian F; Voulgarakis, Apostolos; Stampf, Susanne; Stappert, Christian F J

    2014-01-01

    The aim of this prospective clinical study was to investigate the long-term performance of all-ceramic veneers with overlap (OV) and full veneer (FV) preparation designs. Twenty-five patients were restored using 42 OV restorations (incisal/palatal butt-joint margin) and 24 FV restorations (palatal rounded shoulder margin). All restorations were leucite-reinforced glass-ceramic anterior veneers. The 7-year Kaplan-Meier survival rate was 100% for FV restorations and 97.6% for OV restorations. The all-ceramic veneers revealed significant deterioration over time according to United States Public Health Service criteria, irrespective of the preparation design. Based on the 7-year results of this study, both preparation designs can be considered reliable treatment options for anterior teeth with extended deficits.

  11. Peritraumatic psychological and somatoform dissociation in predicting PTSD symptoms: a prospective study.

    PubMed

    Hagenaars, Muriel A; van Minnen, Agnes; Hoogduin, Kees A L

    2007-11-01

    The present prospective study evaluates the predictive value of 2 different types of dissociation (psychological and somatoform peritraumatic dissociation), and dysfunctional cognitions on symptoms of posttraumatic stress disorder (PTSD) at 6 months. Assessment of dissociation, PTSD symptoms, and dysfunctional cognitions took place in 49 participants approximately 3 weeks after a traumatic event. Six months later PTSD symptoms were assessed again. The effect of both psychological and somatoform peritraumatic dissociation disappeared after controlling for initial PTSD numbing symptoms. Dysfunctional cognitions predicted PTSD at 6 months after controlling for initial numbing symptoms. The present study indicates that peritraumatic dissociation may not be a predictor of PTSD. In contrast, maladaptive posttraumatic coping behavior like persistent dissociation and dysfunctional cognitions may be predictors.

  12. Transmission of enteric disease associated with wastewater irrigation: a prospective epidemiological study.

    PubMed Central

    Shuval, H I; Wax, Y; Yekutiel, P; Fattal, B

    1989-01-01

    We conducted a prospective epidemiological study of possible enteric disease transmission by aerosolized pathogens from sprinkler irrigation of partially treated wastewater in 20 kibbutzim (collective agricultural settlements) in Israel between March 1981 and February 1982. Medical data were collected from the patients' files and daily logs of physicians and nurses at each kibbutz clinic (total population 10,231). Episodes of enteric disease were similar in the kibbutzim most exposed to wastewater aerosols (11.6 per 100 person-year) and the kibbutzim not exposed to wastewater in any form (11.0 per 100 person-year). No excess of enteric disease was seen among wastewater contact workers or their families as compared with the unexposed. No negative health effects were detected in this study which involved a large population, including many young children, exposed to treated wastewater aerosols generated at distances of 300-600 m. PMID:2735471

  13. Trait anger, anger expression, and suicide attempts among adolescents and young adults: a prospective study.

    PubMed

    Daniel, Stephanie S; Goldston, David B; Erkanli, Alaattin; Franklin, Joseph C; Mayfield, Andrew M

    2009-09-01

    Previous studies of the relationship between anger, anger expression, and suicidal behavior have been largely cross-sectional and have yielded mixed findings. In a prospective, naturalistic study, we examined how trait anger and anger expression influenced the likelihood of suicide attempts among 180 adolescents followed for up to 13.3 years after discharge from an inpatient psychiatry unit. Results showed that higher trait anger and anger expressed outwardly over the follow-up was related to increased likelihood of suicide attempts among boys. For girls, trait anger and both the inward and outward expression of anger moderated the risk for suicide attempts associated with major depression. These results are interpreted in light of theory regarding behavioral activation and behavioral inhibition systems.

  14. The effects of changes in the metabolic syndrome detection status on arterial stiffening: a prospective study.

    PubMed

    Tomiyama, Hirofumi; Hirayama, Yoji; Hashimoto, Hideki; Yambe, Minoru; Yamada, Jiko; Koji, Yutaka; Motobe, Kohki; Shiina, Kazuki; Yamamoto, Yoshio; Yamashinai, Akira

    2006-09-01

    We conducted a prospective study to examine the effects of alterations of the metabolic syndrome detection status on the rate of progression of arterial stiffness, which is recognized as a marker of arterial damage and an indicator of cardiovascular risk. Brachial-ankle pulse wave velocity as an index of arterial stiffening was recorded twice over a 3-year period in 2080 Japanese men (age, 42 +/- 9 years). At the start of the prospective study, pulse wave velocity was higher in the subjects with metabolic syndrome (n=125) than in those without metabolic syndrome (n=1,955) even after adjusting for mean blood pressure. The annual rate of increase of the pulse wave velocity was higher in the group with persistent metabolic syndrome (27 +/- 51 cm/s/year, n=71) than in the group with regression of metabolic syndrome (6 +/- 39 cm/s/year, n=54) or the group in which metabolic syndrome was absent (13 +/- 37 cm/s/year, n=1843; p < 0.05) after adjustment for changes in blood pressure. In conclusion, the changes in the metabolic syndrome detection status of the subjects during the study period affected the annual rate of progression of arterial stiffening, and persistent metabolic syndrome during the study period was associated with acceleration of arterial stiffening in middle-aged Japanese men. On the other hand, resolution of metabolic syndrome may be associated with attenuation of the progression of arterial damage. Therefore, the increased cardiovascular risk associated with the presence of metabolic syndrome may be at least partly mediated by acceleration of the progression of arterial stiffening.

  15. A prospective study of fruits, vegetables, and risk of endometrial cancer.

    PubMed

    McCullough, Marjorie L; Bandera, Elisa V; Patel, Roshni; Patel, Alpa V; Gansler, Ted; Kushi, Lawrence H; Thun, Michael J; Calle, Eugenia E

    2007-10-15

    Case-control studies support a lower risk of endometrial cancer associated with greater vegetable consumption but not fruit consumption. One prospective study suggested an inverse association with fruits and vegetables combined. The authors examined associations for vegetables and fruits separately among women in the American Cancer Society's Cancer Prevention Study II Nutrition Cohort. After exclusions, 41,400 postmenopausal women completed a questionnaire on diet, lifestyle, and medical history at baseline in 1992-1993. Information on diet was updated in 1999; historical dietary information from 1982 was also available. The authors identified 435 eligible cases of endometrial cancer through 2003. In multivariate models, neither fruit consumption (top quintile vs. bottom: rate ratio (RR) = 1.24, 95% confidence interval (CI): 0.90, 1.70; p-trend = 0.30) nor vegetable consumption (RR = 1.21, 95% CI: 0.89, 1.65; p-trend = 0.24) at baseline was associated with risk. Results were similar when diet was cumulatively updated. Only among women who had never used hormone replacement therapy was the risk of endometrial cancer lower in the highest (vs. lowest) tertile of fruit (RR = 0.75, 95% CI: 0.52, 1.07; p-interaction = 0.03, p-trend = 0.11) or vegetable (RR = 0.80, 95% CI: 0.57, 1.13; p-interaction = 0.01, p-trend = 0.29) consumption. This prospective study does not support an association between vegetable or fruit consumption and endometrial cancer.

  16. Childhood infectious disease and premature death from cancer: a prospective cohort study.

    PubMed

    Tennant, Peter W G; Parker, Louise; Thomas, Julian E; Craft, Sir Alan W; Pearce, Mark S

    2013-03-01

    Studies of the association between early life infections and cancer have produced inconsistent findings, possibly due to limited adjustment for confounding and retrospective designs. This study utilised data from the Newcastle Thousand Families Study, a prospective cohort of 1,142 individuals born in Newcastle-upon-Tyne in 1947, to assess the impact of various childhood infectious diseases on cancer mortality during ages 15-60 years. Detailed information was collected prospectively on a number of early life factors. Deaths from cancer during ages 15-60 years were analysed in relation to childhood infections, adjusting for potential early-life confounders, using Cox proportional-hazards regression. In a subsample who returned questionnaires at aged 49-51 years, additional adjustment was made for adult factors to predict death from cancer during ages 50-60 years. Childhood history of measles and influenza, were both independently associated with lower cancer mortality during ages 15-60 years (adjusted hazard ratios = 0.39, 95% CI 0.17-0.88 and 0.49, 95% CI 0.24-0.98 respectively). In contrast, childhood pertussis was associated with higher cancer mortality during ages 15-60 years (adjusted hazard ratio = 4.88, 95% CI 2.29-10.38). In the subsample with additional adjustment for adult variables, measles and pertussis remained significantly associated with cancer mortality during ages 50-60 years. In this pre-vaccination cohort, childhood infection with measles and influenza were associated with a reduced risk of death from cancer in adulthood, while pertussis was associated with an increased risk. While these results suggest some disease-specific associations between early-life infections and cancer, further studies are required to confirm the specific associations identified.

  17. Potato intake and incidence of hypertension: results from three prospective US cohort studies

    PubMed Central

    Rimm, Eric B; Willett, Walter C; Forman, John P

    2016-01-01

    Objective To determine whether higher intake of baked or boiled potatoes, French fries, or potato chips is associated with incidence of hypertension. Design Prospective longitudinal cohort studies. Setting Healthcare providers in the United States. Participants 62 175 women in Nurses’ Health Study, 88 475 women in Nurses’ Health Study II, and 36 803 men in Health Professionals Follow-up Study who were non-hypertensive at baseline. Main outcome measure Incident cases of hypertension (self reported diagnosis by healthcare provider). Results Compared with consumption of less than one serving a month, the random effects pooled hazard ratios for four or more servings a week were 1.11 (95% confidence interval 0.96 to 1.28; P for trend=0.05) for baked, boiled, or mashed potatoes, 1.17 (1.07 to 1.27; P for trend=0.001) for French fries, and 0.97 (0.87 to 1.08; P for trend=0.98) for potato chips. In substitution analyses, replacing one serving a day of baked, boiled, or mashed potatoes with one serving a day of non-starchy vegetables was associated with decreased risk of hypertension (hazard ratio 0.93, 0.89 to 0.96). Conclusion Higher intake of baked, boiled, or mashed potatoes and French fries was independently and prospectively associated with an increased risk of developing hypertension in three large cohorts of adult men and women. PMID:27189229

  18. Prenatal maternal depression is associated with offspring inflammation at 25 years: a prospective longitudinal cohort study

    PubMed Central

    Plant, D T; Pawlby, S; Sharp, D; Zunszain, P A; Pariante, C M

    2016-01-01

    Animal studies and a handful of prospective human studies have demonstrated that young offspring exposed to maternal prenatal stress show abnormalities in immune parameters and hypothalamic–pituitary–adrenal (HPA) axis function. No study has examined the effect of maternal prenatal depression on offspring inflammation and HPA axis activity in adulthood, nor the putative role of child maltreatment in inducing these abnormalities. High-sensitivity C-reactive protein (hs-CRP) and awakening cortisol were measured at age 25 in 103 young-adult offspring of the South London Child Development Study (SLCDS), a prospective longitudinal birth cohort of mother–offspring dyads recruited in pregnancy in 1986. Maternal prenatal depression was assessed in pregnancy at 20 and 36 weeks; offspring child maltreatment (birth 17 years) was assessed at offspring ages 11, 16 and 25; and offspring adulthood depression (18–25 years) was assessed at age 25. Exposure to maternal prenatal depression predicted significantly elevated offspring hs-CRP at age 25 (odds ratio=11.8, 95% confidence interval (CI) (1.1, 127.0), P=0.041), independently of child maltreatment and adulthood depression, known risk factors for adulthood inflammation. In contrast, maternal prenatal depression did not predict changes in offspring adulthood cortisol; however, offspring exposure to child maltreatment did, and was associated with elevated awakening cortisol levels (B=161.9, 95% CI (45.4, 278.4), P=0.007). Fetal exposure to maternal depression during pregnancy has effects on immune function that persist for up to a quarter of a century after birth. Findings are consistent with the developmental origins of health and disease (DOHaD) hypothesis for the biological embedding of gestational psychosocial adversity into vulnerability for future physical and mental illness. PMID:27801895

  19. Night Shift Work and Breast Cancer Incidence: Three Prospective Studies and Meta-analysis of Published Studies

    PubMed Central

    Balkwill, Angela; Fensom, Georgina K.; Appleby, Paul N.; Reeves, Gillian K.; Wang, Xiao-Si; Roddam, Andrew W.; Gathani, Toral; Peto, Richard; Green, Jane; Key, Timothy J.; Beral, Valerie

    2016-01-01

    Background: It has been proposed that night shift work could increase breast cancer incidence. A 2007 World Health Organization review concluded, mainly from animal evidence, that shift work involving circadian disruption is probably carcinogenic to humans. We therefore aimed to generate prospective epidemiological evidence on night shift work and breast cancer incidence. Methods: Overall, 522 246 Million Women Study, 22 559 EPIC-Oxford, and 251 045 UK Biobank participants answered questions on shift work and were followed for incident cancer. Cox regression yielded multivariable-adjusted breast cancer incidence rate ratios (RRs) and 95% confidence intervals (CIs) for night shift work vs no night shift work, and likelihood ratio tests for interaction were used to assess heterogeneity. Our meta-analyses combined these and relative risks from the seven previously published prospective studies (1.4 million women in total), using inverse-variance weighted averages of the study-specific log RRs. Results: In the Million Women Study, EPIC-Oxford, and UK Biobank, respectively, 673, 28, and 67 women who reported night shift work developed breast cancer, and the RRs for any vs no night shift work were 1.00 (95% CI = 0.92 to 1.08), 1.07 (95% CI = 0.71 to 1.62), and 0.78 (95% CI = 0.61 to 1.00). In the Million Women Study, the RR for 20 or more years of night shift work was 1.00 (95% CI = 0.81 to 1.23), with no statistically significant heterogeneity by sleep patterns or breast cancer risk factors. Our meta-analysis of all 10 prospective studies included 4660 breast cancers in women reporting night shift work; compared with other women, the combined relative risks were 0.99 (95% CI = 0.95 to 1.03) for any night shift work, 1.01 (95% CI = 0.93 to 1.10) for 20 or more years of night shift work, and 1.00 (95% CI = 0.87 to 1.14) for 30 or more years. Conclusions: The totality of the prospective evidence shows that night shift work, including long

  20. Mines, prospects, mining claims, and sample localities of the Dark Canyon Instant Study Area and vicinity, San Juan County, Utah

    USGS Publications Warehouse

    Light, Thomas D.

    1981-01-01

    In conjunction with studies conducted by the U.S. Geological Survey, the U.S. Bureau of Mines conducted a mineral survey in 1979 of known mines, prospect workings, and mineralized zones in the Dark Canyon Instant Study Area, San Juan County, Utah.  This map is a supplement to the Mineral Resources of the Dark Canyon Instant Study Area (Weitz and Light, 1981)., and depicts the locations of mines, prospects, mining claims and sample localities for the area examined by the U.S. Bureau of Mines.

  1. Height and Breast Cancer Risk: Evidence From Prospective Studies and Mendelian Randomization

    PubMed Central

    Zhang, Ben; Shu, Xiao-Ou; Delahanty, Ryan J.; Zeng, Chenjie; Michailidou, Kyriaki; Bolla, Manjeet K.; Wang, Qin; Dennis, Joe; Wen, Wanqing; Long, Jirong; Li, Chun; Dunning, Alison M.; Chang-Claude, Jenny; Shah, Mitul; Perkins, Barbara J.; Czene, Kamila; Darabi, Hatef; Eriksson, Mikael; Bojesen, Stig E.; Nordestgaard, Børge G.; Nielsen, Sune F.; Flyger, Henrik; Lambrechts, Diether; Neven, Patrick; Wildiers, Hans; Floris, Giuseppe; Schmidt, Marjanka K.; Rookus, Matti A.; van den Hurk, Katja; de Kort, Wim L. A. M.; Couch, Fergus J.; Olson, Janet E.; Hallberg, Emily; Vachon, Celine; Rudolph, Anja; Seibold, Petra; Flesch-Janys, Dieter; Peto, Julian; dos-Santos-Silva, Isabel; Fletcher, Olivia; Johnson, Nichola; Nevanlinna, Heli; Muranen, Taru A.; Aittomäki, Kristiina; Blomqvist, Carl; Li, Jingmei; Humphreys, Keith; Brand, Judith; Guénel, Pascal; Truong, Thérèse; Cordina-Duverger, Emilie; Menegaux, Florence; Burwinkel, Barbara; Marme, Frederik; Yang, Rongxi; Surowy, Harald; Benitez, Javier; Zamora, M. Pilar; Perez, Jose I. A.; Cox, Angela; Cross, Simon S.; Reed, Malcolm W. R.; Andrulis, Irene L.; Knight, Julia A.; Glendon, Gord; Tchatchou, Sandrine; Sawyer, Elinor J.; Tomlinson, Ian; Kerin, Michael J.; Miller, Nicola; Chenevix-Trench, Georgia; Haiman, Christopher A.; Henderson, Brian E.; Schumacher, Fredrick; Marchand, Loic Le; Lindblom, Annika; Margolin, Sara; Hooning, Maartje J.; Martens, John W. M.; Tilanus-Linthorst, Madeleine M. A.; Collée, J. Margriet; Hopper, John L.; Southey, Melissa C.; Tsimiklis, Helen; Apicella, Carmel; Slager, Susan; Toland, Amanda E.; Ambrosone, Christine B.; Yannoukakos, Drakoulis; Giles, Graham G.; Milne, Roger L.; McLean, Catriona; Fasching, Peter A.; Haeberle, Lothar; Ekici, Arif B.; Beckmann, Matthias W.; Brenner, Hermann; Dieffenbach, Aida Karina; Arndt, Volker; Stegmaier, Christa; Swerdlow, Anthony J.; Ashworth, Alan; Orr, Nick; Jones, Michael; Figueroa, Jonine; Garcia-Closas, Montserrat; Brinton, Louise; Lissowska, Jolanta; Dumont, Martine; Winqvist, Robert; Pylkäs, Katri; Jukkola-Vuorinen, Arja; Grip, Mervi; Brauch, Hiltrud; Brüning, Thomas; Ko, Yon-Dschun; Peterlongo, Paolo; Manoukian, Siranoush; Bonanni, Bernardo; Radice, Paolo; Bogdanova, Natalia; Antonenkova, Natalia; Dörk, Thilo; Mannermaa, Arto; Kataja, Vesa; Kosma, Veli-Matti; Hartikainen, Jaana M.; Devilee, Peter; Seynaeve, Caroline; Van Asperen, Christi J.; Jakubowska, Anna; Lubiński, Jan; Jaworska-Bieniek, Katarzyna; Durda, Katarzyna; Hamann, Ute; Torres, Diana; Schmutzler, Rita K.; Neuhausen, Susan L.; Anton-Culver, Hoda; Kristensen, Vessela N.; Grenaker Alnæs, Grethe I.; Pierce, Brandon L.; Kraft, Peter; Peters, Ulrike; Lindstrom, Sara; Seminara, Daniela; Burgess, Stephen; Ahsan, Habibul; Whittemore, Alice S.; John, Esther M.; Gammon, Marilie D.; Malone, Kathleen E.; Tessier, Daniel C.; Vincent, Daniel; Bacot, Francois; Luccarini, Craig; Baynes, Caroline; Ahmed, Shahana; Maranian, Mel; Healey, Catherine S.; González-Neira, Anna; Pita, Guillermo; Alonso, M. Rosario; Álvarez, Nuria; Herrero, Daniel; Pharoah, Paul D. P.; Simard, Jacques; Hall, Per; Hunter, David J.; Easton, Douglas F.

    2015-01-01

    Background: Epidemiological studies have linked adult height with breast cancer risk in women. However, the magnitude of the association, particularly by subtypes of breast cancer, has not been established. Furthermore, the mechanisms of the association remain unclear. Methods: We performed a meta-analysis to investigate associations between height and breast cancer risk using data from 159 prospective cohorts totaling 5216302 women, including 113178 events. In a consortium with individual-level data from 46325 case patients and 42482 control subjects, we conducted a Mendelian randomization analysis using a genetic score that comprised 168 height-associated variants as an instrument. This association was further evaluated in a second consortium using summary statistics data from 16003 case patients and 41335 control subjects. Results: The pooled relative risk of breast cancer was 1.17 (95% confidence interval [CI] = 1.15 to 1.19) per 10cm increase in height in the meta-analysis of prospective studies. In Mendelian randomization analysis, the odds ratio of breast cancer per 10cm increase in genetically predicted height was 1.22 (95% CI = 1.13 to 1.32) in the first consortium and 1.21 (95% CI = 1.05 to 1.39) in the second consortium. The association was found in both premenopausal and postmenopausal women but restricted to hormone receptor–positive breast cancer. Analyses of height-associated variants identified eight new loci associated with breast cancer risk after adjusting for multiple comparisons, including three loci at 1q21.2, DNAJC27, and CCDC91 at genome-wide significance level P < 5×10–8. Conclusions: Our study provides strong evidence that adult height is a risk factor for breast cancer in women and certain genetic factors and biological pathways affecting adult height have an important role in the etiology of breast cancer. PMID:26296642

  2. Same-day discharge in benign esophageal surgery: a prospective cohort study.

    PubMed

    Desbeaux, A; Gronnier, C; Piessen, G; Vanderbeken, M; Ruolt, N; Triboulet, J-P; Mariette, C

    2017-04-01

    Day-case esophageal surgery has been demonstrated to be safe in small prospective cohorts and only for laparoscopic fundoplication. The aims of this study are to assess the feasibility and safety of a large series of esophageal day-case surgeries, including laparoscopic Nissen fundoplication (LNF), Zenker diverticulectomy (ZD), and laparoscopic Heller myotomy (LHM) and to compare the outcomes among three procedures.This was a prospective, observational study of selected patients who underwent day-case LNF, ZD, and LHM between 2003 and 2013. Postoperative outcomes, the patients' satisfaction, and functional results were evaluated with dedicated scores and compared.Of the 427 patients who underwent surgery for those indications during the study period, 168 (39.3%) eligible patients underwent day-case procedures (134 LNF, 14 LHM, and 20 ZD). The overnight unplanned admission rate was 16.2% and was similar among the groups (P = 0.681). Ten patients were readmitted during the first postoperative week because of dysphagia (n = 6, all in the LNF group), flu-like syndrome (n = 1), and secondary perforation (n = 3, all in the LHM group). The unplanned seven-day readmission rate was significantly higher in the LHM group than in the ZD and LNF groups (P = 0.042). The 30-day rates of unplanned readmission and consultation were 8.9% (P = 0.300) and 4.8%, respectively. At follow-up, 87.5% of the patients were satisfied with day-case treatment, and the functional results were good for 81.4% of the patients.Day-case esophageal surgery is feasible for LNF and seems to be feasible for ZD. Safety criteria have not yet been met for LHM, requiring further adaptations.

  3. Taking the Tension Out of Hypertension: A Prospective Study of Psychological Well-Being and Hypertension

    PubMed Central

    TRUDEL-FITZGERALD, Claudia; BOEHM, Julia K.; KIVIMAKI, Mika; KUBZANSKY, Laura D.

    2016-01-01

    Background Previous studies have shown that psychological well-being is associated with reduced risk of cardiovascular disease. However, whether well-being might be specifically associated with reduced risk of hypertension has not been rigorously investigated in prospective studies. Objective This study examined the prospective association between two measures of psychological well-being and incident hypertension. Methods Participants were 6,384 healthy British civil servants age 39 to 63 from the Whitehall II cohort. Psychological well-being (emotional vitality and optimism) and cardiovascular risk factors (demographic characteristics, health status, health behaviors, psychological ill-being) were assessed during the 1991-1994 baseline. Incident hypertension was defined by clinical measures of systolic or diastolic blood pressure >140/90 mmHg, self-reported physician-diagnosed hypertension, or treatment for hypertension. Follow-up assessments of hypertension took place approximately every three years through 2002-2004. Cox proportional hazards regression models estimated hazard ratios. Results There were 2,304 cases of incident hypertension during the follow-up period. High versus low emotional vitality was associated with a significantly reduced risk of hypertension in an age-adjusted model (hazard ratio = 0.89; 95% confidence interval 0.80-0.98). This association was maintained after controlling for demographic characteristics and health status, but was slightly attenuated after adjusting for health behaviors and ill-being. Optimism was not significantly associated with hypertension. Conclusions High emotional vitality was associated with reduced hypertension risk; favorable health behaviors explained only part of the relationship. Associations did not differ by age, were similar for men and women and were maintained after accounting for ill-being. PMID:24786293

  4. Vasopressor Use for Severe Hypotension—A Multicentre Prospective Observational Study

    PubMed Central

    Cook, Deborah J.; Meade, Maureen O.; Seely, Andrew; Day, Andrew G.; Charbonney, Emmanuel; Serri, Karim; Skrobik, Yoanna; Hebert, Paul; St-Arnaud, Charles; Quiroz-Martinez, Hector; Mayette, Michaël; Heyland, Daren K.

    2017-01-01

    Background The optimal approach to titrate vasopressor therapy is unclear. Recent sepsis guidelines recommend a mean arterial pressure (MAP) target of 65 mmHg and higher for chronic hypertensive patients. As data emerge from clinical trials comparing blood pressure targets for vasopressor therapy, an accurate description of usual care is required to interpret study results. Our aim was to measure MAP values during vasopressor therapy in Canadian intensive care units (ICUs) and to compare these with stated practices and guidelines. Method In a multicenter prospective cohort study of critically ill adults with severe hypotension, we recorded MAP and vasopressor doses hourly. We investigated variability across patients and centres using multivariable regression models and Analysis of variance (ANOVA), respectively. Results We included data from 56 patients treated in 6 centers. The mean (standard deviation [SD]) age and Acute Physiology and Chronic Health Evaluation (APACHE) II score were 64 (14) and 25 (8). Half (28 of 56) of the patients were at least 65 years old, and half had chronic hypertension. The patient-averaged MAP while receiving vasopressors was 75 mm Hg (6) and the median (1st quartile, 3rd quartile) duration of vasopressor therapy was 43 hours (23, 84). MAP achieved was not associated with history of underlying hypertension (p = 0.46) but did vary by center (p<0.001). Conclusions In this multicenter, prospective observational study, the patient-level average MAP while receiving vasopressors for severe hypotension was 75 mmHg, approximately 10 mmHg above current recommendations and stated practices. Moreover, our results do not support the notion that clinicians tailor vasopressor therapy to individual patient characteristics such as underlying chronic hypertension but MAP achieved while receiving vasopressors varied by site. PMID:28107357

  5. Risk factors for shunt malfunction in pediatric hydrocephalus: a multicenter prospective cohort study.

    PubMed

    Riva-Cambrin, Jay; Kestle, John R W; Holubkov, Richard; Butler, Jerry; Kulkarni, Abhaya V; Drake, James; Whitehead, William E; Wellons, John C; Shannon, Chevis N; Tamber, Mandeep S; Limbrick, David D; Rozzelle, Curtis; Browd, Samuel R; Simon, Tamara D

    2016-04-01

    OBJECT The rate of CSF shunt failure remains unacceptably high. The Hydrocephalus Clinical Research Network (HCRN) conducted a comprehensive prospective observational study of hydrocephalus management, the aim of which was to isolate specific risk factors for shunt failure. METHODS The study followed all first-time shunt insertions in children younger than 19 years at 6 HCRN centers. The HCRN Investigator Committee selected, a priori, 21 variables to be examined, including clinical, radiographic, and shunt design variables. Shunt failure was defined as shunt revision, subsequent endoscopic third ventriculostomy, or shunt infection. Important a priori-defined risk factors as well as those significant in univariate analyses were then tested for independence using multivariate Cox proportional hazard modeling. RESULTS A total of 1036 children underwent initial CSF shunt placement between April 2008 and December 2011. Of these, 344 patients experienced shunt failure, including 265 malfunctions and 79 infections. The mean and median length of follow-up for the entire cohort was 400 days and 264 days, respectively. The Cox model found that age younger than 6 months at first shunt placement (HR 1.6 [95% CI 1.1-2.1]), a cardiac comorbidity (HR 1.4 [95% CI 1.0-2.1]), and endoscopic placement (HR 1.9 [95% CI 1.2-2.9]) were independently associated with reduced shunt survival. The following had no independent associations with shunt survival: etiology, payer, center, valve design, valve programmability, the use of ultrasound or stereotactic guidance, and surgeon experience and volume. CONCLUSIONS This is the largest prospective study reported on children with CSF shunts for hydrocephalus. It confirms that a young age and the use of the endoscope are risk factors for first shunt failure and that valve type has no impact. A new risk factor-an existing cardiac comorbidity-was also associated with shunt failure.

  6. A Prospective Bicenter Study Investigating the Diagnostic Value of Procalcitonin in Patients with Acute Appendicitis

    PubMed Central

    Sand, M.; Trullen, X.V.; Bechara, F.G.; Pala, X.F.; Sand, D.; Landgrafe, G.; Mann, B.

    2009-01-01

    Background Procalcitonin (PCT) is an established laboratory marker for disease severity in patients with infection and sepsis. In addition, PCT has been shown to be an effective marker for a limited number of localized infections. However, whether or not PCT has any diagnostic value for acute appendicitis, still remains unclear. The purpose of this prospective bicenter study was, therefore, to determine whether or not the PCT levels in the serum of patients with acute appendicitis have any diagnostic value. Methods This prospective study included 103 patients who received an appendectomy, based on the clinical diagnosis of acute appendicitis, in a surgical department of an academic teaching hospital in Germany or in a county hospital in Spain. White blood cell count (WBC), C-reactive protein (CRP) and procalcitonin (PCT) values were determined preoperatively. All appendectomy specimens were sent for routine histopathological evaluation. Based on this information, the patients were assigned to 1 of 5 groups that reflected the severity of the appendicitis. Results Of the 103 patients who were included in the study, 98 had appendicitis. Fourteen (14.3%) showed an increase in PCT values. Of those 14, 4 had a serum PCT >0.5 ng/ml, 9 had a PCT value >2–10 ng/ml and 1 had a PCT value >10 ng/ml. The sensitivity of PCT was calculated to be 0.14. The mean WBC value was 13.0/nl (± 5.2, 3.4–31), and for CRP it was 8.8 mg/dl (± 13, 0–60.2). The values of CRP, WBC and PCT increased with the severity of the appendicitis. Conclusions PCT is potentially increased in rare cases of severe inflammation and, in particular, after appendiceal perforation or gangrenous appendicitis. However, its remarkably low sensitivity prohibits its routine use for the diagnosis of appendicitis. PMID:19672084

  7. Cerebral perfusion pressure and risk of brain hypoxia in severe head injury: a prospective observational study

    PubMed Central

    Marín-Caballos, Antonio J; Murillo-Cabezas, Francisco; Cayuela-Domínguez, Aurelio; Domínguez-Roldán, Jose M; Rincón-Ferrari, M Dolores; Valencia-Anguita, Julio; Flores-Cordero, Juan M; Muñoz-Sánchez, M Angeles

    2005-01-01

    Introduction Higher and lower cerebral perfusion pressure (CPP) thresholds have been proposed to improve brain tissue oxygen pressure (PtiO2) and outcome. We study the distribution of hypoxic PtiO2 samples at different CPP thresholds, using prospective multimodality monitoring in patients with severe traumatic brain injury. Methods This is a prospective observational study of 22 severely head injured patients admitted to a neurosurgical critical care unit from whom multimodality data was collected during standard management directed at improving intracranial pressure, CPP and PtiO2. Local PtiO2 was continuously measured in uninjured areas and snapshot samples were collected hourly and analyzed in relation to simultaneous CPP. Other variables that influence tissue oxygen availability, mainly arterial oxygen saturation, end tidal carbon dioxide, body temperature and effective hemoglobin, were also monitored to keep them stable in order to avoid non-ischemic hypoxia. Results Our main results indicate that half of PtiO2 samples were at risk of hypoxia (defined by a PtiO2 equal to or less than 15 mmHg) when CPP was below 60 mmHg, and that this percentage decreased to 25% and 10% when CPP was between 60 and 70 mmHg and above 70 mmHg, respectively (p < 0.01). Conclusion Our study indicates that the risk of brain tissue hypoxia in severely head injured patients could be really high when CPP is below the normally recommended threshold of 60 mmHg, is still elevated when CPP is slightly over it, but decreases at CPP values above it. PMID:16356218

  8. Risk Factors of Developmental Defects of Enamel-A Prospective Cohort Study

    PubMed Central

    Wong, Hai Ming; Peng, Si-Min; Wen, Yi Feng; King, Nigel M.; McGrath, Colman P. J.

    2014-01-01

    Background and objective Current studies on the aetiology of developmental defects of enamel (DDE) are subject to recall bias because of the retrospective collection of information. Our objective was to investigate potential risk factors associated with the occurrence of DDE through a prospective cohort study. Methods Using a random community sample of Hong Kong children born in 1997, we performed a cohort study in which the subjects’ background information, medical and dental records were prospectively collected. A clinical examination to identify DDE was conducted in 2010 when the subjects were 12 years old. The central incisor, lateral incisor and first molar in each quadrant were chosen as the index teeth and were examined ‘wet’ by two trained and calibrated examiners using the modified FDI (DDE) Index. Results With a response rate of 74.9%, the 514 examined subjects had matched data for background information. Diffuse opacites were the most common type of DDE. Of the various possible aetiological factors considered, only experience of severe diseases during the period 0–3 years was associated with the occurrence of ‘any defect’ (p = 0.017) and diffuse opacities (p = 0.044). The children with experience of severe diseases before 3 years of age were 7.89 times more likely to be affected by ‘any defect’ compared with those who did not have the experience (OR 7.89; 95% CI 1.07, 58.14; p = 0.043). However, after adjusting for confounding factors, the association no longer existed. Conclusion No variables could be identified as risk factors of DDE in this Hong Kong birth cohort. PMID:25275499

  9. Metabolic syndrome and the risk of bone fractures: A Meta-analysis of prospective cohort studies.

    PubMed

    Yang, Libo; Lv, Xiaohong; Wei, Dailin; Yue, Feng; Guo, Jinying; Zhang, Tie

    2016-03-01

    Increasing evidence has suggested an association between metabolic syndrome (MetS) and bone fractures. However, because of controversial results it is still not clear whether this effect is protective or detrimental. Therefore, we conducted a meta-analysis of prospective studies to assess the association between them. Pertinent studies were identified by searching PubMed and EMBASE databases until the end of July 2015. Summary relative risks (RRs) and 95% confidence intervals (CIs) for associations between MetS and fracture risk were estimated with random effects models. Our meta-analysis included five prospective studies. The summarized RRs of any type of fractures for MetS were 0.76 (95%CI: 0.59-0.97, P = 0.026) with moderate heterogeneity (I(2) = 63.80%, P = 0.064). Notably, subgroup analyses by gender showed that significant inverse associations were observed only in men (summarized RR = 0.66; 95%CI = 0.51-0.86, P = 0.002; I(2) = 27.90%, P = 0.235; n = 5) but not in women (summarized RR = 0.96, 95%CI: 0.60-1.54, P = 0.866; I(2) = 83.40%, P = 0.002; n = 3). However, the difference of the pooled RRs from the two subgroups did not reach statistical significance with a test of interaction (p = 0.179 for the interaction test). When pooling the RRs of non-vertebral fractures, significant inverse associations were similarly observed in men (RR = 0.72, 95%CI: 0.52-0.99, P = 0.048) but not in women (RR = 0.99, 95%CI: 0.60-1.64, P = 0.969). There was no evidence of publication bias. Our findings demonstrated that MetS was significantly associated with a lower fracture risk. There might be gender differences in the relationship of MetS with fractures, but further confirmation is needed.

  10. Nursing Workload as a Risk Factor for Healthcare Associated Infections in ICU: A Prospective Study

    PubMed Central

    Daud-Gallotti, Renata M.; Costa, Silvia F.; Guimarães, Thais; Padilha, Katia Grillo; Inoue, Evelize Naomi; Vasconcelos, Tiago Nery; da Silva Cunha Rodrigues, Fernanda; Barbosa, Edizângela Vasconcelos; Figueiredo, Walquíria Barcelos; Levin, Anna S.

    2012-01-01

    Introduction Nurse understaffing is frequently hypothesized as a potential risk factor for healthcare-associated infections (HAI). This study aimed to evaluate the role of nursing workload in the occurrence of HAI, using Nursing Activities Score (NAS). Methods This prospective cohort study enrolled all patients admitted to 3 Medical ICUs and one step-down unit during 3 months (2009). Patients were followed-up until HAI, discharge or death. Information was obtained from direct daily observation of medical and nursing rounds, chart review and monitoring of laboratory system. Nursing workload was determined using NAS. Non-compliance to the nurses’ patient care plans (NPC) was identified. Demographic data, clinical severity, invasive procedures, hospital interventions, and the occurrence of other adverse events were also recorded. Patients who developed HAI were compared with those who did not. Results 195 patients were included and 43 (22%) developed HAI: 16 pneumonia, 12 urinary-tract, 8 bloodstream, 2 surgical site, 2 other respiratory infections and 3 other. Average NAS and average proportion of non compliance with NPC were significantly higher in HAI patients. They were also more likely to suffer other adverse events. Only excessive nursing workload (OR: 11.41; p: 0.019) and severity of patient’s clinical condition (OR: 1.13; p: 0.015) remained as risk factors to HAI. Conclusions Excessive nursing workload was the main risk factor for HAI, when evaluated together with other invasive devices except mechanical ventilation. To our knowledge, this study is the first to evaluate prospectively the nursing workload as a potential risk factor for HAI, using NAS. PMID:23300645

  11. Do Premenopausal Women with Major Depression Have Low Bone Mineral Density? A 36-Month Prospective Study

    PubMed Central

    Cizza, Giovanni; Mistry, Sima; Nguyen, Vi T.; Eskandari, Farideh; Martinez, Pedro; Torvik, Sara; Reynolds, James C.; Gold, Philip W.; Sinai, Ninet; Csako, Gyorgy

    2012-01-01

    Background An inverse relationship between major depressive disorder (MDD) and bone mineral density (BMD) has been suggested, but prospective evaluation in premenopausal women is lacking. Methods Participants of this prospective study were 21 to 45 year-old premenopausal women with MDD (n = 92) and healthy controls (n = 44). We measured BMD at the anteroposterior lumbar spine, femoral neck, total hip, mid-distal radius, trochanter, and Ward's triangle, as well as serum intact parathyroid hormone (iPTH), ionized calcium, plasma adrenocorticotropic hormone (ACTH), serum cortisol, and 24-hour urinary-free cortisol levels at 0, 6, 12, 24, and 36 months. 25-hydroxyvitamin D was measured at baseline. Results At baseline, BMD tended to be lower in women with MDD compared to controls and BMD remained stable over time in both groups. At baseline, 6, 12, and 24 months intact PTH levels were significantly higher in women with MDD vs. controls. At baseline, ionized calcium and 25-hydroxyvitamin D levels were significantly lower in women with MDD compared to controls. At baseline and 12 months, bone-specific alkaline phosphatase, a marker of bone formation, was significantly higher in women with MDD vs. controls. Plasma ACTH was also higher in women with MDD at baseline and 6 months. Serum osteocalcin, urinary N-telopeptide, serum cortisol, and urinary free cortisol levels were not different between the two groups throughout the study. Conclusion Women with MDD tended to have lower BMD than controls over time. Larger and longer studies are necessary to extend these observations with the possibility of prophylactic therapy for osteoporosis. Trial Registration ClinicalTrials.gov NCT 00006180 PMID:22848407

  12. 3q26 Amplification Is an Effective Negative Triage Test for LSIL: A Historical Prospective Study

    PubMed Central

    Heitmann, Erica R.; Lankachandra, Kamani M.; Wall, Jeff; Harris, George D.; McKinney, Hollie J.; Jalali, G. Reza; Verma, Yogita; Kershnar, Eric; Kilpatrick, Michael W.; Tsipouras, Petros; Harper, Diane M.

    2012-01-01

    Background Women with low grade squamous intraepithelial lesions (LSIL) at cervical cancer screening are currently referred for further diagnostic work up despite 80% having no precancerous lesion. The primary purpose of this study is to measure the test characteristics of 3q26 chromosome gain (3q26 gain) as a host marker of carcinogenesis in women with LSIL. A negative triage test may allow these women to be followed by cytology alone without immediate referral to colposcopy. Methods and Findings A historical prospective study was designed to measure 3q26 gain from the archived liquid cytology specimens diagnosed as LSIL among women attending colposcopy between 2007 and 2009. 3q26 gain was assessed on the index liquid sample; and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were measured at immediate triage and at 6–16 months after colposcopic biopsy. The sensitivity of 3q26 gain measured at immediate triage from automated and manually reviewed tests in 65 non-pregnant unique women was 70% (95% CI: 35, 93) with a NPV of 89% (95% CI: 78, 96). The sensitivity and NPV increased to 80% (95% CI: 28, 99) and 98% (95% CI: 87, 100), respectively, when only the automated method of detecting 3q26 gain was used. Conclusions 3q26 gain demonstrates high sensitivity and NPV as a negative triage test for women with LSIL, allowing possible guideline changes to routine surveillance instead of immediate colposcopy. Prospective studies are ongoing to establish the sensitivity, specificity, PPV and NPV of 3q26 gain for LSIL over time. PMID:22792164

  13. Sonographic Growth Charts for Kidney Length in Normal Korean Children: a Prospective Observational Study.

    PubMed

    Oh, Min-Su; Hwang, Geol; Han, Sanghoon; Kang, Hyun Sik; Kim, Seung Hyo; Kim, Young Don; Kang, Ki-Soo; Shin, Kyung-Sue; Lee, Mu Sook; Choi, Guk Myung; Han, Kyoung Hee

    2016-07-01

    Kidney length is the most useful parameter for clinical measurement of kidney size, and is useful to distinguish acute kidney injury from chronic kidney disease. In this prospective observational study of 437 normal children aged between 0 and < 13 years, kidney length was measured using sonography. There were good correlations between kidney length and somatic values, including age, weight, height, and body surface area. The rapid growth of height during the first 2 years of life was intimately associated with a similar increase in kidney length, suggesting that height should be considered an important factor correlating with kidney length. Based on our findings, the following regression equation for the reference values of bilateral kidney length for Korean children was obtained: kidney length of the right kidney (cm) = 0.051 × height (cm) + 2.102; kidney length of the left kidney (cm) = 0.051 × height (cm) + 2.280. This equation may aid in the diagnosis of various kidney disorders.

  14. Nd:YAG laser versus polidocanol injection for palliation of esophageal malignancy: a prospective, randomized study.

    PubMed

    Angelini, G; Pasini, A F; Ederle, A; Castagnini, A; Talamini, G; Bulighin, G

    1991-01-01

    Palliation is often the only treatment that can be offered to patients affected by esophageal malignancy. This prospective study was carried out in order to compare two endoscopic palliative treatments: Nd:YAG laser and local injection of 3% polidocanol. We randomized 34 patients with inoperable malignancies to one of the two treatments. After the first course, 88.8% of the patients in the laser group and 81.5% in the polidocanol group were able to swallow a normal oral caloric intake. Only one major complication (esophageal perforation) was observed (polidocanol group) and was successfully treated with endoscopic placement of a prosthesis. We believe that both techniques are safe and effective for the palliation of esophageal malignant strictures but that polidocanol injection is cheap, simple, and more widely available.

  15. [Smoking behavior of workers--occupational disability and economic sequelae. A prospective study].

    PubMed

    Kozák, J

    1989-01-01

    A prospective study concerning the influence of smoking on duration and frequency of certified sickness absence due to illness or accident and due to respiratory diseases in particular was carried out in a production plant from 1981 to 1984. The results show, that the mean duration of sickness absence due to illness and accident during a year is not in relation to smoking habit. The frequency of sickness absence due to illness and accident as well as to respiratory disease in smokers was significantly higher (p less than 0.05) than in non-smokers. The frequency of visits of male smokers at surgery hours was assessed to be significantly higher in relation to male non-smokers; in females we found an inverted relation. Higher frequency of smokers sickness absence could be expressed in economic terms.

  16. Hand surgery on anticoagulated patients: a prospective study of 121 operations.

    PubMed

    Edmunds, Ian; Avakian, Zorik

    2010-01-01

    The management of anticoagulated patients requiring surgery presents a challenge to hand surgeons. The risk of bleeding related complications needs to be weighed up against the increased risk of thrombotic events if anticoagulants are altered or ceased. There is literature reporting the safety of hand, skin, eye and dental surgery on patients taking anticoagulants, and there is literature highlighting the risks associated with altering regular anticoagulant medication. However, it is common practice to cease or alter patients' anticoagulants peri-operatively for hand surgery. We report a prospective study of 107 patients taking anticoagulants who underwent 121 hand operations from December 2005 to August 2009. There was only one significant complication, that being a haematoma which occurred in a patient taking clopidogrel. We conclude that interruption to therapy with warfarin (provided the INR is not greater than 3.0), clopidogrel or clopidogrel with aspirin is unnecessary for patients undergoing hand surgery.

  17. [Results of the multicenter prospective study of cerebrolysin safety and efficacy in acute stroke].

    PubMed

    Skwortsova, V I; Stakhovskaia, L V; Shamalov, N A; Kerbikov, O B

    2006-01-01

    The multicenter prospective study of cerebrolysin safety and efficacy included 277 patients with ischemic stroke aged 55-85 years, who received therapy within 12 h from the disease development. Cerebrolysin was used in dosage 10 ml daily along with concomitant standard basic treatment during 10 days after stroke onset in 138 patients. A control group comprised 139 patients who received basic treatment only. A quantitative analysis of the dynamics of neurological deficit revealed the accelerated improvement by NIHSS score, modified Rankin score and Barthel index in the cerebrolysin group on days 10 and 28 (p<0,05). The significant improvement of NIHSS score was observed on day 28 (p<0,05) in patients treated with cerebrolysin within the first 3h after stroke onset comparing to those treated within 6-12h. The trial demonstrated cerebrolysin safety and good tolerability in treatment of ischemic stroke in the carotid artery territory as well as its favorable clinical effect.

  18. Mediating Mechanisms for the Intergenerational Transmission of Constructive Parenting: A Prospective Longitudinal Study

    PubMed Central

    Chen, Zeng-yin; Liu, Ruth X.; Kaplan, Howard B.

    2010-01-01

    Based on a prospective longitudinal panel data set that was collected at three developmental stages—early adolescence, young adulthood, and middle adulthood— this study investigates marital satisfaction and educational attainment as mediating mechanisms as well as gender's moderating effect for the intergenerational transmission of constructive parenting (N = 1,560). The results show that perceived satisfying experiences with parents during early adolescence are positively related to marital satisfaction and educational attainment in young adulthood, which, in turn, are positively related to individuals' utilization of constructive parenting in middle adulthood. The two mediating mechanisms account for most of the direct effect of the intergenerational transmission of constructive parenting. Furthermore, the mediating effect of marital relationship is stronger for current fathers than for mothers because of a stronger association between marital satisfaction and constructive parenting for men. The implications are discussed. PMID:20357901

  19. Predicting Reading and Spelling Disorders: A 4-Year Prospective Cohort Study

    PubMed Central

    Bigozzi, Lucia; Tarchi, Christian; Caudek, Corrado; Pinto, Giuliana

    2016-01-01

    In this 4-year prospective cohort study, children with a reading and spelling disorder, children with a spelling impairment, and children without a reading and/or spelling disorder (control group) in a transparent orthography were identified in third grade, and their emergent literacy performances in kindergarten compared retrospectively. Six hundred and forty-two Italian children participated. This cohort was followed from the last year of kindergarten to third grade. In kindergarten, the children were assessed in phonological awareness, conceptual knowledge of writing systems and textual competence. In third grade, 18 children with a reading and spelling impairment and 13 children with a spelling impairment were identified. Overall, conceptual knowledge of the writing system was the only statistically significant predictor of the clinical samples. No differences were found between the two clinical samples. PMID:27014145

  20. Prospective study of /sup 123/I-labeled monoclonal antibody imaging in ovarian cancer

    SciTech Connect

    Granowska, M.; Britton, K.E.; Shepherd, J.H.; Nimmon, C.C.; Mather, S.; Ward, B.; Osborne, R.J.; Slevin, M.L.

    1986-05-01

    Thirty patients presenting with a pelvic mass were entered into a prospective study on the use of radioimmunoscintigraphy with the /sup 123/I-labeled monoclonal antibody HMFG2. The imaging data was obtained without knowledge of the clinical data and compared with subsequent surgical findings. A false-positive diagnosis of ovarian cancer was made in five of ten patients subsequently shown not to have ovarian cancer; thus the technique cannot be used as a screening test. A true-positive diagnosis was made in 19 out of 20 patients shown subsequently to have ovarian cancer. In 18 of these patients the distribution of uptake closely fitted the surgical findings. Methods of improving these results are described. In conclusion, radioimmunoscintigraphy is of no use in determining whether a pelvic mass is due to ovarian cancer, but has benefit in the evaluation of chemotherapy and may, in the future, prevent the need for second-look operations in some circumstances.

  1. Predicting Reading and Spelling Disorders: A 4-Year Prospective Cohort Study.

    PubMed

    Bigozzi, Lucia; Tarchi, Christian; Caudek, Corrado; Pinto, Giuliana

    2016-01-01

    In this 4-year prospective cohort study, children with a reading and spelling disorder, children with a spelling impairment, and children without a reading and/or spelling disorder (control group) in a transparent orthography were identified in third grade, and their emergent literacy performances in kindergarten compared retrospectively. Six hundred and forty-two Italian children participated. This cohort was followed from the last year of kindergarten to third grade. In kindergarten, the children were assessed in phonological awareness, conceptual knowledge of writing systems and textual competence. In third grade, 18 children with a reading and spelling impairment and 13 children with a spelling impairment were identified. Overall, conceptual knowledge of the writing system was the only statistically significant predictor of the clinical samples. No differences were found between the two clinical samples.

  2. Pattern of trauma resulting from motorcycle accidents in Nigerians: a two-year prospective study.

    PubMed

    Odelowo, E O

    1994-06-01

    A two-year prospective study of injuries sustained from motor-cycle accidents (MCA) was conducted at the University of Ilorin Teaching Hospital, Ilorin, Nigeria, in 1983 and 1984 after repeal of the national mandatory helmet law. MCA patients constituted 10.3% of 715 road traffic accident (RTA) patients and also presented a 5.7:1 male preponderance. Peak age was 18 to 30 years. Nearly 75% sustained lower extremity, chest and cranioencephalic injuries. Non-operative management sufficed in 34 patients (45.9%) while 30 (40.5%) and 10 (13.5%) require operations respectively. Eighteen (24.3%) and 17 (23.0%) patients required local/spinal and general anesthesia respectively. Mortality was 6.8% (5 patients). This analysis of MCA injuries provides objective basis for current comparison with what obtains in jurisdictions with/without mandatory helmet law and future comparison when the law is re-enacted in our state.

  3. Role of internal anal sphincter damage in the causation of idiopathic faecal incontinence: a prospective study.

    PubMed

    Petros, Peter; Anderson, Jim

    2005-02-01

    This prospective study aimed to examine the relationship between internal anal sphincter (IAS) damage and 'idiopathic' faecal incontinence (FI) in 50 consecutive patients, using endoanal ultrasound examination. The external anal sphincter (EAS) was intact on direct and ultrasonic assessment in all patients. IAS damage was defined as complete rupture or attenuation, less than 2 mm thickness in some part of the sphincter. Complete rupture was found in one patient and damage in a further 17 (total 36%). All three nulliparous patients had normal IAS and EAS. IAS damage was only minimally associated with 'idiopathic' FI, suggesting IAS per se is unlikely to be a direct cause of FI in the 'idiopathic' group of FI patients. Its role might be analogous to the periurethral striated horse-shoe shape muscle in the urethra, which is thought to act as a mucosal sealant.

  4. Total hip arthroplasty using imageless computer-assisted hip navigation: a prospective randomized study.

    PubMed

    Lass, Richard; Kubista, Bernd; Olischar, Boris; Frantal, Sophie; Windhager, Reinhard; Giurea, Alexander

    2014-04-01

    In a prospective randomized study of two groups of 65 patients each, we compared the acetabular component position when using the imageless navigation system compared to the freehand conventional technique for cementless total hip arthroplasty. The position of the component was determined postoperatively on computed tomographic scans of the pelvis. There was no significant difference for postoperative mean inclination (P = 0.29), but a significant difference for mean postoperative acetabular component anteversion (P = 0.007), for mean deviation of the postoperative anteversion from the target position of 15° (P = 0.02) and for the outliers regarding inclination (P = 0.02) and anteversion (P < 0.05) between the computer-assisted and the freehand-placement group. Our results demonstrate the importance of imageless navigation for the accurate positioning of the acetabular component.

  5. Evaluation of the pressure ulcers risk scales with critically ill patients: a prospective cohort study 1

    PubMed Central

    Borghardt, Andressa Tomazini; do Prado, Thiago Nascimento; de Araújo, Thiago Moura; Rogenski, Noemi Marisa Brunet; Bringuente, Maria Edla de Oliveira

    2015-01-01

    AIMS: to evaluate the accuracy of the Braden and Waterlow risk assessment scales in critically ill inpatients. METHOD: this prospective cohort study, with 55 patients in intensive care units, was performed through evaluation of sociodemographic and clinical variables, through the application of the scales (Braden and Waterlow) upon admission and every 48 hours; and through the evaluation and classification of the ulcers into categories. RESULTS: the pressure ulcer incidence was 30.9%, with the Braden and Waterlow scales presenting high sensitivity (41% and 71%) and low specificity (21% and 47%) respectively in the three evaluations. The cut off scores found in the first, second and third evaluations were 12, 12 and 11 in the Braden scale, and 16, 15 and 14 in the Waterlow scale. CONCLUSION: the Braden scale was shown to be a good screening instrument, and the Waterlow scale proved to have better predictive power. PMID:25806628

  6. Causes and consequences of cerebral small vessel disease. The RUN DMC study: a prospective cohort study. Study rationale and protocol

    PubMed Central

    2011-01-01

    Background Cerebral small vessel disease (SVD) is a frequent finding on CT and MRI scans of elderly people and is related to vascular risk factors and cognitive and motor impairment, ultimately leading to dementia or parkinsonism in some. In general, the relations are weak, and not all subjects with SVD become demented or get parkinsonism. This might be explained by the diversity of underlying pathology of both white matter lesions (WML) and the normal appearing white matter (NAWM). Both cannot be properly appreciated with conventional MRI. Diffusion tensor imaging (DTI) provides alternative information on microstructural white matter integrity. The association between SVD, its microstructural integrity, and incident dementia and parkinsonism has never been investigated. Methods/Design The RUN DMC study is a prospective cohort study on the risk factors and cognitive and motor consequences of brain changes among 503 non-demented elderly, aged between 50-85 years, with cerebral SVD. First follow up is being prepared for July 2011. Participants alive will be included and invited to the research centre to undergo a structured questionnaire on demographics and vascular risk factors, and a cognitive, and motor, assessment, followed by a MRI protocol including conventional MRI, DTI and resting state fMRI. Discussion The follow up of the RUN DMC study has the potential to further unravel the causes and possibly better predict the consequences of changes in white matter integrity in elderly with SVD by using relatively new imaging techniques. When proven, these changes might function as a surrogate endpoint for cognitive and motor function in future therapeutic trials. Our data could furthermore provide a better understanding of the pathophysiology of cognitive and motor disturbances in elderly with SVD. The execution and completion of the follow up of our study might ultimately unravel the role of SVD on the microstructural integrity of the white matter in the transition

  7. The Korean Gastric Cancer Cohort Study: Study Protocol and Brief Results of a Large-Scale Prospective Cohort Study

    PubMed Central

    Eom, Bang Wool; Kim, Young-Woo; Nam, Byung-Ho; Ryu, Keun Won; Jeong, Hyun-Yong; Park, Young-Kyu; Lee, Young-Joon; Yang, Han-Kwang; Yu, Wansik; Yook, Jeong-Hwan; Song, Geun Am; Youn, Sei-Jin; Kim, Heung Up; Noh, Sung-Hoon; Park, Sung Bae; Yang, Doo-Hyun; Kim, Sung

    2016-01-01

    Purpose This study aimed to establish a large-scale database of patients with gastric cancer to facilitate the development of a national-cancer management system and a comprehensive cancer control policy. Materials and Methods An observational prospective cohort study on gastric cancer was initiated in 2010. A total of 14 cancer centers throughout the country and 152 researchers were involved in this study. Patient enrollment began in January 2011, and data regarding clinicopathological characteristics, life style-related factors, quality of life, as well as diet diaries were collected. Results In total, 4,963 patients were enrolled until December 2014, and approximately 5% of all Korean patients with gastric cancer annually were included. The mean age was 58.2±11.5 years, and 68.2% were men. The number of patients in each stage was as follows: 3,394 patients (68.4%) were in stage IA/B; 514 patients (10.4%), in stage IIA/B; 469 patients (9.5%), in stage IIIA/B/C; and 127 patients (2.6%), in stage IV. Surgical treatment was performed in 3,958 patients (79.8%), endoscopic resection was performed in 700 patients (14.1%), and 167 patients (3.4%) received palliative chemotherapy. The response rate for the questionnaire on the quality of life was 95%; however, diet diaries were only collected for 27% of patients. Conclusions To provide comprehensive information on gastric cancer for patients, physicians, and government officials, a large-scale database of Korean patients with gastric cancer was established. Based on the findings of this cohort study, an effective cancer management system and national cancer control policy could be developed. PMID:27752396

  8. Risk Factors for Hospital Readmission after Radical Gastrectomy for Gastric Cancer: A Prospective Study

    PubMed Central

    Huang, Dong-Dong; Pang, Wen-Yang; Lou, Neng; Chen, Bi-Cheng; Chen, Xiao-Lei; Yu, Zhen; Shen, Xian

    2015-01-01

    Background Hospital readmission is gathering increasing attention as a measure of health care quality and a potential cost-saving target. The purpose of this prospective study was to determine risk factors for readmission within 30 days of discharge after gastrectomy for patients with gastric cancer. Methods We conducted a prospective study of patients undergoing radical gastrectomy for gastric cancer from October 2013 to November 2014 in our institution. The incidence, cause and risk factors for 30-day readmission were determined. Results A total of 376 patients were included in our analysis without loss in follow-up. The 30-day readmission rate after radical gastrectomy for gastric cancer was 7.2% (27of 376). The most common cause for readmission included gastrointestinal complications and postoperative infections. On the basis of multivariate logistic regression analysis, preoperative nutritional risk screening 2002 score ≥ 3 was an independent risk factor for 30-day readmission. Factors not associated with a higher readmission rate included a history of a major postoperative complication during the index hospitalization, prolonged primary length of hospital stay after surgery, a history of previous abdominal surgery, advanced age, body mass index, pre-existing cardiopulmonary comorbidities, American Society of Anesthesiology grade, type of resection, extent of node dissection and discharge disposition. Conclusions Readmission within 30 days of discharge after radical gastrectomy for gastric cancer is common. Patients with nutritional risk preoperatively are at high risk for 30-day readmission. Preoperative optimization of nutritional status of patients at nutritional risk may effectively decrease readmission rates. PMID:25915547

  9. A Prospective Cohort Study on Cardiotoxicity of Adjuvant Trastuzumab Therapy in Breast Cancer Patients

    PubMed Central

    Matos, Erika; Jug, Borut; Blagus, Rok; Zakotnik, Branko

    2016-01-01

    Background Cardiotoxicity is an important side effect of trastuzumab therapy and cardiac surveillance is recommended. Objectives The aim of our study was to prospectively assess baseline patients' characteristics, level of N-terminal pro-brain natriuretic peptide (NT-proBNP) and echocardiographic parameters as possible predictors of trastuzumab-related cardiac dysfunction. Methods In a prospective cohort study, clinical, echocardiographic and neurohumoral assessment was performed at baseline, after 4, 8 and 12 months in breast cancer patients undergoing post-anthracycline (3-4 cycles) adjuvant therapy with trastuzumab. Trastuzumab-related cardiac dysfunction was defined as a decline of ≥ 10% in left ventricular ejection fraction (LVEF). Results 92 patients (mean age, 53.6 ± 9.0 years) were included. Patients who developed trastuzumab-related LVEF decline ≥ 10% (20.6%) during treatment had significantly higher baseline LVEF (70.7 ± 4.4%) than those without (64.8 ± 5.5%) (p = 0.0035). All other measured baseline parameters (age, body mass index, arterial hypertension, level of NT-proBNP and other echocardiographic parameters) were not identified as significant. Conclusions Our findings suggest that baseline patient' characteristics, level of NT-proBNP and echocardiographic parameters, as long as they are within normal range, are not a reliable tool to predict early trastuzumab-related cardiac dysfunction in patients undergoing post-low dose anthracycline adjuvant trastuzumab therapy. A LVEF decline in patients with high-normal baseline level although statistically significant is not clinically relevant. PMID:27305108

  10. A 2-year longitudinal study of prospective predictors of pathological Internet use in adolescents.

    PubMed

    Strittmatter, Esther; Parzer, Peter; Brunner, Romuald; Fischer, Gloria; Durkee, Tony; Carli, Vladimir; Hoven, Christina W; Wasserman, Camilla; Sarchiapone, Marco; Wasserman, Danuta; Resch, Franz; Kaess, Michael

    2016-07-01

    Longitudinal studies of prospective predictors for pathological Internet use (PIU) in adolescents as well as its course are lacking. This three-wave longitudinal study was conducted within the framework of the European Union-funded project "Saving and Empowering Young Lives in Europe" over a 2-year period. The sample consisted of 1444 students at the baseline investigation (T0); 1202 students after 1 year (T1); and 515 students after 2 years (T2). Structured self-report questionnaires were administered at all three time points. PIU was assessed using the Young Diagnostic Questionnaire (YDQ). In addition, demographic (i.e., gender), social (i.e., parental involvement), psychological (i.e., emotional problems), and Internet use-related factors (i.e., online activities) were assessed as prospective predictors. The prevalence of PIU was 4.3 % at T0, 2.7 % at T1 and 3.1 % at T2. However, only 3 students (0.58 %) had persistent categorical PIU (YDQ score of ≥5) over the 2-year period. In univariate models, a variety of variables that have been previously identified in cross-sectional investigations predicted PIU at T2. However, multivariate regression demonstrated that only previous PIU symptoms and emotional problems were significant predictors of PIU 2 years later (adjusted R (2) 0.23). The stability of categorical PIU in adolescents over 2 years was lower than previously reported. However, current PIU symptoms were the best predictor of later PIU; emotional symptoms also predicted PIU over and above the influence of previous problematic Internet use. Both PIU symptoms and emotional problems may contribute to the vicious cycle that supports the perpetuation of PIU.

  11. Predictors of renal and patient outcomes in atheroembolic renal disease: a prospective study.

    PubMed

    Scolari, Francesco; Ravani, Pietro; Pola, Alessandra; Guerini, Simona; Zubani, Roberto; Movilli, Ezio; Savoldi, Silvana; Malberti, Fabio; Maiorca, Rosario

    2003-06-01

    Atheroembolic renal disease (AERD) is part of a multisystemic disease accompanied by high cardiovascular comorbidity and mortality. Interrelationships between traditional risk factors for atherosclerosis, vascular comorbidities, precipitating factors, and markers of clinical severity of the disease in determining outcome remain poorly understood. Patients with AERD presenting to a single center between 1996 and 2002 were followed-up with prospective collection of clinical and biochemical data. The major outcomes included end-stage renal disease (ESRD) and death. Ninety-five patients were identified (81 male). AERD was iatrogenic in 87%. Mean age was 71.4 yr. Twenty-three patients (24%) developed ESRD; 36 patients (37.9%) died. Cox regression analysis showed that significant independent predictors of ESRD were long-standing hypertension (hazard ratio [HR] = 1.1; P < 0.001) and preexisting chronic renal impairment (HR = 2.12; P = 0.02); use of statins was independently associated with decreased risk of ESRD (HR = 0.02; P = 0.003). Age (HR = 1.09; P = 0.009), diabetes (HR = 2.55; P = 0.034), and ESRD (HR = 2.21; P = 0.029) were independent risk factors for patient mortality; male gender was independently associated with decreased risk of death (HR = 0.27; P = 0.007). Cardiovascular comorbidities, precipitating factors, and clinical severity of AERD had no prognostic impact on renal and patient survival. It is concluded that AERD has a strong clinical impact on patient and renal survival. The study clearly shows the importance of preexisting chronic renal impairment in determining both renal and patient outcome, this latter being mediated by the development of ESRD. The protective effect of statins on the development of ESRD should be evaluated in a prospective study.

  12. Prospective Study to Assess Progression of Renal Markers after Interruption of Tenofovir due to Nephrotoxicity

    PubMed Central

    Perez-Alvarez, Núria; Estany, Carla; Clotet, Bonaventura

    2016-01-01

    Background. Prospective studies about the reversibility of tenofovir disoproxil fumarate- (TDF-) related renal impairment remain scarce. Methods. This is an observational prospective study including all patients that presented at our HIV Unit who interrupted TDF owing to nephrotoxicity. We assessed the evolution of renal parameters after discontinuation of this drug. Results. We included 59 patients, who were followed up for 72 weeks. Most were male (41, 69.5%), median (IQR) age was 53 (44; 58) years, and median time receiving TDF-containing regimens was 55.4 (28; 87.7) months. Most patients were receiving PI-based treatments (67%). At the final visit, most of the subjects showed complete recovery (35, 59.3%) or improvement (13 subjects, 22%). Significant improvements were observed in creatinine levels (from 84.9 [73.8; 97.5] to 78 [69.6; 91] μmol/L, p = 0.013), estimated glomerular filtration rate (eGFR, CKD EPI equation, from 87.7 [67; 99] to 89.9 [73.6; 99.3] mL/min/1.73 m2, p = 0.017), and number of patients with eGFR <60 mL/min/1.73 m2 (from 9 [15.3%] to 1 [1.7%], p = 0.031). A trend toward significance was observed in abnormal urine proteinuria/creatinine ratio (from 22 [37%] to 8 [13.6%], p = 0.057). Conclusions. Our results corroborate the high frequency of complete or partial renal recovery in patients receiving TDF-containing regimens who discontinued therapy owing to nephrotoxicity. PMID:28078289

  13. Radiation Pneumonitis After Conventional Radiotherapy For Breast Cancer: A Prospective Study

    PubMed Central

    Isiah, Rajesh; Subhashini, J; Backianathan, Selvamani; Thangakunam, Balamugesh; Christopher, Devasagayam J

    2015-01-01

    Background Loco-regional radiotherapy is an important treatment modality in breast cancer and radiation pneumonitis (RP) is one of the early toxicities. Aim To study the occurrence, correlation of RP with patient and radiotherapy related factors and the effects on pulmonary function following conventional radiotherapy in breast cancer. Settings and Design Prospective study, from a tertiary hospital in a developing country. Materials and Methods Prospective analysis of clinical symptoms, pulmonary function and radiologic changes was done prior to and 12 weeks after adjuvant radiotherapy (n=46). Statistical analysis was done using SPSS version 10 software. Results Radiological and clinical RP was seen in 45.65% (n=21) and 19.56% (n=9) respectively. RP was significantly higher with age >50 years (OR 4.4), chest wall irradiation with electrons, (electrons 83.3% vs cobalt60 32.4%, p=0.02) and supraclavicular field treatment with 6 MV photons (p= 0.011). There was significant relationship between Inferior Lung Distance (ILD) and RP (p=0.013). The fall in Total Lung Capacity (TLC) was significantly more in those with RP (p=0.02). Conclusion Clinical RP occurs in almost one-fifth of breast cancer patients treated with conventional radiotherapy. Chest wall irradiation with electrons, supraclavicular field irradiation with 6 MV photons, higher ILD and age >50 years was associated with increased RP. The pulmonary function parameter most affected was TLC. The factors associated with increased RP should be considered when adjuvant radiotherapy is planned to minimize its likelihood and intervene appropriately. PMID:26393189

  14. Prospective Study on Salivary Evening Melatonin and Sleep before and after Pinealectomy in Humans.

    PubMed

    Slawik, Helen; Stoffel, Michael; Riedl, Lina; Veselý, Zdenko; Behr, Michael; Lehmberg, Jens; Pohl, Corina; Meyer, Bernhard; Wiegand, Michael; Krieg, Sandro M

    2016-02-01

    Melatonin is secreted systemically from the pineal gland maximally at night but is also produced locally in many tissues. Its chronobiological function is mainly exerted by pineal melatonin. It is a feedback regulator of the main circadian pacemaker in the hypothalamic suprachiasmatic nuclei and of many peripheral oscillators. Although exogenous melatonin is approved for circadian rhythm sleep disorders and old-age insomnia, research on endogenous melatonin in humans is hindered by the great interindividual variability of its amount and circadian rhythm. Single case studies on pinealectomized patients report on disrupted but also hypersomnic sleep. This is the first systematic prospective report on sleep with respect to pinealectomy due to pinealocytoma World Health Organization grade I without chemo- or radiotherapy. Before and after pinealectomy, 8 patients completed questionnaires on sleep quality and circadian rhythm (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Morningness-Eveningness Questionnaire), 2 nights of polysomnography, salivary evening melatonin profiles, and qualitative assessment of 2 weeks of actigraphy and sleep logs. Six patients were assessed retrospectively up to 4 years after pinealectomy. Before pinealectomy, all but 1 patient showed an evening melatonin rise typical for indifferent chronotypes. After pinealectomy, evening saliva melatonin was markedly diminished, mostly below the detection limit of the assay (0.09 pg/mL). No systematic change in subjective sleep quality or standard measures of polysomnography was found. Mean pre- and postoperative sleep efficiency was 94% and 95%, and mean sleep-onset latency was 21 and 17 min, respectively. Sleep-wake rhythm during normal daily life did not change. Retrospective patients had a reduced sleep efficiency (90%) and more stage changes, although this was not significantly different from prospective patients. In conclusion, melatonin does seem to have a modulatory, not a

  15. Predictors of Positive Airway Pressure Therapy Adherence in Children: A Prospective Study

    PubMed Central

    DiFeo, Natalie; Meltzer, Lisa J.; Beck, Suzanne E.; Karamessinis, Laurie R.; Cornaglia, Mary Anne; Traylor, Joel; Samuel, John; Gallagher, Paul R.; Radcliffe, Jerilynn; Beris, Heidi; Menello, Mary Kate; Marcus, Carole L.

    2012-01-01

    Study Objectives: Children with obstructive sleep apnea are increasingly being treated with positive airway pressure (PAP), particularly if they have underlying medical conditions. Although PAP is an effective treatment, its use is challenging due to poor adherence. We hypothesized that demographic, psychosocial, and polysomnographic parameters would be related to PAP adherence. We therefore prospectively collected data potentially pertaining to PAP adherence, and correlated it with PAP use. Methods: Fifty-six patients and their parents completed a series of psychosocial questionnaires prior to PAP initiation. Objective adherence data were obtained after 1 and 3 months of PAP use. Results: The population was primarily obese; 23% had neurodevelopmental disabilities. PAP adherence varied widely, with PAP being worn 22 ± 8 nights in month-1, but mean use was only 3 ± 3 h/night. The greatest predictor of use was maternal education (p = 0.002 for nights used; p = 0.033 for mean h used/night). Adherence was lower in African American children vs other races (p = 0.021). In the typically developing subgroup, adherence correlated inversely with age. Adherence did not correlate with severity of apnea, pressure levels, or psychosocial parameters other than a correlation between family social support and nights of PAP use in month-3. Conclusions: PAP adherence in children and adolescents is related primarily to family and demographic factors rather than severity of apnea or measures of psychosocial functioning. Further research is needed to determine the relative contributions of maternal education, socioeconomic status and cultural beliefs to PAP adherence in children, in order to develop better adherence programs. Citation: DiFeo N; Meltzer LJ; Beck SE; Karamessinis LR; Cornaglia MA; Traylor J; Samuel J; Gallagher PR; Radcliffe J; Beris H; Menello MK; Marcus CL. Predictors of positive airway pressure therapy adherence in children: a prospective study. J Clin Sleep Med 2012

  16. A prospective study on quality of life in youths after pectus excavatum correction

    PubMed Central

    Jacobsen, Elisabeth Brammer; Thastum, Mikael; Pilegaard, Hans

    2016-01-01

    Background The impact of correction of pectus excavatum (PE) on adolescents’ health-related quality of life (HRQL) has only been investigated in prospective designs using disease-specific measures and without controls. The aim of this prospective study was to evaluate the HRQL before and after surgical correction of PE using a generic HRQL measure, and to compare the reported level of HRQL before surgery with an age-comparable control group. Methods Patients (n=107) and one of their parents (n=106) completed the generic HRQL measure: the Child Health Questionnaire before, 3 months, and 6 months after correction for PE. A control group (n=183) consisting of school children comparable in age completed the same measure on one occasion. Results The patients’ level of HRQL before surgery was comparable to the level of the controls except for physical functioning; here boys reported impaired function compared to controls (P<0.0001, d=0.72). Both patients and parents reported improved emotional wellbeing and self-esteem, as well as an increase in physical and social activities from pre- to post-surgery. These improvements were statistically significant (P≤0.001–0.03) and yielded moderate to high effect sizes (ƞ2=0.04–0.22). Conclusions The improvement of physical and psychosocial HRQL reported by both patients and their parents as proxy indicates the psychological implications of the deformity. Patients reported impaired physical function compared to controls. Further, pre-surgery differences in HRQL between the patients and the controls were lacking. However, the improvement in the patients’ HRQL following surgery may justify the correction of pectus excavatum. The effect of the deformity on patients wellbeing compared with controls’ needs to be addressed in further studies. PMID:27747179

  17. Reference Charts for Fetal Cerebellar Vermis Height: A Prospective Cross-Sectional Study of 10605 Fetuses

    PubMed Central

    Cignini, Pietro; Giorlandino, Maurizio; Brutti, Pierpaolo; Mangiafico, Lucia; Aloisi, Alessia; Giorlandino, Claudio

    2016-01-01

    Objective To establish reference charts for fetal cerebellar vermis height in an unselected population. Methods A prospective cross-sectional study between September 2009 and December 2014 was carried out at ALTAMEDICA Fetal–Maternal Medical Centre, Rome, Italy. Of 25203 fetal biometric measurements, 12167 (48%) measurements of the cerebellar vermis were available. After excluding 1562 (12.8%) measurements, a total of 10605 (87.2%) fetuses were considered and analyzed once only. Parametric and nonparametric quantile regression models were used for the statistical analysis. In order to evaluate the robustness of the proposed reference charts regarding various distributional assumptions on the ultrasound measurements at hand, we compared the gestational age-specific reference curves we produced through the statistical methods used. Normal mean height based on parametric and nonparametric methods were defined for each week of gestation and the regression equation expressing the height of the cerebellar vermis as a function of gestational age was calculated. Finally the correlation between dimension/gestation was measured. Results The mean height of the cerebellar vermis was 12.7mm (SD, 1.6mm; 95% confidence interval, 12.7–12.8mm). The regression equation expressing the height of the CV as a function of the gestational age was: height (mm) = -4.85+0.78 x gestational age. The correlation between dimension/gestation was expressed by the coefficient r = 0.87. Conclusion This is the first prospective cross-sectional study on fetal cerebellar vermis biometry with such a large sample size reported in literature. It is a detailed statistical survey and contains new centile-based reference charts for fetal height of cerebellar vermis measurements. PMID:26812238

  18. Radiation Therapy for Hypersalivation: A Prospective Study in 50 Amyotrophic Lateral Sclerosis Patients

    SciTech Connect

    Assouline, Avi; Levy, Antonin; Abdelnour-Mallet, Maya; Lenglet, Timothée; Le Forestier, Nadine; and others

    2014-03-01

    Purpose: This study aimed to evaluate the efficiency and the tolerance of radiation therapy (RT) on salivary glands in a large series of amyotrophic lateral sclerosis (ALS) patients with hypersalivation. Methods and Materials: Fifty ALS patients that had medically failure pretreatment were included in this prospective study. RT was delivered through a conventional linear accelerator with 6-MV photons and 2 opposed beams fields including both submandibular glands and two-thirds of both parotid glands. Total RT dose was 10 Gy in 2 fractions (n=30) or 20 Gy in 4 fractions (n=20). RT efficacy was assessed with the 9-grade Sialorrhea Scoring Scale (SSS), recently prospectively validated as the most effective and sensitive tool to measure sialorrhea in ALS patients. Results: At the end of RT, all patients had improved: 46 had a complete response (92% CR, SSS 1-3) and 4 had a partial response (8% PR, SSS 4-5). A significant lasting salivary reduction was observed 6 months after RT completion: there was 71% CR and 26% PR, and there was a significant SSS reduction versus baseline (P<10{sup −6}). There was no grade 3 to 4 toxicity, and most side effects (34%) occurred during RT. Nine patients (18%) underwent a second salivary gland RT course, with a 3-months mean delay from the first RT, resulting in a SSS decrease (−77%). Both RT dose regimens induced a significant SSS decrease with no significant toxicity. There were, however, more patients with CR/PR in the 20-Gy protocol (P=.02), and 8 of 9 patients (89%) receiving a second RT course had previously been treated within the 10-Gy protocol. Conclusion: Radiation therapy of 20 Gy in 4 fractions is an efficient and safe treatment for ALS patients with sialorrhea. A shorter RT course (10 Gy in 2 fractions) may be proposed in patients in poor medical condition.

  19. Association between dietary patterns and coronary heart disease: a meta-analysis of prospective cohort studies

    PubMed Central

    Hou, Lina; Li, Fei; Wang, Yuanyuan; Ou, Zejin; Xu, Dingli; Tan, Wanlong; Dai, Meng

    2015-01-01

    The associations of dietary patterns with coronary heart disease (CHD) risk remain unclear. Thereby, a meta-analysis was conducted to examine potential relations between dietary patterns and CHD. PubMed and EMBASE databases were searched up to March 2014 for eligible prospective cohort studies regarding the relationships between common dietary patterns and CHD. Random-effects models were applied to calculate the summary relative risk estimates (SRRE) for the highest versus the lowest category of dietary pattern. Sensitivity analyses were conducted and publication bias was assessed using Begg or Egger’s tests. Twelve prospective cohort studies were included involving 409,780 participants and 6298 CHD cases. There was an inverse association between prudent/healthy dietary pattern and CHD risk (SRRE = 0.80, 95% CI: 0.74-0.87, P-value for heterogeneity = 0.497, I2 = 0%). Furthermore, no significant association was observed between western/unhealthy dietary pattern and risk of CHD (SRRE = 1.05, 95% CI: 0.86-1.27, P-value for heterogeneity = 0.007, I2 = 61.9%). However, increased risk was detected between western/unhealthy dietary pattern and CHD in the United States (USA) (SRRE = 1.45, 95% CI: 1.15-1.82, P-value for heterogeneity = 0.930, I2 = 0%). In conclusion, our analysis provides evidence of an inverse association between prudent/healthy dietary pattern and CHD risk, and suggests null association between western/unhealthy dietary pattern and CHD. However, greater adherence to western/unhealthy pattern possibily increases by 45% the risk of CHD in USA. Further efforts are warranted to confirm these findings and clarify the role of dietary patterns and CHD risk. PMID:25785058

  20. A Prospective Study of the Emergence of Early Behavioral Signs of Autism

    ERIC Educational Resources Information Center

    Ozonoff, Sally; Iosif, Ana-Maria; Baguio, Fam; Cook, Ian C.; Hill, Monique Moore; Hutman, Ted; Rogers, Sally J.; Rozga, Agata; Sangha, Sarabjit; Sigman, Marian; Steinfeld, Mary Beth; Young, Gregory S.

    2010-01-01

    Objective: To examine prospectively the emergence of behavioral signs of autism in the first years of life in infants at low and high risk for autism. Method: A prospective longitudinal design was used to compare 25 infants later diagnosed with an autism spectrum disorder (ASD) with 25 gender-matched low-risk children later determined to have…

  1. Does parental drinking influence children's drinking? A systematic review of prospective cohort studies

    PubMed Central

    Keating, Patrick; Felix, Lambert; McCambridge, Jim

    2015-01-01

    Abstract Aims To evaluate evidence of the capacity for causal inference in studies of associations between parental and offspring alcohol consumption in the general population. Methods A systematic search for, and narrative analysis of, prospective cohort studies of the consequences of drinking, except where assessed prenatally only, or with clinically derived instruments. Primary outcome measures were alcohol use or related problems in offspring, which were collected at least 3 years after exposure measures of parental drinking. The systematic review included 21 studies comprising 26 354 families or parent–child dyads with quantitative effect measures available for each study. Criteria for capacity of causal inference included (1) theory‐driven approach and analysis; (2) analytical rigour; and (3) minimization of sources of bias. Results Four of the 21 included studies filled several, but not all, criteria and were assessed to have some capacity for causal inference. These four studies found some evidence that parental drinking predicted drinking behaviour in adolescent offspring. The remaining 17 studies had little or no such capacity. Conclusions There is a fairly large and consistent literature demonstrating that more parental drinking is associated with more drinking in offspring. Despite this, existing evidence is insufficient to warrant causal inferences at this stage. PMID:26283063

  2. New Models for Large Prospective Studies: Is There a Better Way?

    PubMed Central

    Manolio, Teri A.; Weis, Brenda K.; Cowie, Catherine C.; Hoover, Robert N.; Hudson, Kathy; Kramer, Barnett S.; Berg, Chris; Collins, Rory; Ewart, Wendy; Gaziano, J. Michael; Hirschfeld, Steven; Marcus, Pamela M.; Masys, Daniel; McCarty, Catherine A.; McLaughlin, John; Patel, Alpa V.; Peakman, Tim; Pedersen, Nancy L.; Schaefer, Catherine; Scott, Joan A.; Sprosen, Timothy; Walport, Mark; Collins, Francis S.

    2012-01-01

    Large prospective cohort studies are critical for identifying etiologic factors for disease, but they require substantial long-term research investment. Such studies can be conducted as multisite consortia of academic medical centers, combinations of smaller ongoing studies, or a single large site such as a dominant regional health-care provider. Still another strategy relies upon centralized conduct of most or all aspects, recruiting through multiple temporary assessment centers. This is the approach used by a large-scale national resource in the United Kingdom known as the “UK Biobank,” which completed recruitment/examination of 503,000 participants between 2007 and 2010 within budget and ahead of schedule. A key lesson from UK Biobank and similar studies is that large studies are not simply small studies made large but, rather, require fundamentally different approaches in which “process” expertise is as important as scientific rigor. Embedding recruitment in a structure that facilitates outcome determination, utilizing comprehensive and flexible information technology, automating biospecimen processing, ensuring broad consent, and establishing essentially autonomous leadership with appropriate oversight are all critical to success. Whether and how these approaches may be transportable to the United States remain to be explored, but their success in studies such as UK Biobank makes a compelling case for such explorations to begin. PMID:22411865

  3. The Risk of Reduced Physical Activity in Children with Probable Developmental Coordination Disorder: A Prospective Longitudinal Study

    ERIC Educational Resources Information Center

    Green, Dido; Lingam, Raghu; Mattocks, Calum; Riddoch, Chris; Ness, Andy; Emond, Alan

    2011-01-01

    The aim of the current study was to test the hypothesis that children with probable Developmental Coordination Disorder have an increased risk of reduced moderate to vigorous physical activity (MVPA), using data from a large population based study. Prospectively collected data from 4331 children (boys = 2065, girls = 2266) who had completed motor…

  4. Dietary Vitamin K intake and anticoagulation control during the initiation phase of warfarin therapy: A prospective cohort study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The effect of varying levels of dietary vitamin K intake on therapeutic International Normalized Ratio (INR) values among patients starting warfarin therapy has not been well studied. We performed a prospective cohort study among 282 patients to explore the independent associations between usual in...

  5. Predicting Ecstasy Use among Young People at Risk: A Prospective Study of Initially Ecstasy-Naive Subjects

    ERIC Educational Resources Information Center

    Vervaeke, Hylke K.E.; Benschop, Annemieke; Van Den Brink, Wim; Korf, Dirk J.

    2008-01-01

    Our aim is to identify predictors of first-time ecstasy use in a prospective study among young people at risk. As part of the multidisciplinary Netherlands XTC Toxicity Study (NeXT), we monitored 188 subjects aged up to 18 years who were ecstasy-naive at baseline but seemed likely to start taking ecstasy in the near future. After an 11- to…

  6. Lesson Study in Prospective Mathematics Teacher Education: Didactic and Paradidactic Technology in the Post-Lesson Reflection

    ERIC Educational Resources Information Center

    Rasmussen, Klaus

    2016-01-01

    This paper presents a detailed analysis of the post-lesson reflection, carried out in the context of eight cases of lesson study conducted by teams of Danish, lower secondary prospective teachers and their supervisors. The participants, representing different institutions, were all new to the lesson study format. Nevertheless, it is demonstrated…

  7. Bullied by Peers in Childhood and Borderline Personality Symptoms at 11-Years of Age: A Prospective Study

    ERIC Educational Resources Information Center

    Wolke, Dieter; Schreier, Andrea; Zanarini, Mary C.; Winsper, Catherine

    2012-01-01

    Background: Abuse by adults has been reported as a potent predictor of borderline personality disorder (BPD). Unclear is whether victimisation by peers increases the risk of borderline personality symptoms. Method: The Avon Longitudinal Study of Parents and Children (ALSPAC) prospective, longitudinal observation study of 6050 mothers and their…

  8. Maternal Predictors of Preschool Child-Eating Behaviours, Food Intake and Body Mass Index: A Prospective Study

    ERIC Educational Resources Information Center

    McPhie, Skye; Skouteris, Helen; Fuller-Tyszkiewicz, Matthew; McCabe, Marita; Ricciardelli, Lina A.; Milgrom, Jeannette; Baur, Louise A.; Dell'Aquila, Daniela

    2012-01-01

    This study extends McPhie et al. (2011)'s [Maternal correlates of preschool child eating behaviours and body mass index: A cross-sectional study. "International Journal of Pediatric Obesity", Early Online, 1-5.] McPhie et al. (2011)'s cross-sectional research, by prospectively evaluating maternal child-feeding practices, parenting style and…

  9. Does Universally Accessible Child Care Protect Children from Late Talking? Results from a Norwegian Population-Based Prospective Study

    ERIC Educational Resources Information Center

    Lekhal, Ratib; Zachrisson, Henrik Daae; Wang, Mari Vaage; Schjolberg, Synnve; von Soest, Tilmann

    2011-01-01

    This study examines the association between type of child care arrangement at age 1, 1.5 and 3 years and late talking (LT). The data were from 19,919 children in the population-based prospective Norwegian Mother and Child Cohort Study (MoBa) and included information about child care arrangement, LT and a variety of covariates. Attendance at…

  10. Correlation between subsequent lengths of postpartum amenorrhoea in a prospective study of breast-feeding women in rural Bangladesh.

    PubMed

    Ford, K

    1992-01-01

    The relationship between subsequent lengths of lactational amenorrhoea for individual women in a prospective study of breast-feeding women in Bangladesh was studied. The data indicate that previous length of amenorrhoea has significant predictive value for the subsequent length of amenorrhoea. Information on previous experience with lactational amenorrhoea should be therefore incorporated into guidelines for the introduction of family planning during lactation.

  11. Risk factor assessment of stroke and its awareness among stroke survivors: A prospective study

    PubMed Central

    Shravani, K.; Parmar, Mihir Y.; Macharla, Ramyasri; Mateti, Uday Venkat; Martha, Srinivas

    2015-01-01

    Background: Stroke is the second most common cause of death and major cause of disability worldwide. The objective of this study is to identify the major risk factors and assess the awareness among the stroke survivors. Materials and Methods: A prospective study was conducted at super specialty hospital, from December 2010 to July 2011. All the stroke patients of the age >25 years with either sex admitted in the hospital were included in the study. In order to assess the awareness among the stroke survivors, questionnaire established on the risk factors for stroke from the previously published studies. Results: A total of 100 patients with stroke or cerebrovascular accident were included in the study. Of 100 patients, 73% patients had ischemic stroke and 26% patients had hemorrhagic stroke. The mean age of the patients was 50 years and the incidence of stroke was predominant in males 73%, followed by females 27. It was observed that 70% of patients were hypertensives, 28% were diabetics, 27% were alcoholics, and 24% of patients had a habit of smoking, followed by others. The knowledge of the risk factors for stroke in stroke survivors was also very low, and the knowledge was varied among the subjects according to their level of educational status. Conclusion: This study reveals that hypertension is the most common risk factor for stroke followed by diabetes, smoking, and dyslipidemia. The awareness of risk factor among stroke survivors was poor. PMID:26605226

  12. Attributable cost of a nosocomial infection in the intensive care unit: A prospective cohort study

    PubMed Central

    Chacko, Binila; Thomas, Kurien; David, Thambu; Paul, Hema; Jeyaseelan, Lakshmanan; Peter, John Victor

    2017-01-01

    AIM To study the impact of hospital-acquired infections (HAIs) on cost and outcome from intensive care units (ICU) in India. METHODS Adult patients (> 18 years) admitted over 1-year, to a 24-bed medical critical care unit in India, were enrolled prospectively. Treatment cost and outcome data were collected. This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee. Only infections occurring during ICU stay were included. The impact of HAI on treatment cost and mortality was assessed. RESULTS The mean (± SD) age of the cohort (n = 499) was 42.3 ± 16.5 years. Acute physiology and chronic health evaluation-II score was 13.9 (95%CI: 13.3-14.5); 86% were ventilated. ICU and hospital length of stay were 7.8 ± 5.5 and 13.9 ± 10 d respectively. Hospital mortality was 27.9%. During ICU stay, 76 (15.3%) patients developed an infection (ventilator-associated pneumonia 50; bloodstream infection 35; urinary tract infections 3), translating to 19.7 infections/1000 ICU days. When compared with those who did not develop an infection, an infection occurring during ICU stay was associated with significantly higher treatment cost [median (inter-quartile range, IQR) INR 92893 (USD 1523) (IQR 57168-140286) vs INR 180469 (USD 2958) (IQR 140030-237525); P < 0.001 and longer duration of ICU (6.7 ± 4.5 d vs 13.4 ± 7.0 d; P < 0.01) and hospital stay (12.4 ± 8.2 d vs 21.8 ± 13.9 d; P < 0.001)]. However ICU acquired infections did not impact hospital mortality (31.6% vs 27.2%; P = 0.49). CONCLUSION An infection acquired during ICU stay was associated with doubling of treatment cost and prolonged hospitalization but did not significantly increase mortality. PMID:28224111

  13. Predictive Factors of Late Radiation Fibrosis: A Prospective Study in Non-Small Cell Lung Cancer

    SciTech Connect

    Mazeron, Renaud; Etienne-Mastroianni, Benedicte; Perol, David; Arpin, Dominique; Vincent, Michel; Falchero, Lionel; Martel-Lafay, Isabelle; Carrie, Christian; Claude, Line

    2010-05-01

    Purpose: To determine predictive factors of late radiation fibrosis (RF) after conformal radiotherapy (3D-RT) in non-small cell lung cancer (NSCLC). Methods and Materials: Ninety-six patients with Stage IA-IIIB NSCLC were included in a prospective trial. Clinical evaluation, chest X-ray, and pulmonary functional tests including diffusion parameters were performed before and 6 months after radiotherapy. An independent panel of experts prospectively analyzed RF, using Late Effects in Normal Tissues-Subjective, Objective, Management and Analytic scales classification. Logistic regression analysis was performed to identify relationships between clinical, functional, or treatment parameters and incidence of RF. Variations of circulating serum levels of pro-inflammatory (interleukin-6, tumor necrosis factor alpha, tumor growth factor beta1) and anti-inflammatory (interleukin-10) cytokines during 3D-RT were examined to identify correlations with RF. Results: Of the 96 patients included, 72 were evaluable for RF at 6 months. Thirty-seven (51.4%) developed RF (Grade >=1), including six severe RF (Grades 2-3; 8.3%). In univariate analysis, only poor Karnofsky Performance Status and previous acute radiation pneumonitis were associated with RF (p < 0.05). Dosimetric factors (mean lung dose, percentage of lung volume receiving more than 10, 20, 30, 40, and 50 Gy) were highly correlated with RF (p < 0.001). In multivariate analysis, previous acute radiation pneumonitis and dosimetric parameters were significantly correlated with RF occurrence. It was not significantly correlated either with cytokines at baseline or with their variation during 3D-RT. Conclusions: This study confirms the importance of dosimetric parameters to limit the risk of RF. Contrary to acute radiation pneumonitis, RF was not correlated to cytokine variations during 3D-RT.

  14. Serum Liver Fibrosis Markers in the Prognosis of Liver Cirrhosis: A Prospective Observational Study.

    PubMed

    Qi, Xingshun; Liu, Xu; Zhang, Yongguo; Hou, Yue; Ren, Linan; Wu, Chunyan; Chen, Jiang; Xia, Chunlian; Zhao, Jiajun; Wang, Di; Zhang, Yanlin; Zhang, Xia; Lin, Hao; Wang, Hezhi; Wang, Jinling; Cui, Zhongmin; Li, Xueyan; Deng, Han; Hou, Feifei; Peng, Ying; Wang, Xueying; Shao, Xiaodong; Li, Hongyu; Guo, Xiaozhong

    2016-08-02

    BACKGROUND The prognostic role of serum liver fibrosis markers in cirrhotic patients remains unclear. We performed a prospective observational study to evaluate the effect of amino-terminal pro-peptide of type III pro-collagen (PIIINP), collagen IV (CIV), laminin (LN), and hyaluronic acid (HA) on the prognosis of liver cirrhosis. MATERIAL AND METHODS All patients who were diagnosed with liver cirrhosis and admitted to our department were prospectively enrolled. PIIINP, CIV, LN, and HA levels were tested. RESULTS Overall, 108 cirrhotic patients were included. Correlation analysis demonstrated that CIV (coefficient r: 0.658, p<0.001; coefficient r: 0.368, p<0.001), LN (coefficient r: 0.450, p<0.001; coefficient r: 0.343, p<0.001), and HA (coefficient r: 0.325, p=0.001; coefficient r: 0.282, p=0.004) levels, but not PIIINP level (coefficient r: 0.081, p=0.414; coefficient r: 0.090, p=0.363), significantly correlated with Child-Pugh and MELD scores. Logistic regression analysis demonstrated that HA (odds ratio=1.00003, 95% confidence interval [CI]=1.000004-1.000056, p=0.022) was significantly associated with the 6-month mortality. Receiver operating characteristics analysis demonstrated that the area under the curve (AUC) of HA for predicting the 6-month mortality was 0.612 (95%CI=0.508-0.709, p=0.1531). CONCLUSIONS CIV, LN, and HA levels were significantly associated with the severity of liver dysfunction, but might be inappropriate for the prognostic assessment of liver cirrhosis.

  15. Red and processed meat intake and risk of breast cancer: a meta-analysis of prospective studies.

    PubMed

    Guo, Jingyu; Wei, Wei; Zhan, Lixing

    2015-05-01

    Epidemiological studies regarding the association between red and processed meat intake and the risk of breast cancer have yielded inconsistent results. Therefore, we conducted an updated and comprehensive meta-analysis which included 14 prospective studies to evaluate the association of red and processed meat intake with breast cancer risk. Relevant prospective cohort studies were identified by searching PubMed through October 31, 2014, and by reviewing the reference lists of retrieved articles. Study-specific relative risk (RR) estimates were pooled using a random-effects model. Fourteen prospective studies on red meat (involving 31,552 cases) and 12 prospective studies on processed meat were included in the meta-analysis. The summary RRs (95 % CI) of breast cancer for the highest versus the lowest categories were 1.10 (1.02, 1.19) for red meat, and 1.08 (1.01, 1.15) for processed meat. The estimated summary RRs (95 % CI) were 1.11 (1.05, 1.16) for an increase of 120 g/day of red meat, and 1.09 (1.03, 1.16) for an increase of 50 g/day of processed meat. Our findings indicate that increased intake of red and processed meat is associated with an increased risk of breast cancer. Further research with well-designed cohort or interventional studies is needed to confirm the association.

  16. Multicentre prospective observational study on professional wound care using honey (Medihoney™).

    PubMed

    Biglari, Bahram; Moghaddam, Arash; Santos, Kai; Blaser, Gisela; Büchler, Axel; Jansen, Gisela; Längler, Alfred; Graf, Norbert; Weiler, Ursula; Licht, Verena; Strölin, Anke; Keck, Brigitta; Lauf, Volker; Bode, Udo; Swing, Tyler; Hanano, Ralph; Schwarz, Nicolas T; Simon, Arne

    2013-06-01

    In recent years, the treatment of wounds with honey has received an increasing amount of attention from healthcare professionals in Germany and Austria. We conducted a prospective observational multicentre study using Medihoney™ dressings in 10 hospitals - nine in Germany and one in Austria. Wound-associated parameters were monitored systematically at least three times in all patients. Data derived from the treatment of 121 wounds of various aetiologies over a period of 2 years were analysed. Almost half of the patients were younger than 18 years old, and 32% of the study population was oncology patients. Overall, wound size decreased significantly during the study period and many wounds healed after relatively short time periods. Similarly, perceived pain levels decreased significantly, and the wounds showed noticeably less slough/necrosis. In general, our findings show honey to be an effective and feasible treatment option for professional wound care. In addition, our study showed a relationship between pain and slough/necrosis at the time of recruitment and during wound healing. Future comparative trials are still needed to evaluate the extent to which the positive observations made in this and other studies can definitely be attributed to the effects of honey in wound care.

  17. Psorinum Therapy in Treating Stomach, Gall Bladder, Pancreatic, and Liver Cancers: A Prospective Clinical Study

    PubMed Central

    Chatterjee, Aradeep; Biswas, Jaydip; Chatterjee, Ashim; Bhattacharya, Sudin; Mukhopadhyay, Bishnu; Mandal, Syamsundar

    2011-01-01

    We prospectively studied the clinical efficacy of an alternative cancer treatment “Psorinum Therapy” in treating stomach, gall bladder, pancreatic and liver cancers. Our study was observational, open level and single arm. The participants' eligibility criteria included histopathology/cytopathology confirmation of malignancy, inoperable tumor, and no prior chemotherapy or radiation therapy. The primary outcome measures of the study were (i) to assess the radiological tumor response (ii) to find out how many participants survived at least 1 year, 2 years, 3 years, 4 years and finally 5 years after the beginning of the study considering each type of cancer. Psorinum-6x was administered orally to all the participants up to 0.02 ml/Kg body weight as a single dose in empty stomach per day for 2 years along with allopathic and homeopathic supportive cares. 158 participants (42 of stomach, 40 of gall bladder, 44 of pancreatic, 32 of liver) were included in the final analysis of the study. Complete tumor response occurred in 28 (17.72%) cases and partial tumor response occurred in 56 (35.44%) cases. Double-blind randomized controlled clinical trial should be conducted for further scientific exploration of this alternative cancer treatment. PMID:21197093

  18. Carbohydrate Intake, Glycemic Index, Glycemic Load, and Stroke: A Meta-analysis of Prospective Cohort Studies.

    PubMed

    Cai, Xianlei; Wang, Chen; Wang, Shan; Cao, Gaoyang; Jin, Chao; Yu, Jiawei; Li, Xiuyang; Yan, Jing; Wang, Fudi; Yu, Wei; Ding, Fang

    2015-07-01

    The objective of this study was to investigate associations between carbohydrate intake/glycemic index (GI)/glycemic load (GL) and stroke risk. A literature search of MEDLINE, Embase, Web of Science, and CBM databases was performed to retrieve eligible studies published up to March 2014. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were used to evaluate the strength of this association. Publication bias was assessed by the Egger's regression asymmetry test and Begg's rank correlation test with Begg's funnel plot. All analyses were conducted using software STATA 12.0 (StataCorp LP, College Station, TX) and SAS version 9.1 (SAS Institute Inc, Cary, NC). We identified 7 prospective studies that met the inclusion criteria and processed data from cohort studies to update available evidence. There were 25 independent estimates and 225 000 participants free of diabetes from 6 different countries; 3046 stroke events were included; and the follow-up range was 5 to 18 years. High GI was not associated with risk of stroke events (pooled RR = 1.10; 95% CI: 0.99-1.21); GL was a risk factor for stroke (pooled RR = 1.19; 95% CI: 1.05-1.36). There was no significant association between high carbohydrate intake and stroke risk (RR = 1.12; 95% CI: 0.93-1.35). A daily high GL diet is the risk factor of stroke event, and further researches need to verify the meta-analyses results and study associated mechanisms.

  19. Knee Injuries in Wrestlers: A Prospective Study from the Indian Subcontinent

    PubMed Central

    Agarwal, Shalini; Mann, Ekta

    2016-01-01

    Background Wrestling is a very popular sport the world over and its popularity is rapidly increasing in India. However, due to its arduous nature it is associated with a high incidence of injuries. Out of all the injuries, those to the knee are one of the commonest injuries reported. Objectives Our aim was to study the pattern of these injuries in the Indian wrestlers. Methods A prospective study was conducted involving 196 wrestlers who were followed up over a period of 2 years. Their knee injuries were studied by means of a structured questionnaire which they filled up with assistance from their athletic trainers. Results There were a total of 188 injuries in 121 wrestlers with overall injury rate of 5.13/1,000 athlete exposure. 35 wrestlers sustained 71 knee injuries (71/188; 37.77%). 71.83% injuries were new. More number of injuries occurred in competition (incidence density ratio = 20.7) and in attack position. There was a statistically significant association with age and duration of practice. No association was found between these injuries and style of wrestling, weight and height of wrestlers. Ligament sprains and muscular strains were the commonest injuries. Conclusions Goal of any such study is to minimize the risk of injury in the young athlete by understanding the factors responsible and development of preventive programs. We hope to do just that with this first study involving Indian wrestlers. PMID:28144407

  20. Nocturnal Cramps in Patients with Lumbar Spinal Canal Stenosis Treated Conservatively: A Prospective Study

    PubMed Central

    Chhabra, Harvinder Singh; Kapoor, Kulwant Singh

    2014-01-01

    Study Design Prospective cohort study with questionnaire. Purpose To compare the treatment outcome of nocturnal leg cramps in lumbar spinal canal stenosis (LSCS) patients on conservative treatment with historical surgical cohorts and to determine the sensitivity and specificity as well as positive predictive value and negative predictive value of knee flexion test suggested for LSCS patient. Overview of Literature True prevalence of nocturnal leg cramps in LSCS patients as well as the clinical outcome of its surgical treatment have been reported. Methods A questionnaire suggested from previous study with minor modifications was used in this study. Clinical data was collected. Knee flexion test was performed in two groups. Results The prevalence of nocturnal leg cramp was higher in the LSCS group compared to the control group (second group). In LSCS patients, 38 (88%) had improved leg cramps after the conservative treatment, 3 (6.97%) remained unchanged, and 2 (4.6%) had worsened leg cramps. Of the 43 patients, 21 (48.8%) had no disturbance to their activities of daily living. In the LSCS group, the sensitivity and specificity of the knee flexion test was 53.5% and 33.3%, respectively. The knee flexion test in the LSCS group had a positive predictive value and a negative predictive value of 65.71% and 23.1%, respectively. Conclusions Our study demonstrated that nocturnal leg cramps were significantly more frequent in LSCS patients than in the control group. PMID:25346815

  1. Effect of Cigarette Smoking on Risk of Hip Fracture in Men: A Meta-Analysis of 14 Prospective Cohort Studies

    PubMed Central

    Liu, Bin; Yuan, Zhen-Chao

    2016-01-01

    Background Several observational studies have suggested an association between cigarette smoking and risk of hip fracture. However, no formal systematic review or meta-analysis was performed to summarize this risk in men. Materials and Methods A search was applied to MEDLINE, EMBASE, and web of science (up to November 1 2016). All prospective cohort studies assessing risk of hip fracture with the factor of cigarette smoking in men without language restriction were reviewed, and qualities of all included studies were assessed using the Newcastle-Ottawa Scale. Two authors independently assessed literatures and extracted information eligibility, and any disagreement was resolved by consensus. Newcastle-Ottawa quality assessment scale was used to evaluate studies’ quality in meta-analyses. We calculated the RR with 95% CIs in a random-effects model as well as the fixed-effects model using the metan command in the STATA version 12.0 (StataCorp, USA). Results Fourteen prospective cohort studies were eligible for the present analysis. A meta-analysis of 12 prospective studies showed that the relative risk (RR) for current male smoking was 1.47 [95% confidence interval (CI) (1.28–1.66), p = 0.54; I2 = 0%]. Subgroup analyses show study characteristics (including geography region, length of follow-up, size of cohorts and study quality) did not substantially influence these positive associations. Eight studies reported the RRs for former smokers compared with never smokers and the pooled RR was 1.15 [95% CI, (0.97–1.34), (I2 = 0%, p = 0.975)]. Conclusions The present meta-analysis of 14 prospective studies suggests that, compared with never smokers, cigarette smoking increases risk of hip fracture in man, specifically in current smokers. However, further larger prospective cohorts with more power or meta-analysis of individual patient data are needed to confirm this association. PMID:28036356

  2. Curative resection in Zollinger-Ellison syndrome. Results of a 10-year prospective study.

    PubMed Central

    Norton, J A; Doppman, J L; Jensen, R T

    1992-01-01

    Since 1980, 73 patients with Zollinger-Ellison syndrome (ZES) without radiographic evidence of liver metastases were studied on a prospective protocol including medical management of gastric acid hypersecretion, extensive radiographic tumor localization, and exploratory surgery to find and resect gastrinoma for potential cure. Each patient had gastric acid hypersecretion effectively controlled with either H2-blockers or omeprazole. Patients were divided prospectively into two groups, with all patients undergoing the same preoperative localization studies and extensive laparotomy. In contrast to group 1 (1980-1986) (36 patients), group 2 (1987-Oct. 1990) (37 patients) also underwent additional procedures (transillumination and duodenotomy) at surgery to find duodenal gastrinomas. Preoperative imaging studies localized tumor in 38 (52%) patients, and portal venous sampling for gastrin determinations was positive in 49 (67%) patients. Gastrinomas were found and resected in 57 (78%) patients. Significantly more gastrinomas (92% of patients) were found in group 2 than in group 1 patients (64%) (p less than 0.01). This increase was due to increased numbers of duodenal gastrinomas in group 2 than in group 1 patients (43% versus 11%; p less than 0.01). The increased ability to find duodenal gastrinomas did not significantly improve the immediate disease-free rate, which was 58% for all patients. Duodenal primary gastrinomas were found to have a significantly greater incidence of metastases (55%) and a significantly shorter disease-free interval (12 months) than pancreatic gastrinomas (22% and 84 months, respectively) suggesting that duodenal gastrinomas may be more malignant and not more frequently curable than pancreatic gastrinomas. Operations were performed with no deaths and 11% morbidity rate. Long-term follow-up showed that 50% of patients initially rendered disease free would develop recurrent disease by 5 years. Survival was excellent for all patients, and none

  3. Back pain outcomes in primary care following a practice improvement intervention:- a prospective cohort study

    PubMed Central

    2011-01-01

    Background Back pain is one of the UK's costliest and least understood health problems, whose prevalence still seems to be increasing. Educational interventions for general practitioners on back pain appear to have had little impact on practice, but these did not include quality improvement learning, involve patients in the learning, record costs or document practice activities as well as patient outcomes. Methods We assessed the outcome of providing information about quality improvement techniques and evidence-based practice for back pain using the Clinical Value Compass. This included clinical outcomes (Roland and Morris Disability Questionnaire), functional outcomes, costs of care and patient satisfaction. We provided workshops which used an action learning approach and collected before and after data on routine practice activity from practice electronic databases. In parallel, we studied outcomes in a separate cohort of patients with acute and sub-acute non-specific back pain recruited from the same practices over the same time period. Patient data were analysed as a prospective, split-cohort study with assessments at baseline and eight weeks following the first consultation. Results Data for 1014 patients were recorded in the practice database study, and 101 patients in the prospective cohort study. We found that practice activities, costs and patient outcomes changed little after the intervention. However, the intervention was associated with a small, but statistically significant reduction in disability in female patients. Additionally, baseline disability, downheartedness, self-rated health and leg pain had small but statistically significant effects (p < 0.05) on follow-up disability scores in some subgroups. Conclusions GP education for back pain that both includes health improvement methodologies and involves patients may yield additional benefits for some patients without large changes in patterns of practice activity. The effects in this study were

  4. Association between Global Biomarkers of Oxidative Stress and Hip Fracture in Postmenopausal Women: A Prospective Study

    PubMed Central

    Yang, Shuman; Feskanich, Diane; Willett, Walter C.; Eliassen, A. Heather; Wu, Tianying

    2014-01-01

    Human studies suggest that oxidative stress is a risk factor for osteoporosis, but its relationship with fracture risk is poorly understood. The purpose of the present study was to investigate the association between biomarkers of oxidative stress and hip fracture in postmenopausal women. We conducted a prospective study in the Nurses’ Health Study among 996 women aged 60 years or older at baseline blood collection in 1989–1990. Plasma fluorescent oxidation products (FlOPs) were measured at three excitation/emission wavelengths (360/420 nm named as FlOP_360; 320/420 nm named as FlOP_320 and 400/475 nm named as FlOP_400). FlOPs are generated from many different pathways (lipid, protein and DNA) and reflect a global oxidation burden. FlOP assay is 10–100 times more sensitive than measurement of malondialdehyde. We used Cox proportional hazards regression model to investigate the association between baseline plasma FlOPs and risk of hip fracture, adjusting for multiple hip fracture risk factors such as age, history of osteoporosis, history of hypertension, prior fracture and smoking status. Forty four hip fractures (4.4%) were identified during the follow-up (Maximum = 23 years). In the multivariable model, the hazard ratios (HR) of hip fracture in the second and third tertiles of FlOP_320 were 2.11 (95% confidence interval [CI] = 0.88–5.10) and 2.67 (95% CI = 1.14–6.27), respectively, in comparison with the lowest tertile, and the risk increased linearly with increasing FlOP_320 (P for trend = 0.021). Neither FlOP_360 nor FlOP_400 was significantly associated with risk of hip fracture (Tertile 3 versus tertile 1: HR = 0.70, 95% CI = 0.32–1.54, P for trend = 0.386 for FlOP_360; and HR = 0.88, 95% CI = 0.40–1.96, P for trend = 0.900 for FlOP_400). In this prospective study, higher plasma FlOP_320 was an independent risk factor for hip fracture. Our results need further confirmation. PMID:24957524

  5. Multivitamin use and cardiovascular disease in a prospective study of women123

    PubMed Central

    Lee, I-Min; Rist, Pamela M; Gaziano, J Michael; Manson, JoAnn E; Buring, Julie E; Sesso, Howard D

    2015-01-01

    Background: Although multivitamins are widely used, there are limited prospective studies investigating their association with both long- and short-term risk of cardiovascular disease (CVD). Objective: The objective was to investigate how multivitamin use is associated with the long- and short-term risk of CVD. Design: A prospective cohort study was conducted of 37,193 women from the Women's Health Study aged ≥45 y and free of CVD and cancer at baseline who were followed for an average of 16.2 y. At baseline, women self-reported a wide range of lifestyle, clinical, and dietary factors. Women were categorized into 1) no current use and 2) current use of multivitamins. Duration and updated measures over the course of the follow-up to address short-term effects were also considered. Women were followed for major CVD events, including myocardial infarction (MI), stroke, and CVD death. Results: During the follow-up, 1493 incident cases of CVD [defined as myocardial infarction (MI), stroke, and CVD death] occurred. In multivariable analyses, multivitamin use compared with no use was not associated with major CVD events (HR: 1.01; 95% CI: 0.89, 1.15), MI (HR: 1.04; 95% CI: 0.84, 1.27), stroke (HR: 0.99; 95% CI: 0.83, 1.18), or CVD death (HR: 1.10; 95% CI: 0.84, 1.45). A nonsignificant inverse association was observed between baseline multivitamin use and major CVD events among women aged ≥70 y (P-interaction = 0.04) and those consuming <3 servings/d of fruit and vegetables (P-interaction = 0.01). When updating information on multivitamin use during the course of follow-up, no associations were observed for major CVD events (HR: 0.91; 95% CI: 0.82, 1.02), MI (HR: 0.89; 95% CI: 0.74, 1.06), stroke (HR: 0.91; 95% CI: 0.78, 1.06), and CVD death (HR: 0.91; 95% CI: 0.71, 1.16). Conclusions: In this study of middle-aged and elderly women, neither baseline nor time-varying multivitamin use was associated with the long-term risk of major CVD events, MI, stroke, cardiac

  6. Diagnostic Performance of US for Differentiating Perforated from Nonperforated Pediatric Appendicitis: A Prospective Cohort Study.

    PubMed

    Carpenter, Jennifer L; Orth, Robert C; Zhang, Wei; Lopez, Monica E; Mangona, Kate L; Guillerman, R Paul

    2017-03-01

    Purpose To prospectively evaluate the diagnostic performance of ultrasonography (US) for differentiating perforated from nonperforated pediatric appendicitis and to investigate the association between specific US findings and perforation. Materials and Methods This HIPAA-compliant study had institutional review board approval, and the need for informed consent was waived. All abdominal US studies performed for suspected pediatric appendicitis at one institution from July 1, 2013, to July 9, 2014, were examined prospectively. US studies were reported by using a risk-stratified scoring system (where a score of 1 indicated a normal appendix; a score of 2, an incompletely visualized normal appendix; a score of 3, a nonvisualized appendix; a score of 4, equivocal; a score of 5a, nonperforated appendicitis; and a score of 5b, perforated appendicitis). The diagnostic performance of US studies designated 5a and 5b was calculated. The following US findings were correlated with perforation at multivariate analysis: maximum appendiceal diameter, wall thickness, loss of mural stratification, hyperemia, periappendiceal fat inflammation, periappendiceal fluid, lumen contents, and appendicolith presence. The number of symptomatic days prior to presentation was recorded. Surgical diagnosis and clinical follow-up served as reference standards. Results A total of 577 patients with a diagnosis of appendicitis at US met the study criteria (468 with a score of 5a; 109 with a score of 5b). Appendicitis was correctly identified in 573 (99.3%) of 577 patients. US performance in the detection of perforated appendicitis (5b) was as follows: a sensitivity of 44.0% (80 of 182), a specificity of 93.1% (364 of 391), a positive predictive value of 74.8% (80 of 107), and a negative predictive value of 78.1% (364 of 466). Statistically significant associations with perforated appendicitis were longer duration of symptoms (odds ratio [OR] = 1.46, P < .0001), increased maximum diameter (OR = 1.29, P

  7. Fruit Intake and Abdominal Aortic Calcification in Elderly Women: A Prospective Cohort Study.

    PubMed

    Bondonno, Nicola P; Lewis, Joshua R; Prince, Richard L; Lim, Wai H; Wong, Germaine; Schousboe, John T; Woodman, Richard J; Kiel, Douglas P; Bondonno, Catherine P; Ward, Natalie C; Croft, Kevin D; Hodgson, Jonathan M

    2016-03-10

    Cardiovascular disease (CVD) is the leading cause of death worldwide. There is a consistent inverse relationship between fruit intake with CVD events and mortality in cross-sectional and prospective observational studies, but the relationship of fruit intake with measurements of atherosclerosis in humans is less clear. Nutritional effects on abdominal aortic calcification (AAC), a marker for subclinical intimal and medial atherosclerotic vascular disease, have not been studied previously. The aim of this study was to examine the cross-sectional relationship of total and individual fruit (apple, pear, orange and other citrus, and banana) intake with AAC, scored between 0 and 24. The current study assessed baseline data for a cohort of 1052 women over 70 years of age who completed both a food frequency questionnaire assessing fruit intake, and underwent AAC measurement using dual energy X-ray absorptiometry. AAC scores were significantly negatively correlated with total fruit and apple intakes (p < 0.05), but not with pear, orange or banana intakes (p > 0.25). In multivariable-adjusted logistic regression, each standard deviation (SD; 50 g/day) increase in apple intake was associated with a 24% lower odds of having severe AAC (AAC score >5) (odd ratio OR): 0.76 (0.62, 0.93), p = 0.009). Total and other individual fruit intake were not associated with increased odds of having severe AAC. Apple but not total or other fruit intake is independently negatively associated with AAC in older women.

  8. Body mass index and risk of non-melanoma skin cancer: cumulative evidence from prospective studies

    PubMed Central

    Zhou, Daijun; Wu, Jun; Luo, Gaoxing

    2016-01-01

    Prospective epidemiologic studies that investigated the association between body mass index (BMI) and non-melanoma skin cancer (NMSC) yielded inconsistent findings. A dose-response meta-analysis was conducted to quantitatively summarize the evidence. PubMed and Embase databases were searched for relevant studies. Study-specific relative risk (RR) and 95% confidence interval (CI) for an increase in BMI of 5 kg/m2 was computed with the generalized least squares trend estimation, and these risk estimates were combined with the random-effects model. Nine publications were included in the final analyses, consisting of 18 independent cohorts with 22 risk estimates (971,795 participants and 50,561 NMSC cases). Results of the dose-response analyses showed a nonlinear inverse relationship between BMI and NMSC (RR = 0.88, 95% CI: 0.85–0.91, I2 = 71.2%, P-nonlinearity <0.001), which persisted when limiting to the studies with adjustment for important potential confounders including sun exposure and sensitivity factors. The risk estimates were very similar for squamous cell carcinoma and basal cell carcinoma. Sex appeared a source of heterogeneity (P-difference = 0.06), with a weaker, but still significant inverse association in men than in women. This dose-response meta-analysis suggests a nonlinear inverse association between BMI and NMSC. PMID:27898109

  9. Prospective clinical observational study evaluating gender-associated differences of preoperative pain intensity

    PubMed Central

    Tafelski, Sascha; Kerper, Léonie F; Salz, Anna-Lena; Spies, Claudia; Reuter, Eva; Nachtigall, Irit; Schäfer, Michael; Krannich, Alexander; Krampe, Henning

    2016-01-01

    Abstract Previous studies reported conflicting results concerning different pain perceptions of men and women. Recent research found higher pain levels in men after major surgery, contrasted by women after minor procedures. This trial investigates differences in self-reported preoperative pain intensity between genders before surgery. Patients were enrolled in 2011 and 2012 presenting for preoperative evaluation at the anesthesiological assessment clinic at Charité University hospital. Out of 5102 patients completing a computer-assisted self-assessment, 3042 surgical patients with any preoperative pain were included into this prospective observational clinical study. Preoperative pain intensity (0–100 VAS, visual analog scale) was evaluated integrating psychological cofactors into analysis. Women reported higher preoperative pain intensity than men with median VAS scores of 30 (25th–75th percentiles: 10–52) versus 21 (10–46) (P < 0.001). Adjusted multiple regression analysis showed that female gender remained statistically significantly associated with higher pain intensity (P < 0.001). Gender differences were consistent across several subgroups especially with varying patterns in elderly. Women scheduled for minor and moderate surgical procedures showed largest differences in overall pain compared to men. This large clinical study observed significantly higher preoperative pain intensity in female surgical patients. This gender difference was larger in the elderly potentially contradicting the current hypothesis of a primary sex-hormone derived effect. The observed variability in specific patient subgroups may help to explain heterogeneous findings of previous studies. PMID:27399095

  10. Adverse maternal and perinatal outcomes in women with previous preeclampsia: a prospective study

    PubMed Central

    Bramham, Kate; Briley, Annette L.; Seed, Paul; Poston, Lucilla; Shennan, Andrew H.; Chappell, Lucy C.

    2011-01-01

    Objective The purpose of this study was to assess recurrence rates of preeclampsia and neonatal outcomes in women with a history of preeclampsia that required preterm delivery. Study Design Five hundred women with previous preeclampsia that required delivery at <37 weeks' gestation were followed prospectively. Results Preeclampsia reoccurred in 117 women (23%). Predictive factors included black (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.16–4.53) or Asian (OR, 2.98; 95% CI, 1.33–6.59) ethnicity, enrollment systolic blood pressure of >130 mm Hg (OR, 2.89; 95% CI, 1.52–5.50), current antihypertensive use (OR, 6.39; 95% CI, 2.38–17.16), and proteinuria of ≥2+ on enrollment urinalysis (OR, 12.35; 95% CI, 3.45–44.21). Women who previously delivered at <34 weeks' gestation were more likely to deliver preterm again (29% vs 17%; relative risk, 1.69; 95% CI, 1.19–2.40) than were those women with previous delivery between 34 and 37 weeks' gestation. Conclusion Although this study confirms that women with previous preeclampsia that required early delivery are at high risk of the development of preeclampsia, the study identifies risk factors for recurrence and illustrates that women with previous preeclampsia are at greater risk of adverse neonatal outcome. PMID:21457915

  11. Domestic violence against pregnant women: A prospective study in a metropolitan city, İstanbul

    PubMed Central

    Cengiz, Hüseyin; Kanawati, Ammar; Yıldız, Şükrü; Süzen, Sema; Tombul, Tuba

    2014-01-01

    Objective Violence against women, particularly against pregnant women, is increasingly being recognized as a significant problem around the world. Limited studies were found about domestic violence among pregnant women. The aim of this study was to determine the prevalence of domestic violence during pregnancy and the factors affecting it. Material and Methods This prospective study was conducted at the Department of Obstetrics and Gynecology, between January 2012 and April 2013. A total of 1349 pregnant women, irrespective of age and socioeconomic status, were interviewed using a questionnaire in the local language. Results The incidence of domestic violence in this study was 2.37%. The mean age of women who reported violence was 29.06±5.53 years. Age, marriage duration, gravidity, parity, educational level, partner’s educational level, and monthly income exerted no significant influences on women who experienced domestic violence during their pregnancies (p>0.05). Women who resided in the same houses with large extended families were at significantly higher risk of domestic violence during pregnancy in comparison with the pregnant women who lived within a core family (p=0.018). Conclusion Domestic violence during pregnancy is a potential public health problem. Education, improvements in economic autonomy, and society’s attitudes may reduce domestic violence. Health-care providers should increase their awareness of risk factors to protect women from domestic violence. PMID:24976770

  12. An historical prospective study of mortality within a cohort of gas distribution workers.

    PubMed

    Liveright, T; Stanbury, M

    1983-01-01

    An historical prospective study of mortality within a cohort of 1,410 gas distribution workers was conducted. This cohort was followed for ten years (1971-1980) and data on 118 deaths were obtained. Five-year (1973-1977) averages of both St. Louis and United States age-specific mortality figures were used to create "expected" mortality rates for comparison with the observed deaths in the cohort. Analyses of the cohort were done according to: 1) person-years contributed during the study period (the "age-attained" method) and 2) the number of years from commencement of work in the company until the end of the study period (1980) or death (the "latency" methods of analysis, Standardized Mortality Ratios (SMRs) were calculated for all causes of death, all malignant neoplasms, and for cardiovascular disease and malignant neoplasms of the respiratory and digestive systems. In no case was the SMR found to be beyond the range of what would be expected in the "standard" populations. While the present study does not contradict the negative findings of the one previous investigation of mortality of gas distribution workers, the limitations of small cohort size, reliance on death certificates and non-industrial comparison populations make any conclusions at best provisional.

  13. Fruit Intake and Abdominal Aortic Calcification in Elderly Women: A Prospective Cohort Study

    PubMed Central

    Bondonno, Nicola P.; Lewis, Joshua R.; Prince, Richard L.; Lim, Wai H.; Wong, Germaine; Schousboe, John T.; Woodman, Richard J.; Kiel, Douglas P.; Bondonno, Catherine P.; Ward, Natalie C.; Croft, Kevin D.; Hodgson, Jonathan M.

    2016-01-01

    Cardiovascular disease (CVD) is the leading cause of death worldwide. There is a consistent inverse relationship between fruit intake with CVD events and mortality in cross-sectional and prospective observational studies, but the relationship of fruit intake with measurements of atherosclerosis in humans is less clear. Nutritional effects on abdominal aortic calcification (AAC), a marker for subclinical intimal and medial atherosclerotic vascular disease, have not been studied previously. The aim of this study was to examine the cross-sectional relationship of total and individual fruit (apple, pear, orange and other citrus, and banana) intake with AAC, scored between 0 and 24. The current study assessed baseline data for a cohort of 1052 women over 70 years of age who completed both a food frequency questionnaire assessing fruit intake, and underwent AAC measurement using dual energy X-ray absorptiometry. AAC scores were significantly negatively correlated with total fruit and apple intakes (p < 0.05), but not with pear, orange or banana intakes (p > 0.25). In multivariable-adjusted logistic regression, each standard deviation (SD; 50 g/day) increase in apple intake was associated with a 24% lower odds of having severe AAC (AAC score >5) (odd ratio OR): 0.76 (0.62, 0.93), p = 0.009). Total and other individual fruit intake were not associated with increased odds of having severe AAC. Apple but not total or other fruit intake is independently negatively associated with AAC in older women. PMID:26978394

  14. Factors Associated with Reintubation in an Intensive Care Unit: A Prospective Observational Study

    PubMed Central

    Hsiung Lee, Eric Shih; Jiann Lim, Danny Tse; Taculod, Juvel Mabao; Sahagun, Juliet Tolentino; Otero, Joerie Pasive; Teo, Kaimin; Loh, Will Ne-Hooi; Hui Tan, Addy Yong

    2017-01-01

    Background and Aims: The objective of the study was to determine the incidence of failed extubations in our Intensive Care Unit (ICU) and identify associated clinical factors. Materials and Methods: A prospective observational study of mechanically ventilated patients who underwent extubation attempts in our (predominantly surgical) ICU was undertaken from July 2012 to August 2013. The primary endpoint was the need for nonelective reintubation within 72 h of extubation. Clinical data of the reintubated patients were compared with those who were successfully extubated to identify factors associated with reintubation. Results: Five hundred and eight extubation attempts were documented, 38 (7.5%) of which were unsuccessful. On multivariate analysis, the following clinical factors were found to be associated with an increased risk of failed extubation: unplanned extubations (adjusted odds ratio [OR] 5.8), the use of noninvasive ventilation (NIV) postextubation (adjusted OR 3.2), and sepsis (adjusted OR 2.9). Patient demographic factors, other premorbid and comorbid medical conditions, and differences of laboratory parameters did not appear to significantly influence reintubation rates in our study. Conclusions: Our study has demonstrated a relatively low reintubation rate, likely due to inclusion of elective admissions/intubations in our patient population. Unplanned extubations, the use of NIV postextubation, and sepsis were associated with increased reintubation risk, reinforcing the need for increased vigilance in this subgroup of patients after extubation.

  15. [Rivaroxaban at Non-Valvular Atrial Fibrillation: a Prospective Study and Clinical Practice].

    PubMed

    Fonyakin, A V

    2016-08-01

    The article presents an analytical review of the results of post-registration clinical studies on the efficacy and safety of rivaroxaban in nonvalvular atrial fibrillation (AF) to prevent stroke and other systemic thromboembolic complications. The main purpose of the first large prospective international observational study of rivaroxaban for stroke prevention in patients with non-valvular AF patients XANTUS was the analysis of efficacy and safety of rivaroxaban in clinical practice. Results of one year of observation of 6784 patients confirmed that rivaroxaban is effective and safe in real unselected population of patients with non-valvular AF and various stroke risk. The first Russian multicenter observational study Neuro-Xar dedicated to secondary prevention of stroke and systemic embolism, demonstrated the efficacy and safety of rivaroxaban in routine clinical practice. Lower risk of fatal intracranial and gastrointestinal bleeding was found in retrospective post-marketing studies, of rivaroxaban in the US, such as the PMSS and REVISIT-US. Rivaroxaban therapy was associated with reduced risk of the combined endpoint (ischemic stroke and intracranial hemorrhage).

  16. A new motor performance test in a prospective study on children with suspected myopathy.

    PubMed

    van den Beld, Willeke A; van der Sanden, Gitty A C; Feuth, Ton; Janssen, Anjo J W M; Sengers, Rob C A; Verbeek, André L M; Gabreëls, Fons J M

    2006-09-01

    In the development of a new diagnostic motor performance test to spare more children from painful muscle biopsy, seven functional items were used to measure muscle strength and muscle endurance in a prospective study on new patients. Over a 2-year period, 22 patients (12 males, 10 females; mean age 8y 1mo [SD 2y 6mo], range 4-11y) were recruited for the study. They had all been referred with suspected myopathy. The motor performance test was administered before muscle biopsy. Validity of the seven items was assessed using logistic regression analysis and receiver operating characteristic (ROC) analysis. Two items were withdrawn from the test because they were not suitable for children aged 4 to 5 years. The five remaining items were: Heels, Circuit, Stairs, Jump, and Gowers. A full logistic regression model including these five items was fitted to the total population of 90 patients suspected of having myopathy (from this study and our previous study) to make the best prediction of whether myopathy was present. The ROC area under the curve of the diagnostic prediction model was 0.92 (95% confidence interval [CI] 0.87-0.98) and 0.89 (95% CI 0.87-0.92) after bootstrap correction. This indicated the high diagnostic power that can be expected for future, similar patients. This non-invasive and child-friendly motor performance test can improve diagnostic procedure and, therefore, spare more children from unnecessary muscle biopsy.

  17. Risk factors for hamstring injuries in male soccer players: a systematic review of prospective studies.

    PubMed

    van Beijsterveldt, A M C; van de Port, I G L; Vereijken, A J; Backx, F J G

    2013-06-01

    Hamstring injuries are common injuries in soccer players. In view of the high incidence and the serious consequences, identifying risk factors related to hamstring injuries is essential. The aim of this systematic review was therefore to identify risk factors for hamstring injuries in male adult soccer players. PubMed, Embase/Medline, Cumulative Index to Nursing and Allied Health Literature, and SPORTDiscus were systematically searched, and prospective studies investigating risk factors for hamstring injuries in adult male soccer players were included. The methodological quality of the included articles was assessed using a standardized set of predefined criteria. Seven of the 11 studies identified, involving a total of 1775 players and 344 hamstring injuries, met the inclusion criteria. All but one of the included studies met at least five of nine methodological criteria, causing them to be qualified as 'high quality'. The included studies used univariate as well as multivariate analyses to identify risk factors for hamstring injury. The results from the multivariate analyses suggest that previous hamstring injury is most strongly related to hamstring injury. Conflicting evidence is found for age and hamstring length or flexibility as risk factors for the occurrence of hamstring injuries.

  18. Occupation and the risk of bothersome tinnitus: results from a prospective cohort study (HUNT)

    PubMed Central

    Krog, Norun Hjertager; Kvestad, Ellen; Hoffman, Howard J; Tambs, Kristian

    2012-01-01

    Objectives Estimates of occupation-specific tinnitus prevalence may help identify high-risk occupations where interventions are warranted. The authors studied the effect of occupation on prevalence of bothersome tinnitus and estimated the attributable fraction due to occupation. The authors also studied how much of the effect remained after adjusting for noise exposure, education income, hearing thresholds and other risk factors. Design A prospective cohort study. Setting A health survey of the Nord-Trøndelag county of Norway. Participants A sample of the general adult population (n=49 948). Primary outcome measure The primary outcome measure is bothersome tinnitus. Results Occupation had a marked effect on tinnitus prevalence. The effect of occupation on tinnitus was reduced in men by controlling for self-reported occupational noise exposure and in women by controlling for education and income. Adding hearing loss as a predictor increased the effect of occupation somewhat. In men, age-adjusted prevalence ratios of tinnitus ranged from 1.5 (workshop mechanics) to 2.1 (crane and hoist operators) in the 10 occupations with highest tinnitus prevalence. In women, the most important contribution to the tinnitus prevalence was from the large group of occupationally inactive persons, with a prevalence ratio of 1.5. Conclusion This study found a moderate association between occupation and bothersome tinnitus. PMID:22267709

  19. Nut intake and stroke risk: A dose-response meta-analysis of prospective cohort studies

    PubMed Central

    Shao, Chuan; Tang, Hui; Zhao, Wei; He, Jianquan

    2016-01-01

    We aim to quantify the effects of nut intake on risk of stroke by a dose-response meta-analysis with a random-effects model. Two databases (PubMed and Emabse) were searched for prospective cohort studies regarding nut intake and stroke risk. Studies were included if they fulfilled the predefined criteria. Eleven articles encompassing fourteen cohort studies were included in final analysis. The pooled relative risk (RR) of stroke for the highest versus (vs.) lowest category of nut intake was 0.88 (95% confidence interval [CI] 0.80-0.97). The power to detect a RR of 0.88 for the highest versus vs. lowest category of nut intake was 86.2%. In multiple subset analyses by gender, location, and stroke subtype, the inverse association was only found in women (RR = 0.84, 95% CI 0.73–0.96) and Asia (RR = 0.79, 95% CI 0.67–0.93). In the dose-response meta-analysis, evidence for a nonlinear association between nut intake and stroke risk was observed and a RR of 0.86 was conferred for 12 g/day. Based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, the quality of evidence was moderate. In conclusions, finding from current meta-analysis of fourteen cohort studies indicates that nut intake may be related to decreased risk of stroke. PMID:27469072

  20. Outcome assessment of pregnancy-related acute kidney injury in Morocco: A national prospective study.

    PubMed

    Kabbali, Nadia; Tachfouti, Nabil; Arrayhani, Mohammed; Harandou, Mustapha; Tagnaouti, Mounia; Bentata, Yassamine; Laouad, Inass; Ramdani, Benyounes; Bayahia, Rabia; Oualim, Zouhair; Houssaini, Tarik Sqalli

    2015-01-01

    Acute kidney injury (AKI) is a rare but life-threatening complication of pregnancy. The aim of this paper is to study the characteristics of acute AKI in pregnancy and to emphasize on its management modalities in Moroccan hospitals. This is a national prospective study performed over six months from July 1 to December 31 2010 on AKI developing in pregnant patients, both preand post-partum period. Patients with pre-existing kidney disease were excluded from the study. Outcome was considered unfavorable when complete recovery of renal function was not achieved and/or maternal death occurred. Forty-four patients were included in this study. They were 29.6 ± 6 years old and mostly illiterate (70.6%). Most AKI occurred in the post-partum period, with 66% of the cases occurring in those who did not receive antenatal care. The main etiologies were pre-eclampsia (28 cases), hemorrhagic shock (six cases) and septic events (five cases). We noted three cases of acute fatty liver, one case of obstructive kidney injury and one case of lupus nephritis. Hemodialysis was necessary in 17 (38.6%) cases. The outcome was favorable in 29 patients. The maternal mortality rate was 11.4%. Two poor prognostic factors were identified: Age over 38 years and sepsis. AKI is a severe complication of pregnancy in developing countries. Its prevention necessitates the improvement of the sanitary infrastructure and the establishment of the obligatory antenatal care.

  1. Neurotrophin Genes and Antidepressant-Worsening Suicidal Ideation: A Prospective Case-Control Study

    PubMed Central

    Ramoz, Nicolas; Shekhtman, Tatyana; Courtet, Philippe; Gorwood, Philip; Kelsoe, John R.

    2016-01-01

    Background: Antidepressant-worsening suicidal ideation is a rare but serious phenomenon. This study aimed to test for association between antidepressant-worsening suicidal ideation and polymorphisms of BDNF/NTRK2 neurotrophin pathway genes, known to be involved in depression and suicide. Methods: This was a case-control study comparing patients with antidepressant-worsening suicidal ideation to patients without. Patients were collected from the GENESE cohort (3771 depressed tianeptine-treated outpatients). Antidepressant-worsening suicidal ideation was defined by an increase of at least 2 points on the Montgomery-Åsberg Depression Rating Scale-item10 during treatment. Controls were matched for age, sex, and baseline Montgomery-Åsberg Depression Rating Scale-item10 score. Thirteen single nucleotide polymorphisms covering 5 BDNF/NTRK2 pathway genes were genotyped. Results: A total 78 cases and 312 controls were included. Two NTRK2 single nucleotide polymorphisms were associated to antidepressant-worsening suicidal ideation: rs1439050 (P=.01) and rs1867283 (P=.04). Association with rs1439050 remained significant after adjustment for potentially confounding factors, including previous suicide attempts (P<.01). Conclusions: This naturalistic prospective study is consistent with previous studies on highlighting the potential role of the neurotrophin pathway, and especially of NTRK2, in antidepressant-worsening suicidal ideation. PMID:27378793

  2. Single-Incision Multiport/Single Port Laparoscopic Abdominal Surgery (SILAP): A Prospective Multicenter Observational Quality Study

    PubMed Central

    Diener, Markus; Kropf, Siegfried; Otto, Ronny; Manger, Thomas; Vestweber, Boris; Mirow, Lutz; Winde, Günther; Lippert, Hans

    2016-01-01

    Background Increasing experience with minimally invasive surgery and the development of new instruments has resulted in a tendency toward reducing the number of abdominal skin incisions. Retrospective and randomized prospective studies could show the feasibility of single-incision surgery without any increased risk to the patient. However, large prospective multicenter observational datasets do not currently exist. Objective This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. This study focuses on external validity, clinical relevance, and the patients’ perspective. Accordingly, the single-incision multiport/single port laparoscopic abdominal surgery (SILAP) study will supplement the existing evidence, which does not currently allow evidence-based surgical decision making. Methods The SILAP study is an international prospective multicenter observational quality study. Mortality, morbidity, complications during surgery, complications postoperatively, patient characteristics, and technical aspects will be monitored. We expect more than 100 surgical centers to participate with 5000 patients with abdominal single-incision surgery during the study period. Results Funding was obtained in 2012. Enrollment began on January 01, 2013, and will be completed on December 31, 2018. As of January 2016, 2119 patients have been included, 106 German centers are registered, and 27 centers are very active (>5 patients per year). Conclusions This prospective multicenter observational quality study will provide a relevant dataset reflecting the feasibility and safety of single-incision surgery. An international enlargement and recruitment of centers outside of Germany is meaningful. Trial Registration German Clinical Trials Register: DRKS00004594; https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00004594 (Archived by WebCite at http

  3. Prospective Swiss pilot study of Endocuff-assisted colonoscopy in a screening population

    PubMed Central

    Sawatzki, Mikael; Meyenberger, Christa; Marbet, Urs Albert; Haarer, Johannes; Frei, Remus

    2015-01-01

    Background and study aims: The adenoma detection rate (ADR) is one of the quality measures in screening colonoscopy and is crucial for reducing colorectal cancer morbidity and mortality. Up to 25 % of adenomas are missed during colonoscopy. Endocuff is an easy-to-use device that is attached like a cap to the distal tip of the colonoscope in order to optimize visualization behind the folds of the colon and increase the ADR. This is the first prospective study of Endocuff-assisted colonoscopy (EC) in a screening population with follow-up to determine the ADR and adverse events of EC. Patients and methods: We prospectively enrolled asymptomatic patients referred for screening colonoscopy during the 4-month study period. We documented the Boston Bowel Preparation Scale (BBPS) score, cecal intubation rate, polyp detection rate, ADR, number of advanced adenomas, and number of adverse events. Colonoscopies were performed by five board-certified gastroenterologists. During follow-up, the patients were called 4 to 12 weeks after EC. Results: A total of 104 EC procedures were performed. Cecal intubation was achieved in 99 % of the patients, with a median intubation time of 6 minutes. The polyp detection rate and ADR in our study were 72 % and 47 %, respectively, and 13.5 % of the lesions were advanced adenomas. A significant number of adenomas were detected in the right side of the colon. Considering all the adenomas and hyperplastic polyps above the sigmoid, we recommended that nearly 60 % of our patients repeat an endoscopic follow-up according to the existing Swiss guidelines. We noted no perforations or other serious adverse events, even in the patients with extensive diverticulosis. Conclusions: EC is feasible with the most commonly available colonoscopes without severe adverse events. EC seems to be a safe and effective device for increasing the ADR, including small adenomas in the right side of the colon. Therefore, this technique may be recommended in the

  4. Retention of female volunteer community health workers in Dhaka urban slums: a prospective cohort study

    PubMed Central

    2014-01-01

    Background Volunteer community health workers (CHWs) are a key approach to improving community-based maternal and child health services in developing countries. BRAC, a large Bangladeshi non-governmental organization (NGO), has employed female volunteer CHWs in its community-based health programs since 1977, recently including its Manoshi project, a community-based maternal and child health intervention in the urban slums of Bangladesh. A case–control study conducted in response to high dropout rates in the first year of the project showed that financial incentives, social prestige, community approval and household responsibilities were related to early retention in the project. In our present prospective cohort study, we aimed to better understand the factors associated with retention of volunteer CHWs once the project was more mature. Methods We used a prospective cohort study design to examine the factors affecting retention of volunteer CHWs who remained in the project after the initial start-up period. We surveyed a random sample of 542 CHWs who were working for BRAC Manoshi in December 2008. In December 2009, we revisited this cohort of CHWs and interviewed those who had dropped out about the main reasons for their dropping out. We used a multivariable generalized linear model regression analysis with a log link to estimate the relative risk (RR) of independent factors on retention. Results Of the 542 CHWs originally enrolled, 120 had dropped out by the end of one year, mainly because they left the slums. CHWs who received positive community appraisal (adjusted RR = 1.45, 95% confidence interval (CI) = 1.10 to 1.91) or were associated with other NGOs (adjusted RR = 1.13, 95% CI = 1.04 to 1.23) were more likely to have been retained in the project. Although refresher training was also associated with increased retention (adjusted RR = 2.25, 95% CI = 1.08 to 4.71) in this study, too few CHWs had not attended refresher training

  5. Prospective study of ABO blood type and the risk of pulmonary embolism in two large cohort studies.

    PubMed

    Wolpin, Brian M; Kabrhel, Christopher; Varraso, Raphaëlle; Kraft, Peter; Rimm, Eric B; Goldhaber, Samuel Z; Camargo, Carlos A; Fuchs, Charles S

    2010-11-01

    Prior studies have suggested an association of ABO blood type and the risk of venous thromboembolism; however, most studies were retrospective and lacked important covariates or validated endpoints. Moreover, risk estimates varied widely across studies. Therefore, we prospectively examined the association of blood type and the risk of incident pulmonary embolism (PE) in two large cohort studies, the Nurses' Health Study and Health Professionals Follow-up Study. During 1,010,378 person-years of follow-up among 77,025 women and 30,105 men, 499 participants developed PE. Compared to those with O-blood type, participants with non-O blood type had multivariable-adjusted hazard ratios (HR) of 1.86 (95% CI, 1.35-2.57) for idiopathic PE, 1.29 (95% CI, 1.03-1.62) for non-idiopathic PE, and 1.46 (95% CI, 1.22-1.76) for any PE. Hazard ratios were similar for participants with blood types A, B, and AB. Age-adjusted absolute rates of idiopathic PE over 10 years of follow-up differed by blood type: 0.11% for O, 0.20% for A, 0.19% for AB, and 0.21% for B. For idiopathic PE, the population attributable fraction was 33% for inheritance of non-O blood type. Among past and current smokers, participants with non-O vs. O-blood type had a HR for idiopathic PE of 2.56 (95% CI, 1.61-4.08). Among never smokers, the HR for idiopathic PE was 1.30 (95% CI, 0.82-2.05; P interaction=0.04). In two large, prospective cohorts, ABO blood type was significantly associated with the risk of idiopathic and non-idiopathic PE, with even greater risk for idiopathic PE among current and past smokers with non-O blood type.

  6. Hopes and Prospects for the Sustainability Cross-Curriculum Priority: Provocations from a State-Wide Case Study

    ERIC Educational Resources Information Center

    Hill, Allen; Dyment, Janet E.

    2016-01-01

    This article draws on research data from a state-wide case study, intertwined with three key moments that occurred in late 2014, to critically engage with the hopes and prospects of the Sustainability Cross-Curriculum Priority (CCP) in Australian schools. These key moments--the "IPCC 5th Assessment Synthesis Report" (Intergovernmental…

  7. Sexuality, Substance Use, and Susceptibility to Victimization: Risk for Rape and Sexual Coercion in a Prospective Study of College Women

    ERIC Educational Resources Information Center

    Messman-Moore, Terri L.; Coates, Aubrey A.; Gaffey, Kathryn J.; Johnson, Carrie F.

    2008-01-01

    An 8-month prospective study examined behavioral, personality, and psychological variables thought to increase vulnerability for college women's experience of rape and verbal sexual coercion. Participants were 276 college women who completed self-report surveys. During 1 academic year, 9.5% of women were raped and 11.7% reported verbal sexual…

  8. Modulation of a Fronto-Parietal Network in Event-Based Prospective Memory: An rTMS Study

    ERIC Educational Resources Information Center

    Bisiacchi, P. S.; Cona, G.; Schiff, S.; Basso, D.

    2011-01-01

    Event-based prospective memory (PM) is a multi-component process that requires remembering the delayed execution of an intended action in response to a pre-specified PM cue, while being actively engaged in an ongoing task. Some neuroimaging studies have suggested that both prefrontal and parietal areas are involved in the maintenance and…

  9. Elementary School Children with Behavior Problems: Teacher-Child Relations and Self-Perception. A Prospective Study

    ERIC Educational Resources Information Center

    Henricsson, Lisbeth; Rydell, Ann-Margret

    2004-01-01

    The teacher relations and self-perception of children with externalizing (n = 26) and internalizing behavior problems (n = 25) and a nonproblematic group (n = 44) were studied prospectively. The children were assessed with the Rutter CBQ in 1st grade. Classroom observations of teacher-child interactions were performed in 2nd grade. The teacher…

  10. Abuse-Specific Self-Schemas and Self-Functioning: A Prospective Study of Sexually Abused Youth

    ERIC Educational Resources Information Center

    Feiring, Candice; Cleland, Charles M.; Simon, Valerie A.

    2010-01-01

    Potential pathways from childhood sexual abuse (CSA) to negative self-schemas to subsequent dissociative symptoms and low global self-esteem were examined in a prospective longitudinal study of 160 ethnically diverse youth with confirmed CSA histories. Participants were interviewed at the time of abuse discovery, when they were 8 to 15 years of…

  11. Tea consumption and the risk of five major cancers: a dose–response meta-analysis of prospective studies

    PubMed Central

    2014-01-01

    Background We conducted a dose–response meta-analysis of prospective studies to summarize evidence of the association between tea consumption and the risk of breast, colorectal, liver, prostate, and stomach cancer. Methods We searched PubMed and two other databases. Prospective studies that reported risk ratios (RRs) with 95% confidence intervals (CIs) of cancer risk for ≥3 categories of tea consumption were included. We estimated an overall RR with 95% CI for an increase of three cups/day of tea consumption, and, usingrestricted cubic splines, we examined a nonlinear association between tea consumption and cancer risk. Results Forty-one prospective studies, with a total of 3,027,702 participants and 49,103 cancer cases, were included. From the pooled overall RRs, no inverse association between tea consumption and risk of five major cancers was observed. However, subgroup analysis showed that increase in consumption of three cups of black tea per day was a significant risk factor for breast cancer (RR, 1.18; 95% CI, 1.05-1.32). Conclusion Ourresults did not show a protective role of tea in five major cancers. Additional large prospective cohort studies are needed to make a convincing case for associations. PMID:24636229

  12. Deaf Adults' Reasons for Genetic Testing Depend on Cultural Affiliation: Results from a Prospective, Longitudinal Genetic Counseling and Testing Study

    ERIC Educational Resources Information Center

    Boudreault, Patrick; Baldwin, Erin E.; Fox, Michelle; Dutton, Loriel; Tullis, LeeElle; Linden, Joyce; Kobayashi, Yoko; Zhou, Jin; Sinsheimer, Janet S.; Sininger, Yvonne; Grody, Wayne W.; Palmer, Christina G. S.

    2010-01-01

    This article examines the relationship between cultural affiliation and deaf adults' motivations for genetic testing for deafness in the first prospective, longitudinal study to examine the impact of genetic counseling and genetic testing on deaf adults and the deaf community. Participants (n = 256), classified as affiliating with hearing, Deaf,…

  13. Streptococcal Upper Respiratory Tract Infections and Exacerbations of Tic and Obsessive-Compulsive Symptoms: A Prospective Longitudinal Study

    ERIC Educational Resources Information Center

    Leckman, James F.; King, Robert A.; Gilbert, Donald L.; Coffey, Barbara J.; Singer, Harvey S.; Dure, Leon S., IV; Grantz, Heidi; Katsovich, Liliya; Lin, Haiqun; Lombroso, Paul J.; Kawikova, Ivana; Johnson, Dwight R.; Kurlan, Roger M.; Kaplan, Edward L.

    2011-01-01

    Objective: The objective of this blinded, prospective, longitudinal study was to determine whether new group A beta hemolytic streptococcal (GABHS) infections are temporally associated with exacerbations of tic or obsessive-compulsive (OC) symptoms in children who met published criteria for pediatric autoimmune neuropsychiatric disorders…

  14. Two-Year Prospective Naturalistic Study of Remission from Major Depressive Disorder as a Function of Personality Disorder Comorbidity

    ERIC Educational Resources Information Center

    Grilo, Carlos M.; Sanislow, Charles A.; Shea, Tracie M.; Skodol, Andrew E.; Stout, Robert L.; Gunderson, John G.; Yen, Shirley; Bender, Donna S.; Pagano, Maria E.; Morey, Leslie C.; McGlashan, Thomas H.

    2005-01-01

    In this study, the authors examined prospectively the 24-month natural course of remission from major depressive disorder (MDD) as a function of personality disorder (PD) comorbidity. In 302 participants (196 women, 106 men), psychiatric and PDs were assessed at baseline with diagnostic interviews, and the course of MDD was assessed with the…

  15. A Prospective Three Generational Study of Fathers' Constructive Parenting: Influences from Family of Origin, Adolescent Adjustment, and Offspring Temperament

    ERIC Educational Resources Information Center

    Kerr, David C. R.; Capaldi, Deborah M.; Pears, Katherine C.; Owen, Lee D.

    2009-01-01

    This prospective, intergenerational study considered multiple influences on 102 fathers' constructive parenting of 181 children. Fathers in the 2nd generation (G2) were recruited as boys on the basis of neighborhood risk for delinquency and assessed through early adulthood. The fathers' parents (G1) and the G2 mothers of G3 also participated. A…

  16. Prospects: The Congressionally Mandated Study of Educational Growth and Opportunity. Final Report on Limited English Proficient Students.

    ERIC Educational Resources Information Center

    Buron, Lawrence; Beecroft, Erik; Bell, Stephen; Price, Cristofer; Gemmen, Eric

    As a reflection of the importance attached to successfully educating children whose native language is not English, the U.S. Department of Education's longitudinal study of Chapter 1 assistance, "Prospects," includes a component devoted to the analysis of limited-English-proficient (LEP) students. Chapter 1, renamed Title 1 in 1994, is…

  17. Longitudinal Pathways between Maternal Mental Health in Infancy and Offspring Romantic Relationships in Adulthood: A 30-Year Prospective Study

    ERIC Educational Resources Information Center

    Slominski, Lisa; Sameroff, Arnold; Rosenblum, Katherine; Kasser, Tim

    2011-01-01

    Longitudinal pathways between maternal mental health in infancy and offspring romantic relationship outcomes in adulthood were examined using a 30-year prospective longitudinal study of 196 mothers and their children. Structural equation modeling revealed that maternal mental health at 30 months was related to offspring relationship status and…

  18. Predictive Factors for Anastomotic Leakage After Colorectal Surgery: Study Protocol for a Prospective Observational Study (REVEAL Study)

    PubMed Central

    Bosmans, Joanna WAM; Kartal, Serdar; Lubbers, Tim; Sosef, Meindert; Slooter, Gerrit D; Stoot, Jan H; van Schooten, Frederik-Jan; Bouvy, Nicole D; Derikx, Joep PM

    2016-01-01

    Background Anastomotic leakage (AL) remains the most important complication following colorectal surgery, and is associated with high morbidity and mortality rates. Previous research has focused on identifying risk factors and potential biomarkers for AL, but the sensitivity of these tests remains poor. Objective This prospective multicenter observational study aims at combining multiple parameters to establish a diagnostic algorithm for colorectal AL. Methods This study aims to include 588 patients undergoing surgery for colorectal carcinoma. Patients will be eligible for inclusion when surgery includes the construction of a colorectal anastomosis. Patient characteristics will be collected upon consented inclusion, and buccal swabs, breath, stool, and blood samples will be obtained prior to surgery. These samples will allow for the collection of information regarding patients’ inflammatory status, genetic predisposition, and intestinal microbiota. Additionally, breath and blood samples will be taken postoperatively and patients will be strictly observed during their in-hospital stay, and the period shortly thereafter. Results This study has been open for inclusion since August 2015. Conclusions An estimated 8-10% of patients will develop AL following surgery, and they will be compared to non-leakage patients. The objectives of this study are twofold. The primary aim is to establish and validate a diagnostic algorithm for the pre-operative prediction of the risk of AL development using a combination of inflammatory, immune-related, and genetic parameters. Previously established risk factors and novel parameters will be incorporated into this algorithm, which will aid in the recognition of patients who are at risk for AL. Based on these results, recommendations can be made regarding the construction of an anastomosis or deviating stoma, and possible preventive strategies. Furthermore, we aim to develop a new algorithm for the post-operative diagnosis of AL at an

  19. The Effect of Hypothyroidism on Color Contrast Sensitivity: A Prospective Study

    PubMed Central

    Cakir, Mehtap; Turgut Ozturk, Banu; Turan, Elif; Gonulalan, Gulsum; Polat, Ilker; Gunduz, Kemal

    2015-01-01

    Background Thyroid hormone has been shown to control retinal cone opsin expression, the protein of color vision, in adult rodents. Objectives The aim of this study was to evaluate the effect of hypothyroidism on color contrast sensitivity in adult overt hypothyroid patients. Methods Thirty-eight overt hypothyroid (31 females, 7 males) subjects and 20 euthyroid (16 females, 4 males) controls were studied prospectively. Color vision examination was performed by Chromatest, a software program analyzing the tritan (blue-yellow) color contrast threshold (tritan CCT) and protan (red-green) color contrast threshold (protan CCT). Color contrast sensitivity analyses of hypothyroid subjects were performed on admission and after L-thyroxine treatment when biochemical euthyroidism was achieved. Results After a median period of 90 (90-210) days, 24 (19 females, 5 males) patients were euthyroid and eligible for a second color vision examination. Baseline tritan CCT and protan CCT values were significantly higher in the hypothyroid group compared to euthyroid controls, which clinically translates into impaired color contrast sensitivity (p < 0.001 and p < 0.001, respectively). There was a significant decrease in tritan CCT (p = 0.002) and protan CCT (p < 0.001) values in the hypothyroid group after euthyroidism was achieved, which denotes improvement in color contrast sensitivity. Conclusions It is a novel finding of the current study that color contrast sensitivity is impaired in hypothyroidism and significantly improves after euthyroidism is achieved. PMID:25960961

  20. Prospective study of bacteraemia in acute haemorrhagic diarrhoea syndrome in dogs.

    PubMed

    Unterer, S; Lechner, E; Mueller, R S; Wolf, G; Straubinger, R K; Schulz, B S; Hartmann, K

    2015-03-21

    In dogs with idiopathic acute haemorrhagic diarrhoea syndrome (AHDS), a serious loss of intestinal mucosal barrier integrity occurs. However, the incidence of bacterial translocation in dogs with idiopathic AHDS is not known. Thus, the objectives of this prospective study were to identify the incidence of bacteraemia, to evaluate the frequency of septic events and the influence of bacteraemia on various clinical and laboratory parameters, duration of hospitalisation and survival of dogs with idiopathic AHDS. The study included 87 dogs with idiopathic AHDS. Twenty-one healthy dogs served as control group. To evaluate clinical significance of bacterial translocation, blood culture results were compared between patients and controls. Clinical and laboratory parameters were compared between patients with positive and negative blood cultures. There was no significant difference in either incidence of bacteraemia between patients with idiopathic AHDS (11 per cent) and controls (14 per cent) or in severity of clinical signs, laboratory parameters, duration of hospitalisation or mortality between blood culture-positive and culture-negative dogs with idiopathic AHDS. The results of this study suggest that the incidence of bacteraemia in dogs with idiopathic AHDS is low and not different from that of healthy control dogs. Bacteraemia does not influence the clinical course or survival and thus antibiotic treatment is not indicated to prevent sepsis.

  1. Effect of Deviated Nasal Septum on Mean Platelet Volume: A Prospective Study.

    PubMed

    Poorey, Vijay Kumar; Thakur, Pooja

    2014-12-01

    In E.N.T clinical practice, patients with nasal obstruction due to deviated nasal septum is a common presentation. Nasal airway obstruction is a common cause of upper airway obstruction further leading to obstructive and hypoxic manifestations. Mean platelet volume (MPV) levels increase in hypoxic conditions. MPV is one of the platelet activation index which reflects the platelet production rate. Present prospective study conducted in the department of Otorhinolaryngology and Head and Neck surgery, Gandhi Medical College and Hamidia Hospital, Bhopal, on 63 patients with the clinical evidence of DNS and 63 healthy age matched subjects as control group, aimed to evaluate the relationship between MPV levels and nasal obstruction due to deviated nasal septum (DNS). The diagnosis of patients with DNS was based on anterior rhinoscopy and endoscopic nasal examination. Blood samples were collected before surgical correction. In present study, the authors found that there is preponderance of DNS in the age group of 25-45 years being the most active age group, males having the higher incidence. Majority of cases of DNS being left sided and of obstructed type. MPV were significantly higher in patients with DNS than the control group. Among the cases MPV being higher in females and in the impacted type of DNS. Present study reemphasized the concept that MPV is increased in chronic nasal obstruction due to DNS and this increase is in accordance with the severity of DNS.

  2. Acupuncture for Smoking Cessation in Hong Kong: A Prospective Multicenter Observational Study

    PubMed Central

    Wang, Ying-ying; Wu, Yuan; Zhang, Ou; Chen, Min; Huang, Ling-ling; He, Xiu-qing; Wu, Guan-yi

    2016-01-01

    This was a prospective multicenter observational study, aiming to explore the effects of acupuncture on smoking cessation in Hong Kong. From March of 2010 to August of 2015, a total of 5202 smokers were recruited based on inclusion criteria and treated with acupuncture for 8 weeks. As a result, 2940 subjects finished the study with a drop-out rate of 43.48%. The self-reported 7-day point abstinence rate was 34.00% in Week 8 and 18.40% in Week 52. The exhaled carbon monoxide level and the number of cigarettes smoked per day were reduced significantly after treatment. The time to relapse was calculated to be 38.71 days. In addition, “cigarettes smoked per day,” “Fagerstrom Test for Nicotine Dependence,” “total sessions of acupuncture,” “whether finished 8 acupuncture treatments in the first month,” and “total sessions of acupuncture” were believed to be essential factors for abstinence success. It was concluded that acupuncture was a safe method for smoking cessation and was effective in helping smokers to quit; therefore, acupuncture could be considered as one of the methods to help smokers quit. Further studies regarding the effect differences between acupuncture and medications were needed to clarify the overall benefits of acupuncture. PMID:28003848

  3. Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study

    PubMed Central

    Saperi, Bin Sulong; Ramli, Roszalina; Ahmed, Zafar; Muhd Nur, Amrizal; Ibrahim, Mohd Ismail; Rashdi, Muhd Fazlynizam; Nordin, Rifqah; Rahman, Normastura Abd; Yusoff, Azizah; Nazimi, Abd Jabar; Abdul Rahman, Roselinda; Abdul Razak, Noorhayati; Mohamed, Norlen

    2017-01-01

    Objective Facial injury (FI) may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]). The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. Materials and methods A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment. Direct cost analysis, comparison of cost and length of hospital stay, and Injury Severity Score (ISS) were performed. R