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Sample records for reykjavik prospective study

  1. Impairments in hearing and vision impact on mortality in older people: the AGES-Reykjavik Study.

    PubMed

    Fisher, Diana; Li, Chuan-Ming; Chiu, May S; Themann, Christa L; Petersen, Hannes; Jónasson, Friðbert; Jónsson, Pálmi V; Sverrisdottir, Johanna Eyrun; Garcia, Melissa; Harris, Tamara B; Launer, Lenore J; Eiriksdottir, Gudny; Gudnason, Vilmundur; Hoffman, Howard J; Cotch, Mary Frances

    2014-01-01

    to examine the relationships between impairments in hearing and vision and mortality from all-causes and cardiovascular disease (CVD) among older people. population-based cohort study. the study population included 4,926 Icelandic individuals, aged ≥67 years, 43.4% male, who completed vision and hearing examinations between 2002 and 2006 in the Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-RS) and were followed prospectively for mortality through 2009. participants were classified as having 'moderate or greater' degree of impairment for vision only (VI), hearing only (HI), and both vision and hearing (dual sensory impairment, DSI). Cox proportional hazard regression, with age as the time scale, was used to calculate hazard ratios (HR) associated with impairment and mortality due to all-causes and specifically CVD after a median follow-up of 5.3 years. the prevalence of HI, VI and DSI were 25.4, 9.2 and 7.0%, respectively. After adjusting for age, significantly (P < 0.01) increased mortality from all causes, and CVD was observed for HI and DSI, especially among men. After further adjustment for established mortality risk factors, people with HI remained at higher risk for CVD mortality [HR: 1.70 (1.27-2.27)], whereas people with DSI remained at higher risk of all-cause mortality [HR: 1.43 (1.11-1.85)] and CVD mortality [HR: 1.78 (1.18-2.69)]. Mortality rates were significantly higher in men with HI and DSI and were elevated, although not significantly, among women with HI. older men with HI or DSI had a greater risk of dying from any cause and particularly cardiovascular causes within a median 5-year follow-up. Women with hearing impairment had a non-significantly elevated risk. Vision impairment alone was not associated with increased mortality.

  2. Effect of vertebral fractures on function, quality of life and hospitalisation the AGES-Reykjavik study

    PubMed Central

    Siggeirsdottir, Kristin; Aspelund, Thor; Jonsson, Brynjolfur Y.; Mogensen, Brynjolfur; Launer, Lenore J.; Harris, Tamara B.; Sigurdsson, Gunnar; Gudnason, Vilmundur

    2012-01-01

    Background: understanding the determinants of health burden after a fracture in ageing populations is important. Objective: assess the effect of clinical vertebral and other osteoporotic fractures on function and the subsequent risk of hospitalisation. Design: individuals from the prospective population-based cohort study Age, Gene/Environment Susceptibility (AGES)-Reykjavik study were examined between 2002 and 2006 and followed up for 5.4 years. Subjects: a total of 5,764 individuals, 57.7% women, born 1907–35, mean age 77. Method: four groups with a verified fracture status were used; vertebral fractures, other osteoporotic fractures excluding vertebral, non-osteoporotic fractures and not-fractured were compared and analysed for the effect on mobility, strength, QoL, ADL, co-morbidity and hospitalisation. Results: worst performance on functional tests was in the vertebral fracture group for women (P < 0.0001) and the other osteoporotic fractures group for men (P < 0.05). Both vertebral and other osteoporotic fractures, showed an increased risk of hospitalisation, HR = 1.4 (95% CI: 1.3–1.7) and 1.2 (95% CI: 1.1–1.2) respectively (P < 0.0001). Individuals with vertebral fractures had 50% (P < 0.0001) longer hospitalisation than not-fractured and 33% (P < 0.002) longer than the other osteoporotic fractures group. Conclusion: individuals with a history of clinical vertebral fracture seem to carry the greatest health burden compared with other fracture groups, emphasising the attention which should be given to those individuals. PMID:22367357

  3. Associations of current and remitted major depressive disorder with brain atrophy: the AGES-Reykjavik Study

    PubMed Central

    Geerlings, Mirjam I.; Sigurdsson, Sigurdur; Eiriksdottir, Gudny; Garcia, Melissa E.; Harris, Tamara B.; Sigurdsson, Thordur; Gudnason, Vilmundur; Launer, Lenore J.

    2014-01-01

    Background To examine whether lifetime DSM-IV diagnosis of major depressive disorder (MDD), including age at onset and number of episodes, is associated with brain atrophy in older persons without dementia. Methods Within the population-based AGES-Reykjavik Study 4,354 persons (mean age 76±5 years, 58% women) without dementia had a 1.5Tesla brain MRI. Automated brain segmentation total and regional brain volumes were calculated. History of MDD, including age at onset and number of episodes, and MDD in the past 2 weeks was diagnosed according to DSM-IV criteria using the MINI International Neuropsychiatric Interview. Results Of the total sample, 4.5% reported a lifetime history of MDD; 1.5% had a current diagnosis of MDD (including 75% with a prior history of depression) and 3.0% had a past but no current diagnosis (remission). After adjusting for multiple covariates, compared to participants never depressed, those with current MDD (irrespective of past) had more global brain atrophy (B=−1.25%; 95%CI −2.05 to −0.44%), including more gray and white matter atrophy in most lobes as well as more atrophy of the hippocampus and thalamus. Participants with current, first onset, MDD also had more brain atrophy (B=−1.62%; 95%CI −3.30 to 0.05%), while those remitted did not (B=0.06%; 95%CI −0.54 to 0.66%). Conclusion In older persons without dementia, current MDD, irrespective of prior history, but not remitted MDD, was associated with widespread gray and white matter brain atrophy. Prospective studies should examine whether MDD is a consequence of or contributes to brain volume loss and development of dementia. PMID:22647536

  4. Cardiac and Carotid Markers Link With Accelerated Brain Atrophy: The AGES-Reykjavik Study (Age, Gene/Environment Susceptibility-Reykjavik).

    PubMed

    Sabayan, Behnam; van Buchem, Mark A; Sigurdsson, Sigurdur; Zhang, Qian; Meirelles, Osorio; Harris, Tamara B; Gudnason, Vilmundur; Arai, Andrew E; Launer, Lenore J

    2016-11-01

    Pathologies in the heart-brain axis might, independently or in combination, accelerate the process of brain parenchymal loss. We aimed to investigate the association of serum N-terminal brain natriuretic peptide (NT-proBNP), as a marker of cardiac dysfunction, and carotid intima media thickness (CIMT), as a marker of carotid atherosclerosis burden, with structural brain changes. In the longitudinal population-based AGES-Reykjavik study (Age, Gene/Environment Susceptibility-Reykjavik), we included 2430 subjects (mean age, 74.6 years; 41.4% men) with baseline data on NT-proBNP and CITM (assessed by ultrasound imaging). Participants underwent a high-resolution brain magnetic resonance imaging at baseline and 5 years later to assess total brain (TBV), gray matter, and white matter volumes. Each unit higher log-transformed NT-proBNP was associated with 3.6 mL (95% confidence interval [CI], -6.0 to -1.1) decline in TBV and 3.5 mL (95% CI, -5.7 to -1.3) decline in gray matter volume. Likewise, each millimeter higher CIMT was associated with 10.8 mL (95% CI, -17.3 to -4.2) decline in TBV and 8.6 mL (95% CI, -14.4 to -2.8) decline in gray matter volume. There was no association between NT-proBNP and CIMT and changes in white matter volume. Compared with participants with low NT-proBNP and CIMT, participants with both high NT-proBNP and CIMT had 3.8 mL (95% CI, -6.0 to -1.6) greater decline in their TBV and 4 mL (95% CI, -6.0 to -2.0) greater decline in GMW. These associations were independent of sociodemographic and cardiovascular factors. Older subjects with both cardiac dysfunction and carotid atherosclerosis are at an increased risk for brain parenchymal loss. Accumulated pathologies in the heart-brain axis might accelerate brain atrophy. © 2016 American Heart Association, Inc.

  5. Overweight and Obesity in Midlife and Brain Structure and Dementia 26 Years Later: The AGES-Reykjavik Study.

    PubMed

    Albanese, Emiliano; Davis, Benjamin; Jonsson, Palmi V; Chang, Milan; Aspelund, Thor; Garcia, Melissa; Harris, Tamara; Gudnason, Vilmundur; Launer, Lenore J

    2015-05-01

    High adiposity in midlife might increase risk for late-life brain pathology, including dementia. Using data from the prospective Age, Gene/Environment Susceptibility-Reykjavik Study of men and women (born 1907-1935), we studied the associations of overweight and obesity at midlife (mean age, 50 (standard deviation, 4.7) years) with 1.5-T brain magnetic resonance imaging measures of infarct-like brain lesions, cerebral microbleeds, total brain volume, and white matter lesions volume, as well as dementia, in late life (mean age, 76 (standard deviation, 5.2) years). We used linear and Poisson models to estimate associations in 3,864 persons after adjustment for sociodemographic, health, and lifestyle characteristics. In midlife, the prevalence of overweight was 39% and that of obesity was 8%. After a mean follow-up of 26.2 (standard deviation, 4.9) years, midlife overweight and obesity were not associated with infarct-like brain lesions (relative risk (RR) = 0.82, 95% confidence interval (CI): 0.61, 1.10), cerebral microbleeds (RR = 0.69, 95% CI: 0.37, 1.32), total brain volume (β = 0.05, 95% CI: -0.34, 0.45), white matter lesions volume (β = -0.10, 95% CI: -0.20, 0.01), or dementia (RR = 0.91, 95% CI: 0.49, 1.72) compared with normal weight. These findings do not support the hypothesis that high body mass index in midlife modulates the risk for dementia. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  6. 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

  7. Socioeconomic factors from midlife predict mobility limitation and depressed mood three decades later; Findings from the AGES-Reykjavik Study

    PubMed Central

    2013-01-01

    Background Taking into account our rapidly ageing population, older people are of particular interest in studying health inequalities. Most studies of older persons only include measures of current socioeconomic status (SES) and do not take into account data from earlier stages of life. In addition, only classic SES measures are used, while alternative measures, such as car ownership and house ownership, might equally well predict health. The present study aims to examine the effect of midlife socioeconomic factors on mobility limitation and depressed mood three decades later. Methods Data were from 4,809 men and women aged 33–65 years who participated in the Reykjavik Study (1967–1992) and who were re-examined in old age in the Age, Gene/Environment Susceptibility (AGES) -Reykjavik Study (2002–2006). Results Education and occupation predicted mobility limitation and depressed mood. Independently, home and car ownership and the availability of housing features predicted mobility limitation. Shortages of food in childhood and lack of a car in midlife predicted depressed mood. Conclusion Socioeconomic factors from midlife and from childhood affect mobility limitation and depressed mood in old age. Prevention of health problems in old age should begin as early as midlife. PMID:23379351

  8. 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

  9. 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

  10. Carotid Arterial Stiffness and Risk of Incident Cerebral Microbleeds in Older People: the AGES-Reykjavik Study

    PubMed Central

    Ding, Jie; Mitchell, Gary F; Bots, Michiel L; Sigurdsson, Sigurdur; Harris, Tamara B; Garcia, Melissa; Eiriksdottir, Gudny; van Buchem, Mark A; Gudnason, Vilmundur; Launer, Lenore J

    2015-01-01

    Objective Age and high blood pressure are major risk factors for cerebral microbleeds (CMBs). However, the underlying mechanisms remain unclear and arterial stiffness may be important. We investigated whether carotid arterial stiffness is associated with incidence and location of CMBs. Approach and Results In the prospective, population-based AGES-Reykjavik study, 2,512 participants aged 66–93 years underwent a baseline brain MRI examination and carotid ultrasound in 2002–2006, and returned for a repeat brain MRI in 2007–2011. Common carotid arterial stiffness was assessed using a standardized protocol and expressed as carotid arterial strain (CAS), distensibility coefficient (DC) and Young’s elastic modulus (YEM). Modified poisson regression was applied to relate carotid arterial stiffness parameters to CMBs incidence. During a mean follow-up of 5.2 years, 463 people (18.4%) developed new CMBs, of whom 292 had CMBs restricted to lobar regions and 171 had CMBs in a deep or infratentorial region. After adjusting for age, sex and follow-up interval, arterial stiffness measures were associated with incident CMBs (Risk ratio [RR] per SD decrease in CAS, 1.11 [95%CI, 1.01–1.21]; per SD decrease in natural log-transformed DC, 1.14[1.05–1.24]; per SD increase in natural log-transformed YEM, 1.13[1.04–1.23]). These measures were also significantly associated with incident deep CMBs (1.18[1.02–1.37]; 1.24[1.08–1.42]; 1.23[1.07–1.42]) but not with lobar CMBs. When further adjusted for blood pressure and other baseline vascular risk factors, carotid plaque, prevalent CMBs, subcortical infarcts and white matter hyperintensities, the associations persisted. Conclusions Our findings support the hypothesis that localized increases in carotid arterial stiffness may contribute to the development of CMBs, especially in a deep location atttributable to hypertension. PMID:26112009

  11. Sex-specific predictors of hearing-aid use in older persons: The age, gene/environment susceptibility - Reykjavik study

    PubMed Central

    Fisher, Diana E.; Li, Chuan-Ming; Hoffman, Howard J.; Chiu, May S.; Themann, Christa L.; Petersen, Hannes; Jonsson, Palmi V.; Jonsson, Helgi; Jonasson, Fridbert; Sverrisdottir, Johanna Eyrun; Launer, Lenore J.; Eiriksdottir, Gudny; Gudnason, Vilmundur; Cotch, Mary Frances

    2015-01-01

    Objective We estimate the prevalence of hearing-aid use in Iceland and identify sex-specific factors associated with use. Design Population-based cohort study. Study sample A total of 5172 age, gene/environment susceptibility - Reykjavik study (AGES-RS) participants, aged 67 to 96 years (mean age 76.5 years), who completed air-conduction and pure-tone audiometry. Results Hearing-aid use was reported by 23.0% of men and 15.9% of women in the cohort, although among participants with at least moderate hearing loss in the better ear (pure-tone average [PTA] of thresholds at 0.5, 1, 2, and 4 kHz ≥ 35 dB hearing level [HL]) it was 49.9% and did not differ by sex. Self-reported hearing loss was the strongest predictor of hearing-aid use in men [OR: 2.68 (95% CI: 1.77, 4.08)] and women [OR: 3.07 (95% CI: 1.94, 4.86)], followed by hearing loss severity based on audiometry. Having diabetes or osteoarthritis were significant positive predictors of use in men, whereas greater physical activity and unimpaired cognitive status were important in women. Conclusions Hearing-aid use was comparable in Icelandic men and women with moderate or greater hearing loss. Self-recognition of hearing loss was the factor most predictive of hearing-aid use; other influential factors differed for men and women. PMID:25816699

  12. Sex-specific predictors of hearing-aid use in older persons: The age, gene/environment susceptibility - Reykjavik study.

    PubMed

    Fisher, Diana E; Li, Chuan-Ming; Hoffman, Howard J; Chiu, May S; Themann, Christa L; Petersen, Hannes; Jonsson, Palmi V; Jonsson, Helgi; Jonasson, Fridbert; Sverrisdottir, Johanna Eyrun; Launer, Lenore J; Eiriksdottir, Gudny; Gudnason, Vilmundur; Cotch, Mary Frances

    2015-01-01

    We estimate the prevalence of hearing-aid use in Iceland and identify sex-specific factors associated with use. Population-based cohort study. A total of 5172 age, gene/environment susceptibility - Reykjavik study (AGES-RS) participants, aged 67 to 96 years (mean age 76.5 years), who completed air-conduction and pure-tone audiometry. Hearing-aid use was reported by 23.0% of men and 15.9% of women in the cohort, although among participants with at least moderate hearing loss in the better ear (pure-tone average [PTA] of thresholds at 0.5, 1, 2, and 4 kHz ≥ 35 dB hearing level [HL]) it was 49.9% and did not differ by sex. Self-reported hearing loss was the strongest predictor of hearing-aid use in men [OR: 2.68 (95% CI: 1.77, 4.08)] and women [OR: 3.07 (95% CI: 1.94, 4.86)], followed by hearing loss severity based on audiometry. Having diabetes or osteoarthritis were significant positive predictors of use in men, whereas greater physical activity and unimpaired cognitive status were important in women. Hearing-aid use was comparable in Icelandic men and women with moderate or greater hearing loss. Self-recognition of hearing loss was the factor most predictive of hearing-aid use; other influential factors differed for men and women.

  13. Incidence of Brain Infarcts, Cognitive Change, and Risk of Dementia in the General Population: The AGES-Reykjavik Study (Age Gene/Environment Susceptibility-Reykjavik Study).

    PubMed

    Sigurdsson, Sigurdur; Aspelund, Thor; Kjartansson, Olafur; Gudmundsson, Elias F; Jonsdottir, Maria K; Eiriksdottir, Gudny; Jonsson, Palmi V; van Buchem, Mark A; Gudnason, Vilmundur; Launer, Lenore J

    2017-09-01

    The differentiation of brain infarcts by region is important because their cause and clinical implications may differ. Information on the incidence of these lesions and association with cognition and dementia from longitudinal population studies is scarce. We investigated the incidence of infarcts in cortical, subcortical, cerebellar, and overall brain regions and how prevalent and incident infarcts associate with cognitive change and incident dementia. Participants (n=2612, 41% men, mean age 74.6±4.8) underwent brain magnetic resonance imaging for the assessment of infarcts and cognitive testing at baseline and on average 5.2 years later. Incident dementia was assessed according to the international guidelines. Twenty-one percent of the study participants developed new infarcts. The risk of incident infarcts in men was higher than the risk in women (1.8; 95% confidence interval, 1.5-2.3). Persons with both incident and prevalent infarcts showed steeper cognitive decline and had almost double relative risk of incident dementia (1.7; 95% confidence interval, 1.3-2.2) compared with those without infarcts. Persons with new subcortical infarcts had the highest risk of incident dementia compared with those without infarcts (2.6; 95% confidence interval, 1.9-3.4). Men are at greater risk of developing incident brain infarcts than women. Persons with incident brain infarcts decline faster in cognition and have an increased risk of dementia compared with those free of infarcts. Incident subcortical infarcts contribute more than cortical and cerebellar infarcts to incident dementia which may indicate that infarcts of small vessel disease origin contribute more to the development of dementia than infarcts of embolic origin in larger vessels. © 2017 American Heart Association, Inc.

  14. Carotid arterial stiffness and risk of incident cerebral microbleeds in older people: the Age, Gene/Environment Susceptibility (AGES)-Reykjavik study.

    PubMed

    Ding, Jie; Mitchell, Gary F; Bots, Michiel L; Sigurdsson, Sigurdur; Harris, Tamara B; Garcia, Melissa; Eiriksdottir, Gudny; van Buchem, Mark A; Gudnason, Vilmundur; Launer, Lenore J

    2015-08-01

    Age and high blood pressure are major risk factors for cerebral microbleeds (CMBs). However, the underlying mechanisms remain unclear and arterial stiffness may be important. We investigated whether carotid arterial stiffness is associated with incidence and location of CMBs. In the prospective, population-based Age, Gene/Environment Susceptibility (AGES)-Reykjavik study, 2512 participants aged 66 to 93 years underwent a baseline brain MRI examination and carotid ultrasound in 2002 to 2006 and returned for a repeat brain MRI in 2007 to 2011. Common carotid arterial stiffness was assessed using a standardized protocol and expressed as carotid arterial strain, distensibility coefficient, and Young elastic modulus. Modified Poisson regression was applied to relate carotid arterial stiffness parameters to CMB incidence. During a mean follow-up of 5.2 years, 463 people (18.4%) developed new CMBs, of whom 292 had CMBs restricted to lobar regions and 171 had CMBs in a deep or infratentorial region. After adjusting for age, sex, and follow-up interval, arterial stiffness measures were associated with incident CMBs (risk ratio per SD decrease in carotid arterial strain, 1.11 [95% confidence interval, 1.01-1.21]; per SD decrease in natural log-transformed distensibility coefficient, 1.14 [1.05-1.24]; and per SD increase in natural log-transformed Young elastic modulus, 1.13 [1.04-1.23]). These measures were also significantly associated with incident deep CMBs (1.18 [1.02-1.37]; 1.24 [1.08-1.42]; and 1.23 [1.07-1.42]) but not with lobar CMBs. When further adjusted for blood pressure and other baseline vascular risk factors, carotid plaque, prevalent CMBs, subcortical infarcts, and white matter hyperintensities, the associations persisted. Our findings support the hypothesis that localized increases in carotid arterial stiffness may contribute to the development of CMBs, especially in a deep location attributable to hypertension. © 2015 American Heart Association, Inc.

  15. Associations of fat and muscle tissue with cognitive status in older adults: the AGES-Reykjavik Study.

    PubMed

    Spauwen, Peggy J J; Murphy, Rachel A; Jónsson, Pálmi V; Sigurdsson, Sigurdur; Garcia, Melissa E; Eiriksdottir, Gudny; van Boxtel, Martin P J; Lopez, Oscar L; Gudnason, Vilmundur; Harris, Tamara B; Launer, Lenore J

    2017-03-01

    studies on the association of dementia with specific body composition (BC) components are scarce. Our aim was to investigate associations of BC measures with different levels of cognitive function in late-life. we studied 5,169 participants (mean age 76 years, 42.9% men) in the AGES-Reykjavik Study of whom 485 (9.4%) were diagnosed with mild cognitive impairment (MCI) and 307 (5.9%) with dementia. Visceral fat, abdominal and thigh subcutaneous fat, and thigh muscle were assessed by computed tomography. MCI and dementia were based on clinical assessment and a consensus meeting; those without MCI or dementia were categorised as normal. Multinomial regression models assessed the associations stratified by sex and in additional analyses by midlife body mass index (BMI). among women, there was a decreased likelihood of dementia per SD increase in abdominal subcutaneous fat (OR 0.72; 95% CI: 0.59-0.88), thigh subcutaneous fat (0.81; 0.67-0.98) and thigh muscle (0.63; 0.52-0.76), but not visceral fat, adjusting for demographics, vascular risk factors, stroke and depression. Inverse associations of fat with dementia were attenuated by weight change from midlife and were strongest in women with midlife BMI <25. In men, one SD increase in thigh muscle was associated with a decreased likelihood of dementia (0.75; 0.61-0.92). BC was not associated with MCI in men or women. a higher amount of abdominal and thigh subcutaneous fat were associated with a lower likelihood of dementia in women only, while more thigh muscle was associated with a lower likelihood of dementia in men and women.

  16. 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.

  17. Muscle Quality and Myosteatosis: Novel Associations With Mortality Risk: The Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study.

    PubMed

    Reinders, Ilse; Murphy, Rachel A; Brouwer, Ingeborg A; Visser, Marjolein; Launer, Lenore; Siggeirsdottir, Kristin; Eiriksdottir, Gudny; Gudnason, Vilmundur; Jonsson, Palmi V; Lang, Thomas F; Harris, Tamara B

    2016-01-01

    Muscle composition may affect mortality risk, but prior studies have been limited to specific samples or less precise determination of muscle composition. We evaluated associations of thigh muscle composition, determined using computed tomography imaging, and knee extension strength with mortality risk among 4,824 participants aged 76.4 (standard deviation (SD), 5.5) years from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study (2002-2006). Cox proportional hazards models were used to estimate hazard ratios. After 8.8 years of follow-up, there were 1,942 deaths. For men, each SD-increment increase in muscle lean area, muscle quality, and strength was associated with lower mortality risk, with decreases ranging between 11% and 22%. Each SD-increment increase in intermuscular adipose tissue and intramuscular adipose tissue was associated with higher mortality risk (hazard ratio (HR) = 1.13 (95% confidence interval (CI): 1.06, 1.22) and HR = 1.23 (95% CI: 1.15, 1.30), respectively). For women, each SD-increment increase in muscle lean area, muscle quality, and strength was associated with lower mortality risk, with decreases ranging between 12% and 19%. Greater intramuscular adipose tissue was associated with an 8% higher mortality risk (HR = 1.08, 95% CI: 1.01, 1.16). This study shows that muscle composition is associated with mortality risk. These results also show the importance of improving muscle strength and area and lowering muscle adipose tissue infiltration. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  18. 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

  19. 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

  20. Pulse pressure relation to aortic and left ventricular structure in the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study.

    PubMed

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

    2014-10-01

    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 relationships of pulse pressure with lumen area and wall stiffness and thickness in the thoracic aorta and left ventricular structure in 526 participants (72-94 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 relationship with aortic lumen area (all effects expressed as mm Hg/SD; B=-8.1±1.2; P<0.001) and positive relationships 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. Relationships 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. © 2014 American Heart Association, Inc.

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

    PubMed

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

    2015-04-08

    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). 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/m(3) was selected by the Akaike Information Criterion (AIC). The population of the greater Reykjavik area (n=181,558) during 2003-2009. 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. Percentage increases in risk of death (IR%) following an interquartile range increase in pollutants. 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/m(3)) 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. 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 should be interpreted with caution. Further studies are warranted to

  2. 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

  3. Proximal Femur Volumetric Bone Mineral Density and Mortality: 13 Years of Follow-Up of the AGES-Reykjavik Study.

    PubMed

    Marques, Elisa A; Elbejjani, Martine; Gudnason, Vilmundur; Sigurdsson, Gunnar; Lang, Thomas; Sigurdsson, Sigurdur; Aspelund, Thor; Meirelles, Osorio; Siggeirsdottir, Kristin; Launer, Lenore; Eiriksdottir, Gudny; Harris, Tamara B

    2017-06-01

    Bone mineral density (BMD) has been linked to mortality, but little is known about the independent contribution of each endosteal bone compartment and also the rate of bone loss to risk of mortality. We examined the relationships between (1) baseline trabecular and cortical volumetric BMD (vBMD) at the proximal femur, and (2) the rate of trabecular and cortical bone loss and all-cause mortality in older adults from the AGES-Reykjavik study. The analysis of trabecular and cortical vBMD and mortality was based on the baseline cohort of 4654 participants (aged ≥66 years) with a median follow-up of 9.4 years; the association between rate of bone loss and mortality was based on 2653 participants with bone loss data (median follow-up of 5.6 years). Analyses employed multivariable Cox-proportional models to estimate hazard ratios (HRs) with time-varying fracture status; trabecular and cortical variables were included together in all models. Adjusted for important confounders, Cox models showed that participants in the lowest quartile of trabecular vBMD had an increased risk of mortality compared to participants in other quartiles (HR = 1.12; 95% confidence interval (CI), 1.01 to 1.25); baseline cortical vBMD was not related to mortality (HR = 1.08; 95% CI, 0.97 to 1.20). After adjustment for time-dependent fracture status, results were attenuated and not statistically significant. A faster loss (quartile 1 versus quartiles 2-4) in both trabecular and cortical bone was associated with higher mortality risk (HR = 1.37 and 1.33, respectively); these associations were independent of major potential confounders including time-dependent incident fractures (HR = 1.32 and 1.34, respectively). Overall, data suggest that faster bone losses over time in both the trabecular and cortical bone compartments are associated with mortality risk and that measurements of change in bone health may be more informative than single-point measurements in explaining mortality

  4. Large Perivascular Spaces Visible on Magnetic Resonance Imaging, Cerebral Small Vessel Disease Progression, and Risk of Dementia: The Age, Gene/Environment Susceptibility-Reykjavik Study.

    PubMed

    Ding, Jie; Sigurðsson, Sigurður; Jónsson, Pálmi V; Eiriksdottir, Gudny; Charidimou, Andreas; Lopez, Oscar L; van Buchem, Mark A; Guðnason, Vilmundur; Launer, Lenore J

    2017-09-01

    With advancing age, an increased visibility of perivascular spaces (PVSs) on magnetic resonance imaging (MRI) is hypothesized to represent impaired drainage of interstitial fluid from the brain and may reflect underlying cerebral small vessel disease (SVD). However, whether large perivascular spaces (L-PVSs) (>3 mm in diameter) visible on MRI are associated with SVD and cognitive deterioration in older individuals is unknown. To examine whether L-PVSs are associated with the progression of the established MRI markers of SVD, cognitive decline, and increased risk of dementia. The prospective, population-based Age, Gene/Environment Susceptibility-Reykjavik Study assessed L-PVSs at baseline (September 1, 2002, through February 28, 2006) on MRI studies of the brain in 2612 participants. Participants returned for additional MRI from April 1, 2007, through September 30, 2011, and underwent neuropsychological testing at the 2 time points a mean (SD) of 5.2 (0.2) years apart. Data analysis was conducted from August 1, 2016, to May 4, 2017. The presence, number, and location of L-PVSs. Incident subcortical infarcts, cerebral microbleeds, and progression of white matter hyperintensities detected on MRI; cognitive decline defined as composite score changes between baseline and follow-up in the domains of memory, information processing speed, and executive function; and adjudicated incident dementia cases diagnosed according to international guidelines. Of the 2612 study patients (mean [SD] age, 74.6 [4.8] years; 1542 [59.0%] female), 424 had L-PVSs and 2188 did not. The prevalence of L-PVSs was 16.2% (median number of L-PVSs, 1; range, 1-17). After adjusting for age, sex, and interval between baseline and follow-up scanning, the presence of L-PVSs was significantly associated with an increased risk of incident subcortical infarcts (adjusted risk ratio, 2.54; 95% CI, 1.76-3.68) and microbleeds (adjusted risk ratio, 1.43; 95% CI, 1.18-1.72) and a greater 5-year progression of

  5. 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.

  6. 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

  7. A blunted diurnal cortisol response in the lower educated does not explain educational differences in coronary heart disease: findings from the AGES-Reykjavik study.

    PubMed

    Groffen, Daniëlle A I; Bosma, Hans; Koster, Annemarie; von Bonsdorff, Mikaela B; Aspelund, Thor; Eiriksdottir, Gudny; Penninx, Brenda W J H; Kempen, Gertrudis I J M; Kirschbaum, Clemens; Gudnason, Vilmundur; Harris, Tamara B

    2015-02-01

    Lower educational attainment generally is a strong predictor of coronary heart disease (CHD). The underlying mechanisms of this effect are, however, less clear. One hypothesis is that stress related to limitations imposed by lower socioeconomic status elicits changes in hypothalamic-pituitary-adrenal axis functioning, which, in turn, increases risk of CHD. In a large cohort study, we examined whether educational attainment was related to risk of fatal and non-fatal CHD and the extent to which salivary cortisol mediated this relation independent of potential confounders, including lifestyles. Data came from 3723 participants aged 66 through 96 from the Age, Gene/Environment Susceptibility (AGES) - Reykjavik Study. Between 2002 and 2006, data were collected using questionnaires and examinations including morning and evening salivary samples. Hospital admission records and cause of death registries (ICD-9 and ICD-10 codes) were available until December 2009. Linear regression and Cox proportional hazards analyses were performed. Even after adjustment for potential confounders, including lifestyle, persons with lower educational attainment showed a blunted cortisol response and also greater risk of incident CHD. However, our data did not support the role of cortisol as a mediator in the association between education and CHD in an older sample (192). Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Association of change in brain structure to objectively measured physical activity and sedentary behavior in older adults: Age, Gene/Environment Susceptibility-Reykjavik Study.

    PubMed

    Arnardottir, Nanna Yr; Koster, Annemarie; Domelen, Dane R Van; Brychta, Robert J; Caserotti, Paolo; Eiriksdottir, Gudny; Sverrisdottir, Johanna E; Sigurdsson, Sigurdur; Johannsson, Erlingur; Chen, Kong Y; Gudnason, Vilmundur; Harris, Tamara B; Launer, Lenore J; Sveinsson, Thorarinn

    2016-01-01

    Many studies have examined the hypothesis that greater participation in physical activity (PA) is associated with less brain atrophy. Here we examine, in a sub-sample (n=352, mean age 79.1 years) of the Age, Gene/Environment Susceptibility-Reykjavik Study cohort, the association of the baseline and 5-year change in magnetic resonance imaging (MRI)-derived volumes of gray matter (GM) and white matter (WM) to active and sedentary behavior (SB) measured at the end of the 5-year period by a hip-worn accelerometer for seven consecutive days. More GM (β=0.11; p=0.044) and WM (β=0.11; p=0.030) at baseline was associated with more total physical activity (TPA). Also, when adjusting for baseline values, the 5-year change in GM (β=0.14; p=0.0037) and WM (β=0.11; p=0.030) was associated with TPA. The 5-year change in WM was associated with SB (β=-0.11; p=0.0007). These data suggest that objectively measured PA and SB late in life are associated with current and prior cross-sectional measures of brain atrophy, and that change over time is associated with PA and SB in expected directions. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. 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

  10. Muscle Quality and Muscle Fat Infiltration in Relation to Incident Mobility Disability and Gait Speed Decline: the Age, Gene/Environment Susceptibility-Reykjavik Study.

    PubMed

    Reinders, Ilse; Murphy, Rachel A; Koster, Annemarie; Brouwer, Ingeborg A; Visser, Marjolein; Garcia, Melissa E; Launer, Lenore J; Siggeirsdottir, Kristin; Eiriksdottir, Gudny; Jonsson, Palmi V; Gudnason, Vilmundur; Harris, Tamara B

    2015-08-01

    Aging is associated with increased risk of reduced mobility. However, data on muscle components in relation to subjective and objective indicators of disability is limited. Data were from 2,725 participants (43% men) aged 74.8±4.7 years from the AGES-Reykjavik Study. At baseline, maximal isometric thigh strength (dynamometer chair), and midthigh muscle area and muscle fat infiltration were assessed with computed tomography. Usual 6 m gait speed and mobility disability were assessed at baseline and after 5.2±0.3 years. Incident mobility disability was defined as having much difficulty or unable to walk 500 m or climb-up 10 steps. A decrease of ≥0.1 m/s in gait speed was considered clinically relevant. Greater strength and area were protective for mobility disability risk and gait speed decline. After adjustment for other muscle components, greater strength was independently associated with lower mobility disability risk in women odds ratios (OR) 0.78 (95% CI 0.62, 0.99), and lower decline in gait speed risk among both men OR 0.64 (0.54, 0.76), and women OR 0.72 (0.62, 0.82). Larger muscle area was independently associated with lower mobility disability risk in women OR 0.67 (0.52, 0.87) and lower decline in gait speed risk in men OR 0.74 (0.61, 0.91). Greater muscle strength and area were independently associated with 15-30% decreased risk of mobility disability in women and gait speed decline in men. Among women, greater muscle strength was also associated with lower risk of gait speed decline. Interventions aimed at maintaining muscle strength and area in old age might delay functional decline. Published by Oxford University Press on behalf of the Gerontological Society of America 2015.

  11. Risk Factors Associated With Incident Cerebral Microbleeds According to Location in Older People: The Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study.

    PubMed

    Ding, Jie; Sigurdsson, Sigurdur; Garcia, Melissa; Phillips, Caroline L; Eiriksdottir, Gudny; Gudnason, Vilmundur; van Buchem, Mark A; Launer, Lenore J

    2015-06-01

    The spatial distribution of cerebral microbleeds (CMBs), which are asymptomatic precursors of intracerebral hemorrhage, reflects specific underlying microvascular abnormalities of cerebral amyloid angiopathy (lobar structures) and hypertensive vasculopathy (deep brain structures). Relatively little is known about the occurrence of and modifiable risk factors for developing CMBs, especially in a lobar location, in the general population of older people. To investigate whether lifestyle and lipid factors predict new CMBs in relation to their anatomic location. We enrolled 2635 individuals aged 66 to 93 years from the population-based Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study in a brain imaging study. Participants underwent a baseline magnetic resonance imaging (MRI) examination of the brain from September 1, 2002, through February 28, 2006, and returned for a second MRI examination from April 1, 2007, through September 30, 2011. Lifestyle and lipid factors assessed at baseline included smoking, alcohol consumption, body mass index, and serum levels of total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides. Incident CMBs detected on MRIs, which were further categorized as exclusively lobar or as deep. During a mean follow-up of 5.2 years, 486 people (18.4%) developed new CMBs, of whom 308 had lobar CMBs only and 178 had deep CMBs. In the multivariate logarithm-binomial regression model adjusted for baseline cardiovascular risk factors, including blood pressure, antihypertensive use, prevalent CMBs, and markers of cerebral ischemic small-vessel disease, heavy alcohol consumption (vs light to moderate consumption; relative risk [RR], 2.94 [95% CI, 1.23-7.01]) was associated with incident CMBs in a deep location. Baseline underweight (vs normal weight; RR, 2.41 [95% CI, 1.21-4.80]), current smoking (RR, 1.47 [95% CI, 1.11-1.94]), an elevated serum level of high-density lipoprotein cholesterol (RR per 1-SD increase, 1.13 [95

  12. Risk Factors Associated With Incident Cerebral Microbleeds According to Location in Older People: The Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study

    PubMed Central

    Ding, Jie; Sigurdsson, Sigurdur; Garcia, Melissa; Phillips, Caroline L; Eiriksdottir, Gudny; Gudnason, Vilmundur; van Buchem, Mark A; Launer, Lenore J

    2015-01-01

    Importance The spatial distribution of cerebral microbleeds (CMBs), which are asymptomatic precursors of intracerebral hemorrhage, reflects specific underlying microvascular pathologies of cerebral amyloid angiopathy (lobar) and hypertensive vasculopathy (deep brain structures). Relatively little is known about occurrence of and modifiable risk factors for developing CMBs, especially in a lobar location, in the general population of older people. Objective To investigate whether lifestyle and lipid factors predict new CMBs in relation to their location. Design, setting, participants Population-based sample of the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study of 2,635 individuals aged 66–93 years. Participants underwent a baseline brain MRI examination in 2002–2006, and returned for a repeat brain MRI in 2007–2011. Exposures Lifestyle and lipids factors assessed at baseline, i.e. smoking, alcohol drinking, body mass index, serum levels of total cholesterol, high-density lipoprotein, low-density lipoprotein and triglycerides. Main outcomes and measures Brain MRI-detected incident CMBs, which were further categorized into one of two locations: strictly lobar or deep. Results During a mean follow-up of 5.2 years, 486 people (18.4%) developed new CMBs, of whom 308 had strictly lobar and 178 had deep CMBs. In the multivariate log-binomial regression model adjusting for baseline cardiovascular risk factors including blood pressure and antihypertensive use, prevalent CMBs and markers of cerebral ischemic small vessel disease, heavy alcohol consumption (versus light to moderate, relative risk [RR] 2.94; 95%CI, 1.23 to 7.01) predicted incident CMBs in a deep location. Baseline being underweight (versus normal weight, 2.41; 1.21 to 4.80), current smoking (1.47; 1.11 to 1.94), higher serum high-density lipoprotein cholesterol (per SD increase 1.13; 1.02 to 1.25) and lower triglycerides (per SD decrease in natural log-transformed triglycerides 1.17; 1.03 to

  13. Effect of multi-sensory balance training for unsteady elderly people: pilot study of the "Reykjavik model".

    PubMed

    Kristinsdottir, Ella Kolbrun; Baldursdottir, Bergthora

    2014-01-01

    To evaluate effects of combined mechano- and proprioceptive, vestibular and fall-prevention training on postural control, functional ability, confidence in activities of daily living (ADL) and frequency of falls among unsteady elderly people. Subjects were 37 elderly outpatients attending physiotherapy because of instability. Treatment consisted of 18 multisensory balance training sessions. RESULTS from Sensory Organization Test, Five-Times-Sit-to-Stand Test, 30-m normal and fast walk with a turn, Ascending-Descending 11 steps and Activities-specific Balance Confidence Scale were compared before and after training. Information was gathered about number of falls 1 year prior to training, during training period and for 6 months after completion of training. Significant improvement was observed in all measured parameters (p < 0.001). The subjects aged between 70 and 92 years (mean age 80.8 years), had considerable medical history. Thirty four of them reported 159 falls in the year prior to the study. Six subjects reported seven falls during the training period and seven subjects reported 17 falls in the 6 months follow-up period. Combined vestibular, proprioceptive and fall-prevention training improve postural control, functional ability, confidence in ADL and might even decrease the risk of falling among elderly people.

  14. 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.

  15. History and future of hemorheology: From Reykjavik to Lisboa.

    PubMed

    Stoltz, J F

    2016-01-01

    The word "Biorheology" was introduced in 1948 during the first international congress on Rheology but "hemorheology" was first employed in 1951 during a meeting of the American Institute of Physics. Basically this science is related to physics and mechanics. The first international conference devoted to hemorheology was organized by AL Copley in Reykjavik (Iceland) in July 1969 and an International Society on Hemorheology was created. But after Reykjavik this society was named "International Society of Biorheology". The term "Clinical Hemorheology" was proposed in Nancy in 1979 which was named "First European Symposium on Clinical Hemorheology" and an European Coordinating Committee on Clinical Hemorheology (ECCCH) was created. The European Society on Clinical Hemorheology and Microcirculation was in fact created in Frankfurt in 1990 initiated by Albrecht Ehrly. In Nancy it was also decided to create a European Award named "Fahraeus Medal". After Nancy, the ECCCH and the European Society organized symposia in London, Baden Baden, Sienna, Frankfurt, Bordeaux,  ...  , Sofia  ...   and now Lisboa. Now it is necessary to give new directions for the development of Hemorheology and Clinical Hemorheology. Different ways can be considered:-Development of new theoretical models which take into account the heterogeneity of blood and blood vessel-Research on cell mechanobiology and mechanotransduction (leucocyte, endothelial and smooth muscle cells)-Study of cellular interactions (aggregation, adhesion,  ...) and intracellular transport-Membrane rheology and concept of molecular fluidity-Dynamic blood coagulation in relation with molecular reactions-Development of metrology for clinical hemorheology.

  16. 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

  17. The presence of total knee or hip replacements due to OA enhances the positive association between hand OA and atherosclerosis in females: 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 This study examines the relationship between total knee replacements (TKR),total hip replacements (THR) or replacements of either joint (TJR) due to osteoarthritis (OA) and atherosclerosis in a large population-based study. Methods The participants were 2195 males and 2975 females, mean age 76±6 years. The OA data were analysed in relation to measures of atherosclerosis, including carotid artery intima media thickness and plaque severity (ultrasound), coronary and aortic calcifications (CT), cerebral white matter lesions (MRI) and history of previous cardiac and cerebral events. Results The prevalence of TKR was 223(4.3%) and THR 316(6.1%). The presence of TJR’s in females was associated with a nonsignificant trend towards increased carotid plaque severity, coronary calcifications and periventricular white matter hyperintensities (PVHs) but not with history of cardiac or cerebral events. No associations were seen in males. When TJR’s were grouped according to the presence or absence of HOA there was a highly significant association in the order –TJR/−HOA < +TJR/−HOA < −TJR/+HOA < +TJR/+HOA, for carotid plaque severity, coronary calcifications and PVHs. Conclusion The presence of TJR’s did not show a significant independent association with atherosclerosis but enhanced the strength of the positive association between HOA and subclinical atherosclerosis in females. PMID:21367759

  18. 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.

  19. 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…

  20. 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…

  1. Assessment of flood hazard in a combined sewer system in Reykjavik city centre.

    PubMed

    Hlodversdottir, Asta Osk; Bjornsson, Brynjolfur; Andradottir, Hrund Olof; Eliasson, Jonas; Crochet, Philippe

    2015-01-01

    Short-duration precipitation bursts can cause substantial property damage and pose operational risks for wastewater managers. The objective of this study was to assess the present and possible future flood hazard in the combined sewer system in Reykjavik city centre. The catchment is characterised by two hills separated by a plain. A large portion of the pipes in the aging network are smaller than the current minimum diameter of 250 mm. Runoff and sewer flows were modelled using the MIKE URBAN software package incorporating both historical precipitation and synthetic storms derived from annual maximum rainfall data. Results suggest that 3% of public network manholes were vulnerable to flooding during an 11-year long rainfall sequence. A Chicago Design Storm (CDS) incorporating a 10-minute rainfall burst with a 5-year return period predicted twice as many flooded manholes at similar locations. A 20% increase in CDS intensity increased the number of flooded manholes and surface flood volume by 70% and 80%, respectively. The flood volume tripled if rainfall increase were combined with urban re-development, leading to a 20% increase in the runoff coefficient. Results highlight the need for reducing network vulnerabilities, which include decreased pipe diameters and low or drastically varying pipe grades.

  2. 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…

  3. [Prospective study in 2 hospitals].

    PubMed

    Jiménez-Buñuales, M T; Martínez-Sáenz, M S; González-Diego, P; Vallejo-García, M; Gallardo-Anciano, J; Cestafe-Martínez, A

    2016-06-01

    The purpose of this study is to know the incidence rate of medication reconciliation at admission and discharge in patients of La Rioja and to improve the patient safety on medication reconciliation. An observational prospective study, part of the Joint Action PaSQ, Work Package 5, European Union Network for Patient Safety and Quality of Care. The study has taken into account the definitions of the Institute for Safe Medication Practices. Any unintended discrepancy in medication between chronic treatment and the treatment prescribed in the hospital was considered as a reconciliation error. A total of 750 patients were included, 9 (1.2%) of whom showed at least one discrepancy. The patients had a total of 3,156 mediations registered: 2,313 prescriptions (73.4%) showed no differences, while 821 prescriptions (26%) were intended discrepancies and 21 prescriptions (0.6%) unintended discrepancies were considered by the physician as reconciliation errors. A percentage of 1.2 of the patients, which represents 0.6% of the medicines (one in 166 medications registered) had reconciliation errors during their hospital stay. A proceeding has been implemented by means of the physician doing the medication reconciliation and reviewing it with the help of a medication reconciliation form. The medication reconciliation is a priority strategic objective to improve the safety of patients. Copyright © 2016 SECA. Published by Elsevier Espana. All rights reserved.

  4. 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…

  5. 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…

  6. [Incidence of Bicycle injuries presenting to the Emergency Department in Reykjavik 2005-2010].

    PubMed

    Jonsson, Armann; Larusson, Saevar H; Mogensen, Arni; Bjornsson, Hjalti Mar; Mogensen, Brynjolfur A

    2016-02-01

    Bicycling has become increasingly popular in Iceland. Official registration of bicycle accidents is based on police reports. As minor accidents are often not reported to the police, these accidents may be underreported in police records. The aim of this study was to examine the epidemiology of bicycle related accidents in patients seeking medical assistance at the Emergency Department (ED) at Landspitali-University Hospital, Reykjavik (LUH), Iceland. This retrospective cohort study was conducted at the ED at LUH, Iceland from January 2005 to December 2010. All medical files were reviewed and sex, age, year and month of accident/injury, helmet wearing, ICD-10 diagnosis, severity of injury according to the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) recorded. The rate of hospital admission was examined with length of stay, Intensive Care Unit admission, use of medical imaging and operative treatment. A total of 3472 patients presented to the ED with bicycle related accidents , 68.3% men and 31.7% female. The average age of patients was 22,6 years (1-95 years). Most are injured during recreational activities (72.4%) and in residence areas (45,7%). Most injuries occurred during May-September (71.4%). Data on counterparty was missing in 74.9% of cases. The cause of accident was in 44.0% a low fall or jump. The upper extremity was injured in 47.1% cases. A majority of the patients (65.6%) had a mild injury (ISS≤3points) and 29.3% had a moderate injury (4-8 points). No fatalities were found during the study period. Use of helmets was only recorded in 14.2% of cases. In total 124 patients were admitted during the period where the mean time of admission was 5 days. The incidence of bicycle injuries increased during the study period but appears to have increased less than the number of bicyclists. Injuries are more frequent among males and the majority are of a young age. The accidents usually occur during the spring and summer. Most injuries are

  7. [Psychogenic paralysis. A prospective study].

    PubMed

    Binzer, M N; Kullgren, G

    2000-10-16

    Patients with motor conversion disorder are frequently seen in neurological departments. Long term prognosis is usually considered to be good, although earlier research has been somewhat unsystematic and mostly retrospective. This study follows a well investigated sample of patients for two to five years and attempts to identify predictors associated with prognosis. Thirty patients with a recent onset of motor conversion disorder were assessed for key psychiatric and demographic variables. They were reassessed two to five years later. Nineteen patients had recovered completely and eight patients had improved, while only three patients were unchanged or worse. Contrary to other follow-up studies none of the patients received a rediagnosis of neurological disease. The presence of a personality disorder, concomitant somatic disease, and low DSM-IV axis V score proved to be associated with poor outcome. The results of this study stresses the need for careful and well-conducted neurological and psychiatric assessments in patients with psychogenic paralyses, bearing in mind the substantial possibility for coinciding illnesses. If this is ensured, it appears that the risk of subsequent neurological rediagnosis is negligible.

  8. Renal Function and Risk of Coronary Heart Disease in General Populations: New Prospective Study and Systematic Review

    PubMed Central

    Di Angelantonio, Emanuele; Danesh, John; Eiriksdottir, Gudny; Gudnason, Vilmundur

    2007-01-01

    Background End-stage chronic kidney disease is associated with striking excesses of cardiovascular mortality, but it is uncertain to what extent renal function is related to risk of subsequent coronary heart disease (CHD) in apparently healthy adults. This study aims to quantify the association of markers of renal function with CHD risk in essentially general populations. Methods and Findings Estimated glomerular filtration rate (eGFR) was calculated using standard prediction equations based on serum creatinine measurements made in 2,007 patients diagnosed with nonfatal myocardial infarction or coronary death during follow-up and in 3,869 people without CHD in the Reykjavik population-based cohort of 18,569 individuals. There were small and nonsignificant odds ratios (ORs) for CHD risk over most of the range in eGFR, except in the lowest category of the lowest fifth (corresponding to values of <60 ml/min/1.73m2), in which the OR was 1.33 (95% confidence interval 1.01–1.75) after adjustment for several established cardiovascular risk factors. Findings from the Reykjavik study were reinforced by a meta-analysis of six previous reports (identified in electronic and other databases) involving a total of 4,720 incident CHD cases (including Reykjavik), which yielded a combined risk ratio of 1.41 (95% confidence interval 1.19–1.68) in individuals with baseline eGFR less than 60 ml/min/1.73m2 compared with those with higher values. Conclusions Although there are no strong associations between lower-than-average eGFR and CHD risk in apparently healthy adults over most of the range in renal function, there may be a moderate increase in CHD risk associated with very low eGFR (i.e., renal dysfunction) in the general population. These findings could have implications for the further understanding of CHD and targeting cardioprotective interventions. PMID:17803353

  9. Refractory status epilepticus: a prospective observational study.

    PubMed

    Novy, Jan; Logroscino, Giancarlo; Rossetti, Andrea O

    2010-02-01

    Status epilepticus (SE) that is resistant to two antiepileptic compounds is defined as refractory status epilepticus (RSE). In the few available retrospective studies, estimated RSE frequency is between 31% and 43% of patients presenting an SE episode; almost all seem to require a coma induction for treatment. We prospectively assessed RSE frequency, clinical predictors, and outcome in a tertiary clinical setting. Over 2 years we collected 128 consecutive SE episodes (118 patients) in adults. Clinical data and their relationship to outcome (mortality and return to baseline clinical conditions) were analyzed. Twenty-nine of 128 SE episodes (22.6%) were refractory to first- and second-line antiepileptic treatments. Severity of consciousness impairment and de novo episodes were independent predictors of RSE. RSE showed a worse outcome than non-RSE (39% vs. 11% for mortality; 21% vs. 63% for return to baseline clinical conditions). Only 12 patients with RSE (41%) required coma induction for treatment. This prospective study identifies clinical factors predicting the onset of SE refractoriness. RSE appears to be less frequent than previously reported in retrospective studies; furthermore, most RSE episodes were treated outside the intensive care unit (ICU). Nonetheless, we confirm that RSE is characterized by high mortality and morbidity.

  10. 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.

  11. 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.

  12. Laparoscopic Sigmoidectomy for Diverticulitis: a Prospective Study

    PubMed Central

    Baca, Ivo; Grzybowski, Leszek; Jaacks, Armin

    2010-01-01

    Background: Surgical treatment of complicated colonic diverticular disease is still debatable. The aim of this prospective study was to evaluate the outcome of laparoscopic sigmoid colectomy in patients with diverticulitis. Patients offered laparoscopic surgery presented with acute complicated diverticulitis (Hinchey type I, II, III), chronically recurrent diverticulitis, bleeding, or sigmoid stenosis caused by chronic diverticulitis. Method: All patients who underwent laparoscopic colectomy within a 12-year period were prospectively entered into a database registry. One-stage laparoscopic resection and primary anastomosis constituted the planned procedure. A 4-trocar approach with suprapubic minilaparotomy was performed. Main data recorded were age, sex, postoperative pain, return of bowel function, operation time, duration of hospital stay, and early and late complications. Results: During the study period, 260 sigmoid colectomies were performed for diverticulitis. The cohort included 104 male and 156 female patients; M to F ratio was 4:6. Postoperative pain was controlled by NSAIDs or weak opioid analgesia. Fifteen patients (5.7%) required conversion from laparoscopic to open colectomy. The most common reasons for conversion were directly related to the inflammatory process, abscess, and peritonitis. Mean operative time was 130±54. Average postoperative hospital stay was 10±3 days. A longer hospital stay was recorded for Hinchey type IIb patients. Complications were recorded in 30 patients (11.5%). The most common complications that required reoperation were hemorrhage in 2 patients (0.76) and anastomotic leak in 5 patients (only 3 of them required reoperation). The mortality among them was 2 patients (0.76%). Conclusions: Laparoscopic surgery for diverticular disease is safe, feasible, and effective. Therefore, laparoscopic colectomy has replaced open resection as standard surgery for recurrent and complicated diverticulitis at our institution. PMID:21605507

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. [Prospective study of patients with prolonged fever].

    PubMed

    Calderón, E; Legorreta, J; Sztabinski, G; Hernández, M; Wilkins, A; Gómez, D; Dávila, A

    1975-01-01

    A prospective study was made in 283 patients who attended IMAN's Children's Hospital, with fever the main symptom. A clinical and paraclinical procedure was designed for the study of each patient. 112 patients were eliminated because they did not follow the established criteria. All patients had acute infectious diseases considered trivial; 85% were 3 weeks to 2 years of age. They all had an antibacterial treatment without precise diagnosis. It was considered that on admission the patients showed a normal course in the natural history of the basic disease. The study group included 171 patients 2 months to 13 years of age; 62.5% had fever due to infection, 12.2% to collagenopathies, 7% to neoplasias 5.2% to miscellaneous causes and 12.8% were not diagnosed. The most common infectious causes for prolonged fever were tuberculosis, upper respiratory infections, amoebic liver abscess, typhoid fever and malaria. Careful questioning and clinical examination were enough to enlighten diagnosis in more than 80% of the patients.

  18. 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…

  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. 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

  1. 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

  2. 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…

  3. Prospects for future proton studies at HRIBF

    NASA Astrophysics Data System (ADS)

    Bingham, C. R.; Batchelder, J. C.; Ginter, T. N.; Gross, C. J.; Grzywacz, R.; Janas, Z.; Karny, M.; McConnell, J. W.; Rykaczewski, K.; Toth, K. S.; Zganjar, E. F.

    2000-05-01

    Great progress has been made in the last 20 years in the study of proton emission from unstable nuclei, but the prospects for additional strides in the next several years are bright. The present main limitations on the study of proton radioactivity are related to the inability to produce copious quantities of nuclides beyond the proton drip line, and the difficulty of measuring proton radioactivity of a mass-separated nucleus in the first few microseconds of its existence. At the Holifield Facility we will attack the second of these limitations by using new signal processing CAMAC modules DGF-4C. Digitizing of the preamplifier signals should enable the analysis of a proton decay occurring at times even less than 1 microsecond after an implant in a strip detector. In the same process, the threshold energy at which we can make measurements will be lowered. These two things will hopefully enable the measurement of lower-energy, but faster decays of isotopes in the 100Sn region and below. For the latter region, the proton decays crucial for a rp-process scenario are of particular interest (e.g. 69Br decay). Secondly, for very short-lived species, we plan to make measurements (without residue separation) at points much closer to the target, thus reducing the flight time between the target and detector. As more intense radioactive beams become available, eg. 56Ni, we will utilize these to produce more neutron-deficient nuclides by use of colder reactions than is possible with stable beams. In some cases where delayed proton emitters are present in the same isobaric chain, the use of the cold reactions with radioactive beams can provide purer samples of the isotope of interest, with a reduction in background from the delayed proton emitters in the same mass chain.

  4. Hand injuries in children: a prospective study.

    PubMed

    Vadivelu, Ramanan; Dias, Joseph J; Burke, Frank D; Stanton, Jeremy

    2006-01-01

    The purpose of this prospective clinical study was to identify the true incidence, pattern, and location of the injury and nature of fracture after hand injuries in different pediatric age groups attending a hand unit. Three hundred sixty children (237 boys, 123 girls) under 16 years of age who presented with hand injuries between April 1, 2000, and Sept. 30, 2000, were included in the study. Bony injuries accounted for 65.5% (236 injuries); 33.3% (120 injuries) were soft tissue injuries. The projected annual incidence rate for skeletal injuries was 418/100,000 children. The incidence was low in toddlers (34/100,000), more than doubled in preschool children (73/100,000), and steeply increased to around 20-fold after the 10th year (663/100,000). Girls had a higher incidence of hand injuries among toddlers and preschool children. Crushing was the most common cause of hand injury (64%), and most injuries were sustained at home (45%). Toddlers sustained soft tissue injuries predominantly (86%) and older children sustained more bony injuries (77%). Sport was the cause of injures commonly in the older children. There was a higher incidence of fracture in the little finger (52%) followed by the thumb (23%). The proximal phalanx was the most frequently fractured bone (67%) among the phalanges. Diaphyseal fractures (46%) were more common in the metacarpals, and basal fractures (51%) were common in the phalanges. At discharge more than 80% of the patients felt that they were cured or significantly better. This paper highlights the changing pattern and the different varieties of hand injuries in different pediatric age groups.

  5. 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

  6. Suction evacuation of hemothorax: A prospective study.

    PubMed

    Savage, Stephanie A; Cibulas, George A; Ward, Tyler A; Davis, Corinne A; Croce, Martin A; Zarzaur, Ben L

    2016-07-01

    Although tube thoracostomy is a common procedure after thoracic trauma, incomplete evacuation of fluid places the patient at risk for retained hemothorax. As little as 300 to 500 cm of blood may result in the need for an additional thoracostomy tube or, in more severe cases, lung entrapment and empyema. We hypothesized that suction evacuation of the thoracic cavity before tube placement would decrease the incidence of late complications. Patients requiring tube thoracostomy within 96 hours of admission were prospectively identified and underwent suction evacuation of the pleural space (SEPS) before tube placement. These patients were compared to historical controls without suction evacuation. Demographics, admission vital signs, laboratory values, details of chest tube placement, and outcomes were collected on all patients. Multivariable logistic regression was used to compare outcomes between groups. A total of 199 patients were identified, consisting of 100 retrospective controls and 99 SEPS patients. There were no differences in age, sex, admission injury severity score or chest abbreviated injury score, admission laboratory values or vital signs, or hospital length of stay. Mean (SD) volume of hemothorax in SEPS patients was 220 (297) cm; with only 48% having a volume greater than 100 cm at the time of tube placement. Three patients developed empyema, and 19 demonstrated retained blood; there was no difference between SEPS and control patients. Suction evacuation of the pleural space was significantly protective against recurrent pneumothorax after chest tube removal (odds ratio, 0.332; 95% confidence interval, 0.148-0.745). Preemptive suction evacuation of the thoracic cavity did not have a significant impact on subsequent development of retained hemothorax or empyema. Suction evacuation of the pleural space significantly decreased incidence of recurrent pneumothorax after thoracostomy removal. Although the mechanism is unclear, such a benefit may make this

  7. 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

  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. 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...

  11. Social Capital and Health: A Review of Prospective Multilevel Studies

    PubMed Central

    Murayama, Hiroshi; Fujiwara, Yoshinori; Kawachi, Ichiro

    2012-01-01

    Background This article presents an overview of the concept of social capital, reviews prospective multilevel analytic studies of the association between social capital and health, and discusses intervention strategies that enhance social capital. Methods We conducted a systematic search of published peer-reviewed literature on the PubMed database and categorized studies according to health outcome. Results We identified 13 articles that satisfied the inclusion criteria for the review. In general, both individual social capital and area/workplace social capital had positive effects on health outcomes, regardless of study design, setting, follow-up period, or type of health outcome. Prospective studies that used a multilevel approach were mainly conducted in Western countries. Although we identified some cross-sectional multilevel studies that were conducted in Asian countries, including Japan, no prospective studies have been conducted in Asia. Conclusions Prospective evidence from multilevel analytic studies of the effect of social capital on health is very limited at present. If epidemiologic findings on the association between social capital and health are to be put to practical use, we must gather additional evidence and explore the feasibility of interventions that build social capital as a means of promoting health. PMID:22447212

  12. Studying Native America: Problems and Prospects.

    ERIC Educational Resources Information Center

    Thornton, Russell, Ed.

    Based on a conference, this volume examines the past, present, and future of Native American studies. Native American studies seeks to understand Native Americans, America, and the world from a Native American indigenous perspective, and thereby broaden the education of both Native and non-Native Americans. Part 1 asks who Native Americans are…

  13. Studying Native America: Problems and Prospects.

    ERIC Educational Resources Information Center

    Thornton, Russell, Ed.

    Based on a conference, this volume examines the past, present, and future of Native American studies. Native American studies seeks to understand Native Americans, America, and the world from a Native American indigenous perspective, and thereby broaden the education of both Native and non-Native Americans. Part 1 asks who Native Americans are…

  14. Surface reflectance and material studies for the PROSPECT Experiment

    NASA Astrophysics Data System (ADS)

    Bowes, Alyssa; Prospect Collaboration

    2015-10-01

    The PROSPECT Experiment aims to probe the existence of sterile neutrino oscillations by measuring the energy spectrum of antineutrinos emanating from nuclear reactors in a matrix of optically separated target scintillator cells at a variety of reactor-detector baselines. By measuring the absolute spectrum we also learn about reactors and what isotopes they produce. In order to properly model and optimise PROSPECT's energy resolution and background rejection capabilities, the reflective properties of the cell surfaces must be well understood. To address this, a study of various reflective surfaces under consideration to be used in the detector was conducted at non-normal incident angles through liquid using a custom-built laser-based reflectance measurement system. This presentation will describe the apparatus, reflectance measurements, and implications for the PROSPECT optical cell performance. Future plans to incorporate measurements into existing optical simulations will also be discussed. Funding provided by Illinois Institute of Technology College of Science.

  15. Finasteride induced depression: a prospective study

    PubMed Central

    Rahimi-Ardabili, Babak; Pourandarjani, Ramin; Habibollahi, Peiman; Mualeki, Amir

    2006-01-01

    Background Finasteride is a competitive inhibitor of 5 alpha-reductase enzyme, and is used for treatment of benign prostatic hyperplasia and androgenetic alopecia. Animal studies have shown that finasteride might induce behavioral changes. Additionally, some cases of finasteride-induced depression have been reported in humans. The purpose of this study was to examine whether depressive symptoms or anxiety might be induced by finasteride administration. Methods One hundred and twenty eight men with androgenetic alopecia, who were prescribed finasteride (1 mg/day) were enrolled in this study. Information on depressed mood and anxiety was obtained by Beck Depression Inventory (BDI), and Hospital Anxiety and Depression Scale (HADS). Participants completed BDI and HADS questionnaires before beginning the treatment and also two months after it. Results Mean age of the subjects was 25.8(± 4.4) years. At baseline, mean BDI and HADS depression scores were 12.11(± 7.50) and 4.04(± 2.51), respectively. Finasteride treatment increased both BDI (p < 0.001) and HADS depression scores significantly (p = 0.005). HADS anxiety scores were increased, but the difference was not significant (p = 0.061). Conclusion This preliminary study suggests that finasteride might induce depressive symptoms; therefore this medication should be prescribed cautiously for patients with high risk of depression. It seems that further studies would be necessary to determine behavioral effects of this medication in higher doses and in more susceptible patients. PMID:17026771

  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. Mastalgia-Cancer Relationship: A Prospective Study.

    PubMed

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

    2015-04-01

    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. 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. 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. 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.

  20. 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…

  1. 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…

  2. Prospective Study of the Effectiveness of Coping in Pediatric Patients

    ERIC Educational Resources Information Center

    Zehnder, Daniel; Prchal, Alice; Vollrath, Margarete; Landolt, Markus A.

    2006-01-01

    Findings about the influence of coping on psychological adjustment in children with different medical conditions are inconsistent and often based on cross-sectional data. This prospective study evaluated the effect of various coping strategies on children's post-traumatic stress symptoms and behavioral problems 1 month and 1 year after an…

  3. 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...

  4. 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…

  5. Friendly and Hostile Country Perceptions of Prospective Social Studies Teachers

    ERIC Educational Resources Information Center

    Kaya, Beytullah; Topçu, Ersin

    2017-01-01

    Peace education requires that students have a correct and academic perception regarding other countries. These perceptions of students, who acquire certain perceptions starting from primary school to university, need to be based on real facts and should not contain extravagance. This study aims to determine whether 3rd year Prospective Social…

  6. 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…

  7. 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...

  8. 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.

  9. Stature and idiopathic scoliosis. A prospective study.

    PubMed

    Archer, I A; Dickson, R A

    1985-03-01

    A study of 130 scoliotic children with curves measuring 10 degrees or more has been performed in order to elucidate the importance of stature, growth and development. Girls with adolescent idiopathic curves measuring 15 degrees or more were taller than girls with smaller idiopathic curves and taller than those whose scoliosis was secondary to leg-length inequality (pelvic tilt scoliosis). No differences were observed as regards growth velocity or development. The increased standing height may be genetic but the uncoiling effect of the normal kyphosis to give a flat lateral profile is a more likely cause. The familial trend in idiopathic scoliosis may therefore be explained by the genetically determined shape of the spine in the median (sagittal) plane.

  10. 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.

  11. [Cardiovascular changes in acromegaly. Prospective study].

    PubMed

    Badui, E; González, C; García Rubi, D; Futran, J; Olguín, R; Espinosa, R

    1984-01-01

    We present 38 acromegalyc patients who were studied by non invasive methods to assess the frequency of cardiovascular complications. Seventy one percent of the cases presented some type of cardiovascular alteration. In 68% we observed left ventricular hypertrophy by echocardiography which was the most sensitive method to detect it. In 71% we obtained abnormal electrocardiograms, mainly because of conduction disturbances, being right bundle branch block the most frequent. Half of the cases had pulmonary fibrosis and chronic bronchitis. Arterial hypertension was present in 32%. Diabetes mellitus in 21%. Only 2 cases had coronary heart disease. In 37% of the patients who underwent hypophisectomy we observed regression up to 90% of the cardiac complications except for left ventricular hypertrophy and pulmonary fibrosis. None of the patients has died.

  12. Overdose after detoxification: a prospective study.

    PubMed

    Wines, James D; Saitz, Richard; Horton, Nicholas J; Lloyd-Travaglini, Christine; Samet, Jeffrey H

    2007-07-10

    The aim of this study was to determine predictors of non-fatal overdose (OD) among a cohort of 470 adults after detoxification from heroin, cocaine or alcohol. We examined factors associated with time to OD during 2 years after discharge from an urban detoxification unit in Boston, MA, USA using multivariable regression analyses. Separate analyses were performed for both the total sample and a subgroup with problem opioid use. Lifetime prevalence for any OD was 30.9% (145/470) in the total sample and 42.3% (85/201) in patients with opioid problems. During the 2-year follow-up, OD was estimated to occur in 16.9% of the total sample and 26.7% of the opioid problem subgroup, with new-onset (incidence) OD estimated at 5.7% and 11.0%, respectively. Factors associated with an increased hazard of OD in both samples included white race, more depressive symptoms, and prior OD regardless of intent. Prior suicidal ideation or attempt was not associated with future OD. Findings underscore both the high prevalence of non-fatal OD among detoxification patients especially opioid users, and the potency of prior OD as a risk factor for future OD. Depressive symptoms, a modifiable risk factor, may represent a potential intervention target to prevent OD, including some "unintentional" ODs.

  13. Tobramycin nephrotoxicity. A prospective clinical study

    PubMed Central

    Coca, Antonio; Martinez, Alberto; Soriano, Eladio; Blade, Juan; Segura, Fernando; Ribas-Mundo, Manuel

    1979-01-01

    The nephrotoxicity of tobramycin given at a dose of 4·5 mg/kg/day for a period of 12 days to a group of 90 patients with a mean age of 62·9 years was studied. Toxicity was determined on the basis of 3 main criteria (oliguria <400 ml/24 hr, serum creatinine 0·4 mg increase over a minimum basal level of 1·2 mg/100 ml, BUN 5 mg increase over a minimum of 25 mg/100 ml); and 3 minor criteria (proteinuria, microhaematuria and cylindruria). These parameters were determined before treatment at 7, 10, 14, 17, 21, and 30 days afterwards. The age and coexistence of factors such as hypertension, diabetes, anaemia, cardiac insufficiency, shock and dehydration were considered. Nephrotoxicity level ranges from 3·3 to 38·8% depending on the criterion used, and is related to hypertension (P<0·001), age (P<0·005) and association with ampicillin (P<0·005). Nephrotoxicity was reversible spontaneously in 96·7% of the cases and no differences have been observed between patients with moderate renal insufficiency and those with normal renal function on the initiation of treatment. PMID:523366

  14. 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.

  15. A Prospective Study of Holiday Weight Gain

    PubMed Central

    Yanovski, Jack A.; Yanovski, Susan Z.; Sovik, Kara N.; Nguyen, Tuc T.; O'Neil, Patrick M.; Sebring, Nancy G.

    2015-01-01

    Background It is commonly asserted that the “average American” gains five pounds (2.27 kg) or more over the holiday period between Thanksgiving and New Year's Day, yet few data support this statement. Methods To estimate actual holiday-related weight variation, we measured body weight in a non-clinical sample of 195 adults. Subjects were weighed four times, 6-8 weeks apart, such that weight change was determined for three intervals: Pre-Holiday (from late September to mid-November, Holiday (November to January) and Post-Holiday (January to March). A final weight was obtained in 165 participants the following September. Other vital signs and self-reported health measures were obtained to mask the main outcome of interest. Results Mean weight increased significantly during the Holiday (+0.37 ± 1.52 kg, P<0.001), but not during the Pre-Holiday (+0.18 ± 1.49 kg, P=0.09), or Post-Holiday (–0.07 ± 1.14 kg, P=0.36) interval. Holiday weight gain was greater than Post-holiday weight gain (P < 0.002). Compared with their weight in September, study subjects had an average net weight gain of +0.48 ± 2.22 kg at their March measurement (P<0.003). Between March and the next September, there was no significant additional weight change (+0.21 kg ± 2.3 kg, P=0.13) for the 165 participants who returned for follow-up. Conclusions Average holiday weight gain is 0.37 kg, far less than commonly asserted. As this gain is not reversed during spring or summer months, the net 0.48 kg fall/winter weight gain appears likely to contribute to the increase in body weight that frequently occurs during adulthood. PMID:10727591

  16. A prospective study of holiday weight gain.

    PubMed

    Yanovski, J A; Yanovski, S Z; Sovik, K N; Nguyen, T T; O'Neil, P M; Sebring, N G

    2000-03-23

    It is commonly asserted that the average American gains 5 lb (2.3 kg) or more over the holiday period between Thanksgiving and New Year's Day, yet few data support this statement. To estimate actual holiday-related weight variation, we measured body weight in a convenience sample of 195 adults. The subjects were weighed four times at intervals of six to eight weeks, so that weight change was determined for three periods: preholiday (from late September or early October to mid-November), holiday (from mid-November to early or mid-January), and postholiday (from early or mid-January to late February or early March). A final measurement of body weight was obtained in 165 subjects the following September or October. Data on other vital signs and self-reported health measures were obtained from the patients in order to mask the main outcome of interest. The mean (+/-SD) weight increased significantly during the holiday period (gain, 0.37+/-1.52 kg; P<0.001), but not during the preholiday period (gain, 0.18+/-1.49 kg; P=0.09) or the postholiday period (loss, 0.07+/-1.14 kg; P=0.36). As compared with their weight in late September or early October, the study subjects had an average net weight gain of 0.48+/-2.22 kg in late February or March (P=0.003). Between February or March and the next September or early October, there was no significant additional change in weight (gain, 0.21 kg+/-2.3 kg; P=0.13) for the 165 participants who returned for follow-up. The average holiday weight gain is less than commonly asserted. Since this gain is not reversed during the spring or summer months, the net 0.48-kg weight gain in the fall and winter probably contributes to the increase in body weight that frequently occurs during adulthood.

  17. [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.

  18. 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.

  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. Sedentary behaviour and cardiovascular disease: a review of prospective studies

    PubMed Central

    Ford, Earl S; Caspersen, Carl J

    2015-01-01

    Background Current estimates from objective accelerometer data suggest that American adults are sedentary for ~7.7h/day. Historically, sedentary behaviour was conceptualized as one end of the physical activity spectrum but is increasingly being viewed as a behaviour distinct from physical activity. Methods Prospective studies examining the associations between screen time (watching television, watching videos and using a computer) and sitting time and fatal and non-fatal cardiovascular disease (CVD) were identified. These prospective studies relied on self-reported sedentary behaviour. Results The majority of prospective studies of screen time and sitting time has shown that greater sedentary time is associated with an increased risk of fatal and non-fatal CVD. Compared with the lowest levels of sedentary time, risk estimates ranged up to 1.68 for the highest level of sitting time and 2.25 for the highest level of screen time after adjustment for a series of covariates, including measures of physical activity. For six studies of screen time and CVD, the summary hazard ratio per 2-h increase was 1.17 (95% CI: 1.13–1.20). For two studies of sitting time, the summary hazard ratio per 2-h increase was 1.05 (95% CI: 1.01–1.09). Conclusions Future prospective studies using more objective measures of sedentary behaviour might prove helpful in quantifying better the risk between sedentary behaviour and CVD morbidity and mortality. This budding science may better shape future guideline development as well as clinical and public health interventions to reduce the amount of sedentary behaviour in modern societies. PMID:22634869

  1. A Prospective Study of Factors Affecting Recovery from Musculoskeletal Injuries

    DTIC Science & Technology

    2014-01-01

    for musculoskeletal disorders . J Occup Rehabil. 2005;15:377–92. 18. Crook J, Milner R, Schultz IZ, Stringer B. Determinants of occupational disability...Spine. 1996;21:2900–7. 61. Hansson T, Jensen I. Sickness absence due to back and neck disorders . Scan J Public Health. 2004;32:109–51. 62. Lincoln AE...Naval Health Research Center A Prospective Study of Factors Affecting Recovery from Musculoskeletal Injuries Stephanie Booth-Kewley Emily

  2. The PROSPECTS study: design of a prospective cohort study on prognosis and perpetuating factors of medically unexplained physical symptoms (MUPS).

    PubMed

    van Dessel, Nikki; Leone, Stephanie S; van der Wouden, Johannes C; Dekker, Joost; van der Horst, Henriëtte E

    2014-03-01

    This paper describes the rationale and methodology of the PROSPECTS study, a study which aims to assess the course and prognosis of medically unexplained physical symptoms (MUPS), in terms of symptom severity and physical and social functioning. Additionally, it aims to identify different course types and to determine which factors are associated with these course types. Based on these factors, one or more prediction models will be developed. This study is a prospective, multicenter longitudinal cohort study with 1 baseline and 4 follow-up measurements during a 3 year period. 450 MUPS patients (age 18-70 years) will be included, divided over a primary care group, recruited in general practices, and a secondary/tertiary care group, recruited in specialized MUPS care programs. Primary outcome measures are severity of symptoms and degree of functional impairment. Secondary outcome measures are health care consumption and level of depressive symptoms and anxiety. Potential predictors are based on current theoretical models describing the perpetuation of MUPS and include somatic, psychological and social factors. Latent Class Growth Mixture Modeling will be used to identify distinct course types. Logistic regression analysis will be used to identify risk factors associated with these course types. Finally, one or more multivariate prediction models for the course of MUPS will be developed and tested. The PROSPECTS study aims to enhance our insight into the course of MUPS, thus contributing to better recognition of future patients at risk for persistent MUPS. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. 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.

  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. Testicular atrophy following paediatric primary orchidopexy: A prospective study.

    PubMed

    Durell, J; Johal, N; Burge, D; Wheeler, R; Griffiths, M; Kitteringham, L; Stanton, M; Manoharan, S; Steinbrecher, H; Malone, P; Griffin, S J

    2016-08-01

    With the Nordic consensus statement advocating orchidopexy at an earlier age, the present study sought to investigate the outcomes of primary paediatric orchidopexy at a tertiary UK centre. To prospectively assess testicular atrophy following primary orchidopexy for undescended testes in a paediatric population. Secondary outcomes were complication rates and whether outcomes were dependent on grade of operating surgeon. Prospective data regarding age at operation, classification of the undescended testis, length of follow-up, and subjective comparison of intraoperative and postoperative testicular volumes compared with the contralateral testis were collected. Testicular atrophy was defined as >50% loss of testicular volume or a postoperative testicular volume <25% of the volume of the contralateral testis. Patients were excluded for incomplete data and follow-up <6 months. Data for 234 patients were analysed. Testicular atrophy occurred in 2.6% of cases. There was no reported testicular re-ascent. All secondary acquired cases underwent a previous ipsilateral hernia repair. There was no significant difference in outcomes comparing the grade of surgeon (consultant n = 8, trainee/staff-grade surgeon n = 7-8). There was a trend towards postoperative catch-up growth in approximately one fifth of cases. Previous studies have reported a testicular atrophy rate of 5%. The present study reported a similar rate of 2.6%. In agreement with a previous publication, it was also found that testicular atrophy was not dependent on the grade of operating surgeon. The mechanism for testicular catch-up growth is not well understood. Animal studies have supported the hypothesis that increased temperature has a detrimental effect on testicular volume. However, follow-up in the present cohort was short (median 6.9 months), making interpretation of this finding difficult. It is acknowledged that clinical palpation alone to determine testicular volume potentially introduces intra

  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. Environmental biotechnology in India: prospects and case studies.

    PubMed

    Khanna, P

    1996-09-01

    The emergence and acceptance of the concept of sustainable development warrants that the scope of environmental biotechnology be enlarged to address issues like environmental monitoring, restoration of environmental quality, resource/residue/waste-recovery/utilization/treatment, and substitution of the non-renewable resource base with renewable resources. This paper delineates the current and prospective applications in these sub-areas of environmental biotechnology, and documents case studies on environmental monitoring (enteric viruses), restoration of environmental quality (oil spill remediation), resource recovery (hydrocarbon recovery from oily sludges, biosurfactants from distillery spentwash, desulphurization of coal & sour gases), and substitution of non-renewable resources with renewables (conversion of lignocellulisics into value added chemicals).

  8. 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

  9. 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.

  10. 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

  11. Causes of anorexia in untreated hyperthyroidism: a prospective study

    PubMed Central

    Dai, W.; Meng, X.

    2000-01-01

    Seventeen consecutive patients (mean (SD) 46 (11) years) with untreated hyperthyroidism and anorexia and 29 patients (35 (9) years) with untreated hyperthyroidism without anorexia were studied. The study was conducted at the thyroid clinic of the PUMC Hospital, Beijing, China from March to August 1997. The patients' ages, serum free calcium, liver function and emotional state, specifically the level of anxiety (using the self anxiety scale, Chinese version), were compared before and/or after antithyroid drug treatment in the two groups. This prospective study suggested that the causes of anorexia in untreated hyperthyroidism are complicated. Older age, abnormal liver function, and the level of anxiety are significantly related to anorexia in untreated hyperthyroidism, but hypercalcaemia was not confirmed to be related to anorexia in the study.


Keywords: hypercalcaemia; hyperthyroidism; anorexia; anxiety PMID:10775283

  12. 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

  13. 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

  14. Prospective study of phobic anxiety and risk of Parkinson's disease.

    PubMed

    Weisskopf, Marc G; Chen, Honglei; Schwarzschild, Michael A; Kawachi, Ichiro; Ascherio, Alberto

    2003-06-01

    Anxiety disorders are common in Parkinson's disease (PD). However, the risk of PD among people with anxiety has not been examined in a prospective cohort study. We examined this relation prospectively within the Health Professionals Follow-Up Study, a cohort of US male health professionals. In 1988, anxiety was assessed using the Crown-Crisp phobic anxiety index in 35,815 men without PD, stroke, or cancer at baseline. There were 189 incident cases of PD during 12 years of follow-up. After adjusting for age, smoking, and caffeine intake, the relative risk of PD among men with the highest level of anxiety (Crown-Crisp index scores of 4 and above) was 1.5 (95% CI = 1.0-2.1; P-trend = 0.01) compared to men with the lowest level of anxiety. This positive association persisted after excluding cases of PD with onset in the first 2 years of follow-up. Use of anxiolytic medication was also associated with an elevated risk of PD (RR= 1.6; 95% CI = 0.9-3.1), but adjusting for this potential confounder did not materially affect the association between anxiety and risk of PD. Our results suggest that anxiety is a risk factor for PD. Whether this association is causal or the result of shared underlying biology remains a question. Copyright 2003 Movement Disorder Society

  15. [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.

  16. 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.

  17. 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

  18. Bone density in proton pump inhibitors users: a prospective study.

    PubMed

    Ozdil, Kamil; Kahraman, Resul; Sahin, Abdurrahman; Calhan, Turan; Gozden, Erdem H; Akyuz, Umit; Erer, Burak; Sokmen, Mehmet H

    2013-09-01

    Patients with gastroesophageal reflux disease (GERD) receive long-term therapy with proton pump inhibitor (PPI) agents. Several studies have recently been published suggesting that treatment with PPI may cause bone fractures, although the number of prospective studies in this regard is limited. The aim of this study is to prospectively investigate the effect of PPIs on bone density. Between March 2009 and January 2011, 114 GERD patients (18-56 years) and 110 healthy controls were included in the present study. Bone mineral densitometry (BMD) by using dual-energy X-ray absorptiometry was assessed at lumbar spine and femur neck. BMD measurements were performed on all subjects at the beginning of the study. The patients were divided according to three drugs by their treatment with esomeprazole, lansoprazole, or pantoprazole. The study group was followed for at least 6 months on PPI therapy, and then BMD measurements were repeated. The mean duration of treatment with PPIs was 8.5 ± 2.3 months. In patients receiving PPIs, the mean reduction in total vertebra T score following treatment compared to pre-treatment values was 00.23 ± 0.42 units (95 % CI 0.15-0.30) (p < 0.01), while the mean reduction in the femur T score was 0.10 ± 0.40 units (95 % CI 0.03-0.18) (p = 0.03). Reduction following treatment in L4 and total vertebra T scores of lansoprazole group was significantly higher than of pantoprazole group (p = 0.04). Reduction in femur T score of esomeprazole group was higher than of lansoprazole group and pantroprazole group, but it is not statistically significant. Treatment with a PPI results in a significant reduction in bone density. Close monitoring is beneficial for patients who are to receive long-term treatment with PPI.

  19. 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

  20. Exposure to aripiprazole during embryogenesis: a prospective multicenter cohort study.

    PubMed

    Bellet, Florelle; Beyens, Marie-Noëlle; Bernard, Nathalie; Beghin, Delphine; Elefant, Elisabeth; Vial, Thierry

    2015-04-01

    The main purpose of this study was to evaluate the risk of major malformations after aripiprazole exposure during the embryonic period. The secondary purposes were to assess the risk of miscarriage, prematurity, fetal growth retardation and maternal complications and to describe possible neonatal adverse effects. We conducted a cohort study using data prospectively collected by the French Pharmacovigilance Centres participating to the Terappel program and the Centre de Référence sur les Agents Tératogènes between 2004 and 2011. The exposed group consisted of pregnant women exposed to aripiprazole during embryogenesis, and the unexposed group consisted of pregnant women without exposure or exposed to non-teratogenic agents. Two unexposed patients, matched for age and gestational age at call, were randomly selected for each exposed patient. Eighty-six patients were included in the exposed group and 172 in the unexposed group. Exposure to aripiprazole was not significantly associated with an increased rate of major malformations (OR 2.30, 95%CI 0.32-16.7) or miscarriage (1.66, 0.63-4.38) or gestational diabetes (1.15, 0.33-4.04) compared to non-exposure. The study revealed significantly increased rates of prematurity (OR 2.57, 95%CI 1.06-6.27) and fetal growth retardation (2.97, 1.23-7.16) in exposed newborns, difficult to interpret because of the short duration of maternal exposure. Two cases of neonatal complications were reported among the 19 newborns exposed to aripiprazole near delivery. This study failed to demonstrate a significant association between aripiprazole exposure during the embryonic period and major malformations. More powerful prospective studies are required to clarify the reproductive safety profile of aripiprazole. Copyright © 2015 John Wiley & Sons, Ltd.

  1. 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.

  2. Early breastfeeding experiences of adolescent mothers: a qualitative prospective study

    PubMed Central

    2012-01-01

    Background Teen mothers face many challenges to successful breastfeeding and are less likely to breastfeed than any other population group in the U.S. Few studies have investigated this population; all prior studies are cross-sectional and collect breastfeeding data retrospectively. The purpose of our qualitative prospective study was to understand the factors that contribute to the breastfeeding decisions and practices of teen mothers. Methods This prospective study took place from January through December 2009 in Greensboro, North Carolina in the U.S. We followed the cohort from pregnancy until two weeks after they ceased all breastfeeding and milk expression. We conducted semi-structured interviews at baseline and follow-up, and tracked infant feeding weekly by phone. We analyzed the data to create individual life and breastfeeding journeys and then identified themes that cut across the individual journeys. Results Four of the five teenagers breastfed at the breast for nine days: in contrast, one teen breastfed exclusively for five months. Milk expression by pumping was associated with significantly longer provision of human milk. Breastfeeding practices and cessation were closely connected with their experiences as new mothers in the context of ongoing multiple roles, complex living situations, youth and dependency, and poor knowledge of the fundamentals of breastfeeding and infant development. Breastfeeding cessation was influenced by inadequate breastfeeding skill, physically unpleasant and painful early experiences they were unprepared to manage, and inadequate health care response to real problems. Conclusions Continued breastfeeding depends on a complex interplay of multiple factors, including having made an informed choice and having the skills, support and experiences needed to sustain the belief that breastfeeding is the best choice for them and their baby given their life situation. Teenagers in the US context need to have a positive early

  3. Serum creatinine and prostate cancer risk in a prospective study.

    PubMed

    Weinstein, Stephanie J; Mackrain, Katrina; Stolzenberg-Solomon, Rachael Z; Selhub, Jacob; Virtamo, Jarmo; Albanes, Demetrius

    2009-10-01

    Several studies have examined serum creatinine as a marker for prostate cancer stage, recurrence, and prognosis. We evaluated whether serum creatinine concentration was associated with risk of developing prostate cancer in a prospective cohort of male smokers. A nested case-control study within the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study of 50- to 69-year-old Finnish men was conducted. Two controls (n = 464) were matched to each case (n = 232) on study center, intervention group, date of baseline blood draw (+/-45 days), and age (+/-5 years). Conditional logistic regression was used to calculate odds ratios and 95% confidence intervals. All P values were two-sided. Cases had significantly higher prediagnostic serum creatinine concentrations compared with controls (medians of 1.13 versus 1.10 mg/dL, respectively; P = 0.004). Serum creatinine was associated with a significantly greater risk of prostate cancer (multivariate odds ratio, 2.23; 95% confidence interval, 1.33-3.75 for highest versus lowest quartile), with a significant trend (P trend = 0.0008). Exclusion of subjects with a reported history of diabetes, benign prostatic hyperplasia, or hypertension, or whose cancer was diagnosed within the first 5 years of follow-up, did not alter the association. Risk did not differ by disease stage or time from blood draw to diagnosis. Prospectively measured serum creatinine, within normal ranges, is positively related to prostate cancer risk. Future research should reexamine the association in other populations, including any interrelationship with serum prostate-specific antigen.

  4. Can semiology predict psychogenic nonepileptic seizures? A prospective study.

    PubMed

    Syed, Tanvir U; LaFrance, W Curt; Kahriman, Emine S; Hasan, Saba N; Rajasekaran, Vijayalakshmi; Gulati, Deepak; Borad, Samip; Shahid, Asim; Fernandez-Baca, Guadalupe; Garcia, Naiara; Pawlowski, Matthias; Loddenkemper, Tobias; Amina, Shahram; Koubeissi, Mohamad Z

    2011-06-01

    Reducing health and economic burdens from diagnostic delay of psychogenic nonepileptic seizures (PNES) requires prompt referral for video electroencephalography (VEEG) monitoring, the diagnostic gold standard. Practitioners make VEEG referrals when semiology suggests PNES, although few semiological signs are supported by well-designed studies, and most VEEG studies neglect to concurrently measure how accurately seizure witnesses can ascertain semiology. In this study, we estimate the value of eyewitness-reported and video-documented semiology for predicting PNES, and we measure accuracy of eyewitness reports. We prospectively interviewed eyewitnesses of seizures in patients referred for VEEG monitoring, to inquire about 48 putative PNES and ES signs. Multiple, EEG-blinded, epileptologists independently evaluated seizure videos and documented the presence/absence of signs. We used generalized estimating equations to identify reliable video-documented PNES and ES signs, and we compared eyewitness reports with video findings to assess how accurately signs are reported. We used logistic regression to determine whether eyewitness reports could predict VEEG-ascertained seizure type. We analyzed 120 seizures (36 PNES, 84 ES) from 35 consecutive subjects. Of 45 video-documented signs, only 3 PNES signs ("preserved awareness," "eye flutter," and "bystanders can intensify or alleviate") and 3 ES signs ("abrupt onset," "eye-opening/widening," and postictal "confusion/sleep") were significant and reliable indicators of seizure type. Eyewitness reports of these 6 signs were inaccurate and not statistically different from guessing. Consequentially, eyewitness reports of signs did not predict VEEG-ascertained diagnosis. We validated our findings in a second, prospective cohort of 36 consecutive subjects. We identified 6 semiological signs that reliably distinguish PNES and ES, and found that eyewitness reports of these signs are unreliable. We offer suggestions to improve the

  5. [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.

  6. Voice therapy in pediatric functional dysphonia: a prospective study.

    PubMed

    Trani, Margherita; Ghidini, Angelo; Bergamini, Giuseppe; Presutti, Livio

    2007-03-01

    We evaluated the efficacy of voice therapy according to Borragan's method associated to S. Magnani's vocal counselling in functional dysphonia in children. We prospectively treated 16 patients with vocal fold nodules (10 males, 6 females). Age ranged from 6 to 11 years with a mean age of 9 years. We performed a full screening phoniatric evaluation. In addition psychological tests were carried out to investigate psychological background. We lost three patients at follow-up; one patient received surgery, eight patients healed (43.75%), four improved (25%). There was no statistical difference in the analysis of electroacoustical parameters while MPT significatively raised after therapy. If patients have motivation voice therapy could improve functional dysphonia in children. It is also important psychological background. Further studies on bigger populations with long-term follow-up are needed.

  7. 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

  8. 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.

  9. A prospective study of injury affecting competitive collegiate swimmers.

    PubMed

    Chase, Kristin I; Caine, Dennis J; Goodwin, Brett J; Whitehead, James R; Romanick, Mark A

    2013-01-01

    The purposes of this study were to determine the incidence and distribution of injuries affecting collegiate competitive swimmers and to test possible injury risk factors. A prospective cohort design was used to follow 34 swimmers (16 M, 18 F) from an NCAA Division I Midwest University over one academic year. Exposure-based injury rates were determined for both practice and competition. Risk of injury was assessed relative to gender, years swimming, and history of injury. Twenty of 34 swimmers sustained 31 injuries with overall injury rates of 5.55 injuries per 1000 athlete exposures and 3.04 injuries per 1000 hours exposure. Practice injury rates for female swimmers were higher than for women's practice injury rates in other NCAA sports. The most common injury locations were the shoulder, back, and knee. Risk factors that remained significant in the multivariate analysis were history of injury to the same anatomical location and history of injury at other anatomical sites.

  10. Palliative Care Caregivers' Grief Mediators: A Prospective Study.

    PubMed

    Coelho, Alexandra M; Delalibera, Mayra A; Barbosa, António

    2016-05-01

    The aim of the study is to identify the mediators of complicated grief in a Portuguese sample of caregivers. Grief mediators were prospectively evaluated using a list of risk factors completed by the palliative care team members, during the predeath and bereavement period. More than 6 months after the death, we applied PG-13 to diagnose prolonged grief disorder (PGD). The sample was composed of 64 family caregivers. Factors associated with PGD were insecure and dependent relationship, unresolved family crisis, and the perceived deterioration and disfigurement of the patient. The results show relational factors are relevant, but we must consider the reciprocal influence among factors, as well as their impact on specific symptoms. © The Author(s) 2015.

  11. Transformational leadership and depressive symptoms: a prospective study.

    PubMed

    Munir, Fehmidah; Nielsen, Karina; Carneiro, Isabella Gomes

    2010-01-01

    The aim of this study was to examine the association between transformational leadership and depressive symptoms in employees working within healthcare. 447 employees completed a baseline survey and 274 completed a follow-up survey 18 months later. 188 completed both baseline and follow-up survey. Transformational leadership was measured using the Global Transformational Leadership Scale and depression was measured using with the Major Depression Inventory. Transformational leadership was negatively associated with depressive symptoms at baseline (beta=-0.31, p<.01, 8% variance) follow-up (beta=- 0.25, p<.01, 3% variance) and prospectively (beta=- 0.21, p<.05, 4% variance). Managers with a transformational leadership style may help toward protecting employees from developing major depression.

  12. 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.

  13. 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

  14. 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

  15. [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.

  16. Acute diabetes insipidus in severe head injury: a prospective study.

    PubMed

    Hadjizacharia, Pantelis; Beale, Elizabeth O; Inaba, Kenji; Chan, Linda S; Demetriades, Demetrios

    2008-10-01

    The incidence and risk factors for acute diabetes insipidus after severe head injury and the effect of this complication on outcomes have not been evaluated in any large prospective studies. We conducted a prospective study of all patients admitted to the surgical ICU of a Level I trauma center with severe head injury (head Abbreviated Injury Score [AIS] >or= 3). The following potential risk factors with p < 0.2 on bivariate analysis were included in a stepwise logistic regression to identify independent risk factors for diabetes insipidus and its association with mortality: age, mechanism of injury (blunt or penetrating), blood pressure, Glasgow Coma Scale, Injury Severity Score, head and other body area AIS, skull fracture, cerebral edema and shift, intracranial hemorrhage, and pneumocephaly. There were 436 patients (blunt injuries, 392; penetrating injuries, 44); 387 patients had isolated head injury. Diabetes insipidus occurred in 15.4% of all patients (blunt, 12.5%; penetrating, 40.9%; p < 0.0001) and in 14.7% of patients with isolated head injury (blunt, 11.8%; penetrating, 39.5%; p < 0.0001). The presence of major extracranial injuries did not influence the incidence of diabetes insipidus. Independent risk factors for diabetes insipidus in isolated head injury were Glasgow Coma Scale3. Diabetes insipidus was an independent risk factor for death (adjusted odds ratio, 3.96; 95% CI [1.65, 9.72]; adjusted p value = 0.002). The incidence of acute diabetes insipidus in severe head injury is high, especially in penetrating injuries. Independent risk factors for diabetes insipidus include a Glasgow Coma Scale3. Acute diabetes insipidus was associated with significantly increased mortality.

  17. Vaginal breech delivery: results of a prospective registration study

    PubMed Central

    2013-01-01

    Background Most countries recommend planned cesarean section in breech deliveries, which is considered safer than vaginal delivery. As one of few countries in the western world Norway has continued to practice planned vaginal delivery in selected women. The aim of this study is to evaluate prospectively registered neonatal and maternal outcomes in term singleton breech deliveries in a Norwegian hospital during a ten years period. We aim to compare maternal and neonatal outcomes in term breech pregnancies subjected either to planned vaginal or elective cesarean section. Methods A prospective registration study including 568 women with term breech deliveries (>37 weeks) consecutively registered at Sorlandet Hospital Kristiansand between 2001 and 2011. Fetal and maternal outcomes were compared according to delivery method; planned vaginal delivery versus planned cesarean section. Results Of 568 women, elective cesarean section was planned in 279 (49%) cases and vaginal delivery was planned in 289 (51%) cases. Acute cesarean section was performed in 104 of the planned vaginal deliveries (36.3%). There were no neonatal deaths. Two cases of serious neonatal morbidity were reported in the planned vaginal group. One infant had seizures, brachial plexus injury, and cephalhematoma. The other infant had 5-minutes Apgar < 4. Twenty-nine in the planned vaginal group (10.0%) and eight in the planned cesarean section group (2.9%) (p < 0.001) were transferred to the neonatal intensive care unit. However, only one infant was admitted for ≥4 days. According to follow-up data (median six years) none of these infants had long-term sequelae. Regarding maternal morbidity, blood loss was the only variable that was significantly higher in the planned cesarean section group versus in the vaginal delivery group (p < 0.001). Conclusions Strict guidelines were followed in all cases. There were no neonatal deaths. Two infants had serious neonatal morbidity in the planned

  18. 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,…

  19. [Sexuality and contraception: a prospective study of 85 cases].

    PubMed

    Mathlouthi, Nabil; Jarraya, Mouna; Bengharbi, Anissa; Dhouib, Mohamed; Chaabene, Kaies; Trabelsi, Khaled; Amouri, Habib; Ben Ayed, Belhassen; Guermazi, Mohamed

    2013-03-01

    Contraception opposing procreation interferes with the primary purpose of sexuality. Few studies have yet been made on the actual interaction between contraception and sexuality. To study contraceptive practices ie non medicalized contraception and oral contraception, study aspects of women's sexuality and to study the physiological impact and psychological contraception on women's sexuality. Prospective and analytical study conducted over a period spanning from October 2008 to February 2009. This study was based on a survey, carried out through an oral questionnaire to 85 women in reproductive age, married, with contraceptive-based pill or natural birth control for at least one cycle, having experienced during their personal background a sexuality contraception or at least one contraceptive method other than its current average. Comparison between the group of women using oral contraception and women not using contraception medicalized showed significant differences in outcomes relating to: the average frequency of intercourse / month (p = 0.01), sexual desire ( p = 0.01), sexual pleasure (p = 0.03). The comparison of the different parameters of sexuality among the group of women using intra uterine device and women using oral contraceptives showed no significant differences in the parameters of sexuality. The awareness of the big importance of the interaction between sexuality and contraception, in one way or another, could help us tailor our applications to contraceptive practices of each woman.

  20. Clinical features of headache at altitude: a prospective study.

    PubMed

    Silber, E; Sonnenberg, P; Collier, D J; Pollard, A J; Murdoch, D R; Goadsby, P J

    2003-04-08

    Headache is the most common nervous system complication at altitude; however, there have been few attempts to characterize clinical features of high-altitude headaches (HAH). To measure prospectively the incidence of HAH and to determine its risk factors and characteristics. Members of an expedition to Kanchenjunga base camp in Nepal (5,100 m) were prospectively studied. Subjects were interviewed prior to the trip and while trekking recorded headaches experienced at >3,000 m using a structured questionnaire incorporating International Headache Society (IHS) and acute mountain sickness (AMS) criteria. In addition, clinical features of headaches in 19 trekkers in other groups above 3,000 m were recorded using the same questionnaire. Eighty-three percent (50/60) reported at least 1 HAH (median 2, range 0 to 10). Those who developed HAH were younger (p = 0.04); women and persons with headaches in daily life were more likely to report severe headaches (p = 0.03 and p = 0.07). One hundred thirty-eight HAH, experienced by 69 persons, are described. The mean altitude at which headaches occurred was 4,723 m. Twenty-six percent of headaches woke subjects at night or occurred upon awakening. HAH reported by migraineurs were accompanied by more phonophobia (p = 0.008). There were no IHS accompanying symptoms in 44% of headaches or symptoms of AMS in 52% of headaches. Headaches are a frequent complication of ascent to altitude. Older age appears to offer some protection, whereas headaches were more severe in women and persons with headaches in daily life. There is a wide clinical spectrum, with some suggesting intracranial hypertension. There is a need for evidence-based diagnostic criteria for headaches at altitude.

  1. 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

  2. Percutaneous ultrasonic tenotomy for chronic elbow tendinosis: a prospective study.

    PubMed

    Barnes, Darryl E; Beckley, James M; Smith, Jay

    2015-01-01

    Elbow tendinopathy is the most common cause of elbow pain affecting active populations. Surgical excision is reserved for patients with refractory symptoms. Percutaneous ultrasonic tenotomy performed under local anesthesia also removes degenerated tissue and therefore provides an alternative treatment option to surgical excision. This investigation prospectively documented the safety and 1-year efficacy of ultrasonic percutaneous tenotomy performed by a single operator. Nineteen patients, aged 38 to 67 years, in whom >6 months of conservative management for medial (7) or lateral (12) elbow tendinopathy had failed were prospectively studied. All patients were treated with percutaneous ultrasonic tenotomy of the elbow by a single operator. Visual analog scale (VAS) for pain, the 11-item version of the Disabilities of the Arm, Shoulder, and Hand (Quick DASH) index, and the Mayo Elbow Performance Score (MEPS) were assessed by an independent observer before treatment and at 6 weeks, 3 months, 6 months, and 12 months after treatment. No procedural complications occurred. Total treatment time was <15 minutes, and ultrasonic energy time averaged 38.6 ± 8.8 seconds per procedure. Average VAS scores were significantly improved from 6.4 to 2.6 at 6 weeks and were 0.7 at 12 months (P < .0001). Similar improvement occurred with the Quick DASH (pretreatment, 44.1; 12 months, 8.6, P < .0001) and MEPS (pretreatment, 59.1; 12 months, 83.4; P < .0001). Percutaneous ultrasonic tenotomy performed under local anesthesia appears to be a safe and effective treatment option for chronic, refractory lateral or medial elbow tendinopathy up to 1 year after the procedure. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  3. 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.

  4. The Early Growth and Development Study: A Prospective Adoption Design

    PubMed Central

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

    2014-01-01

    The Early Growth and Development Study is a prospective adoption study of birth parents, adoptive parents, and adopted children (N = 350 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 were recruited following the birth of the child through adoption agencies located throughout the United States. Assessments occur at 6-month intervals until child age 3 years. Data collection includes the following primary constructs: infant/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. PMID:17539368

  5. A prospective study of iliotibial band strain in runners.

    PubMed

    Hamill, Joseph; Miller, Ross; Noehren, Brian; Davis, Irene

    2008-10-01

    Iliotibial band syndrome is the leading cause of lateral knee pain in runners. It is thought that pain develops from strain on the iliotibial band due to friction of the iliotibial band sliding over the lateral femoral epicondyle. The purpose of this study was to investigate mechanical strain in the iliotibial band as a possible causative factor in the development of iliotibial band syndrome. From a large prospective study, female runners who incurred iliotibial band syndrome during the study were compared to a control group who incurred no injuries. Strain, strain rate and duration of impingement were determined from a musculoskeletal model of the lower extremity. The results indicated that the iliotibial band syndrome subjects exhibited greater strain throughout the support period, but particularly at midsupport compared to the control group. Strain rate was significantly greater in the iliotibial band syndrome group compared to the control group and was greater in the involved limb of the iliotibial band syndrome group compared to their contralateral limb. However, there were no differences in the duration of impingement between the groups. This study indicates that a major factor in the development of iliotibial band syndrome is strain rate. Therefore, we suggest that strain rate, rather than the magnitude of strain, may be a causative factor in developing iliotibial band syndrome. The effect size (>0.5) indicated that strain rate may be biologically significant in the etiology of iliotibial band syndrome.

  6. Nonoperative treatment of acute traumatic spinal injuries: A prospective study.

    PubMed

    Nnadi, Mon; Bankole, O B

    2014-01-01

    Traumatic spinal injury is a major cause of morbidity and mortality worldwide. There is no agreed method of care. Neurological recovery in complete injury has been dismal. Aims and Objectives : The aim of this study is to determine the neurological recovery at discharge in traumatic spinal injury patients managed nonoperatively in our center. This was a prospective descriptive study carried out on traumatic spinal injury patients managed by neurosurgical unit in our center from August 2010 to July 2013. The unit started in July 2010 with virtually no available facilities for surgical care for these patients. All patients were managed nonoperatively. The unit recorded data of the patients in accident and emergency, intensive care unit, and wards using structured proforma. Data were analyzed using Epi Info 7 software. There were 76 patients studied of which 57 were males and 25 were females. Fifty three were caused by road traffic accident. Nineteen were complete injury. Patients with incomplete injuries did well at discharge. Completeness of injury significantly affected the outcome. The neurological recovery in incomplete spinal injuries in our study was good, but poor in complete injury. Conservative treatment should be adopted in developing countries in patients with poor resources and in centers where facilities are not available for adequate imaging and surgical care. Trauma system is imperative in our country.

  7. Migraine, Headache and the Risk of Depression: Prospective Cohort Study

    PubMed Central

    Rist, Pamela M.; Schürks, Markus; Buring, Julie E.; Kurth, Tobias

    2013-01-01

    Background While cross-sectional studies have shown associations between migraine and depression, few studies have been able to evaluate the association between migraine and incident depression. Methods Prospective cohort study among 36,016 women without a history of depression enrolled in the Women’s Health Study who provided information about migraine and headache at baseline. Women were classified as either having non-migraine headache, migraine with aura, migraine without aura, past history of migraine or no history of headache. Cox proportional hazards models were used to evaluate the association between migraine and headache status and incident depression. Results At baseline, 5115 women reported a history of non-migraine headache, 1805 reported migraine with aura, 2723 reported migraine without aura and 1896 reported a past history of migraine. During 13.8 mean years of follow-up, 3833 new cases of depression occurred. The adjusted relative risks of incident depression were 1.44 (95% CI: 1.32, 1.56) for non-migraine headache, 1.53 (95% CI: 1.35, 1.74) for migraine with aura, 1.40 (95% CI: 1.25, 1.56) for migraine without aura and 1.56 (95% CI: 1.37, 1.77) for past history of migraine compared to no history of headache. Conclusions Middle-aged women with migraine or non-migraine headache are at increased risk of incident depression. PMID:23588795

  8. Migraine, headache, and the risk of depression: Prospective cohort study.

    PubMed

    Rist, Pamela M; Schürks, Markus; Buring, Julie E; Kurth, Tobias

    2013-09-01

    While cross-sectional studies have shown associations between migraine and depression, few studies have been able to evaluate the association between migraine and incident depression. A prospective cohort study among 36,016 women without a history of depression enrolled in the Women's Health Study who provided information about migraine and headache at baseline. Women were classified as either having nonmigraine headache, migraine with aura, migraine without aura, past history of migraine or no history of headache. Cox proportional hazards models were used to evaluate the association between migraine and headache status and incident depression. At baseline, 5115 women reported a history of nonmigraine headache, 1805 reported migraine with aura, 2723 reported migraine without aura, and 1896 reported a past history of migraine. During 13.8 mean years of follow-up, 3833 new cases of depression occurred. The adjusted relative risks of incident depression were 1.44 (95% CI: 1.32, 1.56) for nonmigraine headache, 1.53 (95% CI: 1.35, 1.74) for migraine with aura, 1.40 (95% CI: 1.25, 1.56) for migraine without aura, and 1.56 (95% CI: 1.37, 1.77) for past history of migraine compared to no history of headache. Middle-aged women with migraine or nonmigraine headache are at increased risk of incident depression. Frequent migraine attacks (weekly or daily) were associated with the highest risk for developing depression.

  9. 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.

  10. 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.

  11. 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.

  12. A prospective study of injuries inflicted on children by children.

    PubMed

    Wyatt, Jonathan P; Woodhams, Sarah; Weinberg, Laurence; Alao, David; Mitchell, Louisa

    2010-01-01

    Intentional injuries inflicted upon children by adults rightly cause great concern and have been studied extensively. In contrast, little is known about the pattern, nature and extent of injuries sustained by children inflicted by other children. A funded prospective study of injured children was undertaken over 18 months. Children's injuries were studied in an epidemiologically complete population comprising the western two-thirds of Cornwall. Information was collected from ten hospitals in standardised fashion using the widely accepted Children's Hospital Injury Reporting and Prevention Programme (CHIRPP). 597 injuries (67% involving boys) were identified as having been inflicted apparently deliberately by other children. 62% of injuries affected children aged under 12 years. 245 injuries (41%) occurred at or around school, 143 (24%) at home. Most injuries involved soft tissues, but there were 116 fractures, which accounted for 22 of the 40 hospital admissions. Interestingly, despite a description of an ''assault'', only 38% of injuries were initially coded as intentional by treating hospital staff. These results reveal the previously largely unrecognised scale of the problem of interpersonal violence between children. It is not surprising that most injuries occurred in or around school, given that this is where children interact with other children. The attitude of healthcare professionals may need to change if this problem is to be properly addressed. 2009 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  13. Vitreous Microparticle Shedding in Retinal Detachment: A Prospective Comparative Study.

    PubMed

    Tumahai, Perle; Saas, Philippe; Ricouard, Fanny; Biichlé, Sabéha; Puyraveau, Marc; Laheurte, Caroline; Delbosc, Bernard; Saleh, Maher

    2016-01-01

    Microparticles (MPs) are membrane-derived vesicles measuring less than 1 μm in diameter. They are shed from nearly every activated or preapoptotic cell and may exhibit biologic activities in inflammation or apoptosis settings. The main purpose of this study was to determine whether MP shedding was higher in the vitreous of patients with retinal detachment (RD). This was a prospective, comparative study. Levels of vitreous MPs (including phosphatidylserine [PS]-expressing MPs, photoreceptor cell-derived MPs, and photoreceptor cell-derived MPs expressing PS) and soluble proinflammatory factors (i.e., monocyte chemoattractant protein-1, intercellular adhesion molecule-1, and IL-6) were analyzed by flow cytometry. Samples were obtained from 49 eyes undergoing RD surgery and 41 control eyes. Vitreous levels of all the MPs studied were significantly increased in the RD group. Vitreous MP levels were correlated with levels of at least one proinflammatory factor depending on MP subsets. Concerning clinical parameters, vitreous PS-expressing MP and PS-expressing photoreceptor cell-derived MP levels were higher depending on the duration of RD at surgery, the detached retina surface, and the macula status and were found more sensitive than proinflammatory factors only for the duration of RD at surgery. Vitreous concentrations of MPs (mainly derived from photoreceptor cells) are higher after rhegmatogenous RD and found to be correlated with soluble proinflammatory factors.

  14. 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

  15. 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

  16. Adolescent risk factors for poisonings - a prospective cohort study.

    PubMed

    Kivistö, Juho E; Rimpelä, Arja; Mattila, Ville M

    2011-12-01

    This study assessed whether adolescents' socioeconomic background, health and health behaviours are associated with later risk of poisoning hospitalization. A prospective cohort of 54,169 Finns aged 14-18 years was followed for an average of 10.6 years. The end-point of the study was poisoning hospitalization, death or termination of follow-up in 2001. The relationships of socioeconomic background, health and health behaviour characteristics with poisoning hospitalization were studied with adjusted Cox's proportional hazard model. We identified 443 persons (0.8%) with a diagnosed poisoning leading to hospital admission. The mean age at the time of the poisoning hospitalization was 22.7 years. The strongest risk factors for poisoning hospitalization in males were more than three stress symptoms weekly (HR 1.9), poor school success (HR 1.9) and not living with both of the parents in adolescence (HR 1.8). In females, the strongest risk factors were more than three stress symptoms weekly (HR 2.1), poor school success (HR 2.2) and recurring drunkenness as drinking style (HR 1.7). Poor school performance, health and health-compromising behaviour adopted in adolescence are associated with a poisoning hospitalization risk in adulthood. Daily smoking and recurring drunkenness were strongly associated with a later poisoning hospitalization. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

  17. 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.

  18. Asthma control measurement using five different questionnaires: a prospective study.

    PubMed

    Vermeulen, Francois; de Meulder, Isabelle; Paesmans, Marianne; Muylle, Inge; Bruyneel, Marie; Ninane, Vincent

    2013-09-01

    Questionnaires play a key place in the assessment of asthma control. Different questionnaires have been developed. However, it remains largely unknown whether they can be used interchangeably. We wondered whether the panel of frequently used scores would give similar measurement of asthma control. The present study aimed to assess the agreement between five specific questionnaires. In this prospective study, ninety-nine patients completed five commonly used asthma control scores: the GINA, the Asthma Control Test™, the Royal College of Physician score, the Asthma Therapy Assessment Questionnaire (ATAQ), and the Asthma Control Questionnaire(©) (ACQ). The kappa coefficient was used to assess the agreement between questionnaires. The agreement between the GINA and other scores was only moderate (kappa coefficients amounted from 0.41 to 0.60). With respect to the "controlled" level, all the other scores gave higher results than GINA. All other scores also tended to underestimate GINA "uncontrolled level". For the "partly controlled level" defined by 3 of the 5 questionnaires, ACQ identified the same percentage of patients than GINA while ATAQ overestimated this percentage. This study shows only moderate agreement between five commonly used asthma control scores. The GINA score showed the lowest percentage of controlled and the highest percentage of uncontrolled asthma. As a consequence, all these scores do not seem to evaluate the same symptoms. NCT01350661. © 2013 Elsevier Ltd. All rights reserved.

  19. 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

  20. 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

  1. 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

  2. Treatment of Micrognathia by Intraoral Distraction Osteogenesis: A Prospective Study

    PubMed Central

    Baskaran, M.; Arularasan, S. Gidean; Divakar, T. K.; Thirunavukkarasu, Rohini

    2017-01-01

    Purpose: Maxillofacial deformities are always psychologically and physically distressing to the patients and is also challenging to the treating surgeons. The term Micrognathia means a “small jaw”. True micrognathia, where the maxilla or the mandibular skeleton does not grow to the full size can be congenital or acquired. Distraction osteogenesis also called as callus distraction or callostasis or osteodistraction or distraction histogenesis is a biological process of regenerating newly formed bone and adjacent soft tissue by a gradual and controlled traction of surgically separated bone segments. The purpose of this prospective study was to assess the versatility of distraction osteogenesis in the treatment of micrognathia. Materials and Methods: Four patients (three males and one female) with micrognathia of mandible were included in this prospective study. The patients were between the age group of 10-20 years. Facial asymmetry was the chief complaint of all the patients. In all the patients following treatment protocol was carried out, Osteotomy and placement of intraoral distraction device under general anaesthesia, latency phase (5-7 days), activation period-rate 1.5 mm per day, consolidation period of 8 weeks, removal of distraction device under local anaesthesia. The parameters assessed were ramus height, body length, hyo mental distance, posterior pharyngeal airway space, chin projection, facial symmetry occlusion, mid line shift pre and post operatively. Results: The mean increase in ramus height achieved was 9.2 + 2.17 mm and the mandibular body length achieved was 10.4+1.67 mm. There was an average increase in hyo-mental distance of 2.75 cm +0.9 cm postoperatively showing a definitive improvement in the airway. The posterior pharyngeal space measured from the lateral cephalogram preoperatively ranged from 3-6 mm and post operatively from 6-9 mm.Intraorally there was a shift in occlusion to class I molar relation in three patients and there was

  3. Treatment of Micrognathia by Intraoral Distraction Osteogenesis: A Prospective Study.

    PubMed

    Baskaran, M; Arularasan, S Gidean; Divakar, T K; Thirunavukkarasu, Rohini

    2017-01-01

    Maxillofacial deformities are always psychologically and physically distressing to the patients and is also challenging to the treating surgeons. The term Micrognathia means a "small jaw". True micrognathia, where the maxilla or the mandibular skeleton does not grow to the full size can be congenital or acquired. Distraction osteogenesis also called as callus distraction or callostasis or osteodistraction or distraction histogenesis is a biological process of regenerating newly formed bone and adjacent soft tissue by a gradual and controlled traction of surgically separated bone segments. The purpose of this prospective study was to assess the versatility of distraction osteogenesis in the treatment of micrognathia. Four patients (three males and one female) with micrognathia of mandible were included in this prospective study. The patients were between the age group of 10-20 years. Facial asymmetry was the chief complaint of all the patients. In all the patients following treatment protocol was carried out, Osteotomy and placement of intraoral distraction device under general anaesthesia, latency phase (5-7 days), activation period-rate 1.5 mm per day, consolidation period of 8 weeks, removal of distraction device under local anaesthesia. The parameters assessed were ramus height, body length, hyo mental distance, posterior pharyngeal airway space, chin projection, facial symmetry occlusion, mid line shift pre and post operatively. The mean increase in ramus height achieved was 9.2 + 2.17 mm and the mandibular body length achieved was 10.4+1.67 mm. There was an average increase in hyo-mental distance of 2.75 cm +0.9 cm postoperatively showing a definitive improvement in the airway. The posterior pharyngeal space measured from the lateral cephalogram preoperatively ranged from 3-6 mm and post operatively from 6-9 mm.Intraorally there was a shift in occlusion to class I molar relation in three patients and there was posterior open bite in one patient. Marked

  4. Brachiobasilic versus brachiocephalic arteriovenous fistula: a prospective randomized study.

    PubMed

    Koksoy, Cuneyt; Demirci, Rojbin Karakoyun; Balci, Deniz; Solak, Tuba; Köse, S Kenan

    2009-01-01

    The most recent Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines recommend that the order of preference for arteriovenous fistula (AVF) placement is the radial-cephalic primary AVF, followed by the secondary brachiocephalic (BC) and, if either of these is not viable, then brachiobasilic (BB) AVF should be fashioned. However, there is limited prospective data comparing technical and clinical outcomes of these two approaches. The purpose of our study was to compare outcome, patency, and complication rates in these two autogenous upper arm AV accesses. Between December 2003 and and January 2007, patients (61 male, 39 female) who have lost more distal AVFs were enrolled in the study. After preoperative duplex mapping, patients with patent both basilic and cephalic veins greater than 3 mm of diameter were randomized into BCAVF and BBAVF groups, each group consisting of 50 patients. All procedures were performed under local anesthesia as one-stage procedures. Follow-up data were prospectively collected. Kaplan-Meier analysis was used to calculate primary and secondary patency rates. Univariate and multivariate Cox-regression analysis was used to find risks for the occurrence of thrombosis. Baseline demographics, clinical characteristics, and preoperative history dialysis access were comparable between groups with the exception of the fact that mean caliber of the basilic veins were larger (4.51 +/- 0.93 mm vs 3.90 +/- 0.1 mm; P = .002). The mean duration of operation was significantly shorter in the BC group compared with the BB group (P < .001). There was no significant difference in the thirty day mortality, wound complications, 24 hour thrombosis, postoperative hemorrhage, maturation, and time to maturation between the groups. Mean follow-up was 43.2 +/- 1.8 months. Primary patency at 1 and 3 years of follow-up was 87% and 81% for the BC group and 86% and 73% for the BB group (P = .7) Secondary patency at one and three year follow-up was 87% and 70% for

  5. Morbidity of harvesting of chin grafts: a prospective study.

    PubMed

    Nkenke, E; Schultze-Mosgau, S; Radespiel-Tröger, M; Kloss, F; Neukam, F W

    2001-10-01

    In a prospective study, 20 patients who underwent harvesting of chin grafts as outpatients, were followed up for 12 months (3 further patients with incomplete follow-up data were excluded from the study). Preoperatively and 7 days, 1, 3, 6 and 12 months postoperatively, follow-up data were assessed. Evaluation of the superficial sensory function of the inferior alveolar nerve was determined by the Pointed-Blunt Test and the Two-Point-Discrimination Test. Sensory disturbances were objectively assessed by testing thermal sensitivity with the "Pain and Thermal Sensitivity" Test (PATH Test). In addition, evaluation of the pulp sensitivity of teeth 35-45 was carried out by cold vitality testing. One week postoperatively, 8 patients were affected by superficial sensory impairment. 8 nerve territories showed hypoaesthetic reactions and 5 showed hyperaesthetic reactions. After 12 months, two patients still suffered from hypoaesthesia of one side of the chin. There was a statistically significant sensitivity impairment of the chin for all patients comparing the preoperative data of the Two-Point-Discrimination Test (left/right median: 8.17/8.17 mm, interquartile range (IQR) 1.00/2.00 mm) with the first postoperative measurement (left/right median 9.00/8.33 mm, IQR 1.67/2.66 mm). Comparing the latter to the last postoperative measurement there was significant tendency for regeneration of a nerve function (left/right median 8.00/7.84 mm, IQR 0.66/2.00 mm). In the PATH Test all hypoaesthetic areas could be identified by a reduction of thermal sensitivity. After the first postoperative examination 21.6% (n=38/176) of the examined teeth had lost their pulp sensitivity. After 12 postoperative months 11.4% (n=20/176) still did not react sensitively. Many of these were canines (n=8/20). Comparing the preoperative to the first postoperative examination, there was a significant reduction of pulp sensitivity. However, statistically significant recovery until the last postoperative

  6. 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

  7. 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

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

    PubMed

    Thomson, William Murray; Zeng, Jiaxu; Broadbent, Jonathan M; Foster Page, Lyndie A; Shalev, Idan; Moffitt, Terrie E; Caspi, Avshalom; Williams, Sheila M; Braithwaite, Antony W; Robertson, Stephen P; Poulton, Richie

    2016-02-01

    The aim of the study was to examine the association between telomere erosion and periodontitis in a long-standing prospective cohort study of New Zealand adults. Specific hypotheses tested were as follows: (i) that exposure to periodontitis at ages 26 and 38 was associated with accelerated leucocyte telomere erosion and (ii) that accelerated leucocyte telomere erosion was associated with higher rates of periodontitis by ages 26 and 38. 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. Overall, the mean telomere length was 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. 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. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Tooth loss in individuals under periodontal maintenance therapy: prospective study.

    PubMed

    Lorentz, Telma Campos Medeiros; Cota, Luís Otávio Miranda; Cortelli, José Roberto; Vargas, Andréia Maria Duarte; Costa, Fernando Oliveira

    2010-01-01

    This prospective study aimed to evaluate the incidence, the underlying reasons, and the influence of predictors of risk for the occurrence of tooth loss (TL) in a program of Periodontal Maintenance Therapy (PMT). The sample was composed of 150 complier individuals diagnosed with chronic moderate-severe periodontitis who had finished active periodontal treatment and were incorporated in a program of PMT. Social, demographic, behavioral and biological variables were collected at quarterly recalls, over a 12-month period. The effect of predictors of risk of and confounding for the dependent variable TL was tested by univariate and multivariate analysis, as well as the underlying reasons and the types of teeth lost. During the monitoring period, there was a considerable improvement in periodontal clinical parameters, with a stability of periodontal status in the majority of individuals. Twenty-eight subjects (18.66%) had TL, totaling 47 lost teeth (1.4%). The underlying reasons for TL were: periodontal disease (n = 34, 72.3%), caries (n = 3, 6.4%), prosthetic reasons (n = 9, 19.2%), and endodontic reasons (n = 1, 2.1%). Additionally, subjects with 10% of sites with probing depth between 4 and 6 mm were 5 times more likely to present TL (OR = 5.13, 95% CI 2.04-12.09). In this study, the incidence of TL was small and limited to few individuals. Additionally, gender and severity of periodontitis were significantly associated with TL during the monitoring period.

  10. [Tricuspid valve stenosis. A prospective study of 35 cases].

    PubMed

    Diaof, M; Ba, S A; Kane, A; Sarr, M; Diop, I B; Diouf, S M

    2004-01-01

    Authors report the results of prospective and longitudinal study. The aims of this study were to evaluate among 35 patients, prevalence, diagnosis and treatment aspects of tricuspid stenosis (TS), as well as evolution and pronostical factors. The prevalence of TS was about 4.2%. The main clinical signs were: dyspnoea (94.2%), jugular veinus pulses (42.8%), superior cave syndrom (68.8%), diastolic rumble (74.3%). ECG showed sinus rhythm (51.4%), a right atrial hypertrophy (48.5%). Echocardiography showed tricuspid leaflets thickened (82.8%), a right atrial hypertrophy (48.5%), a mean gradient between right atrial and right ventricle: 8.6 +/- 3.14 mmHg (65.7%) and mean tricuspid area about 1.41 +/- 0.83 cm2 (continuous equation); about 1.74 +/- 1.29 cm2 (Hatle formula) and 1.11 0.84 cm2 (simplified Hatle formula). Aetiology was only rheumatic fever. After a follow-up of 8.53 +/- 6.06 months, the mortality rate was 28.5%. Complications were irreducible heart failure (24 cases), liver failure (2 cases) and stroke (3 cases). Factors associated with mortality were: severity of tricuspid stenosis and pulmonary hypertension, importance of dyspnea and heart failure (p < 0.041).

  11. Relation between hysterectomy and the irritable bowel: a prospective study.

    PubMed Central

    Prior, A; Stanley, K M; Smith, A R; Read, N W

    1992-01-01

    Some women with irritable bowel syndrome date the onset of symptoms to previous hysterectomy. To assess prospectively the incidence of gastrointestinal symptomatology arising de novo after hysterectomy, and to study the effect of surgery on pre-existing symptoms, 205 women completed a symptom questionnaire before and six weeks and six months after surgery. Beforehand, symptoms suggestive of irritable bowel syndrome occurred in 22% of patients. At six months after operation, 60% of these had improved or were symptom free while 20% had increased symptomatology. New gastrointestinal symptoms were present more than once per week in 10% of previously asymptomatic women. Constipation predominant irritable bowel syndrome was the commonest symptom complex seen de novo, occurring more than once per week in 5% of the group. No relation was found between new symptomatology and the type of hysterectomy, oophorectomy, or the administration of perioperative antibiotics. This study suggests that many women with pre-existing gastrointestinal symptomatology improve after hysterectomy. However, symptoms suggestive of irritable bowel syndrome do arise de novo in 10%. As hysterectomy is common, gastroenterologists can expect to see women presenting with post-hysterectomy problems. PMID:1624165

  12. 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

  13. 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

  14. 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

  15. Course of migraine during pregnancy and postpartum: a prospective study.

    PubMed

    Sances, G; Granella, F; Nappi, R E; Fignon, A; Ghiotto, N; Polatti, F; Nappi, G

    2003-04-01

    The aim of this study was to investigate prospectively the course of migraine during pregnancy and postpartum. Of all the pregnant women consecutively attending an obstetrics and gynaecology department for a routine first-trimester antenatal check-up, 49 migraine sufferers--two were affected by migraine with aura (MA) and 47 by migraine without aura (MO)--who had experienced at least one attack during the 3 months preceding pregnancy were identified, enrolled in the study and given a headache diary. Subsequent examinations were performed at the end of the second and third trimesters and 1 month after delivery. Migraine was seen to improve in 46.8% of the 47 MO sufferers during the first trimester, in 83.0% during the second and in 87.2% during the third, while complete remission was attained by 10.6%, 53.2%, and 78.7% of the women, respectively. Migraine recurred during the first week after childbirth in 34.0% of the women and during the first month in 55.3%. Certain risk factors for lack of improvement of migraine during pregnancy were identified: the presence of menstrually related migraine before pregnancy was associated with a lack of headache improvement in the first and third trimesters, while second-trimester hyperemesis, and a pathological pregnancy course were associated with a lack of headache improvement in the second trimester. Breast feeding seemed to protect from migraine recurrence during postpartum.

  16. Mastitis in Chinese breastfeeding mothers: a prospective cohort study.

    PubMed

    Tang, Li; Lee, Andy H; Qiu, Liqian; Binns, Colin W

    2014-01-01

    Mastitis is a common problem encountered by breastfeeding mothers. This study investigated the incidence and risk factors of lactation mastitis among Chinese women. A prospective cohort study on infant feeding practices was conducted during 2010 and 2011 in Jiangyou, Sichuan Province, China. Poisson regression analysis was performed to determine factors influencing the incidence of mastitis within 6 months postpartum. Of the 670 Chinese mothers who were breastfeeding at discharge, 42 women (6.3%) experienced at least one episode of mastitis during the first 6 months after delivery. The cumulative incidence of mastitis was 10.3%. Mothers with a cracked and sore nipple (incidence rate ratio 2.24; 95% confidence interval 1.38, 3.63) and those who felt stressed (incidence rate ratio 3.15; 95% confidence interval 1.56, 6.37) appeared to sustain more episodes of mastitis. The incidence of lactation mastitis was low among Chinese mothers. To further reduce the risk of mastitis, instructions on the correct positioning of the baby during breastfeeding should be emphasized. Providing new mothers with guidance on how to cope with stress may also prevent the recurrence of the condition.

  17. 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.

  18. A prospective study of teleconferencing for orthopaedic consultations.

    PubMed

    Aarnio, P; Lamminen, H; Lepistö, J; Alho, A

    1999-01-01

    We carried out a prospective study of teleconsulting in orthopaedics. A commercial videoconferencing system was connected by three ISDN lines between the Satakunta Central Hospital in Pori and the Orton Orthopaedic Hospital in Helsinki, 240 km away. A document camera was used to transfer radiographic images and paper documents. Twenty-nine patients who needed an orthopaedic consultation were studied over three months. They were examined by a surgeon in Pori with the aid of teleconferencing and again later in a traditional, face-to-face appointment in Helsinki. Patients and doctors completed questionnaires after the consultations. Technically, the videoconferencing system functioned reliably and the quality of the video was judged to be good. Twenty patients (69%) would not have needed to travel for a face-to-face appointment, because the teleconsultation afforded a definite treatment decision. The orthopaedic surgeons considered all the treatment decisions arising from the teleconsultation good, except in one case which was considered satisfactory. The quality of the radiographic images transferred with the document camera was good or very good in 17 cases and satisfactory in three cases. None of the patients had experienced videoconferencing before; 87% of them thought that teleconsultation was a good or very good method and the rest felt that it was satisfactory. All patients wanted to participate in teleconsultations again and most would have recommended it to other patients.

  19. Political violence and mental health in Nepal: prospective study.

    PubMed

    Kohrt, Brandon A; Hruschka, Daniel J; Worthman, Carol M; Kunz, Richard D; Baldwin, Jennifer L; Upadhaya, Nawaraj; Acharya, Nanda Raj; Koirala, Suraj; Thapa, Suraj B; Tol, Wietse A; Jordans, Mark J D; Robkin, Navit; Sharma, Vidya Dev; Nepal, Mahendra K

    2012-10-01

    Post-conflict mental health studies in low-income countries have lacked pre-conflict data to evaluate changes in psychiatric morbidity resulting from political violence. This prospective study compares mental health before and after exposure to direct political violence during the People's War in Nepal. An adult cohort completed the Beck Depression Inventory and Beck Anxiety Inventory in 2000 prior to conflict violence in their community and in 2007 after the war. Of the original 316 participants, 298 (94%) participated in the post-conflict assessment. Depression increased from 30.9 to 40.6%. Anxiety increased from 26.2 to 47.7%. Post-conflict post-traumatic stress disorder (PTSD) was 14.1%. Controlling for ageing, the depression increase was not significant. The anxiety increase showed a dose-response association with conflict exposure when controlling for ageing and daily stressors. No demographic group displayed unique vulnerability or resilience to the effects of conflict exposure. Conflict exposure should be considered in the context of other types of psychiatric risk factors. Conflict exposure predicted increases in anxiety whereas socioeconomic factors and non-conflict stressful life events were the major predictors of depression. Research and interventions in post-conflict settings therefore should consider differential trajectories for depression v. anxiety and the importance of addressing chronic social problems ranging from poverty to gender and ethnic/caste discrimination.

  20. 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.

  1. Penetrating head injury: a prospective study of outcomes.

    PubMed

    Zafonte, R D; Wood, D L; Harrison-Felix, C L; Valena, N V; Black, K

    2001-01-01

    The purpose of our study was to describe the outcomes of persons with penetrating brain injury resulting from a gunshot wound to the head. It is a prospective study of 442 patients admitted with gunshot wounds to the head over a 7 year period to our University Trauma Center Emergency Department, an urban trauma center and an inpatient rehabilitation hospital with a specialized brain injury unit. Measures and factors described include initial Glasgow Coma Scale score, Revised Trauma Score, the Disability Rating Scale, Functional Independence Measure, levels of cognitive functioning, patient demographics, length of stay, hospital charges, and discharge disposition. Initially 36% of patients expired in or were dead upon arrival to the Emergency Department; 64% of patients survived to be admitted for inpatient care. Of those admitted, 41% expired within the first 48 h of admission. Fifty-two percent of those admitted had severe injuries, 7% moderate injuries, and 42% had mild head injuries. Sixty-two percent of the survivors were discharged from acute care to private residences. The remaining 38% were discharged to programs providing varying levels of care depending upon their level of functioning and care needs. Patients sustaining severe injuries following gunshot wound(s) to the head have high early mortality. Survivors able to participate in an inpatient rehabilitation program have good potential for functional improvement.

  2. 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

  3. A prospective study of 138 arthroscopies of the temporomandibular joint.

    PubMed

    Silva, Paulo Alexandre da; Lopes, Maria Teresa de Fatima Fernandes; Freire, Fernando Silva

    2015-01-01

    Internal derangements (ID) of the temporomandibular joint (TMJ) have a multifactorial etiology and are most often treated conservatively by splints, physical therapy and medications. Only in 2-5% of cases are the treatment surgical, either by arthroscopy or arthrotomy. To evaluate improvement of mouth opening, pain relief during function, position of the articular disk and complications following Arthroscopic Lyse and Lavage (ALL). A prospective study of 78 patients (138 TMJs) with TMJ ID, 5 males and 73 females, mean age 29.7 years, treated between January 2010 and April 2013, who were refractory to conservative treatment, had limited mouth opening and pain localized to the TMJ during function, and who were submitted to TMJ ALL and followed for a period of 12 months, with periodic reviews. ALL was effective in 93.6% of cases, with 85.3% experiencing improvement in mouth opening and 91.2% in pain reduction during function, 63% improvement in disk position and a rate of complications of 6.2%. In this study the ALL exhibited a high rate of success with low morbidity in internal derangements of the TMJ. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  4. 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.

  5. Interdisciplinary rehabilitation after whiplash injury: an observational prospective outcome study.

    PubMed

    Angst, Felix; Françoise, Gysi; Verra, Martin; Lehmann, Susanne; Jenni, Walter; Aeschlimann, André

    2010-04-01

    To examine the state of, and change in, biopsycho-social health and quality of life of patients after whiplash injury, before and after an inpatient interdisciplinary pain management programme. Observational, prospective cohort study (n = 103) using medical record data and standardized self-assessments to compare health state with general population norms and to determine effects by means of standardized effect sizes. The therapy programme consisted of drug adaptation, graded activity exercise, relaxation therapies, and behavioural therapy. Compared with population norms, patients' health was significantly deteriorated in all dimensions of the Short Form 36, depression and anxiety at all examined times. After rehabilitation, pain improved by effect sizes up to 0.65, function/role performance up to 0.87, vitality up to 0.67 and coping up to 0.41. At the 6-month follow-up, these effects remained, with effect sizes between 0.45 and 0.87. The median working capacity improved from 8 h per week at baseline to 21 h at follow-ups. The rehabilitation programme showed moderate to large mid-term improvements in important health dimensions, medication reduction and working capacity. Further controlled studies are required to quantify and attribute these improvements more precisely.

  6. Autoantibodies in Burkitt's lymphoma patients from the Ugandan prospective study.

    PubMed

    Mori, H; Lenoir, G M; Franklin, R M

    1986-03-01

    Pre- and post syndrome sera from five Burkitt's lymphoma patients who partook in the Ugandan prospective study (A. Geser et al., Int. J. Cancer 29 (1982) 397-400) were investigated with respect to autoantibodies. Neighbours and siblings of these patients served as controls and all of these groups were compared with sera from 50 Caucasian normal controls (CNC). Antibody levels significantly higher than those in CNC were found in all African groups for actin, desmin, vimentin, tubulin, keratin, laminin, and collagen type I. Polyclonal B-cell activation, as measured by antibodies to DNP, and high levels of antibodies to P. falciparum were also found. Anti-DNP and antibodies to malaria were also present in sera from our earlier study on Burkitt's lymphoma (E. Vainio et al., Clin. exp. Immunol. 54 (1983) 387-396). Whereas EBV infected B cells do produce autoantibodies, there is a potentiation of autoantibody formation as a result of infection with malaria, which seems to provide an independent trigger of polyclonal B cell activation. This latter event might be one of the factors which results in a correlation of Burkitt's lymphoma with malaria endemic regions.

  7. 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

  8. Prospective study of injury in volleyball players: 6 year results.

    PubMed

    Pastor, M F; Ezechieli, M; Classen, L; Kieffer, O; Miltner, O

    2015-01-01

    The volleyball game has a high complexity and thus entails a lot of strain to the players. Due to this high and different training and competition strain comprehensive and individual training plans should be developed with competing training objectives in order to prevent injuries. The aim of the study was to analyse prospectively over six seasons the acute and overuse injuries of a German male professional volleyball team. The study included 34 male national league players from season the 2007/08 to 2012/13. All players received a sport medicine examination and a functional diagnosis before each season. Based on the results the players received an individual training plan. The players suffered 186 injuries. The prevalence of acute injuries was 1.94 per player and overuse injuries 0.64 per player. The incidence of acute injuries was 3.3/1000 h volleyball and overuse injuries 1.08/1000 h volleyball. The largest number of injuries was found in the spine. The players had most likely minor injuries. The players had significantly fewer injuries in their second season (1.92) than in their first season (3.25; p= 0.004). It could be concluded that volleyball is a sport with a relative low prevalence of injuries compared to other team sports. The prevalence of injury is 2.58 per player. Due to an injury a player dropped out 16.91 days per season. An individual training program seems to reduce the incidence of injury.

  9. Monitoring of Gas Emboli During Hysteroscopic Surgery: A Prospective Study.

    PubMed

    Liu, Sheng-Qun; Zhao, Su-Zhen; Li, Zhan-Wen; Lv, Su-Ping; Liu, Yue-Qiang; Li, Yi

    2017-04-01

    Previous studies have demonstrated a high frequency of gas emboli during hysteroscopy, but guidelines for the prevention, early detection, and intervention of gas embolism during hysteroscopic procedures are still lacking. This study aimed to gain a clearer understanding of risk factors and specific signs and symptoms associated with gas emboli. This prospective study enrolled 120 women scheduled for hysteroscopy using 5% glucose as distension medium. The gas bubbles were monitored sequentially in internal iliac vein, common iliac vein, inferior vena cava, superior vena cava, heart, and pulmonary artery under the gray-scale imaging of Doppler ultrasound. The frequency, extent, and the hemodynamic and respiratory effects of gas emboli were evaluated. The interventions and outcomes were recorded. The risk factors associated with gas emboli, and their relationship with the frequency and extent of gas emboli, were assessed. In our study, evidence of gas emboli under Doppler ultrasound monitoring was observed in 44 (36.7%) patients. The operation was continued and finished as soon as possible for patients presenting with stable vital signs or transient hemodynamic and respiratory changes, which resolved spontaneously without intervention. The operation was paused for patients presenting with significant hemodynamic changes or loss of consciousness, and the operation was resumed shortly after resumption of stable vital signs following symptomatic treatment. All patients in our study finished the operation and recovered without developing serious complications. Data analysis showed prolonged procedure duration and increased bleeding volume were both positively correlated with the frequency and extent of gas emboli. Our study demonstrated a high frequency of gas emboli during hysteroscopy. Doppler ultrasonic monitoring combined with a clearer understanding of specific signs, symptoms, and risk factors will facilitate early detection and intervention of gas emboli during

  10. Letter from Reykjavik.

    PubMed

    Jónsson, P V

    1998-06-01

    Medical care in Iceland can be viewed as an experiment of nature. This small island society has combined the Nordic social and welfare structures with advanced international medicine. The Vikings settled Iceland in the ninth century, and the population has remained biologically homogeneous because of its remote isolation. This homogeneity may provide a unique opportunity to contribute to the understanding of the genetics of common disorders. Iceland's isolation has also limited the resources that are available for clinical training. Therefore, it has been necessary for most physicians who graduate from the medical school at the University of Iceland to obtain postgraduate training abroad. This has been of enormous benefit to Icelandic medicine. Fewer opportunities for foreign medical graduates to train in the United States would have a substantial effect on the future practice of Icelandic medicine. The Icelandic health care system faces many challenges. Because health care spending has been reined in, priorities must be set more clearly than in the past, and heated discussions have erupted about gatekeeping and merging of hospitals. These have been "interesting times" for Icelandic medicine. Other countries may learn lessons from our medical situation: a microcosm, to be sure, but no longer an isolated one.

  11. Subsidence following anterior lumbar interbody fusion (ALIF): a prospective study

    PubMed Central

    Phan, Kevin; Giang, Gloria; Maharaj, Monish M.; Phan, Steven; Mobbs, Ralph J.

    2017-01-01

    Background Anterior lumbar interbody fusion (ALIF) is a widely used surgical technique for disorders of the lumbar spine. One potential complication is the subsidence of disc height in the post-operative period. Few studies have reported the rate of subsidence in ALIF surgery prospectively. We prospectively evaluated the rate of subsidence in adult patients undergoing ALIF. Methods Results were obtained by reviewing scans of 147 patients. Disc heights were measured on radiographic scans taken pre-operatively in addition to post-operatively immediately, at 6 weeks and at 18 months. The anterior and posterior intervertebral disc heights were measured. Subsidence was defined as greater than or equal to 2 mm loss of height. Results A total of 15 patients (10.2%) had subsidence, with 7 being male. Each case was of delayed cage subsidence (DCS) >6 weeks postoperatively. The mean subsidence was 4.7 mm (range, 2.4–7.8). Mean anterior disc height was 8.6±0.4 mm preoperatively, which improved to 15.1±0.5 mm at latest follow-up. Mean posterior disc height was 4.7±0.2 mm preoperatively, which improved to 8.7±0.4 mm at latest follow-up. The mean lumbar lordosis (LL) angle was 42.5°±10.8° and the mean local disc angle (LDA) was 6.7°±4.0°. The 91.2% (n=114/125) of patients with appropriate radiological follow-up demonstrated fusion by latest follow-up. There was no correlation between subsidence rate with patient reported outcomes [Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and Short Form 12 Item survey (SF-12)] and fusion rates. There was a significant negative correlation between LL and extent of subsidence (Pearson correlation =−0.754, P=0.012). Conclusions In conclusion, we found that the subsidence rate at follow-up was generally low following standalone ALIF for this patient series. Patient clinical outcomes and bony fusion rates were not significantly influenced by subsidence. PMID:28744497

  12. Subsidence following anterior lumbar interbody fusion (ALIF): a prospective study.

    PubMed

    Rao, Prashanth J; Phan, Kevin; Giang, Gloria; Maharaj, Monish M; Phan, Steven; Mobbs, Ralph J

    2017-06-01

    Anterior lumbar interbody fusion (ALIF) is a widely used surgical technique for disorders of the lumbar spine. One potential complication is the subsidence of disc height in the post-operative period. Few studies have reported the rate of subsidence in ALIF surgery prospectively. We prospectively evaluated the rate of subsidence in adult patients undergoing ALIF. Results were obtained by reviewing scans of 147 patients. Disc heights were measured on radiographic scans taken pre-operatively in addition to post-operatively immediately, at 6 weeks and at 18 months. The anterior and posterior intervertebral disc heights were measured. Subsidence was defined as greater than or equal to 2 mm loss of height. A total of 15 patients (10.2%) had subsidence, with 7 being male. Each case was of delayed cage subsidence (DCS) >6 weeks postoperatively. The mean subsidence was 4.7 mm (range, 2.4-7.8). Mean anterior disc height was 8.6±0.4 mm preoperatively, which improved to 15.1±0.5 mm at latest follow-up. Mean posterior disc height was 4.7±0.2 mm preoperatively, which improved to 8.7±0.4 mm at latest follow-up. The mean lumbar lordosis (LL) angle was 42.5°±10.8° and the mean local disc angle (LDA) was 6.7°±4.0°. The 91.2% (n=114/125) of patients with appropriate radiological follow-up demonstrated fusion by latest follow-up. There was no correlation between subsidence rate with patient reported outcomes [Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and Short Form 12 Item survey (SF-12)] and fusion rates. There was a significant negative correlation between LL and extent of subsidence (Pearson correlation =-0.754, P=0.012). In conclusion, we found that the subsidence rate at follow-up was generally low following standalone ALIF for this patient series. Patient clinical outcomes and bony fusion rates were not significantly influenced by subsidence.

  13. 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.

  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. A prospective study of work stressors and the common cold.

    PubMed

    Park, S-G; Kim, H-C; Min, J-Y; Hwang, S H; Park, Y-S; Min, K-B

    2011-01-01

    Psychological stress is a risk factor for infectious diseases. Although psychological stress at work is considered an important problem for many workers, there is little evidence for the effect of work-related stress on infectious diseases. To investigate whether work-related stress affected the occurrence of the common cold in South Korean workers in small- to medium-sized manufacturing companies. We conducted a prospective study, involving 1241 workers. At the outset, we collected information regarding sociodemographic and work characteristics. At follow-up after 6 months, we asked subjects whether they had experienced common cold symptoms during the preceding 4 months. Male subjects experiencing stress at the outset were more likely to report having experienced the common cold at follow-up (odds ratios: high job demand group 1.74; 95% CI: 1.28-2.36; insufficient job control 1.42; 95% CI: 1.05-1.93; inadequate social support 1.40; 95% CI: 1.03-1.91). For females, no significant association between work stress and occurrence of the common cold was detected. Males experiencing work stress in job demand, job control and social support reported an increased occurrence of the common cold at follow-up but this association was not seen in females.

  16. 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

  17. 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.

  18. 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

  19. Right heart in septic shock: prospective observational study.

    PubMed

    Singh, Ratender Kumar; Kumar, Sudeep; Nadig, Sreevatsa; Baronia, Arvind Kumar; Poddar, Banani; Azim, Afzal; Gurjar, Mohan

    2016-01-01

    The right heart often receives less attention during echocardiography. The situation is no different in septic shock. We prospectively investigated the echocardiographic indices of the right heart in septic shock adult patients. Septic shock ICU patients within 24 h of admission were subjected to transthoracic echocardiography (TTE) as per the 2005 guidelines from the American Society of Echocardiography. Eighty-eight septic shock patients (M:F = 52:36) underwent TTE. Thirty-six patients survived. Significant differences in demographic and biochemical (laboratory and metabolic) parameters, severity scores, life-support therapies (vasopressors, ventilation), and length of ICU stay were observed between survivors and non-survivors. Right heart abnormalities of chamber dimension and systolic and diastolic function existed in 79, 25, and 86 % of patients, respectively. Right ventricle subcostal wall thickness (91 %), pulse Doppler myocardial performance index (73 %), and E/E' (63 %) were the predominant abnormalities in chamber dimension, systolic function, and diastolic function of the right heart, respectively. However, the presence of these abnormalities did not signify poor survival in our study. Right heart dimensional and functional abnormalities exist in high proportions in septic shock. However, their predictability of poor outcomes remains questionable.

  20. Diarrhoea in irradiated patients: a prospective multicentre observational study.

    PubMed

    Pergolizzi, Stefano; Maranzano, Ernesto; De Angelis, Verena; Lupattelli, Marco; Frata, Paolo; Spagnesi, Stefano; Frisio, Maria Luisa; Mandoliti, Giovanni; Delia, Pietro; Malinverni, Giuseppe; Trippa, Fabio; Fabbietti, Letizia; Parisi, Salvatore; De Vecchi, Pietro; Sansotta, Giuseppe; Giorgetti, Celestino; Bergami, Tiziano; Orecchia, Roberto; Portaluri, Maurizio; Signor, Marco; Pontoriero, Antonio; Santacaterina, Anna; Di Gennaro, Davide

    2013-11-01

    To determine the incidence of cancer treatment-induced diarrhoea in patients submitted to irradiation. Forty-five Italian radiation oncology departments took part in this prospective observational study and a total of 1020 patients were enrolled. The accrual lasted three consecutive weeks; evaluation was based on diary cards filled in daily by patients during radiotherapy and one week after cessation. Diary cards recorded both the onset and intensity of diarrhoea. A total of 1004 patients were eligible for this analysis. 147/1004 (14.6%) patients had diarrhoea. The median minimum number of daily events was 1 (range 1-7) with a median maximum events of 3 (range 1-23). 82/147 patients (56.2%) had a drug prescription for diarrhoea. In the evaluation of the onset of diarrhoea, in multivariate analysis, we found the following factors to be statistically significant predictors of an increased likelihood of diarrhoea: primitive tumour site, therapeutic purpose and field size. Patients with abdominal-pelvic cancer, treated with curative purpose and using large field sizes are at high risk of cancer treatment-induced diarrhoea. Diarrhoea was also observed in patients treated at other sites. In this population group there is the need for more stringent monitoring during the delivery of radiation therapy. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  1. 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.

  2. Herpes simplex virus encephalitis in Peru: a multicentre prospective study.

    PubMed

    Montano, S M; Mori, N; Nelson, C A; Ton, T G N; Celis, V; Ticona, E; Sihuincha, M; Tilley, D H; Kochel, T; Zunt, J R

    2016-06-01

    Herpes simplex virus (HSV) is one of the most commonly identified infectious aetiologies of encephalitis in North America and Europe. The epidemiology of encephalitis beyond these regions, however, is poorly defined. During 2009-2012 we enrolled 313 patients in a multicentre prospective study of encephalitis in Peru, 45 (14·4%) of whom had confirmed HSV infection. Of 38 patients with known HSV type, 84% had HSV-1 and 16% had HSV-2. Patients with HSV infection were significantly more likely to present in the summer months (44·4% vs. 20·0%, P = 0·003) and have nausea (60·0% vs. 39·8%, P = 0·01) and rash (15·6% vs. 5·3%, P = 0·01) compared to patients without HSV infection. These findings highlight differences in the epidemiology and clinical presentation of HSV encephalitis outside of the Northern Hemisphere that warrant further investigation. Furthermore, there is an urgent need for improved HSV diagnostic capacity and availability of intravenous acyclovir in Peru.

  3. Neonatal invasive candidiasis: a prospective multicenter study of 118 cases.

    PubMed

    López Sastre, José B; Coto Cotallo, Gil D; Fernández Colomer, Belén

    2003-04-01

    A prospective multicenter study was conducted to assess the epidemiology of neonatal invasive candidiasis in Spain. In a total of 20,565 admissions to the 27 participating neonatal units over an 18-month period, systemic candidiasis was diagnosed in 118 (0.57%) neonates. Candida species were isolated from the blood in 79 infants, from the urine in 33, and from the cerebrospinal fluid in 4; in 2 cases, histologic evidence of deep tissue candidiasis was found at autopsy. Very-low-birth-weight (VLBW) infants (< or = 1500 g) showed a significantly higher incidence of systemic candidiasis (4.8%) than infants weighing > 1500 g (0.2%) ( p < 0.001). Candida albicans was the most frequent species (52.5%) followed by C. parapsilosis (23.7%), and C. tropicalis (7.6%). Only seven infants were treated with amphotericin B (initial dose 0.18 +/- 0.3 mg/kg, maximal daily dose 1.7 +/- 0.9 mg/kg) but treatment was stopped in three of them (43%) due to nephrotoxicity. Liposomal amphotericin B was given to 81 neonates and amphotericin B lipid complex to 29. There were no differences in mortality rate and in the incidence of adverse effects in relation to treatment with liposomal amphotericin B or amphotericin B lipid complex. The mortality rate was 10.2% and all deaths occurred in the VLBW cohort with candidemia.

  4. 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.

  5. Pain perception following different neurosurgical procedures: a quantitative prospective study.

    PubMed

    Dhandapani, Manju; Dhandapani, Sivashanmugam; Agarwal, Meena; Mahapatra, A K

    2016-08-01

    Pain following neurosurgery has never been given due attention. This was a prospective study to assess pain following various neurosurgical procedures. Patients underwent pain assessment on 11-point scale(0-10) for 24 hours following neurosurgery, and analyzed in relation to various factors. Among total 159 patients, 88(55%), 58(37%) and 13(8%) had undergone cranial, spinal and peripheral nerve procedures respectively. The mean pain score within 12 hours was 3.51(SD ± 2.53), which increased significantly during 13-24 hours to 5.06(SD ± 2.6)(P<0.001). During 13-24 hours, the pain score among those who underwent infratentorial procedures (8.02 ± 2.77) was significantly higher than among those who underwent supratentorial procedures (3.48 ± 1.99)(P<0.001). The pain score of patients who underwent lumbar surgery (6.5 ± 1.93) was significantly higher than of those who underwent cervical surgery (4.04 ± 2.43)(P<0.001). Age and gender did not show any significant influence on pain. Pain is significantly greater during 13-24 hours after neurosurgery, especially after infratentorial and lumbar surgical procedures, compared to others.

  6. Injuries in military parachuting: a prospective study of 4499 jumps.

    PubMed

    Ekeland, A

    1997-04-01

    In this prospective study, the parachuting injuries which occurred during 2031 jumps in basic courses of free fall were compared with the injuries occurring during 2468 jumps for reserve paratroopers on training exercises. Fifty-eight injuries were recorded in 51 paratroopers. The ankle was most commonly affected, and 80 per cent of the injuries involved the lower extremity. Only 14 per cent of the injured troopers suffered severe injuries (fractures, knee ligament ruptures). The injury rate for paratroopers on basic courses (19.7 injuries per 1000 jumps) was significantly higher (P < 0.0001) than for those on training exercises (4.5 injuries per 1000 jumps). Similar observations were made for severe injuries (2.0 versus 1.2 injuries per 1000 jumps, respectively). The injury risk increased with age. Most of the injuries occurred on landing, and about 70 per cent were mainly caused by improper landing fall technique. The rate of serious parachuting injuries was low for Norwegian paratroopers.

  7. Ultrasonography of Leprosy Neuropathy: A Longitudinal Prospective Study.

    PubMed

    Lugão, Helena Barbosa; Frade, Marco Andrey Cipriani; Marques, Wilson; Foss, Norma Tiraboschi; Nogueira-Barbosa, Marcello Henrique

    2016-11-01

    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. 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. US nerve abnormalities can worsen after treatment despite the leprosy classification or the presence of reactions.

  8. 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

  9. Antipsychotic induced metabolic changes & treatment response: a prospective study.

    PubMed

    Sharma, Eesha; Venkatasubramanian, Ganesan; Varambally, Shivarama; Sivakumar, Palanimuthu T; Subbakrishna, Doddaballapur K; Gangadhar, Bangalore N

    2014-10-01

    Metabolic side effects of antipsychotics contribute to morbidity and non-compliance in treatment of psychosis. Multiple studies suggest that metabolic side effects correlate with response to antipsychotic treatment. However, few studies have systematically looked at this. We conducted an exploratory, naturalistic, prospective, trans-diagnostic study to examine this association. 100 patients with psychosis, initiated on antipsychotic treatment alone, were assessed on Brief Psychiatric Rating Scale (BPRS), visual analog scale for appetite, anthropometric measurements (weight, waist circumference, body mass index), and fasting serum lipid and glucose profiles at baseline, 2-4 weeks (n=71) and 8-12 weeks (n=39). Subjects who dropped out at first/second follow-ups did not differ from those who followed-up, in age, sex, illness duration and BPRS scores. On forward stepwise multiple linear regression analysis, early (2-4 weeks) increase in appetite and triglyceride levels (R(2)=0.257; p=0.003) together predicted 26% variance in treatment response (BPRS score reduction) at first follow-up. At second follow-up 16% of variance in treatment response was predicted by early (2-4 weeks) increase in triglyceride levels (R(2)=0.169; p=0.009). Early appetite and triglyceride changes predicted antipsychotic treatment response. Involvement of dopaminergic, serotonergic and histaminergic neural pathways could explain the association between appetite and treatment response. Insulin signaling pathways have been implicated in lipid changes with antipsychotics. Study findings suggest metabolic side effects may be early predictors of antipsychotic response. These findings warrant further examination to elucidate the interaction between metabolic pathways and psychotic illnesses, and possibly mechanism of action of antipsychotics beyond dopamine blockade. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. A Multimodal Approach for Myofascial Pain Syndrome: A Prospective Study.

    PubMed

    Segura-Pérez, María; Hernández-Criado, M Teresa; Calvo-Lobo, César; Vega-Piris, Lorena; Fernández-Martín, Raquel; Rodríguez-Sanz, David

    The purpose of this study was to analyze pain intensity in patients with myofascial pain syndrome (MPS) following a multimodal rehabilitation protocol. A prospective study was carried out following the Template for Intervention Description and Replication criteria. Patients were recruited from the rehabilitation unit of a university hospital in Spain between 2009 and 2013. Patients were included if they had a medical diagnosis of MPS in any of the following regions: cervicobrachial (n = 102), lumbosacral (n = 30), elbow (n = 14), ankle and foot (n = 10), and temporomandibular jaw (n = 1). The multimodal rehabilitation protocol included myofascial trigger point dry needling, spray and stretching, Kinesio taping, eccentric exercise, and patient education. The protocol was applied for 4 weeks (5 sessions) for the active and/or latent myofascial trigger points in each body region. Pain intensity was measured by using the visual analog scale (VAS) immediately before beginning of the study and 1 week after completion of the protocol. The study sample comprised 150 patients (mean ± standard deviation age, 51.5 ± 1.19 years). Statistically significant differences were obtained for reduction in pain intensity (4 ± 2.03; P = .002). Clinically relevant reductions (VAS ≥30 mm; P < .001) were obtained in 78.7% of the interventions. Four treatment sessions reduced the VAS score by 10 mm in 83.55% of the sample. There were no statistically significant differences (P = .064) for reduction in pain intensity in the different body regions. A multimodal rehabilitation protocol showed clinically relevant differences in the reduction in pain intensity in different body regions in patients with MPS. Copyright © 2017. Published by Elsevier Inc.

  11. 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.

  12. Methylphenidate in Pregnancy: A Multicenter, Prospective, Comparative, Observational Study.

    PubMed

    Diav-Citrin, Orna; Shechtman, Svetlana; Arnon, Judy; Wajnberg, Rebecka; Borisch, Cornelia; Beck, Evelin; Richardson, Jonathan Luke; Bozzo, Pina; Nulman, Irena; Ornoy, Asher

    2016-09-01

    Methylphenidate is a central nervous system stimulant medicinally used in the treatment of attention-deficit disorder with or without hyperactivity (ADD/ADHD). Data on its use in human pregnancy are limited. The primary objective of the study was to evaluate the risk of major congenital anomalies after pregnancy exposure to methylphenidate for medical indications. In a prospective, comparative, multicenter observational study performed in 4 participating Teratology Information Services (in Jerusalem, Berlin, Newcastle upon Tyne, and Toronto) between 1996 and 2013, methylphenidate-exposed pregnancies were compared with pregnancies counseled for nonteratogenic exposure (NTE) after matching by maternal age, gestational age, and year at initial contact. 382 methylphenidate-exposed pregnancies (89.5% in the first trimester) were followed up. The overall rate of major congenital anomalies was similar between the groups (10/309 = 3.2% [methylphenidate] vs 13/358 = 3.6% [NTE], P = .780). The rates of major congenital anomalies (6/247 = 2.4% [methylphenidate] vs 12/358 = 3.4% [NTE], P = .511) and cardiovascular anomalies (2/247 = 0.8% [methylphenidate] vs 3/358 = 0.8% [NTE], P = .970) were also similar after exclusion of genetic or cytogenetic anomalies and limiting methylphenidate exposure to the period of organogenesis (weeks 4-13 after the last menstrual period). There was a higher rate of miscarriages and elective terminations of pregnancy in the methylphenidate group. Significant predictors for the miscarriages using Cox proportional hazards model were methylphenidate exposure (adjusted hazard ratio [HR] = 1.98; 95% CI, 1.23-3.20; P = .005) and past miscarriage (adjusted HR = 1.35; 95% CI, 1.18-1.55; P < .001). The present study suggests that methylphenidate does not seem to increase the risk for major malformations. Further studies are required to establish its pregnancy safety and its possible association with miscarriages.

  13. 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

  14. Sense of coherence predicts uncomplicated delivery: a prospective observational study.

    PubMed

    Oz, Yasmin; Sarid, Orly; Peleg, Roni; Sheiner, Eyal

    2009-03-01

    The present study aimed to investigate factors predicting uncomplicated deliveries and specifically whether a sense of coherence (SOC) and perceived stress can predict such deliveries. A prospective observational study was conducted employing self-administered SOC and perceived stress scale (PSS) questionnaires with pregnant women attending the outpatient clinic for routine surveillance. Following delivery, data regarding maternal and fetal delivery complications were collected from the participants' medical records. Of one hundred forty-five women completing the study, 43.4% completed the delivery process without complications. Women experiencing delivery complications, on average, had lower SOC scores (67.7 +/- 1.19 vs. 72.2 +/- 1.32, p = 0.014). Maternal complications (as opposed to fetal complications) accounted for this divergence and were related to lower SOC scores (67.74 +/- 1.19 vs. 72.18 +/- 1.32, p = 0.01). PSS was not associated with uncomplicated delivery (18.82 +/- 0.59 vs. 17.98 +/- 0.62, p = 0.341). Nulliparity, however, was associated with higher occurrence of complicated delivery (31.9% of complicated vs. 13.2% of uncomplicated deliveries, p = 0.007). Multivariable analysis demonstrated that high SOC (OR = 1.042; 95% CI = 1.004-1.08; p = 0.03) and nulliparity (OR = 0.293; 95% CI = 0.113-0.758; p = 0.011) both were independent predictors of uncomplicated delivery, directly and inversely, respectively. In conclusion, higher SOC scores are an independent protective factor for the prediction of uncomplicated delivery.

  15. Prevalence of anal symptoms in general practice: a prospective study.

    PubMed

    Tournu, Géraldine; Abramowitz, Laurent; Couffignal, Camille; Juguet, Frédéric; Sénéjoux, Agnès; Berger, Stéphane; Wiart, Anne-Laure; Bernard, Marc; Provost, Françoise; Pillant-Le Moult, Hélène; Bouchard, Dominique; Aubert, Jean-Pierre

    2017-08-03

    Anal disorders are largely underestimated in general practice. Studies have shown patients conceal anal symptoms leading to late diagnosis and treatment. Management by general practitioners is poorly described. The aim of this study is to assess the prevalence of anal symptoms and their management in general practice. In this prospective, observational, national study set in France, all adult patients consulting their general practitioner during 2 days of consultation were included. Anal symptoms, whether spontaneously revealed or not, were systematically collected and assessed. For symptomatic patients, the obstacles to anal examination were evaluated. The general practitioner's diagnosis was collected and a proctologist visit was systematically proposed in case of anal symptoms. If the proctologist was consulted, his or her diagnosis was collected. From October 2014 to April 2015, 1061 patients were included by 57 general practitioners. The prevalence of anal symptoms was 15.6% (95% CI: 14-18). However, 85% of these patients did not spontaneously share their symptoms with their doctors, despite a discomfort rating of 3 out of 10 (range 1-5). Although 65% of patients agreed to an anal examination, it was not proposed in 45% of cases with anal symptoms. Performing the examination was associated with a significantly higher diagnosis rate of 76% versus 20% (p < 0.001). Proctologist and general practitioner diagnoses were consistent in 14 out of 17 cases. Patients' concealed anal symptoms are significant in general practice despite the impact on quality of life. Anal examination is seldom done. Improved training of general practitioners is required to break the taboo.

  16. Combined pubic rami and sacral osteoporotic fractures: a prospective study.

    PubMed

    Alnaib, M; Waters, S; Shanshal, Y; Caplan, N; Jones, S; St Clair Gibson, A; Kader, D

    2012-06-01

    Pelvic osteoporotic fractures (POFs) are often associated with considerable morbidity and mortality mainly as a result of infections and cardiovascular events. Patients usually need prolonged institutionalization, rehabilitation, and follow-up, with a high rate of dependency and cost. The most common sites of POFs include the pubic rami, sacrum, ilium, and acetabulum. Combined pubic rami (PROFs) and sacral osteoporotic fractures (SOFs) have been reported, mostly in retrospective studies, describing the mechanism of injury and incidence. The aim of this study was to evaluate the association between PROFs and SOFs and to assess the effect of combined PROFs and SOFs on patients' mobility, discharge destination, and length of stay. We prospectively studied 67 patients with low-impact PROFs and/or SOFs. There were 54 (80.4%) female and 13 (19.6%) male patients, and the average age was 87.5 (range 65-96) years. All patients were assessed by the fracture liaison service. Patients had magnetic resonance imaging or bone scan when there was history of low back pain following the injury or lumbosacral tenderness on clinical examination. The mean length of stay for all patients was 45 (± 35) days. Mortality rate was 10.4%. A significant relationship was found between low back pain and a positive finding of sacral fracture. Patients with combined PROFs and SOFs showed significantly longer length of stay than those with isolated PROFs. The presence of low back pain and tenderness in patients who had low-impact pelvic injuries was highly suggestive of the presence of an associated SOF. There was a high association between sacral and PROFs. The length of stay of patients with PROFs associated with sacral osteoporotic fractures was significantly longer than that of patients with PROFs only. Therefore, we recommend considering the high association between SOFs and PROFs in planning the management and rehabilitation of patients with POFs.

  17. Psychological stress during pregnancy and stillbirth: prospective study.

    PubMed

    Wisborg, K; Barklin, A; Hedegaard, M; Henriksen, T B

    2008-06-01

    To study the association between psychological stress during pregnancy and stillbirth. Prospective follow-up study. Aarhus University Hospital, Skejby, Denmark,1989-98. A total of 19 282 singleton pregnancies in women with valid information about psychological stress during pregnancy. Information about psychological stress during pregnancy was obtained from questionnaires and measured by the 12-item General Health Questionnaires (GHQ). A score was generated by the sum of all the answers, each contributing a value between 0 (low psychological stress) and 3 (high psychological stress). Women with an intermediate level of psychological stress (scores of 7-11) were considered the reference group. Scores of 0-6 were defined as a low level of psychological stress and scores of 12-36 as the highest level. The association between psychological stress and stillbirth was presented as relative risks with 95% CIs. Adjustment for potential confounding factors was carried out by logistic regression analyses. Stillbirth (delivery of a dead fetus at >28 weeks of gestation). There were 66 stillbirths (3.4 per thousand) in the population studied. Compared with women with an intermediate level of psychological stress during pregnancy, women with a high level of stress had 80% increased risk of stillbirth (relative risk = 1.8; 95% CI 1.1-3.2). Adjustment for maternal age, parity, maternal pre-pregnancy body mass index, smoking habits, alcohol and caffeine intake during pregnancy, education and cohabitation failed to change the result. The results remained essentially unchanged after exclusion of preterm deliveries. Exclusion of women with complications during pregnancy such as diabetes, hypertension, vaginal bleeding, immunisation and imminent preterm delivery failed to change the results. Likewise, restriction to women's first pregnancy in the cohort did not change the results. Psychological stress during pregnancy was associated with an increased risk of stillbirth.

  18. Evaluation of neurosensory disturbance following orthognathic surgery: a prospective study.

    PubMed

    Degala, Saikrishna; Shetty, Sujeeth Kumar; Bhanumathi, M

    2015-03-01

    The prospective study was to evaluate the incidence, type of neurosensory disturbance (NSD), grade its severity and monitor its recovery occurring in the lower lip and chin due to damage to inferior alveolar nerve following orthognathic surgery involving mandible. The study included 10 patients who have undergone sagittal split osteotomy, genioplasty, and anterior subapical osteotomy (ASO). All the patients examined preoperatively and post operatively 1 week, 1 and 6 months according to standardized test to clarify the subjective and objective neurosensory status of the injured nerve. Pin prick test, blunt test, two-point discrimator test, brush stoke direction, light touch test, warm and cold test were used bilaterally to lower lip and chin area. Seven patients underwent bilateral sagittal split osteotomy (BSSO) (70 %), one patient had BSSO with genioplasty (10 %), two patients had BSSO with ASO (20 %). During the operation none of the nerves were transectioned, in 60 % of patients nerve was not visible and in 40 % of patients nerve was seen in distal segment. 70 % of patients underwent setback, 30 % of patients underwent advancement. The subjective evaluation of the patients revealed the incidence of 90 % at 1 week, 30 % at 1 month, 20 % at 6 months and 10 % at 1 year post operatively. The altered sensation reported subjectively was hypoesthesia in 50 % of the patients, anaesthesia in 40 % of the patients. There was 100 % recovery in advancement cases and 93.5 % recovery in setback cases. There is a high incidence of NSD of the lower lip and chin after BSSO related to advancement, setback, intraoperative nerve encounter and surgical skill. However, recovery of sensation occurs with increasing frequency during the follow-up period. The clinical neurosensory tests are effective guides to study the neurosensory deficit.

  19. Methadone and perinatal outcomes: a prospective cohort study.

    PubMed

    Cleary, Brian J; Eogan, Maeve; O'Connell, Michael P; Fahey, Tom; Gallagher, Paul J; Clarke, Tom; White, Martin J; McDermott, Christine; O'Sullivan, Anne; Carmody, Deirdre; Gleeson, Justin; Murphy, Deirdre J

    2012-08-01

      Methadone use in pregnancy has been associated with adverse perinatal outcomes and neonatal abstinence syndrome (NAS). This study aimed to examine perinatal outcomes and NAS in relation to (i) concomitant drug use and (ii) methadone dose.   Prospective cohort study.   Two tertiary care maternity hospitals.   A total of 117 pregnant women on methadone maintenance treatment recruited between July 2009 and July 2010.   Information on concomitant drug use was recorded with the Addiction Severity Index. Perinatal outcomes included pre-term birth (<37 weeks' gestation), small-for-gestational-age (<10th centile) and neonatal unit admission. NAS outcomes included: incidence of medically treated NAS, peak Finnegan score, cumulative dose of NAS treatment and duration of hospitalization.   Of the 114 liveborn infants 11 (9.6%) were born pre-term, 49 (42.9%) were small-for-gestational-age, 56 (49.1%) had a neonatal unit admission and 29 (25.4%) were treated medically for NAS. Neonates exposed to methadone-only had a shorter hospitalization than those exposed to methadone and concomitant drugs (median 5.0 days versus 6.0 days, P = 0.03). Neonates exposed to methadone doses ≥80 mg required higher cumulative doses of morphine treatment for NAS (median 13.2 mg versus 19.3 mg, P = 0.03). The incidence and duration of NAS did not differ between the two dosage groups.   The incidence and duration of the neonatal abstinence syndrome is not associated with maternal methadone dose, but maternal opiate, benzodiazepine or cocaine use is associated with longer neonatal hospitalization. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  20. Laparoscopic cholecystectomy under spinal anaesthesia: a prospective study.

    PubMed

    Kumar, A

    2014-12-01

    Laparoscopic cholecystectomy under general anaesthesia is the present gold standard in treatment of symptomatic gall bladder disease. This study was conducted to determine the efficacy and safety of laparoscopic cholecystectomy under spinal anaesthesia which could be more cost effective. A prospective study was conducted was over a fourteen month period at a teaching hospital to evaluate efficacy, safety and cost benefit of conducting laparoscopic cholecystectomy under spinal anaesthesia(SA). Patients meeting inclusion criteria were taken up for laparoscopic cholecystectomy under spinal anaesthesia by standardized techniques. They underwent standard four port laparoscopic cholecystectomy. Mean anaesthesia time, pneumoperitoneum time and surgery time defined primary outcome measures. Intraoperative events and post operative pain score were the secondary outcomes measured. All patients underwent laparoscopic cholecystectomy without any major complications. None had to be converted to general anaesthesia in this series. The operation had to be converted to open incision in 3 patients. Commonest complaint was pain in right shoulder and anxiety at the beginning of operation/pneumoperitoneum. All patients were highly or well satisfied during follow up. Laparoscopic cholecystectomy done under spinal anaesthesia as a routine anaesthesia of choice is feasible and safe. In this study spinal anaesthesia for laparoscopic cholecystectomy was found to be safe even in patients with respiratory problems, cost-effective, with minimal postoperative pain and smooth recovery; the disadvantage being occasional right shoulder pain following pneumo-peritoneum (40%). Spinal anaesthesia can be recommended to be the anaesthesia technique of choice for conducting laparoscopic cholecystectomy in hospital setups where cost is a major factor; provided proper backup is present.

  1. Laparoscopic cholecystectomy under spinal anaesthesia: A prospective, randomised study

    PubMed Central

    Tiwari, Sangeeta; Chauhan, Ashutosh; Chaterjee, Pallab; Alam, Mohammed T

    2013-01-01

    CONTEXT: Spinal anaesthesia has been reported as an alternative to general anaesthesia for performing laparoscopic cholecystectomy (LC). AIMS: Study aimed to evaluate efficacy, safety and cost benefit of conducting laparoscopic cholecystectomy under spinal anaesthesia (SA) in comparison to general anaesthesia(GA) SETTINGS AND DESIGN: A prospective, randomised study conducted over a two year period at an urban, non teaching hospital. MATERIALS AND METHODS: Patients meeting inclusion criteria e randomised into two groups. Group A and Group B received general and spinal anaesthesia by standardised techniques. Both groups underwent standard four port laparoscopic cholecystectomy. Mean anaesthesia time, pneumoperitoneum time and surgery time defined primary outcome measures. Intraoperative events and post operative pain score were secondary outcome measure. STATISTICAL ANALYSIS USED: The Student t test, Pearson′s chi-square test and Fisher exact test. RESULTS: Out of 235 cases enrolled in the study, 114 cases in Group A and 110 in Group B analysed. Mean anaesthesia time appeared to be more in the GA group (49.45 vs. 40.64, P = 0.02) while pneumoperitoneum time and corresponding the total surgery time was slightly longer in the SA group. 27/117 cases who received SA experienced intraoperative events, four significant enough to convert to GA. No postoperative complications noted in either group. Pain relief significantly more in SA group in immediate post operative period (06 and 12 hours) but same as GA group at time of discharge (24 hours). No late postoperative complication or readmission noted in either group. CONCLUSION: Laparoscopic cholecystectomy done under spinal anaesthesia as a routine anaesthesia of choice is feasible and safe. Spinal anaesthesia can be recommended to be the anaesthesia technique of choice for conducting laparoscopic cholecystectomy in hospital setups in developing countries where cost factor is a major factor. PMID:23741111

  2. Short term prospective study of cognitive functioning in lead workers.

    PubMed Central

    Stollery, B T; Broadbent, D E; Banks, H A; Lee, W R

    1991-01-01

    In a short term prospective study 70 male lead workers performed a series of cognitive tasks on three occasions during an eight month period. Concurrently with the cognitive testing, the concentrations of blood lead, zinc protoporphyrin (ZPP) and urinary aminolaevulinic acid (ALA) were measured. Indicators of lead absorption were stable during the study and each subject was allocated to either a low (below 20 micrograms/dl), medium (21-40 micrograms/dl), or high (41-80 micrograms/dl) group on the basis of their average blood lead concentrations. Performance deficits tended to be restricted to the high lead group and, in general, neither practice nor continued exposure during the study altered the magnitude of these deficits. The main deficit was a slowing of sensory motor reaction time, which was seen most clearly when the cognitive demands of the task were low. In the cognitively simple five choice task, blood lead concentration correlated with impaired decision making, response execution, and "lapses in concentration." In the other cognitive tasks the high blood lead group tended also to be slower by a factor of about 1.08 but the dominance of cognitive over sensory motor demands attenuated the exposure-performance correlations. The high lead group also had difficulty in recalling nouns poorly related to the focus of an earlier semantic classification task. This difficulty increased over time and was one of the few findings that correlated with all measures of lead absorption. It is concluded that the primary psychological profile of lead impairment is one of sensory motor slowing coupled with difficulties in remembering incidental information. PMID:1954152

  3. Conservative Treatment of Distal Radius Fractures: A Prospective Descriptive Study.

    PubMed

    Aparicio, Pilar; Izquierdo, Óscar; Castellanos, Juan

    2017-06-01

    Disability of the upper limb is one of the consequences of distal radius fracture (DRF). The outcome of DRF treatment is based on objective clinical variables, as strength or range of movement (ROM); sometimes these variables do not correlate with the functional level of the patient. The principal objective of our study was to assess the repercussion of conservative treatment of DRF on upper limb disability. This is a retrospective review of prospectively collected data. We collected data of 61 nonconsecutive DRFs treated conservatively from July 2007 to August 2008. Average Disabilities of the Arm, Shoulder and Hand (DASH) score before fracture was 20.8 points; average DASH score after the fracture was 42.6. There was a significant increase in the upper limb disability after 1 year of follow-up in the patients treated conservatively ( P < .001; size effect, 1.06). Average radial inclination, radial tilt, and radial length were 18.18°, 3.35°, and 5.76 mm, respectively. Average ROM for flexion-extension was 100.6° and for pronation-supination 144.0°. ROM for flexion-extension of the unaffected wrist was 128.2° and for pronation-supination 172.4°. We did not find any significant statistical correlation between the increase in disability and the decrease in the ROM ( P > .05). We did not find any significant statistical correlation between the increase in the disability and the worsening in the radiological parameters ( P > .05). Our results confirm the hypothesis that the conservative treatment of DRF produced an increase in the upper limb disability after 1 year of follow-up. Our study does not show a correlation between the increase in upper limb disability and the decrease in wrist ROM. Our study did not find a correlation between radiological measures and DASH scores.

  4. Outcomes of borderline rheumatic heart disease: A prospective cohort study.

    PubMed

    Bertaina, Geneviève; Rouchon, Bernard; Huon, Bertrand; Guillot, Nina; Robillard, Corinne; Noël, Baptiste; Nadra, Marie; Tribouilloy, Christophe; Marijon, Eloi; Jouven, Xavier; Mirabel, Mariana

    2017-02-01

    The advent of systematic screening for rheumatic heart disease (RHD) by echocardiography in endemic regions has led to a new entity: borderline RHD. The pathogenicity and natural history of borderline RHD needs to be addressed. The aim of this study was to assess the outcomes of children detected by echocardiography as having borderline RHD. Schoolchildren in 4th grade (i.e., aged 9-10years) who were prospectively echo-screened for RHD (2012-2014) in Nouméa, New Caledonia, were asked to participate. Children with borderline RHD according to consistent independent review by two cardiologists were included and followed-up in 2015. Among the 8684 schoolchildren screened, 49 were diagnosed with borderline RHD according to the Cardiologist clinically involved in the child's management plan. After independent review by two cardiologists, 25 children were consistently diagnosed with borderline RHD and included in the follow-up study. Overall, inter-observer agreement was moderate with diagnostic kappa values of 0.63 (95% CI 0.45-0.78). After a median follow-up of 23months (IQR (20.5-33.0), 15 children (60.0%) had stability of valvular lesions, 8 (32.0%) had normal findings according to the WHF criteria. Two children (8.0%) had definite RHD on the follow-up echocardiogram, but no clinical events or audible pathological murmur during the study period. No factor could be identified as prognostic of either stability or progression. Borderline RHD diagnosed by systematic screening in high-risk populations remains mostly unchanged at 2years follow-up. Diagnosis of borderline RHD may require two reviewers for consistency. Copyright © 2016. Published by Elsevier Ireland Ltd.

  5. Prospective study of filtering blebs after XEN45 surgery.

    PubMed

    Olate-Pérez, Á; Pérez-Torregrosa, V T; Gargallo-Benedicto, A; Neira-Ibáñez, P; Cerdà-Ibáñez, M; Osorio-Alayo, V; Barreiro-Rego, A; Duch-Samper, A

    2017-08-01

    To qualitatively analyse the evolution of filtering blebs after XEN surgery, by using anterior segment optical coherence tomography (AS-OCT). A prospective study was performed on filtering blebs of 30 eyes with cataracts and glaucoma, surgically operated on using phacoemulsification and XEN45 implantation (PHACO-XEN). AS-OCT was used to analyse bleb morphology and reflectivity at 3, 6, and 12 months after surgery. Functionality was studied considering an intraocular pressure (IOP)≤18mmHg without antihypertensive medication. The IOP enabled the blebs to be classified into non-functional: flat (6.67%) and encapsulated (3.33%); and functional (90%), which were then divide by their morphology into cystic (5/27), diffuse (2/27), and layered (20/27). Cystic types had a mean IOP of 12.8, 12.6, and 14.0mmHg at 3, 6 and 12 months, respectively. In the diffuse type, the mean IOP was 13.0, 11.5 and 13.0mmHg at 3, 6 and 12 months, respectively. In the layers pattern the mean IOP was 14.45, 14.55 and 14.8mmHg at 3, 6 and 12 months respectively. The percentage of blebs with high reflectivity was 48.15%, 62.96%, and 77.78%, at 3, 6 and 12 months, with a mean IOP of 14.23, 14.59, and 15.14mmHg in each time period, respectively. AS-OCT could be a good predictor of bleb functionality in PHACO-XEN surgery. Those with a cystic pattern or low reflectivity seem to have better post-operative success. Nevertheless, more long-term studies are required. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. 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…

  7. 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…

  8. 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…

  9. 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…

  10. 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…

  11. 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…

  12. A Prospective Cohort Study of Mineral Metabolism After Kidney Transplantation.

    PubMed

    Wolf, Myles; Weir, Matthew R; Kopyt, Nelson; Mannon, Roslyn B; Von Visger, Jon; Deng, Hongjie; Yue, Susan; Vincenti, Flavio

    2016-01-01

    Kidney transplantation corrects or improves many complications of chronic kidney disease, but its impact on disordered mineral metabolism is incompletely understood. We performed a multicenter, prospective, observational cohort study of 246 kidney transplant recipients in the United States to investigate the evolution of mineral metabolism from pretransplant through the first year after transplantation. Participants were enrolled into 2 strata defined by their pretransplant levels of parathyroid hormone (PTH), low PTH (>65 to ≤300 pg/mL; n = 112), and high PTH (>300 pg/mL; n = 134) and underwent repeated, longitudinal testing for mineral metabolites. The prevalence of posttransplant, persistent hyperparathyroidism (PTH >65 pg/mL) was 89.5%, 86.8%, 83.1%, and 86.2%, at months 3, 6, 9, and 12, respectively, among participants who remained untreated with cinacalcet, vitamin D sterols, or parathyroidectomy. The results did not differ across the low and high PTH strata, and rates of persistent hyperparathyroidism remained higher than 40% when defined using a higher PTH threshold greater than 130 pg/mL. Rates of hypercalcemia peaked at 48% at week 8 in the high PTH stratum and then steadily decreased through month 12. Rates of hypophosphatemia (<2.5 mg/dL) peaked at week 2 and then progressively decreased through month 12. Levels of intact fibroblast growth factor 23 decreased rapidly during the first 3 months after transplantation in both PTH strata and remained less than 40 pg/mL thereafter. Persistent hyperparathyroidism is common after kidney transplantation. Further studies should determine if persistent hyperparathyroidism or its treatment influences long-term posttransplantation clinical outcomes.

  13. Phonetic Approaches of Laryngopharyngeal Reflux Disease: A Prospective Study.

    PubMed

    Lechien, Jérôme R; Delvaux, Véronique; Huet, Kathy; Khalife, Mohamad; Fourneau, Anne-Françoise; Piccaluga, Myriam; Harmegnies, Bernard; Saussez, Sven

    2017-01-01

    The study aimed to explore the impact of the selection of the analyzed time interval on the significance of acoustic measurements used to investigate laryngopharyngeal reflux (LPR) treatment efficacy, and based on these results to develop an alternative statistical approach in data analysis focusing on individual patient vocal behavior. This is a prospective case series. From September 2013 to July 2015, 41 patients with a reflux finding score (RFS) > 7 and a reflux symptom index (RSI) > 13 were enrolled and treated with pantoprazole 20 mg twice daily and diet behavioral changes for 3 months. Voice recordings were performed at baseline and after 3 months of treatment. Most stable time intervals of 1, 2, 3, 4, and 5 seconds, and a 1-second time interval positioned at mid-production, were subjected to acoustic analysis. Based on the latter, we developed an "informativeness coefficient" for each acoustic parameter that aimed at assessing its sensitivity to clinical resolution in the case of LPR disease. Significant clinical improvement (RSI and RFS) was observed after treatment (P < 0.05). The acoustic analysis revealed that acoustic parameters significantly improving from pre- to posttreatment varied across time intervals. The duration and the position of the analyzed time interval in the production yielded considerable differences in the results. Analysis of the informativeness coefficient indicated that jitter, jitter percent, relative average perturbation (RAP), pitch perturbation quotient (PPQ), shimmer (ShdB), shimmer percent (Shim), amplitude perturbation quotient (APQ), and smoothed amplitude perturbation quotient (sAPQ) were the indices most sensitive to medical treatment efficacy, with a coefficient ranging from 75.86% to 86.21%. Depending on the selection of the time interval over which the acoustic parameters are measured, the potential effect of the treatment may or may not be statistically demonstrated. Future studies are needed to

  14. Prospective cohort study of bowel function after robotic sacrocolpopexy.

    PubMed

    Lewis, Christa; Salamon, Charbel; Priestley, Jennifer L; Gurshumov, Emil; Culligan, Patrick

    2014-01-01

    This study aimed to determine bowel function changes 12 months after robotic sacrocolpopexy. We performed a single-center prospective cohort study evaluating bowel function 12 months after robotic sacrocolpopexy between 2007 and 2011. Bowel function symptoms were measured by the Colorectal-Anal Distress Inventory, Short Form 8 (CRADI-8). Specific impacts on quality of life with regard to bowel function were evaluated using the Colorectal-Anal Impact Questionnaire, Short Form 7 (CRAIQ-7). "Splinting to defecate" was defined as any positive response to question 4 of the Pelvic Floor Distress Inventory-20 which reads, "do you ever have to push on the vagina or around the rectum to have or complete a bowel movement?." Lastly, patients were grouped according to perineorrhaphy versus no perineorrhaphy and bowel function scores were examined. Of 423 consecutive patients who underwent robotic sacrocolpopexy at our institution, 393 (93%) completed a 12-month follow-up. Mean CRADI-8 scores at baseline and 12 months were 21.1 (20) and 7.3 (11), respectively (P < 0.0001). Mean CRAIQ-7 scores at baseline and 12 months were 11.1 (20) and 2.4 (9), respectively (P < 0.0001). Preoperatively, 152 patients reported a need to splint the vagina or perineum to complete a bowel movement. At 12 months, 70% reported complete resolution of "splinting." Con comitant perineorrhaphy was performed on 87 patients and there were no differences in 12-month CRADI-8 or CRAIQ-7 scores between groups. Robotic sacrocolpopexy was associated with significant improvements in bowel function as measured by CRADI-8 as well as improvements in impact on quality of life as measured by CRAIQ-7.

  15. 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

  16. Breast cancer in Sabah, Malaysia: a two year prospective study.

    PubMed

    Leong, Benjamin Dak Keung; Chuah, Jitt Aun; Kumar, Vinod Mutyala; Yip, Cheng Har

    2007-01-01

    Malaysian women have a 1 in 20 chance of developing breast cancer in their lifetime. Sabah, formerly known as North Borneo, is part of East Malaysia with a population of 3.39 million and more than 30 ethnic groups. We conducted a 2 year prospective epidemiological study to provide unreported data of breast cancer from this part of the world and to recognise which particular group of patients are more likely to present with advanced disease. All newly diagnosed breast cancers seen at the Queen Elizabeth Hospital, Kota Kinabalu, from January 2005 to December 2006 were included in the study. Patient and tumour characteristics, including age, race, education, socioeconomic background, parity, practice of breast feeding, hormonal medication intake, menopausal status, family history, mode of presentation, histology, grade, stage of disease and hormonal receptors status were collected and analysed. A total of 186 patients were seen. The commonest age group was 40 to 49 years old (32.3%). Chinese was the commonest race (30.6%) followed by Kadazan-Dusun (24.2%). The commonest histology was invasive ductal carcinoma (88.4%). Stages at presentation were Stage 0- 4.8%, Stage I- 12.9%, Stage II- 30.1%, Stage III- 36.6% and Stage IV- 15.6%. The estrogen and progesterone receptor status was positive in 59.1% and 54.8% of cases, respectively. 73.7% of Chinese patients presented with early cancer compared to 36.4% of the other races. Patients who presented with advanced disease were also poor, non-educated and from rural areas. 20.4% of patients defaulted treatment; most of them opted for traditional alternatives. Sabahan women with breast cancer present late. Great efforts are needed to improve public awareness of breast cancer, especially among those who have higher risk of presenting with advanced disease.

  17. Postoperative Pain Following Foot and Ankle Surgery: A Prospective Study

    PubMed Central

    Chou, Loretta B.; Wagner, Dominic; Witten, Daniela M.; Martinez-Diaz, Gabriel J.; Brook, Nancy S.; Toussaint, Michele; Carroll, Ian R.

    2009-01-01

    Background Orthopaedic procedures have been reported to have the highest incidence of pain compared to other types of operations. There are limited studies in the literature that investigate postoperative pain. Materials and Methods A prospective study of 98 patients undergoing orthopedic foot and ankle operations was undertaken to evaluate their pain experience. A Short-Form McGill Pain Questionnaire (SF-MPQ) was administered preoperatively and postoperatively. Results The results showed that patients who experienced pain before the operation anticipated feeling higher pain intensity immediately postoperatively. Patients, on average, experienced higher pain intensity 3 days after the operation than anticipated. The postoperative pain intensity at 3 days was the most severe, while postoperative pain intensity at 6 weeks was the least severe. Age, gender and preoperative diagnosis (acute versus chronic) did not have a significant effect on the severity of pain that patients experienced. Six weeks following the operation, the majority of patients felt no pain. In addition, the severity of preoperative pain was highly predictive of their anticipated postoperative pain and 6-week postoperative pain, and both preoperative pain and anticipated pain predict higher immediate postoperative pain. Conclusion The intensity of patients' preoperative pain was predictive of the anticipated postoperative pain. Patients' preoperative pain and anticipated postoperative pain were independently predictive of the 3-day postoperative pain. The higher pain intensity a patient experienced preoperatively suggested that their postoperative pain severity would be greater. Therefore, surgeons should be aware of these findings when treating postoperative pain after orthopaedic foot and ankle operations. PMID:19026197

  18. Prospective studies of infectious mononucleosis in university students

    PubMed Central

    Grimm, Jennifer M; Schmeling, David O; Dunmire, Samantha K; Knight, Jennifer A; Mullan, Beth D; Ed, Julie A; Brundage, Richard C; Hogquist, Kristin A; Balfour, Henry H

    2016-01-01

    We performed an intensive prospective study designed to obtain as much data as possible on the incubation and early illness periods of primary Epstein–Barr virus (EBV) infection. Undergraduate students who lacked EBV antibody and oral EBV DNA (EBV-naive) were seen every 2 weeks during their freshman year. Clinical and behavioral data, oral washes and venous blood were obtained. EBV antibodies were quantified by enzyme immunoassay and viral loads by PCR. During a median 8 months of observation, 14/85 subjects experienced primary EBV infections (24 cases/100 person-years). The only significant risk factor for acquisition of EBV infection was deep kissing (P=0.02). Eleven subjects had infectious mononucleosis with a median duration of 21 days. Two subjects were hospitalized. Infections were initially identified in 12 subjects by finding EBV DNA in oral cells before onset of symptoms and in 2 subjects by symptom reporting. EBV DNA and viral capsid antigen (VCA) IgM and gp350 IgG antibodies were present in the blood before onset of illness. To provide a more robust evaluation of primary EBV infection in undergraduate university students, we combined data on risk factors and antibody responses from this and an earlier study that used the exact same clinical and laboratory methods. The observation that the only significant risk factor for acquisition of EBV infection was deep kissing was confirmed. Most importantly, higher amounts of gp350 antibody correlated significantly with a lower severity of infectious mononucleosis (P<0.0001), which strengthens the rationale for a gp350-based prophylactic EBV vaccine. PMID:27588199

  19. 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

  20. Outcomes of hypospadias repair in older children: a prospective study.

    PubMed

    Ziada, Ali; Hamza, Amgad; Abdel-Rassoul, Mohammed; Habib, Enmar; Mohamed, Ahmad; Daw, Mahmoud

    2011-06-01

    The American Academy of Pediatrics recommendation is to perform hypospadias repair at age 6 to 12 months. However, our patient population included a significant proportion of patients in adolescence and beyond undergoing primary repair. We report a comparison of outcomes in patients in different age groups. We prospectively report on patients with distal hypospadias who underwent primary repair at our institution during 7 months. Study parameters included age, degree of hypospadias, surgical technique and the complications rate. A total of 61 patients were included in analysis. All cases underwent repair using the tubularized incised plate technique. More proximal hypospadias and different repair techniques were excluded from study. Patients were classified by age, including group 1-25 (40%) 6 months to 2 years old, group 2-17 (28%) 2.2 to 3.7 years old and group 3-19 (32%) 4 years old or older. Only 6 patients (9.8%) had postoperative complications and all were in groups 2 and 3. In group 2 there were 3 complications (17.6%), including loss of repair, meatal stenosis and hematoma in 1 case each. In group 3 there were 3 cases (15.8%) of postoperative fistula. The fistula incidence was higher in group 3 (p = 0.032). Despite previous reports suggesting a much higher incidence of complications in older children the complication rate is within the acceptable range for infant hypospadias repair in some series. However, these complications were statistically significantly different between the older groups when compared with the recommended age group under American Academy of Pediatrics guidelines. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  1. Optimism and Cause-Specific Mortality: A Prospective Cohort Study.

    PubMed

    Kim, Eric S; Hagan, Kaitlin A; Grodstein, Francine; DeMeo, Dawn L; De Vivo, Immaculata; Kubzansky, Laura D

    2017-01-01

    Growing evidence has linked positive psychological attributes like optimism to a lower risk of poor health outcomes, especially cardiovascular disease. It has been demonstrated in randomized trials that optimism can be learned. If associations between optimism and broader health outcomes are established, it may lead to novel interventions that improve public health and longevity. In the present study, we evaluated the association between optimism and cause-specific mortality in women after considering the role of potential confounding (sociodemographic characteristics, depression) and intermediary (health behaviors, health conditions) variables. We used prospective data from the Nurses' Health Study (n = 70,021). Dispositional optimism was measured in 2004; all-cause and cause-specific mortality rates were assessed from 2006 to 2012. Using Cox proportional hazard models, we found that a higher degree of optimism was associated with a lower mortality risk. After adjustment for sociodemographic confounders, compared with women in the lowest quartile of optimism, women in the highest quartile had a hazard ratio of 0.71 (95% confidence interval: 0.66, 0.76) for all-cause mortality. Adding health behaviors, health conditions, and depression attenuated but did not eliminate the associations (hazard ratio = 0.91, 95% confidence interval: 0.85, 0.97). Associations were maintained for various causes of death, including cancer, heart disease, stroke, respiratory disease, and infection. Given that optimism was associated with numerous causes of mortality, it may provide a valuable target for new research on strategies to improve health. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. 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

  3. 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

  4. Dermal flaps in breast reduction: prospective study in 100 breasts.

    PubMed

    Domergue, Sophie; Ziade, Makram; Lefevre, Marine; Prud'homme, Alexandre; Yachouh, Jacques

    2014-06-01

    The most common complication of breast reduction with inverted T-scar technique is wound dehiscence at the junction of the vertical and horizontal sutures. In this study, a technique involving three triangular dermal flaps is presented with the results for healing in the junctional T zone. Fifty women were included in a comparative, single-center randomized double-blind prospective study to evaluate the efficiency of the three-triangular dermal-flap technique in healing in the junctional T zone. All patients were seen for follow-up at 7 days, 14 days, 21 days, 28 days, 35 days, 42 days, and 49 days after surgery to evaluate primary healing in the T zone. Average healing time was 19.7 days in the triangular-skin-flap series and 25.48 days in the control series, with a statistically significant difference (p < 0.01). One patient in the triangular-skin-flap series experienced dehiscence in the T zone (2%) versus eight patients (16%) in the control series. A statistically significant difference was noted (p = 0.012). This technique is based on the association of two principles. First, ischemia on the edges as well as skin necrosis is limited by suturing the two superior skin flaps rather than directly suturing the cutaneous angles. In addition, this technique brings an underlying dermal support. Second, the inferior flap width allows fixing two sutures laterally to limit the central tension. This easy technique does not lengthen total operative time and significantly improves healing time. It is applicable to all breast reductions with inverted T scars. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Pain after shoulder arthroscopy: a prospective study on 231 cases.

    PubMed

    Stiglitz, Y; Gosselin, O; Sedaghatian, J; Sirveaux, F; Molé, D

    2011-05-01

    Shoulder arthroscopy is reputed to be painful, but progression of postoperative pain after this type of surgery has never been described and analyzed. This study had a triple objective: the description, search for risk factors, and analysis of the long-term impact of postoperative pain. This continuous prospective series includes 231 patients who underwent arthroscopic shoulder surgery. Pain was evaluated from D-1 to D3, then at D7, D30, and 1 year. Three pain criteria were noted: visual analog scale (VAS), morphine intake, and satisfaction with pain management. Surgery was performed under general anesthesia and/or interscalene block. A local anesthetic complement was administered in one of four modes: single subacromial injection, subacromial catheter, intra-articular catheter, or no complement. The VAS values remained less than 4 out of 10 during the entire study. Immediate postoperative pain was less than preoperative pain. It was followed by a pain bounce on D1 and D2 and did not return to a level significantly lower than its preoperative value until D30. Rotator cuff repair is the most painful surgery in the first postoperative days. The main risk factor for pain is a work related accident or occupational disease, associated with higher VAS values from D1 to 1 year and greater morphine intake. There was no correlation between immediate postoperative and 1-year VAS values. Pain after shoulder arthroscopy is relatively low and the efficacy of the intervention is long-lasting in terms of pain symptom. A pain bounce appears on D1, which must be taken into account, notably in the context of outpatient surgery. The use of local anesthesia is therefore advantageous. Despite the efficacy of postoperative pain relief protocols, their effect on longer term perspective was not demonstrated. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  6. 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.

  7. Video analysis of craniofacial soccer incidents: a prospective study.

    PubMed

    Correa, Marcos B; Knabach, Cesar B; Collares, Kauê; Hallal, Pedro C; Demarco, Flávio F

    2012-01-01

    The aim of this study was to assess the occurrence of incidents involving the craniofacial region during Brazilian Professional Soccer League matches. The mechanisms of these incidents and the association between their characteristics and severity were also analyzed. Prospective Epidemiology Study. A total of 113 first division matches of the Brazilian Soccer League were analyzed in 2009. Data collected included incident type, site affected, causing agent, severity, player position, field zone, referee decision and time of the match when the incident took place. Descriptive analysis considered absolute and relative frequencies and 95% confidence intervals. Fisher Exact Tests were used to test associations (p≤0.05). Out of all matches, in 84.1% at least one craniofacial region related incident happened, totaling 227 incidents (mean of 2.0 per match). With reference to incident mechanisms and characteristics, 91.2% were hits and the most affected site was the face (70.0%). The most frequent causing agent was the upper extremity (59.5%) and the most frequently affected player was the striker (31.7%). The incident severity was associated with player position (p<0.01), the causing agent (p<0.01), field zone (p<0.01), site affected (p=0.03) and incident type (p<0.01). Soccer presented a high number of incidents against head and face during professional practice in Brazil, representing a real risk to athletes. Preventive strategies should be focused on game rule observance and "fair play". Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  8. Role of Ramadan specific diabetes education (RSDE); A prospective study.

    PubMed

    Ahmedani, Muhammad Yakoob; Ahsan, Shahid; Haque, Muhammad Saif Ul

    2017-01-01

    To observe the role of Ramadan Specific Diabetes Education (RSDE) in the management of fasting patients with diabetes. This prospective study was carried out at out-patients department (OPD) of Baqai Institute of Diabetology & Endocrinology (BIDE), in 2012. Recruitment of patients started a month prior to Ramadan. Muslim patients with diabetes whether had their first or on follow up visit to the OPD and showed intention to hold fast in the month of Ramadan, were included. A printed broacher focused on six cardinal areas of fasting and diabetes identified in Ramadan specific guidelines was given to all participants. All patients had their first visit to the OPD (n=32) were also given RSDE on one-to-one basis (Group A). Whereas patients had follow up visit were advised to attend a group session on RSDE. Those attended (n= 25) and those did not opt (n=45) the group session were included in Group B and Group C respectively. All participants were instructed to visit the OPD after Ramadan. Group D was constituted after Ramadan. It included patients who had not visited the OPD during induction period thus did not receive RSDE (n=76) they however hold fast in the month of Ramadan. Data regarding compliance to structured education through different modes was collected during post Ramadan visit. Comparisons among groups who received education(A with B with C) revealed non-significant difference in self-monitoring of blood glucose, alteration of drug dosage and timing, appreciation of hypoglycemia and action taken on development of hypoglycemic symptoms. However, significant differences were noted when group who received education was compared individually with group who did not receive education. Patients who receive Pre-Ramadan diabetes education were found to be significantly better in following Ramadan specific diabetes management recommendations compared to patients who did not receive education. Further large scale studies are needed to validate our findings.

  9. Neurotrophic and inflammatory markers in bipolar disorder: A prospective study.

    PubMed

    van den Ameele, Seline; Coppens, Violette; Schuermans, Jeroen; De Boer, Peter; Timmers, Maarten; Fransen, Erik; Sabbe, Bernard; Morrens, Manuel

    2017-10-01

    Altered neurotrophic signaling is thought to impair neuroplasticity in bipolar disorder (BD). Brain-derived neurotrophic factor (BDNF) is proposed as a neurotrophic marker in BD. However, the current evidence for its use in monitoring disease activity and illness progression is conflicting and an exploration of additional neurotrophic markers is needed. This prospective case-control study investigated mood-specific changes in potential neurotrophic markers and their association to inflammatory activity. Patients with BD were included during an acute mood episode, either depressive (n=35) or (hypo)manic (n=32). Fifty-nine patients (88%) and 29 healthy controls (97%) completed the study. Peripheral blood levels of BDNF, vascular endothelial growth factor A (VEGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and tumor necrosis factor alpha (TNF-α) were measured at baseline and after 2 months. Biomarker levels in patients were compared to controls and correlated to HDRS-17 and YMRS total scores and the PANSS positive subscale scores. Linear mixed model analysis revealed no significant differences in neurotrophic markers between patients and controls. We found significantly increased TNF-α levels in patients and a subsequent normalization during euthymia. None of the biomarkers strongly correlated to mood symptom severity. Despite standardized methodological practices, BDNF and VEGF levels had a wide distribution range. We need a better understanding of methodological aspects influencing the analysis of neurotrophic factors to improve future research on markers for mood state monitoring and illness progression in BD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. 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

  11. [Prosthetic joint infection: a prospective study in five Catalonian hospitals].

    PubMed

    García-Pont, Javier; Blanch-Falp, Jesús; Coll-Colell, Rosa; Rosell-Abaurrea, Francesc; Tapiz-Reula, Alfons; Dorca-Badía, Ester; Masabeu-Urrutia, Angels; Martín-Urda, Anabel; Barrufet-Barque, Pilar; Force-Sanmartín, Lluis

    2006-03-01

    Prosthetic joint infections are a cause of increasing morbidity and medical expenditure. To determine the incidence and the clinical and the epidemiological characteristics of knee and hip prosthetic infections (PI) in patients undergoing elective surgery in five Catalonian hospitals. To determine the predictive factors of PI. A total of 425 patients operated on between 8 January and 8 July 2001 were prospectively followed for a period of two years. The cumulative incidence, incidence rate and effect measures were determined. Logistic regression was used to identify variables associated with PI. Average age was 71 years and 63.1% were women. Antibiotic prophylaxis with cefazolin was given to 44.7% of the patients, with a mean duration of two days. Prophylaxis was administered during anesthesia induction in 75.6% of the patients. Among the total, 63.4% of the patients were ASA 2. Microbiological confirmation was obtained in all the infected patients; Staphylococcus epidermidis was found in 58%. Fourteen PI were diagnosed, 71% during the first 3 months, with a cumulative incidence of 3.29% and a 3-month incidence rate of 63 patients/10,000 patients/month. Diabetes mellitus was the only variable related to PI in the multivariate analysis: 3.18, 95% CI (1.1-9.9). The cumulative incidence of PI was slightly higher than that seen in other studies. Variations were observed in the antibiotic used for prophylaxis, and the place where it was administered. PI occurred 3.18 times more frequently in diabetic patients.

  12. [Traumatic subarachnoid hemorrhage: a prospective study of 58 cases].

    PubMed

    Okten, Ali Ihsan; Gezercan, Yurdal; Ergün, Rüçhan

    2006-04-01

    We evaluated the prognostic factors in traumatic subarachnoid hemorrhage (tSAH). This study was conducted with 58 patients (44 males, 14 females; mean age 39.2; range 17 to 79 years) with tSAH, between 2001 and 2003. The patients who were admitted to the hospital within in the first 6 hours of head injury were included, whereas patients with gun shot wounds, multiple injured patients and postoperative patients were excluded. Fifty-eight patients with tSAH were prospectively followed. The neurological status of the patients and the outcomes were evaluated using Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS), respectively and computed tomography (CT) examinations were done according to the grading criteria by Hijdra and Fisher. The etiology of tSAH included traffic accidents (73%), falls (20%) and others (7%). The GCS scores of patients at admission were mild (9%), moderate (39%) and severe (52%). In the CT scans, the amount and distribution of bleeding was grade 1 (small SAH) in 21 patients, grade 2 (moderate SAH) in 17 patients, and grade 3 (extensive SAH) in 20 patients according to Hijdra grading system and according to Fisher's criteria. The thickness of blood layer was grade 1 (no blood) in 6 patients, grade 2 (bleeding layer less than 1 mm) in 21 patients, grade 3 (bleeding layer more than 1 mm) in 15 patients and grade 4 (ventricular bleeding) in 16 patients. Neurological outcomes of patients were favorable (good recovery or moderate disability) in 59%, and unfavorable (severe disability, persistent vegetative state or death) in 41% according to GOS. We have found in our series that the prognosis was poor in patients with poor admission scores of GCS, cysternal or fissural hemorrhage, tSAH with cerebral contusion or acute subdural hematoma, higher than 13 points according to Hidjra's classification and patients of grade 3 or 4 in Fisher's criteria.

  13. 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

  14. A multicentre prospective study of post-traumatic endophthalmitis.

    PubMed

    Cornut, Pierre-Loïc; Youssef, El Bichara; Bron, Alain; Thuret, Gilles; Gain, Philippe; Burillon, Carole; Romanet, Jean-Paul; Vandenesch, François; Maurin, Max; Creuzot-Garcher, Catherine; Chiquet, Christophe

    2013-08-01

    Study the clinical and microbiological characteristics and the prognostic factors of post-traumatic endophthalmitis. Seventeen eyes were included between 2004 and 2010, with clinical and microbiological data collected prospectively. Conventional cultures and panbacterial PCR were performed on aqueous and vitreous samples. Clinical signs of endophthalmitis were observed soon after trauma (1.5 ± 2.5 days). Laceration with an intraocular foreign body (IOFB) was noted in 53% of the patients. At admission, all patients had aqueous humour (71%) and/or vitreous (53%) samples. Fifteen patients (88%) underwent a pars plana vitrectomy. Bacteria were identified in 77% of the cases: Staphylococcus epidermidis (n = 5), Streptococcus (n = 4), Bacillus (n = 2), Pseudomonas stuzeri (n = 1), and Streptococcus salivarius and Gemella haemolysans (multibacterial infection, n = 1). Progression toward phthisis was observed in 35% of the cases; 41% of the patients recuperated visual acuity (VA) ≥20/40. A good final visual prognosis (≥20/40) was significantly associated with initial VA better than light perception (0% versus 70%, p = 0.01) and absence of pupillary fibrin membrane (80% versus 20%, p = 0.05). There was no correlation between visual prognosis and age, the type of laceration (corneal or scleral) or presence of an IOFB. We found a statistical trend toward an association between bacterial virulence and poor final VA. This series showed that better final VA outcomes were associated with initial VA better than light perception, S. epidermidis or culture-negative cases and absence of retinal detachment during the clinical course. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  15. 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

  16. Standardising analgesic administration for nurses: a prospective intervention study.

    PubMed

    Schiek, Susanne; Moritz, Katharina; Seichter, Stefanie J; Ghanem, Mohamed; von Salis-Soglio, Georg; Frontini, Roberto; Bertsche, Thilo

    2016-12-01

    Background Uncontrolled pain reduces quality of life, delays recovery from surgery and can potentially contribute to the development of chronic pain. Strategies to improve pain management are desirable in view of these detrimental outcomes, yet frequently they are predominately medically based despite nurses playing key roles in pain assessment and analgesic administration. Objective To develop an algorithm-based guidance addressing nurses' pain assessment and analgesic administration and investigating its impact on quality of pain management. Setting Two orthopaedic units in a university hospital. Method An interdisciplinary expert panel consisting of physicians, nurses and clinical pharmacists developed an algorithm-based guidance in analgesic administration for nurses. The guidance was based on current guidelines addressing the appropriate use of analgesics. In a prospective intervention study, clinical pharmacists acted as independent monitors who assessed nurses' pain assessment and analgesic administration before (control period: usual care without any further support) and after implementation of the algorithm-based guidance (intervention period). We evaluated patient-nurse contacts for guideline adherence. We predefined guideline adherence (main outcome) as fulfilling all three of the following criteria: (A) nurses' pain intensity assessment, (B) their assessment of the patients' need for analgesics, and (C) analgesic administration depending on patients' individual pain intensity (including choice of prescribed analgesics). Main outcome measure Adherence to pain management guidelines. Results We analysed 706 patient-nurse contacts with 162 patients in the control and 748 contacts with 168 patients in the intervention period. Without support, guidelines were followed in 6 % of the patient contacts. We achieved an increase to 54 % (p < 0.001) after guidance implementation (main outcome). Guideline adherence decreased with rising pain intensity (slope

  17. A prospective study of acute movement disorders in children.

    PubMed

    Dale, Russell C; Singh, Harry; Troedson, Christopher; Pillai, Sekhar; Gaikiwari, Shilpa; Kozlowska, Kasia

    2010-08-01

    The purpose of this study was to report a prospective cohort of children with acute-onset movement disorders. We report on 52 individuals (31 females, 21 males; mean age 6y 5mo, range 2mo-15y) with acute-onset movement disorders managed at a busy tertiary paediatric referral hospital over a 40-month period. In descending order of frequency, the movement disorders reported were chorea, dystonia, tremor, myoclonus, and parkinsonism. It was possible to divide the participants into three groups: (1) those with inflammatory or autoimmune disorders (n=22), (2) those with non-inflammatory disorders (n=18), and (3) those with psychogenic disorders (n=12). The inflammatory or autoimmune aetiologies included N-methyl-D-aspartate receptor encephalitis (n=5), opsoclonus-myoclonus syndrome (n=4), Sydenham chorea (n=3), systemic lupus erythematosus (n=3), acute necrotizing encephalopathy (n=3), and other types of encephalitis (n=4). Other important non-inflammatory movement disorder aetiologies included drug-induced movement disorder (n=6), post-pump chorea (n=5), metabolic (n=3) and vascular (n=2) disease. The participants with psychogenic movement disorders (n=12) were all over 10 years of age and were more likely to be female. Tremor and myoclonus were significantly over-represented in the psychogenic movement disorder subgroup. The outcomes of the total cohort were variable, and included full recovery, severe morbidity, and death. Acute-onset movement disorders in children are important and may be treatable. Management should focus upon identifying the cause and treating the underlying disease process, as symptomatic treatment of the abnormal movements is variably effective.

  18. Variable costs of ICU patients: a multicenter prospective study.

    PubMed

    Rossi, Carlotta; Simini, Bruno; Brazzi, Luca; Rossi, Giancarlo; Radrizzani, Danilo; Iapichino, Gaetano; Bertolini, Guido

    2006-04-01

    To analyze the costs of treating critically ill patients. Multicenter, observational, prospective, cohort, bottom-up study on variable costs in 51 ICUs. A total of 1,034 patients aged over 14 years who either spent less than 48 h in the ICU or had multiple trauma, major abdominal surgery, ischemic stroke, chronic obstructive pulmonary disease, cardiac failure, isolated head injury, acute lung injury/adult respiratory distress syndrome (ALI/ARDS), nontraumatic intracranial hemorrhage or coronary surgery. Data recorded for each patient: length of ICU stay, and cost in euros of all diagnostic and therapeutic procedures, drugs and equipment used, and consultations by physicians from other units. To express cost-efficiency we calculated for each diagnostic group the cost per surviving patient (expenditure for all patients/number of surviving patients) and money loss per patient (expenditure for patients who died/total number of patients). Median costs for a multiple trauma patient were euro 4076 and for coronary surgery patient euro 380. The variability is largely due to different lengths of ICU stay. Cost per surviving patient was higher for ALI/ARDS, nontraumatic intracranial hemorrhage, multiple trauma, and emergency abdominal surgery. Money loss per patient was higher for ALI/ARDS and lower for multiple trauma. Planned coronary and major abdominal surgery and short-stay patients were treated most cost-efficiently. Cost of treatment in an ICU varies widely for different types of patients. Strategies are needed to contain the major determinants of high costs and low cost-efficiency.

  19. 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

  20. Development in infants with autism spectrum disorders: a prospective study.

    PubMed

    Landa, Rebecca; Garrett-Mayer, Elizabeth

    2006-06-01

    Autism is rarely diagnosed before three years of age despite evidence suggesting prenatal abnormalities in neurobiological processes. Little is known about when or how development becomes disrupted in the first two years of life in autism. Such information is needed to facilitate early detection and early intervention. This prospective study of autism spectrum disorders (ASD) examined development using the Mullen Scales of Early Learning (MSEL) in 87 infants tested at target ages 6, 14, and 24 months. Participants came from infants at high risk (siblings of children with autism) and low risk (no family history of autism) groups. Based on language test scores, Autism Diagnostic Observation Schedule, and clinical judgment at 24 months of age, participants were categorized as: unaffected, ASD, or language delayed (LD). Longitudinal linear regression and ANOVA models were applied to MSEL raw scores, and estimates were compared between the three diagnostic groups. No statistically significant group differences were detected at 6 months. By 14 months of age, the ASD group performed significantly worse than the unaffected group on all scales except Visual Reception. By 24 months of age, the ASD group performed significantly worse than the unaffected group in all domains, and worse than the language delayed group in Gross Motor, Fine Motor, and Receptive Language. The developmental trajectory of the ASD group was slower than the other groups', and showed a significant decrease in development between the first and second birthdays. Variations from typical and language delayed development are detectable in many children with ASD using a measure of general development by 24 months of age. Unusual slowing in performance occurred between 14 and 24 months of age in ASD.

  1. Parathyroidectomy for primary hyperparathyroidism improves sleep quality: A prospective study.

    PubMed

    La, Justin; Wang, Tracy S; Hammad, Abdulrahman Y; Burgardt, Laura; Doffek, Kara; Carr, Azadeh A; Shaker, Joseph L; Carroll, Ty B; Evans, Douglas B; Yen, Tina W F

    2017-01-01

    This prospective survey study assessed changes in sleep quality in patients with primary hyperparathyroidism after parathyroidectomy. Patients undergoing parathyroidectomy for primary hyperparathyroidism (n = 110) or thyroidectomy for benign euthyroid disease (control group; n = 45) were recruited between June 2013 and June 2015 and completed the Pittsburgh Sleep Quality Index preoperatively and at 1- and 6 months postoperatively. "Poor" sleep quality was defined as a score >5; a clinically important and relevant improvement was a ≥3-point decrease. Preoperatively, parathyroid patients had worse sleep quality than thyroid patients (mean 8.1 vs 5.3; P < .001); 76 (69%) parathyroid and 23 (51%) thyroid patients reported poor sleep quality (P = .03). Postoperatively, only parathyroid patients demonstrated improvement in sleep quality; mean scores did not differ between the parathyroid and thyroid groups at 1 month (6.3 vs 5.3; P = .12) or 6 months (5.8 vs 4.6; P = .11). The proportion of patients with a clinically important improvement in sleep quality was greater in the parathyroid group at 1 month (37% vs 10%; P < .001) and 6 months (40% vs 17%; P = .01). Importantly, there was no difference in the proportion of patients with poor sleep quality between the 2 groups at 1 month (50% vs 40%; P = .32) and 6 months (40% vs 29%; P = .22). More than two-thirds of patients with primary hyperparathyroidism report poor sleep quality. After parathyroidectomy, over one-third experienced improvement, typically within the first month postoperatively. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. 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

  3. A prospective study of micronutrient status in adolescent pregnancy.

    PubMed

    Baker, Philip N; Wheeler, Simon J; Sanders, Tom A; Thomas, Jane E; Hutchinson, Cindy J; Clarke, Karen; Berry, Jacqueline L; Jones, Rebecca L; Seed, Paul T; Poston, Lucilla

    2009-04-01

    Adolescents are more likely than adults to consume energy-dense, micronutrient-poor diets and to experience adverse pregnancy outcomes. The objectives were to assess micronutrient intake and blood biomarkers prospectively in pregnant adolescents recruited to the About Teenage Eating (ATE) Study and to determine associations with pregnancy outcome. Pregnant adolescents (n = 500) were recruited from 2 UK inner city populations. Dietary intake was assessed with three 24-h dietary recalls, and micronutrient status was assessed by measurement of third trimester blood biomarkers. Pregnancy outcomes included small-for-gestational age (SGA) birth and preterm delivery. Median iron and folate intakes were lower than UK and US recommended amounts. Folate and vitamin B-12 status were lower in smokers, despite no differences in dietary intake. Serum folate was <7.0 nmol/L in 12% of subjects, and serum total homocysteine (tHcy) was elevated (>10 micromol/L) in 20% of subjects. Fifty-two percent of the subjects had iron deficiency anemia, and 30% had serum 25-hydroxyvitamin D concentrations <25 nmol/L. The incidence of SGA birth was higher in subjects with poorer folate status (red blood cell folate, P = 0.003; serum folate, P = 0.02; tHcy, P = 0.01; simple regression) and those with low folate intakes, regardless of the inclusion (P = 0.021) or exclusion (P = 0.049) of intake from supplements (simple regression). Adjustment for confounding variables confirmed the independence of these associations. The risk of SGA birth was also higher in subjects with low food iron intake (P = 0.049), but not when intake included iron from supplements (P = 0.21). The risk of SGA birth was lower in subjects with iron deficiency anemia (P = 0.002). Poor micronutrient intake and status increase the risk of SGA births in pregnant adolescents.

  4. 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

  5. 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

  6. 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…

  7. 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…

  8. 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

  9. 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

  10. 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

  11. A prospective study of fever in the intensive care unit.

    PubMed

    Circiumaru, B; Baldock, G; Cohen, J

    1999-07-01

    To determine the epidemiology of fever on the intensive care unit (ICU). Prospective, observational study. Nine-bed general ICU in a 500-bed tertiary care inner city institution. 100 consecutive admissions of 93 patients over a 4-month period between July and October 1996. All patients were seen and examined by one investigator within 24 h of ICU admission. Patients were followed up on a daily basis throughout their ICU stay, and all clinical and laboratory data were recorded during the admission. Fever (core temperature > or = 38.4 degrees C) was present in 70% of admissions, and it was caused by infective and non-infective processes in approximately equal number. Most fevers occurred early in the course of the admission, within the first 1-2 days, and most lasted less than 5 days. The median Acute Physiology and Chronic Health Evaluation (APACHE) II score was 15 (+/- 0.6). The 70 episodes associated with fever at any time were associated with a significantly higher APACHE II score on admission than the afebrile episodes (15.8 +/- 6.1 vs 12.1 +/- 6.7, p = 0.04). The most common cause of non-infective fever was in the group designated post-operative fever (n = 34). All the patients in the post-operative fever group were febrile on day 0 or day 1; their mean admission APACHE score was 12.4 (+/- 4.4) compared to 15.9 (+/- 7.1) for the remaining patients (p = 0.01). Fever alone was not associated with a higher mortality: 26/70 (37%) of febrile patients died, compared to 8/30 (27%) of afebrile patients, (chi 2 = 1.23, p = 0.38). Prolonged fever (> 5 days) occurred in 16 patients. In 13 cases, fever was due to infection, and in the remaining 3 both infective and non-infective processes occurred concurrently. The mortality in the group with prolonged fever was 62.5% (10/16) compared to 29.6% (16/54) in patients with fever of less than 5 days' duration, a highly significant difference (p < 0.0001). Fever is a common event on the intensive care unit. It usually occurs

  12. A multicenter prospective study of surgical audit systems.

    PubMed

    Haga, Yoshio; Ikejiri, Koji; Wada, Yasuo; Takahashi, Tadateru; Ikenaga, Masakazu; Akiyama, Noriyoshi; Koike, Shoichiro; Koseki, Masato; Saitoh, Toshihiro

    2011-01-01

    This study was undertaken to evaluate a modified form of Estimation of Physiologic Ability and Surgical Stress (E-PASS) for surgical audit comparing with other existing models. Although several scoring systems have been devised for surgical audit, no nation-wide survey has been performed yet. We modified our previous E-PASS surgical audit system by computing the weights of 41 procedures, using data from 4925 patients who underwent elective digestive surgery, designated it as mE-PASS. Subsequently, a prospective cohort study was conducted in 43 national hospitals in Japan from April 1, 2005, to April 8, 2007. Variables for the E-PASS and American Society of Anesthesiologists (ASA) status-based model were collected for 5272 surgically treated patients. Of the 5272 patients, we also collected data for the Portsmouth modification of Physiologic and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) in 3128 patients. The area under the receiver operative characteristic curve (AUC) was used to evaluate discrimination performance to detect in-hospital mortality. The ratio of observed to estimated in-hospital mortality rates (OE ratio) was defined as a measure of quality. The numbers of variables required were 10 for E-PASS, 7 for mE-PASS, 20 for P-POSSUM, and 4 for the ASA status-based model. The AUC (95% confidence interval) values were 0.86 (0.79-0.93) for E-PASS, 0.86 (0.79-0.92) for mE-PASS, 0.81 (0.75-0.88) for P-POSSUM, and 0.73 (0.63-0.83) for the ASA status-based model. The OE ratios for mE-PASS among large-volume hospitals significantly correlated with those for E-PASS (R = 0.93, N = 9, P = 0.00026), P-POSSUM (R = 0.96, N = 6, P = 0.0021), and ASA status-based model (R = 0.83, N = 9, P = 0.0051). Because of its features of easy use, accuracy, and generalizability, mE-PASS is a candidate for a nation-wide survey.

  13. Serum erythropoietin and outcome after ischaemic stroke: a prospective study

    PubMed Central

    Åberg, N David; Stanne, Tara M; Jood, Katarina; Schiöler, Linus; Blomstrand, Christian; Andreasson, Ulf; Blennow, Kaj; Zetterberg, Henrik; Isgaard, Jörgen; Jern, Christina; Svensson, Johan

    2016-01-01

    Objectives Erythropoietin (EPO), which is inversely associated with blood haemoglobin (Hb), exerts neuroprotective effects in experimental ischaemic stroke (IS). However, clinical treatment trials have so far been negative. Here, in patients with IS, we analysed whether serum EPO is associated with (1) initial stroke severity, (2) recovery and (3) functional outcome. Design Prospective. Controls available at baseline. Setting A Swedish hospital-initiated study with outpatient follow-up after 3 months. Participants Patients (n=600; 64% males, mean age 56 years, controls n=600) were included from the Sahlgrenska Academy Study on IS (SAHLSIS). Primary and secondary outcome measures In addition to EPO and Hb, initial stroke severity was assessed by the Scandinavian Stroke Scale (SSS) and compared with SSS after 3 months (follow-up) as a measure of recovery. Functional outcome was evaluated using the modified Rankin Scale (mRS) at follow-up. Serum EPO and SSS were divided into quintiles in the multivariate regression analyses. Results Serum EPO was 21% and 31% higher than in controls at the acute phase of IS and follow-up, respectively. In patients, acute serum EPO was 19.5% higher in severe versus mild IS. The highest acute EPO quintile adjusted for sex, age and Hb was associated with worse stroke severity quintile (OR 1.70, 95% CI 1.00 to 2.87), better stroke recovery quintile (OR 1.93, CI 1.09 to 3.41) and unfavourable mRS 3–6 (OR 2.59, CI 1.15 to 5.80). However, the fourth quintile of EPO increase (from acute to follow-up) was associated with favourable mRS 0–2 (OR 3.42, CI 1.46 to 8.03). Only the last association withstood full adjustment. Conclusions The crude associations between EPO and worse stroke severity and outcome lost significance after multivariate modelling. However, in patients in whom EPO increased, the association with favourable outcome remained after adjustment for multiple covariates. PMID:26916692

  14. A prospective study of faecal bile acids and colorectal cancer.

    PubMed

    Haines, A; Hill, M J; Thompson, M H; Owen, R W; Williams, R E; Meade, T W; Wilkes, H; Griffin, M

    2000-10-01

    A prospective study of 7079 people aged 45-74 recruited through general practices in South Wales, Herefordshire and Edinburgh, Scotland was undertaken to test the hypothesis that faecal bile acids are implicated in the causation of large bowel cancer. The population was recruited between 1974 and 1980 and the response rate for stool collection was 67%. Bile acid analyses were performed on those cases that presented by 1990. It was decided in advance to examine the hypothesis separately for left- and right-sided bowel cancer because of known epidemiological differences between the two sites and to exclude the cases presenting within 2 years of the stool sample from the analyses because the cancer could have been present at recruitment and might have possibly affected faecal bile acid concentrations. Each case (n = 51 left-sided and 8 right-sided) was matched with three controls by age (within 5 years), sex, place of residence and time of providing the stool sample (within 3 months). Statistical analyses using conditional logistic regression showed no significant differences between the left-sided cases and controls for any of the concentrations of individual bile acids, total bile acid concentrations, faecal neutral steroids, percentage bacterial conversion and the ratio of lithocholic acid to deoxycholic acid concentrations. There was a statistically significant (P = 0.021) association of the presence of chenodeoxycholic acid (5/8 samples) in the right-sided cases compared with the controls (3/23), odds ratio 6.26 (95% confidence interval 1.19, 32.84). A high proportion of primary bile acids has also been found in other studies of patients with a genetic predisposition to proximal bowel cancer, however this pattern may also occur in low risk groups, such as Indian vegetarians, suggesting that they may predispose to right-sided bowel cancer only in the presence of other, as yet unknown factors. If bile acids are involved in the causation of large bowel cancer, they

  15. Etiologic yield of autistic spectrum disorders: a prospective study.

    PubMed

    Battaglia, Agatino; Carey, John C

    2006-02-15

    Studies addressing etiologic yield in childhood developmental disabilities have mainly looked at individuals with developmental delay/mental retardation. The few studies addressing the question of etiologic yield in patients with pervasive developmental disorders (PDDs) had a major drawback, in that the enrolled subjects were diagnosed as having the autistic spectrum disorders based only on history and clinical examination, and/or on unspecified instruments. In addition, only some of these patients underwent a complete laboratory evaluation. To investigate the etiologic yield of PDDs, we undertook a large prospective study on subjects selected according to very strict criteria and diagnosed as having PDD based on the present "gold standard" (ADI-R and ADOS-G), and a clinical diagnosis made by a child psychiatrist. Eighty-five (85) patients with PDD and their first degree relatives participated in this study. These patients were selected from a sample of 236 subjects who had received a clinical diagnosis of PDD at the Stella Maris Institute between March 2002 and 2005. Selection criteria for entering the study were: (1) a diagnosis of PDD (with exclusion of the Rett syndrome) confirmed after the administration of the ADI-R (autism diagnostic interview-revised) and the ADOS-G (autism diagnostic observation schedule-generic). In addition, a clinical diagnosis was made by the child psychiatrist, on the basis of presence or absence of DSM-IV symptoms of autism; (2) chronological age between 4 and 18 years; (3) IQ>30; (4) availability of both biologic parents. Patients, 65/85 (76.5%), had autism, 18/85 (21.2%) had PDD-NOS, and the remaining 2/85 (2.3%) had Asperger syndrome. Ages varied between 4 years 2 months and 12 years 5 months (mean 7.6 years), and there was a marked male preponderance (68/85). All subjects underwent various laboratory studies and neuroimaging. With respect to possible etiologic determination, a detailed history and physical examination in this

  16. Durability of flexible ureteroscopes: a randomized, prospective study.

    PubMed

    Monga, Manoj; Best, Sara; Venkatesh, Ramakrishna; Ames, Caroline; Lee, Courtney; Kuskowski, Michael; Schwartz, Steven; Vanlangendock, Richard; Skenazy, Jason; Landman, Jaime

    2006-07-01

    We performed a randomized, prospective, multi-institutional study evaluating the durability of commercially available flexible ureteroscopes. A total of 192 patients were randomized to the use of 7 less than 9Fr flexible ureteroscopes, including the Storz 11274AA and Flex-X, the ACMI DUR-8 and DUR-8 Elite, Wolf models 7330.170 and 7325.172, and the Olympus URF-P3. Information about total and lower pole use time, the number and method of ureteroscope insertion, and they type and duration of accessory instrumentation was recorded. Surgeons were asked to rate the visibility and maneuverability of the instrument on a scale of 0-poor to 10-excellent. The indication for ureteroscopy was upper tract calculi in 87% of cases. Of ureteroscope insertions 97% were performed through an access sheath. The average of number of cases before repair ranged from 3.25 for the Wolf 7325 to 14.4 for the ACMI DUR-8 Elite. Average ureteroscope operative time was statistically longer for the DUR-8 Elite (494 minutes) than for the Flex-X (p = 0.047), and the Wolf 7325 and 7330 (p = 0.001 and 0.001, respectively). Duration of use before repair for the URF-P3 (373 minutes) was statistically longer than for the Wolf 7325 and 7330 (p = 0.016 and 0.017, respectively). Minutes of use with an instrument in the working channel were significantly more with the DUR-8 Elite and the URF-P3 than the Wolf 7330 (p = 0.017 and 0.008) and 7325 (p = 0.012 and 0.005, respectively). The ureteroscope that experienced the greatest average duration of lower pole use was the URF-P3, while the shortest was the Wolf 7325 (103 vs 20 minutes, p = 0.005). Average minutes of laser use before breakage was significantly longer for the DUR-8 Elite than for the Wolf 7325 (110 vs 21 minutes, p = 0.021) and 7330 (24 minutes, p = 0.025). Currently available less than 9Fr flexible ureteroscopes remain fragile instruments. The DUR-8 Elite and Olympus URF-P3 proved to be the most durable devices.

  17. Anosognosia for hemiplegia: a clinical-anatomical prospective study.

    PubMed

    Vocat, Roland; Staub, Fabienne; Stroppini, Tiziano; Vuilleumier, Patrik

    2010-12-01

    Anosognosia for hemiplegia is a common and striking disorder following stroke. Because it is typically transient and variable, it remains poorly understood and has rarely been investigated at different times in a systematic manner. Our study evaluated a prospective cohort of 58 patients with right-hemisphere stroke and significant motor deficit of the left hemibody, who were examined using a comprehensive neuropsychological battery at 3 days (hyperacute), 1 week (subacute) and 6 months (chronic) after stroke onset. Anosognosia for hemiplegia was frequent in the hyperacute phase (32%), but reduced by almost half 1 week later (18%) and only rarely seen at 6 months (5%). Anosognosia for hemiplegia was correlated with the severity of several other deficits, most notably losses in proprioception, extrapersonal spatial neglect and disorientation. While multiple regression analyses highlighted proprioceptive loss as the most determinant factor for the hyperacute period, and visuospatial neglect and disorientation as more determinant for the subacute phase, patients with both proprioceptive loss and neglect had significantly higher incidence of anosognosia for hemiplegia than those with only one deficit or no deficits (although a few double dissociations were observed). Personal neglect and frontal lobe tests showed no significant relation with anosognosia for hemiplegia, nor did psychological traits such as optimism and mood. Moreover, anosognosia for neglect and prediction of performance in non-motor tasks were unrelated to anosognosia for hemiplegia, suggesting distinct monitoring mechanisms for each of these domains. Finally, by using a voxel-based statistical mapping method to identify lesions associated with a greater severity of anosognosia, we found that damage to the insula (particularly its anterior part) and adjacent subcortical structures was determinant for anosognosia for hemiplegia in the hyperacute period, while additional lesions in the premotor cortex

  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. [Time of cord clamping and neonatal complications, a prospective study].

    PubMed

    Rincón, D; Foguet, A; Rojas, M; Segarra, E; Sacristán, E; Teixidor, R; Ortega, A

    2014-09-01

    To assess the effects of early or late clamping of the umbilical cord in term newborns, assessing the levels of hemoglobin, hematocrit, and ferritin, and their correlation with some of the complications. A prospective study of healthy newborns at term or born by dystotic or eutocic delivery in our hospital between May 2009 until May 2010. Patients were assigned according to the time of clamping, group 1 (<60 seconds), group 2 (1 to<2 minutes), and group 3 (2 to 3 minutes). Laboratory tests were performed at birth and at 48 hours of life, assessing the levels of hemoglobin, hematocrit, ferritin, and bilirubin. The risk of polycythemia, respiratory distress syndrome, neonatal phototherapy or admission to the Intensive Care Unit and the hospital stay, were evaluated. A total of 242 patients were included: group 1 (g1=80), group 2 (g2=31) y group 3 (g3=131). The background maternal and neonatal characteristics were similar in all sets. The first test showed significant differences in ferritin levels in those infants with delayed clamping (g1: 111 mg/dl, g2: 125 mg/dl, g3: 173 mg/dl; p<0.01). In the second analysis the values of hemoglobin (g1: 17.3 g/dl, g2: 18.9 g/dl, g3: 19.2 g/dl; p<0.01), hematocrit (g1: 53.4%, g2: 58%, g3: 59%; p<0.01) and ferritin (g1: 254 mg/dl, g2: 254.7 mg/dl, g3: 313 mg/dl; p = 0.008) were statistically higher in this group. As regards complications, a significant increase was observed in the number of cases of polycythemia symptoms in group 3. The late cord clamping is associated with an increase in hematocrit, hemoglobin and ferritin at 48 hours of life, as well as an increased risk of polycythemia present with symptoms. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  20. 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.

  1. [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

  2. Benchmarking of surgical complications in gynaecological oncology: prospective multicentre study.

    PubMed

    Burnell, M; Iyer, R; Gentry-Maharaj, A; Nordin, A; Liston, R; Manchanda, R; Das, N; Gornall, R; Beardmore-Gray, A; Hillaby, K; Leeson, S; Linder, A; Lopes, A; Meechan, D; Mould, T; Nevin, J; Olaitan, A; Rufford, B; Shanbhag, S; Thackeray, A; Wood, N; Reynolds, K; Ryan, A; Menon, U

    2016-12-01

    To explore the impact of risk-adjustment on surgical complication rates (CRs) for benchmarking gynaecological oncology centres. Prospective cohort study. Ten UK accredited gynaecological oncology centres. Women undergoing major surgery on a gynaecological oncology operating list. Patient co-morbidity, surgical procedures and intra-operative (IntraOp) complications were recorded contemporaneously by surgeons for 2948 major surgical procedures. Postoperative (PostOp) complications were collected from hospitals and patients. Risk-prediction models for IntraOp and PostOp complications were created using penalised (lasso) logistic regression using over 30 potential patient/surgical risk factors. Observed and risk-adjusted IntraOp and PostOp CRs for individual hospitals were calculated. Benchmarking using colour-coded funnel plots and observed-to-expected ratios was undertaken. Overall, IntraOp CR was 4.7% (95% CI 4.0-5.6) and PostOp CR was 25.7% (95% CI 23.7-28.2). The observed CRs for all hospitals were under the upper 95% control limit for both IntraOp and PostOp funnel plots. Risk-adjustment and use of observed-to-expected ratio resulted in one hospital moving to the >95-98% CI (red) band for IntraOp CRs. Use of only hospital-reported data for PostOp CRs would have resulted in one hospital being unfairly allocated to the red band. There was little concordance between IntraOp and PostOp CRs. The funnel plots and overall IntraOp (≈5%) and PostOp (≈26%) CRs could be used for benchmarking gynaecological oncology centres. Hospital benchmarking using risk-adjusted CRs allows fairer institutional comparison. IntraOp and PostOp CRs are best assessed separately. As hospital under-reporting is common for postoperative complications, use of patient-reported outcomes is important. Risk-adjusted benchmarking of surgical complications for ten UK gynaecological oncology centres allows fairer comparison. © 2016 Royal College of Obstetricians and Gynaecologists.

  3. 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

  4. Human kidney histopathology in acute obstructive jaundice: a prospective study.

    PubMed

    Uslu, Adam; Taşli, Funda Alkan; Nart, Ahmet; Postaci, Hakan; Aykas, Ahmet; Bati, Hasan; Coşkun, Yavuz

    2010-12-01

    Cholemia and bacterial translocation with portal endotoxemia are integral in the pathogenesis of obstructive jaundice (OJ). There is sufficient experimental data about hemodynamic and histopathological consequences of OJ. In contrast, pathological information of renal changes in patients with OJ is still lacking. Therefore; the primary objective of this prospective study is to show the specific histopathological changes in kidneys of patients with short-term biliary tract obstruction receiving a standard perioperative medical treatment protocol. Twenty consecutive patients with biliary obstruction were included in the study. Fluid replacement, prevention of biliary sepsis, and portal endotoxemia were mainstays of the perioperative treatment protocol. Fluid and electrolyte balance was maintained by twice daily body weight calculations, central venous pressure, and mean arterial pressure monitoring. Renal function was assessed by glomerular filtration rate estimation by modification of diet in renal disease-7 formula. Kidney biopsy evaluation was focused on tubular changes, thrombotic microangiopathy, endothelial damage, and peritubular capillary (PTC) dilatation with or without C4d staining. Fresh frozen sections were evaluated with immunofluorescence microscopy for glomerular IgG, IgA, IgM, C3, and C1q staining. The mean duration of OJ was 15.5 ± 1.4 days. Body weight increased before surgery through volume expansion (P = 0.001). All patients have shown mean arterial pressure ≥ 70 and ≤ 120 mmHg and renal function was very well preserved in all but one subject during the perioperative period. Despite those favorable figures, dilatation of peritubular venules and acute tubular necrosis were shown synchronously in all cases. C4d staining in PTC and arterioles and thrombotic microangiopathy were entirely absent in the study group. Immune complex deposits in PTCs and in glomeruli were not detected. Three patients had isolated glomerular C4d deposition without

  5. 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

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

    PubMed

    Garg, Arun; Hegmann, Kurt T; Moore, J Steven; Kapellusch, Jay; Thiese, Matthew S; Boda, Sruthi; Bhoyr, Parag; Bloswick, Donald; Merryweather, Andrew; Sesek, Richard; Deckow-Schaefer, Gwen; Foster, James; Wood, Eric; Sheng, Xiaoming; Holubkov, Richard

    2013-03-07

    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. 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. Data analysis of a prospective cohort study of low back pain is underway and has successfully enrolled over 800 workers to date.

  7. 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

  8. Generic substitution of antiepileptic drugs: a systematic review of prospective and retrospective studies.

    PubMed

    Yamada, Mikiko; Welty, Timothy E

    2011-11-01

    To systematically review the literature on generic antiepileptic drugs (AEDs), evaluate the efficacy and safety of generic AED substitution, and perform pharmacokinetic (PK) analysis using the American Academy of Neurology (AAN) scheme to classify evidence. PubMed and Cumulative Index to Nursing and Allied Health Literature searches from January 1, 1980, to October 15, 2010, were performed using the search terms anticonvulsant, antiepileptic drug, carbamazepine, divalproex, ethosuximide, gabapentin, lamotrigine, levetiracetam, oxcarbazepine, pheno-barbital, phenytoin, primidone, topiramate, valproate, valproic acid, and zonisamide; bioavailability, bioequivalence, bioequivalency, bioequivalent, and substitution; and generic. Retrospective and prospective controlled studies of generic substitution of AEDs were included in the review. Non-English-language articles and uncontrolled clinical studies were excluded. Published articles were categorized using the AAN criteria for systematic reviews. We identified 156 articles. Of these, 20 met our inclusion criteria; 7 were retrospective studies, 6 were prospective studies in patients with epilepsy, and 7 were prospective studies in healthy subjects. All articles were rated Class I to Class III, using AAN criteria. The retrospective studies were categorized as Class III and showed a significant relationship between generic substitution and increased use of health care resources because of seizures or AED toxicity. Prospective studies were categorized as Class I, II, and III. Prospective studies in patients showed no differences between brand and generic drugs in PK parameters of bioequivalence. Three prospective studies in healthy subjects reported significant differences in maximum drug concentrations. Comparison of brand and generic drugs revealed no significant difference in seizure frequency; however, some prospective studies showed significant differences in PK parameters, primarily those not used for bioequivalence

  9. Juvenile myoclonic epilepsy: a 5-year prospective study.

    PubMed

    Panayiotopoulos, C P; Obeid, T; Tahan, A R

    1994-01-01

    We made a long term prospective study of 66 patients with juvenile myoclonic epilepsy (JME). Prevalence was 10.2% among 672 patients with epilepsies. Sex distribution was equal. Sixty-three were not diagnosed on referral; JME was not initially recognized in the epilepsy clinic in 22. Clinical typical absence seizures were reported in 33.3%, myoclonic jerks in 97% and generalized tonic-clonic seizures (GTC) in 78.8% of the patients. Mean age (+/- SD) at onset was 10.5 +/- 3.4 years (range 5-16 years) for absence seizures, 15 +/- 3.5 years (range 8-26 years) for myoclonic jerks, and 16 +/- 3.5 years (9-28) years (range 1-9 years) and GTC by 4.4 +/- 2.7 years (range 1-8 years) in 14 (21.2%) patients who manifested all three types of seizure. Absence were never antedated by myoclonic jerks or GTC. Myoclonic jerks occurred on awakening in 87.5% of the patients. GTC occurred mainly on awakening, but other patients had nocturnal or diurnal GTC with no circadian distribution. Neurologic examination was normal for all patients except for tremor of the hands similar to essential tremor, noted in 35% of patients. Computed tomography (CT) brain scans were normal: 93% of patients had precipitating factors: sleep deprivation (89.5%), fatigue (73.7%), photosensitivity (36.8%; television and video games 8.8%), menstruation (24.1% of women), mental concentration (22.8%), and stress (12.3%). Incidence of JME among siblings (13 of 41 examined families) implies an autosomal recessive mode of inheritance for this Arab population. EEGs were frequently normal in treated patients. At least one abnormal EEG was recorded in 56 (84.9%) patients. Abnormalities consisted mainly of generalized discharges of spike/double spike and/or polyspike and slow wave. Frequent multiple spikes and discharge fragmentations varied from 0.5- to 20-s duration (mean 6.8 s). Twenty (30.3%) had focal abnormalities, and 18 (27.3%) had photoconvulsive discharges. Eighty-eight percent of patients remained seizure

  10. Optical Simulations and Studies with the PROSPECT-20 Detector

    NASA Astrophysics Data System (ADS)

    Stemen, Nathaniel; Prospect Collaboration

    2015-10-01

    The PROSPECT (Precision Reactor Oscillation and SPECTrum) experiment at the High Flux Isotope Reactor (HFIR) at Oak Ridge National Laboratory will make a precise measurement of the reactor antineutrino spectrum from a highly-enriched uranium nuclear reactor while also probing for short-baseline oscillations as a signature of possible sterile-neutrinos. Two liquid scintillator detectors at distances of 7-10m and 16-20m from the reactor will identify inverse beta decay events initiated by reactor antineutrinos. The near detector will be divided into optically separated segments filled with lithium loaded liquid scintillator read out by photomultiplier tubes (PMTs) on either end. Light guides will be employed to direct photons from the scintillator cells to the active PMT photo-cathodes. An optical simulation was built to optimize the performance of the detectors with respect to both light collection and detector uniformity and guide the design of the scintillator cells. We present experimental data and simulation results from the PROSPECT-20 prototype detector.

  11. 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

  12. Orthodontics as a prospective career choice among undergraduate dental students: A prospective study

    PubMed Central

    Sam, George

    2015-01-01

    Objectives: The purposes of this study were to investigate the factors influencing the career choice of dental students and to identify the future life plans of the students at Prince Sattam Bin Abdulaziz University Dental College who had chosen orthodontics as their future specialty. Materials and Methods: An epidemiological descriptive survey was conducted using a set of questionnaire among the second year to fourth year students at Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia. Data were categorized by demographic variables and were analyzed with statistical methods using descriptive statistical analysis. Results: The most important factor influencing the decision to pursue specialty in orthodontics was considering that “orthodontics is intellectually challenging” (23%), followed by “previous positive experience” (15%). The decision to become an orthodontist was made by 3.7% of the respondents in the first year of their course, 44.4% in the second year of their study, 11.1% during the third year of their study, 25.9% during the fourth year of their study, while none of them had made their decision during the final year of their dental school studies. Only one student (3.7) said he planned to work in a private college in an academic setting, five students (18.5%) had plans to do private practice, two students indicated that they would work for the Ministry of Health, while most students (40.7%) reported that they were planning to try a combination of all of the above. Six students (22.2%) remained undecided. Conclusions: Majority of the students who had chosen orthodontics as their future specialty of choice at Sattam Bin Abdulaziz University Dental College, Saudi Arabia had taken up this specialty as they felt that orthodontics was intellectually challenging. PMID:26312228

  13. Orthodontics as a prospective career choice among undergraduate dental students: A prospective study.

    PubMed

    Sam, George

    2015-01-01

    The purposes of this study were to investigate the factors influencing the career choice of dental students and to identify the future life plans of the students at Prince Sattam Bin Abdulaziz University Dental College who had chosen orthodontics as their future specialty. An epidemiological descriptive survey was conducted using a set of questionnaire among the second year to fourth year students at Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia. Data were categorized by demographic variables and were analyzed with statistical methods using descriptive statistical analysis. The most important factor influencing the decision to pursue specialty in orthodontics was considering that "orthodontics is intellectually challenging" (23%), followed by "previous positive experience" (15%). The decision to become an orthodontist was made by 3.7% of the respondents in the first year of their course, 44.4% in the second year of their study, 11.1% during the third year of their study, 25.9% during the fourth year of their study, while none of them had made their decision during the final year of their dental school studies. Only one student (3.7) said he planned to work in a private college in an academic setting, five students (18.5%) had plans to do private practice, two students indicated that they would work for the Ministry of Health, while most students (40.7%) reported that they were planning to try a combination of all of the above. Six students (22.2%) remained undecided. Majority of the students who had chosen orthodontics as their future specialty of choice at Sattam Bin Abdulaziz University Dental College, Saudi Arabia had taken up this specialty as they felt that orthodontics was intellectually challenging.

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. Prospective study of serologic tests for lyme disease.

    PubMed

    Steere, Allen C; McHugh, Gail; Damle, Nitin; Sikand, Vijay K

    2008-07-15

    Tests to determine serum antibody levels-the 2-tier sonicate immunoglobulin M (IgM) and immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) and Western blot method or the IgG of the variable major protein-like sequence-expressed (VlsE) sixth invariant region (C6) peptide ELISA method-are the major tests available for support of the diagnosis of Lyme disease. However, these tests have not been assessed prospectively. We used these tests prospectively to determine serologic responses in 134 patients with various manifestations of Lyme disease, 89 patients with other illnesses (with or without a history of Lyme disease), and 136 healthy subjects from areas of endemicity and areas in which the infection was not endemic. With 2-tier tests and the C6 peptide ELISA, only approximately one-third of 76 patients with erythema migrans had results that were positive for IgM or IgG seroreactivity with Borrelia burgdorferi in acute-phase samples. During convalescence, 3-4 weeks later, almost two-thirds of patients had seroreactivity with the spirochete B. burgdorferi. The frequencies of seroreactivity were significantly greater among patients with spirochetal dissemination than they were among those who lacked evidence of disseminated disease. Of the 44 patients with Lyme disease who had neurologic, heart, or joint involvement, all had positive C6 peptide ELISA results, 42 had IgG responses with 2-tier tests, and 2 patients with facial palsy had only IgM responses. However, among the control groups, the IgG Western blot was slightly more specific than the C6 peptide ELISA. The differences between the 2 test systems (2-tier testing and C6 peptide ELISA) with respect to sensitivity and specificity were not statistically significant. Except in patients with erythema migrans, both test systems were sensitive for support of the diagnosis of Lyme disease. However, with current methods, 2-tier testing was associated with slightly better specificity.

  19. The role of rostral prefrontal cortex in prospective memory: A voxel-based lesion study

    PubMed Central

    Volle, Emmanuelle; Gonen-Yaacovi, Gil; de Lacy Costello, Angela; Gilbert, Sam J.; Burgess, Paul W.

    2011-01-01

    Patients with lesions in rostral prefrontal cortex (PFC) often experience problems in everyday-life situations requiring multitasking. A key cognitive component that is critical in multitasking situations is prospective memory, defined as the ability to carry out an intended action after a delay period filled with unrelated activity. The few functional imaging studies investigating prospective memory have shown consistent activation in both medial and lateral rostral PFC but also in more posterior prefrontal regions and non-frontal regions. The aim of this study was to determine regions that are necessary for prospective memory performance, using the human lesion approach. We designed an experimental paradigm allowing us to assess time-based (remembering to do something at a particular time) and event-based (remembering to do something in a particular situation) prospective memory, using two types of material, words and pictures. Time estimation tasks and tasks controlling for basic attention, inhibition and multiple instructions processing were also administered. We examined brain-behaviour relationships with a voxelwise lesion method in 45 patients with focal brain lesions and 107 control subjects using this paradigm. The results showed that lesions in the right polar prefrontal region (in Brodmann area 10) were specifically associated with a deficit in time-based prospective memory tasks for both words and pictures. This deficit could not be explained by impairments in basic attention, detection, inhibition or multiple instruction processing, and there was also no deficit in event-based prospective memory conditions. In addition to their prospective memory difficulties, these polar prefrontal patients were significantly impaired in time estimation ability compared to other patients. The same region was found to be involved using both words and pictures, suggesting that right rostral PFC plays a material nonspecific role in prospective memory. This is the first

  20. 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…

  1. 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…

  2. 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.

  3. Morbidity pattern of children with asthma: a prospective study.

    PubMed

    Manandhar, K; Bajracharya, B L; Dhakal, S; Shrestha, M

    2006-01-01

    To determine the morbidity pattern of asthma in children attending the paediatric asthma follow-up clinic. Longitudinal prospective follow up of hundred and four patients, diagnosed as asthma, over a period of 2 years was done. Regular follow up by the same person during each visit and proper supervision of standard treatment along with parental education regarding the asthma, was done. The mean age of children presenting with asthma was 6.7 years. Majority of children 49 (47.5%) were graded as mild persistent asthma. Fifty nine (56.7%) children were missing school more than 7 days per month. Family history was present in forty one percent of the children. Fifty seven (54.8%) children were taking significant amount of junk food and were undernourished. Significant reduction in school-missing days and Emergency Room visits was noted in these children during the follow up period. Awareness of disease is an important aspect of asthma management. Proper treatment and follow up with emotional support and education of the care taker, about the asthma, can reduce the morbidity pattern of asthma in children.

  4. 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

  5. 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.

  6. The Effect of Teacher Training on the Learning Styles of Prospective Teachers of Social Studies

    ERIC Educational Resources Information Center

    Özdemir, Nevin; Kesten, Alper; Iskin, Pinar

    2017-01-01

    The purpose of this study is to examine the effects of four-year-long undergraduate education on the learning styles of prospective teachers of social studies. This study was conducted in accordance with longitudinal method, which is one of the research designs used in developmental psychology researches. The study was conducted with the…

  7. Staphylococcus aureus Bloodstream Infection and Endocarditis - A Prospective Cohort Study

    PubMed Central

    Le Moing, Vincent; Alla, François; Doco-Lecompte, Thanh; Delahaye, François; Piroth, Lionel; Chirouze, Catherine; Tattevin, Pierre; Lavigne, Jean-Philippe; Erpelding, Marie-Line; Hoen, Bruno; Vandenesch, François; Duval, Xavier

    2015-01-01

    Objectives To update the epidemiology of S. aureus bloodstream infection (SAB) in a high-income country and its link with infective endocarditis (IE). Methods All consecutive adult patients with incident SAB (n = 2008) were prospectively enrolled between 2009 and 2011 in 8 university hospitals in France. Results SAB was nosocomial in 54%, non-nosocomial healthcare related in 18% and community-acquired in 26%. Methicillin resistance was present in 19% of isolates. SAB Incidence of nosocomial SAB was 0.159/1000 patients-days of hospitalization (95% confidence interval [CI] 0.111-0.219). A deep focus of infection was detected in 37%, the two most frequent were IE (11%) and pneumonia (8%). The higher rates of IE were observed in injecting drug users (IE: 38%) and patients with prosthetic (IE: 33%) or native valve disease (IE: 20%) but 40% of IE occurred in patients without heart disease nor injecting drug use. IE was more frequent in case of community-acquired (IE: 21%, adjusted odds-ratio (aOR) = 2.9, CI = 2.0-4.3) or non-nosocomial healthcare-related SAB (IE: 12%, aOR = 2.3, CI = 1.4-3.5). S. aureus meningitis (IE: 59%), persistent bacteremia at 48 hours (IE: 25%) and C-reactive protein > 190 mg/L (IE: 15%) were also independently associated with IE. Criteria for severe sepsis or septic shock were met in 30% of SAB without IE (overall in hospital mortality rate 24%) and in 51% of IE (overall in hospital mortality rate 35%). Conclusion SAB is still a severe disease, mostly related to healthcare in a high-income country. IE is the most frequent complication and occurs frequently in patients without known predisposing conditions. PMID:26020939

  8. 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

  9. Postpartum migraines: a long-term prospective study.

    PubMed

    Hoshiyama, Eisei; Tatsumoto, Muneto; Iwanami, Hisatake; Saisu, Akihiro; Watanabe, Hiroshi; Inaba, Noriyuki; Hirata, Koichi

    2012-01-01

    There are many reports regarding the course of migraines during pregnancy. However, the prevalence and characteristics of migraines during the postpartum period have not been adequately investigated. We prospectively investigated the patients suffering from migraines over a long postpartum period in an obstetrics department in Japan. We investigated the course of migraines experienced during the postpartum period by patients in a postnatal ward. The patients were surveyed during the first postpartum week and 1, 3, 6 and 12 months after delivery. The patients were provided a headache diary to assess medication use and migraine attack frequency, severity (the faces pain scale) and duration. The migraine remission rate was 63%, 83% and 85% during the first, second and third trimesters, respectively. No patient experienced a worsening of headaches during pregnancy. Headache recurrence during the first month after delivery was more frequent in the patients >30 years of age than in those ≤30 years of age (p<0.05). The percentage of women experiencing recurrence at 1, 3, 6 and 12 months after delivery was 63%, 75%, 78% (n=60) and 87.5% (n=40), respectively. In breastfeeding patients, the rates were 50%, 65.8%, 71.1% and 91.7% and in bottle feeding patients, the rates were 86.4%, 90.9%, 95.5% and 81.3%, respectively. We found that 85% of the patients with migraines experience remission during pregnancy and that more than 50% experience recurrence during the first month after delivery. Until six months after delivery, breastfeeding is associated with a lower recurrence rate than bottle feeding.

  10. Hyperbilirubinemia after extracorporeal circulation surgery: a recent and prospective study.

    PubMed

    An, Yong; Xiao, Ying-Bin; Zhong, Qian-Jin

    2006-11-07

    To clarify the incidence and nature of postoperative hyperbilirubinemia in patients after modern extracorporeal circulation, to analyze possible perioperative risk factors, and to elucidate the clinical significance of postoperative hyperbilirubinemia associated mortality and morbidity. Between March 2005 and May 2006, three hundred and eighty six consecutive patients undergoing extracorporeal circulation surgery due to a variety of cardiac lesions were investigated prospectively. The incidence of postoperative hyperbilirubinemia was defined as a serum total bilirubin concentration of more than 51 micromol/L. Several perioperative parameters were compared by logistic regression between hyperbilirubinemia and non-hyperbilirubinemia patients to determine possible risk factors contributing to postoperative hyperbilirubinemia and mortality. Overall incidence of postoperative hyperbilirubinemia was 25.3% (98/386). In patients with postoperative hyperbilirubinemia, 56.2% reached peak total bilirubin concentration on the first postoperative day, 33.5% on the second day, and 10.3% on the seventh day. Eighty percent of the increase of total bilirubin resulted from an increase of both conjugated and unconjugated bilirubin. Development of postoperative hyperbilirubinemia was associated with a higher mortality (P<0.01), longer duration of mechanical ventilation (P<0.05) and longer ICU stay time (P<0.05). Preoperative total bilirubin concentration, preoperative right atrium pressure, numbers of valves replaced and of blood transfusion requirement were identified as important predictors for postoperative hyperbilirubinemia. Early postoperative hyperbilirubinemia after modern extracorporeal circulation is mainly caused by an increase in both conjugated and unconjugated bilirubin, and is associated with a high mortality. Important contributing factors are the preoperative total bilirubin concentration, preoperative severity of right atrial pressure, numbers of valve replacement

  11. Endogenous-cue prospective memory involving incremental updating of working memory: an fMRI study.

    PubMed

    Halahalli, Harsha N; John, John P; Lukose, Ammu; Jain, Sanjeev; Kutty, Bindu M

    2015-11-01

    Prospective memory paradigms are conventionally classified on the basis of event-, time-, or activity-based intention retrieval. In the vast majority of such paradigms, intention retrieval is provoked by some kind of external event. However, prospective memory retrieval cues that prompt intention retrieval in everyday life are commonly endogenous, i.e., linked to a specific imagined retrieval context. We describe herein a novel prospective memory paradigm wherein the endogenous cue is generated by incremental updating of working memory, and investigated the hemodynamic correlates of this task. Eighteen healthy adult volunteers underwent functional magnetic resonance imaging while they performed a prospective memory task where the delayed intention was triggered by an endogenous cue generated by incremental updating of working memory. Working memory and ongoing task control conditions were also administered. The 'endogenous-cue prospective memory condition' with incremental working memory updating was associated with maximum activations in the right rostral prefrontal cortex, and additional activations in the brain regions that constitute the bilateral fronto-parietal network, central and dorsal salience networks as well as cerebellum. In the working memory control condition, maximal activations were noted in the left dorsal anterior insula. Activation of the bilateral dorsal anterior insula, a component of the central salience network, was found to be unique to this 'endogenous-cue prospective memory task' in comparison to previously reported exogenous- and endogenous-cue prospective memory tasks without incremental working memory updating. Thus, the findings of the present study highlight the important role played by the dorsal anterior insula in incremental working memory updating that is integral to our endogenous-cue prospective memory task.

  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. 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.

  14. 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

  15. 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…

  16. 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…

  17. Investigating How and What Prospective Teachers Learn through Microteaching Lesson Study

    ERIC Educational Resources Information Center

    Fernandez, Maria Lorelei

    2010-01-01

    Microteaching Lesson Study [MLS] combines elements of Japanese lesson study and microteaching. A case study of MLS was conducted with 18 prospective teachers in an initial course on learning to teach. Various data sources (i.e., pre- and post-lesson plans, MLS lesson plans, videotaped lessons, transcripts of group discussions, observation field…

  18. 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…

  19. Inpatient Treatment in Child and Adolescent Psychiatry--A Prospective Study of Health Gain and Costs

    ERIC Educational Resources Information Center

    Green, Jonathan; Jacobs, Brian; Beecham, Jennifer; Dunn, Graham; Kroll, Leo; Tobias, Catherine; Briskman, Jackie

    2007-01-01

    Background: Inpatient treatment is a complex intervention for the most serious mental health disorders in child and adolescent psychiatry. This is the first large-scale study into its effectiveness and costs. Previous studies have been criticised for methodological weaknesses. Methods: A prospective cohort study, including economic evaluation,…

  20. 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…

  1. Liver elasticity measurement before and after biliary drainage in patients with obstructive jaundice: a prospective cohort studya prospective cohort study.

    PubMed

    Kubo, Kimitoshi; Kawakami, Hiroshi; Kuwatani, Masaki; Nishida, Mutsumi; Kawakubo, Kazumichi; Kawahata, Shuhei; Taya, Yoko; Kubota, Yoshimasa; Amano, Toraji; Shirato, Hiroki; Sakamoto, Naoya

    2016-07-08

    Obstructive jaundice has been reported to influence liver elasticity, independent of liver fibrosis. The aim of our prospective study was to evaluate the changes in liver elasticity, before and after biliary drainage, in patients with obstructive jaundice, and to evaluate the correlation between elasticity measures and serum markers of liver fibrosis. This is a prospective cohort study of 20 patients with obstructive jaundice. Liver elasticity was assessed by Transient Elastography (TE) and Virtual Touch™ Quantification (VTQ). Serum total bilirubin (T-Bil) level was measured before biliary drainage (Day 0), with measures repeated at 2 days (Day 2) and 7 days (Day 7) after biliary drainage. Serum levels of the following markers of liver fibrosis were also obtained on Day 0 and Day 7: hyaluronic acid (HA), procollagen-III-peptide (P-III-P). T-Bil, TE, and VTQ for the left (VTQ-L) and right (VTQ-R) lobes of the liver were all elevated before biliary drainage, with respective levels, measured at Day 0, of 11.9 ± 1.5 mg/dl, 12.1 ± 0.9 kPa, 2.23 ± 0.10 m/s, and 1.85 ± 0.10 m/s. All values decreased on Day 7 after drainage: T-Bil, 4.7 ± 1.0 mg/dl (P < 0.001); TE, 7.6 ± 0.6 kPa (P < 0.001); VTQ-L, 1.53 ± 0.08 m/s (P < 0.001); and VTQ-R, 1.30 ± 0.05 m/s (P < 0.001). Similar changes were observed in serum markers of liver fibrosis. Liver elasticity measures correlated with serum levels of T-Bil, P-III-P, and HA (r = 0.35-0.67, P < 0.001). This study confirmed decreases in liver elasticity, measured by TE and VTQ, after biliary drainage. Measures of liver elasticity correlated to levels of T-Bil and serum markers of liver fibrosis. (UMIN ID: UMIN00001284313). University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN ID: UMIN00001284313 ); Registration date: 2014-01-14.

  2. The millennium Cohort Study: a 21-year prospective cohort study of 140,000 military personnel.

    PubMed

    Gray, Gregory C; Chesbrough, Karen B; Ryan, Margaret A K; Amoroso, Paul; Boyko, Edward J; Gackstetter, Gary D; Hooper, Tomoko I; Riddle, James R

    2002-06-01

    Does military service, in particular operational deployment, result in a higher risk of chronic illness among military personnel and veterans? The Millennium Cohort Study, the largest Department of Defense prospective cohort study ever conducted, will attempt to answer this question. The probability-based sample of 140,000 military personnel will be surveyed every 3 years during a 21-year period. The first questionnaire, scheduled for release in summer 2001, will be sent to 30,000 veterans who have been deployed to southwest Asia, Bosnia, or Kosovo since August 1997 and 70,000 veterans who have not been deployed to these conflict areas. Twenty thousand new participants will be added to the group in each of the years 2004 and 2007 to complete the study population of 140,000. The participants will have the option of completing the study questionnaire either on the paper copy received in the mail or through the World Wide Web-based version, which is available at www.MillenniumCohort.org. This will be one of the first prospective studies ever to offer such an option. The initial survey instrument will collect data regarding demographic characteristics, self-reported medical conditions and symptoms, and health-related behaviors. Validated instruments will be incorporated to capture self-assessed physical and mental functional status (Short Form for Veterans), psychosocial assessment (Patient Health Questionnaire), and post-traumatic stress disorder (Patient Checklist-17). Information obtained from the survey responses will be linked with other military databases, including data on deployment, occupation, vaccinations, health care utilization, and disability. In addition to revealing changes in veterans' health status over time, the Millennium Cohort Study will serve as a data repository, providing a solid foundation upon which additional epidemiological studies may be constructed.

  3. 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.

  4. 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

  5. A prospective study of total sleep duration and incident metabolic syndrome: the ARIRANG study.

    PubMed

    Kim, Jang-Young; Yadav, Dhananjay; Ahn, Song Vogue; Koh, Sang-Baek; Park, Jong Taek; Yoon, Junghan; Yoo, Byung-Su; Lee, Seung-Hwan

    2015-12-01

    Chronic sleep deprivation is increasingly common in industrialized societies. Recent data have revealed that chronic sleep deprivation is associated with negative health outcome. While prospective studies lack the predictive value of sleep duration to identify individuals at high risk of new-onset metabolic syndrome, total sleep duration may play a role in the development of metabolic abnormalities. This study investigates the association between total sleep duration and the incidence of metabolic syndrome in a population-based longitudinal study. At baseline, a prospective cohort study was conducted with 2579 adults without metabolic syndrome aged between 40 and 70 years. Based on a self-reported questionnaire, the participants in this study were investigated between 2005-2008 (baseline) and 2008-2011 (follow-up) and were categorized according to their total sleep duration (<6 h, 6-7.9 h, 8-9.9 h, ≥10 h). Metabolic syndrome was defined according to the recent harmonized definition. During an average of 2.6 years of follow-up, 558 (21.6%) subjects developed metabolic syndrome. In multivariable adjusted models, the odds ratio (95% confidence interval (CI)) for incident metabolic syndrome comparing the 6 to 7.9 h to the <6 h of total sleep duration was 1.41 (1.06-1.88). The corresponding odds ratios (95% CI) for high waist circumference, low high-density lipoprotein (HDL) cholesterol, high triglycerides, high blood pressure, and high blood glucose were 1.30 (0.98-1.69), 0.75 (0.56-0.97), 0.82 (0.60-1.11), 1.56 (1.19-2.03), and 1.31 (0.96-1.79), respectively. Short sleep duration is an independent risk factor for incident metabolic syndrome in a population-based longitudinal study. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. 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

  7. 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.

  8. 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…

  9. 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…

  10. 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…

  11. 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…

  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. The Intergenerational Continuity of Observed Early Parenting: A Prospective, Longitudinal Study

    ERIC Educational Resources Information Center

    Kovan, Nikki M.; Chung, Alissa L.; Sroufe, L. Alan

    2009-01-01

    The authors report the results from a prospective, longitudinal study of cross-generational parenting quality in a lower socioeconomic status sample of moderate ethnic diversity (N = 61). The study extends previous research on intergenerational continuity of parenting in several significant ways: (a) Assessments in both generations were based on…

  14. 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…

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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.…

  2. 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…

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 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.…

  8. 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…

  9. Parenting styles and body mass index: a systematic review of prospective studies among children.

    PubMed

    Sokol, R L; Qin, B; Poti, J M

    2017-03-01

    Parenting style may be an important determinant of an individual's future weight status. However, reviews that evaluate the relationship between parenting style and weight-related outcomes have not focused on prospective studies. We systematically searched PubMed, Embase and PsychInfo for studies published between 1995 and 2016 that evaluated the prospective relationship between parenting style experienced in childhood and subsequent weight outcomes. We identified 11 prospective cohort studies. Among the eight studies that categorized parenting style into distinct groups (i.e. authoritative, authoritarian, permissive and neglectful), five provided evidence that authoritative parenting was associated with lower body mass index gains. Among the six highest quality studies, four suggested a protective role of authoritative parenting style against adverse weight-related outcomes. However, only one study controlled for a comprehensive set of confounders, and the small number of studies conducted within certain age groups precluded our ability to ascertain critical periods when parenting style is most strongly related to child weight. The present literature supports the idea that authoritative parenting may be protective against later overweight and obesity, although findings are mixed. More prospective cohort studies of longer durations, with more sophisticated methods that examine age-varying relationships, and that control for a comprehensive set of confounders, are needed. © 2017 World Obesity Federation.

  10. 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…

  11. 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…

  12. 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…

  13. 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…

  14. 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…

  15. 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…

  16. 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

  17. The Shozu Herpes Zoster (SHEZ) Study: Rationale, Design, and Description of a Prospective Cohort Study

    PubMed Central

    Takao, Yukiko; Miyazaki, Yoshiyuki; Onishi, Fumitake; Kumihashi, Hideaki; Gomi, Yasuyuki; Ishikawa, Toyokazu; Okuno, Yoshinobu; Mori, Yasuko; Asada, Hideo; Yamanishi, Koichi; Iso, Hiroyasu

    2012-01-01

    Background The incidence and risk factors for herpes zoster have been studied in cross-sectional and cohort studies, although most such studies have been conducted in Western countries. Evidence from Asian populations is limited, and no cohort study has been conducted in Asia. We are conducting a 3-year prospective cohort study in Shozu County in Kagawa Prefecture, Japan to determine the incidence and predictive and immunologic factors for herpes zoster among Japanese. Methods The participants are followed for 3 years, and a telephone survey is conducted every 4 weeks. The participants were assigned to 1 of 3 studies. Participants in study A gave information on past history of herpes zoster and completed health questionnaires. Study B participants additionally underwent varicella-zoster virus (VZV) skin testing, and study C participants additionally underwent blood testing. If the participants develop herpes zoster, we evaluate clinical symptoms, measure cell-mediated immunity and humoral immunity using venous blood sampling, photograph skin areas with rash, conduct virus identification testing by polymerase chain reaction (PCR) and virus isolation from crust sampling, and evaluate postherpetic pain. Results We recruited 12 522 participants aged 50 years or older in Shozu County from December 2009 through November 2010. The participation rate was 65.7% of the target population. Conclusions The present study is likely to provide valuable data on the incidence and predictive and immunologic factors for herpes zoster in a defined community-based population of Japanese. PMID:22343323

  18. The Shozu Herpes Zoster (SHEZ) study: rationale, design, and description of a prospective cohort study.

    PubMed

    Takao, Yukiko; Miyazaki, Yoshiyuki; Onishi, Fumitake; Kumihashi, Hideaki; Gomi, Yasuyuki; Ishikawa, Toyokazu; Okuno, Yoshinobu; Mori, Yasuko; Asada, Hideo; Yamanishi, Koichi; Iso, Hiroyasu

    2012-01-01

    The incidence and risk factors for herpes zoster have been studied in cross-sectional and cohort studies, although most such studies have been conducted in Western countries. Evidence from Asian populations is limited, and no cohort study has been conducted in Asia. We are conducting a 3-year prospective cohort study in Shozu County in Kagawa Prefecture, Japan to determine the incidence and predictive and immunologic factors for herpes zoster among Japanese. The participants are followed for 3 years, and a telephone survey is conducted every 4 weeks. The participants were assigned to 1 of 3 studies. Participants in study A gave information on past history of herpes zoster and completed health questionnaires. Study B participants additionally underwent varicella-zoster virus (VZV) skin testing, and study C participants additionally underwent blood testing. If the participants develop herpes zoster, we evaluate clinical symptoms, measure cell-mediated immunity and humoral immunity using venous blood sampling, photograph skin areas with rash, conduct virus identification testing by polymerase chain reaction (PCR) and virus isolation from crust sampling, and evaluate postherpetic pain. We recruited 12 522 participants aged 50 years or older in Shozu County from December 2009 through November 2010. The participation rate was 65.7% of the target population. The present study is likely to provide valuable data on the incidence and predictive and immunologic factors for herpes zoster in a defined community-based population of Japanese.

  19. 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)

  20. 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

  1. 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)

  2. Retrospect and Prospect of Studies of Teacher Efficacy in China

    ERIC Educational Resources Information Center

    He, Ning; Miao, Danmin

    2006-01-01

    Teacher efficacy is a powerful variable in educational and psychological studies. And it aroused much attention and interest from Chinese scholars in the past decade, which led to an accumulation of documents in this field. Following an introduction of efficacy studies in the west, the article reviews the brief history of those in China,…

  3. Lexical studies of indigenous personality factors: premises, products, and prospects.

    PubMed

    Saucier, G; Goldberg, L R; Institute, O R

    2001-12-01

    The rationale for lexical studies rests on the assumption that the most meaningful personality attributes tend to become encoded in language as single-word descriptors. We articulate some key premises of the lexical approach and then review a number of studies that have been conducted examining the factor structure of personality descriptors extracted from dictionaries. We compare lexical studies in English and 12 other languages, with attention to delineating consistencies between the structures found in diverse languages. Our review suggests that the Anglo-Germanic Big Five is reproduced better in some languages than in others. We propose some organizing rules for lexical factor structures that may be more generalizable than the contemporary Big-Five model. And, we propose several candidate structural models that should be compared with the Big Five in future studies, including structures with one, two, and three very broad factors, an alternative five-factor structure identified in Italian and Hungarian studies, and a seven-factor structure represented in Hebrew and Philippine studies. We recommend that in future studies more attention be paid to middle-level personality constructs and to examining the effects of methodological variations on the resulting factor structures.

  4. 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.

  5. 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

  6. [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.

  7. 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,…

  8. Chocolate consumption and risk of myocardial infarction: a prospective study and meta-analysis.

    PubMed

    Larsson, Susanna C; Åkesson, Agneta; Gigante, Bruna; Wolk, Alicja

    2016-07-01

    To examine whether chocolate consumption is associated with a reduced risk of ischaemic heart disease, we used data from a prospective study of Swedish adults and we performed a meta-analysis of available prospective data. The Swedish prospective study included 67 640 women and men from the Cohort of Swedish Men and the Swedish Mammography Cohort who had completed a food-frequency questionnaire and were free of cardiovascular disease at baseline. Myocardial infarction (MI) cases were ascertained through linkage with the Swedish National Patient and Cause of Death Registers. PubMed and EMBASE databases were searched from inception until 4 February 2016 to identify prospective studies on chocolate consumption and risk of ischaemic heart disease. The results from eligible studies were combined using a random-effects model. During follow-up (1998-2010), 4417 MI cases were ascertained in the Swedish study. Chocolate consumption was inversely associated with MI risk. Compared with non-consumers, the multivariable relative risk for those who consumed ≥3-4 servings/week of chocolate was 0.87 (95% CI 0.77 to 0.98; p for trend =0.04). Five prospective studies on chocolate consumption and ischaemic heart disease were identified. Together with the Swedish study, the meta-analysis included six studies with a total of 6851 ischaemic heart disease cases. The overall relative risk for the highest versus lowest category of chocolate consumption was 0.90 (95% CI 0.82 to 0.97), with little heterogeneity among studies (I(2)=24.3%). Chocolate consumption is associated with lower risk of MI and ischaemic heart disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. 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.

  10. 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

  11. 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).

  12. 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.

  13. 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

  14. 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.

  15. Parametric study of prospective early commercial OCMHD power plants /PSPEC/

    NASA Technical Reports Server (NTRS)

    Marston, C. H.; Bender, D. J.; Hnat, J. G.; Dellinger, T. C.

    1980-01-01

    The paper presents a parametric study conducted to obtain the performance, economics, natural resource requirements, and environmental impact of moderate technology MHD/steam power plants that do not require development of direct-fired high-temperature air heaters. The study was divided into three base cases, each with a reference case and parametric variations. The case using recuperative air preheat in the range of 1000 F to 1300 F, combined with O2 enrichment to 42% by volume has been selected for conceptual design.

  16. Swarna Bhasma in cancer: A prospective clinical study

    PubMed Central

    Das, Soumen; Das, Mangal C.; Paul, Retina

    2012-01-01

    Despite the advances in the treatment of cancer, mortality is still high. Complementary and alternative medicine is emerging as a potent modality in cancer treatment. ‘Swarna Bhasma’ (SB), containing gold particles, is an ancient Indian medicine has shown its anticancer activity. This present study was conducted to detect the effect of SB on solid malignancies. A total of 43 patients were included in this study received SB for 1 year. Seventeen patients showed response. The response was best in rectal cancer group 70% (7/10). Nearly 41.02% patients survived for 1 year after treatment but after 5 years this came down to 15.38%. PMID:23723642

  17. Swarna Bhasma in cancer: A prospective clinical study.

    PubMed

    Das, Soumen; Das, Mangal C; Paul, Retina

    2012-07-01

    Despite the advances in the treatment of cancer, mortality is still high. Complementary and alternative medicine is emerging as a potent modality in cancer treatment. 'Swarna Bhasma' (SB), containing gold particles, is an ancient Indian medicine has shown its anticancer activity. This present study was conducted to detect the effect of SB on solid malignancies. A total of 43 patients were included in this study received SB for 1 year. Seventeen patients showed response. The response was best in rectal cancer group 70% (7/10). Nearly 41.02% patients survived for 1 year after treatment but after 5 years this came down to 15.38%.

  18. International, prospective haemovigilance study on methylene blue-treated plasma.

    PubMed

    Noens, L; Vilariño, Ma D; Megalou, A; Qureshi, H

    2017-05-01

    Methylene blue is a phenothiazine dye, which in combination with visible light has virucidal and bactericidal properties, disrupting the replication of a broad range of enveloped viruses and some non-enveloped viruses. The study objective was to collect data on adverse reactions occurring with methylene blue plasma administered in a routine clinical practice environment and document their characteristics and severity. This was an open label, multicentre, non-controlled, non-randomized, non-interventional study. Patients who receive a methylene blue plasma transfusion were observed for any signs and symptoms (adverse reactions) within 24 h safter the start of the transfusion, in different hospitals for a study duration of at least 1 year. A total of 19 315 methylene blue plasma units were transfused. There were eight patients with adverse reactions recorded during the study, one of them serious. Two had more than one reaction (two and four, respectively). Three patients had previous transfusions with methylene blue plasma only. Methylene blue plasma has a very acceptable safety profile with a rate of serious adverse reactions of 0·5/10 000 units. © 2017 International Society of Blood Transfusion.

  19. 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…

  20. 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…

  1. 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…

  2. Child and Adolescent Abuse and Subsequent Victimization: A Prospective Study

    ERIC Educational Resources Information Center

    Rich, Cindy L.; Gidycz, Christine A.; Warkentin, Jennifer B.; Loh, Catherine; Weiland, Paul

    2005-01-01

    Objective: We investigated the possible reciprocal relationship between victimization experiences and psychological functioning by assessing abuse experiences in childhood, adolescence, and during a 2-month follow-up period. Method: At the beginning of the study (Time 1), abuse histories, trauma and depressive symptoms, and interpersonal…

  3. Website Study: What Information Are Prospective Graduate Students Seeking?

    ERIC Educational Resources Information Center

    Lampley, James H.; Owens, Megan E.

    2015-01-01

    The purpose of this website study was to get feedback from recently admitted students to discover if the site was meeting their needs and expectations for information regarding the program and processes. Websites are often the first contact a student has with a university and, especially for those seeking a degree online, could potentially leave…

  4. 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…

  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. The "New Social Studies"--Retrospect and Prospect

    ERIC Educational Resources Information Center

    Massialas, Byron G.

    2009-01-01

    When he looks back to the 1960s, the author feels sentimental about the New Social Studies movement that began very strong and then suddenly disintegrated. At the time of the genesis of the movement, there was a group of professionals, representing both the social sciences and education, who felt they had a vision of what was needed to revitalize…

  7. Ultrasonic scalpel for gastric cancer surgery: a prospective randomized study.

    PubMed

    Inoue, Kentaro; Nakane, Yasushi; Michiura, Taku; Yamada, Masanori; Mukaide, Hiromi; Fukui, Junichi; Miki, Hirokazu; Ueyama, Yosuke; Nakatake, Richi; Tokuhara, Katsuji; Iwamoto, Shigeyoshi; Yanagimoto, Hiroaki; Toyokawa, Hideyoshi; Satoi, Sohei; Kwon, A-Hon

    2012-10-01

    The aim of the study was to evaluate the potential advantages of the ultrasonic scalpel compared with the conventional technique in gastric cancer surgery. Patients with resectable adenocarcinoma of the stomach were randomly assigned to ultrasonic scalpel or conventional technique. We used the HARMONIC FOCUS (Ethicon Endo-Surgery, Inc.) as ultrasonic scalpel. Between February 2010 and December 2010, 60 patients with resectable gastric cancer were enrolled into the study. Operative time was significantly shorter with the ultrasonic arm than with the conventional arm (median 238.5 vs. 300.5 min; P = 0.0004). Blood loss was also significantly lower in the ultrasonic arm than in the conventional arm (median 351.0 vs. 569.5 ml; P = 0.016). Clavien-Dindo grades of postoperative complications were similar in the two groups. From a questionnaire survey of operators, the ultrasonic scalpel significantly reduced the stress of lymph node dissection (3.67 vs. 2.87; P = 0.0006). However, in assisting surgeons, the contributions to surgery, study, and technical improvement of the ultrasonic group were lower than in the conventional group. This study shows that the ultrasonic scalpel is a reliable and safe tool for open gastric cancer surgery.

  8. 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…

  9. 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

  10. Psychological factors associated with development of TMD: the OPPERA prospective cohort study.

    PubMed

    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

    2013-12-01

    Case-control studies have consistently associated psychological factors with chronic pain in general and with temporomandibular disorder (TMD) specifically. However, only a handful of prospective studies have explored whether preexisting 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 4 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. This article reports that several premorbid psychological variables predict first-onset TMD in the OPPERA study, a large prospective cohort study designed to discover causal determinants of TMD pain. Measures of somatic

  11. 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

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

    DTIC Science & Technology

    2005-05-01

    Cognitive Lifetime Drinking History (26-27). Prior to the interview, participants completed a lifetime events calendar on which they recorded the date and...eliminate the effect on hormone levels by treatment, cases were enrolled in the study prior to starting chemotherapy or hormone therapy ; thus increasing...Freudenheim JL, Chan AW, Markovic N, Vena JE, Priore RL (1997) Test-retest reliability of the cognitive lifetime drinking history. Am J Epidemiol, 146(11

  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. Quasi-Prospective Study of Breast Cancer and Diet

    DTIC Science & Technology

    2006-08-01

    between physical activity, diet , and adult weight history and breast cancer. Our goal is to recruit 648 incident cases of breast cancer and up 2...systematic reporting errors, such as simple errors in recall and social desirability biases. This case-control study was designed to measure diet , adult ...that may be protective. High levels of adult weight gain and physical inactivity, both of which may be related to increased risk, are examined both as

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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…

  20. 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…

  1. 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…

  2. 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,…

  3. 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…

  4. 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…

  5. 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…

  6. 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…

  7. 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…

  8. 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…

  9. 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…

  10. 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…

  11. Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies.

    PubMed

    Salvagioni, Denise Albieri Jodas; Melanda, Francine Nesello; Mesas, Arthur Eumann; González, Alberto Durán; Gabani, Flávia Lopes; Andrade, Selma Maffei de

    2017-01-01

    Burnout is a syndrome that results from chronic stress at work, with several consequences to workers' well-being and health. This systematic review aimed to summarize the evidence of the physical, psychological and occupational consequences of job burnout in prospective studies. The PubMed, Science Direct, PsycInfo, SciELO, LILACS and Web of Science databases were searched without language or date restrictions. The Transparent Reporting of Systematic Reviews and Meta-Analyses guidelines were followed. Prospective studies that analyzed burnout as the exposure condition were included. Among the 993 articles initially identified, 61 fulfilled the inclusion criteria, and 36 were analyzed because they met three criteria that must be followed in prospective studies. Burnout was a significant predictor of the following physical consequences: hypercholesterolemia, type 2 diabetes, coronary heart disease, hospitalization due to cardiovascular disorder, musculoskeletal pain, changes in pain experiences, prolonged fatigue, headaches, gastrointestinal issues, respiratory problems, severe injuries and mortality below the age of 45 years. The psychological effects were insomnia, depressive symptoms, use of psychotropic and antidepressant medications, hospitalization for mental disorders and psychological ill-health symptoms. Job dissatisfaction, absenteeism, new disability pension, job demands, job resources and presenteeism were identified as professional outcomes. Conflicting findings were observed. In conclusion, several prospective and high-quality studies showed physical, psychological and occupational consequences of job burnout. The individual and social impacts of burnout highlight the need for preventive interventions and early identification of this health condition in the work environment.

  12. 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…

  13. 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…

  14. 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,…

  15. 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,…

  16. 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…

  17. 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…

  18. 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…

  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. 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…

  1. 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…

  2. 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…

  3. 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…

  4. Improving the Cultural Responsiveness of Prospective Social Studies Teachers: An Action Research

    ERIC Educational Resources Information Center

    Tuncel, Gül

    2017-01-01

    In recent years, studies on teacher training have focused on the development of a culturally responsive understanding in prospective teachers and its use to allow students benefit from learning-teaching environments in the best way possible. Considering diverse cultural and linguistic backgrounds of students as wealth is a prerequisite for…

  5. 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…

  6. 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…

  7. 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 ...

  8. 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…

  9. 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 ...

  10. 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…

  11. 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…

  12. 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…

  13. 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…

  14. Prospects for Future Studies of the XYZ: BESIII, GlueX, Panda

    NASA Astrophysics Data System (ADS)

    Mitchell, Ryan

    2013-04-01

    The unexpected XYZ states of charmonium are still yet to be fully explained. Further progress will require additional experimental input. This talk will review the prospects for future studies of the XYZ states at BESIII (in Beijing, China), GlueX (in Newport News, USA), and Panda (in Darmstadt, Germany).

  15. 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…

  16. 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…

  17. 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…

  18. 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…

  19. 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,…

  20. 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…

  1. Prospective Multicenter Study of Pneumocystis jirovecii Colonization among Cystic Fibrosis Patients in France

    PubMed Central

    Hernández-Hernández, Francisca; Fréalle, Emilie; Caneiro, Patrick; Salleron, Julia; Durand-Joly, Isabelle; Accoceberry, Isabelle; Bouchara, Jean-Philippe; Wallaert, Benoit; Dei-Cas, Eduardo

    2012-01-01

    Pneumocystis carriage was detected in 12.5% of 104 cystic fibrosis (CF) patients during a prospective multicenter French study, with a prevalence of genotype 85C/248C and geographic variations. It was significantly associated with the absence of Pseudomonas aeruginosa colonization and a greater forced expiratory volume in 1 s. Results are discussed considering the natural history of CF. PMID:23015669

  2. A Prospective Study of Risk Factors for the Development of Depression and Disordered Eating in Adolescents

    ERIC Educational Resources Information Center

    Ferreiro, Fatima; Seoane, Gloria; Senra, Carmen

    2011-01-01

    There is evidence that females display higher levels of depressive symptoms and disordered eating than males from adolescence onward. This study examined whether different risk factors and their interaction with sex (moderator effect) prospectively predicted depressive symptoms and disordered eating in adolescents. A total of 415 female…

  3. 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).…

  4. 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…

  5. 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…

  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. 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…

  8. Tea Consumption and Endometrial Cancer Risk: Meta-Analysis of Prospective Cohort Studies.

    PubMed

    Je, Youjin; Park, Taeyoung

    2015-01-01

    Several lines of evidence suggest that tea consumption may reduce the risk of endometrial cancer due to antioxidant properties of tea, but the results of prospective data to date are inconsistent. We thus conducted a meta-analysis of prospective cohort studies to examine the relationship between tea consumption and endometrial cancer risk, using a random-effects model. We identified 5 eligible cohort studies, which included 231,870 female participants and 1831 cases for endometrial cancer. The pooled relative risk (RR) for the highest (median 2 cups/day) vs. no/lowest category of tea consumption on endometrial cancer risk was 0.95 [95% confidence interval (CI): 0.80-1.12] with no significant heterogeneity (P for heterogeneity = 0.68, I(2) = 0.0%). By country of origin, the pooled RR of 3 studies conducted in the United States was 1.00 (95% CI: 0.83-1.21), in which black tea was consumed by most people. Because of limited data on Asian population, the association of green tea on endometrial cancer was not calculated separately. There was no indication of publication bias (Begg's P = 0.46; Egger's P = 0.43). Our findings from prospective data do not support a role of tea consumption in endometrial carcinogenesis. More prospective cohort studies with green tea consumption should be conducted.

  9. 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…

  10. A Prospective Study of Risk Factors for the Development of Depression and Disordered Eating in Adolescents

    ERIC Educational Resources Information Center

    Ferreiro, Fatima; Seoane, Gloria; Senra, Carmen

    2011-01-01

    There is evidence that females display higher levels of depressive symptoms and disordered eating than males from adolescence onward. This study examined whether different risk factors and their interaction with sex (moderator effect) prospectively predicted depressive symptoms and disordered eating in adolescents. A total of 415 female…

  11. Neurodevelopmental outcome of isolated ventriculomegaly: a prospective cohort study.

    PubMed

    Bar-Yosef, Omer; Barzilay, Eran; Dorembus, Sara; Achiron, Reuven; Katorza, Eldad

    2017-08-01

    Data regarding the neurodevelopmental outcome of children diagnosed in utero with isolated ventriculomegaly (IVM) are limited and principally founded on ultrasound-based studies. Here, we endeavored to assess the outcome of such cases in a large-scale, magnetic resonance imaging (MRI)-based study. We conducted a study on 133 cases of IVM with a documented fetal brain MRI scan. Children were assessed at ages 18 to 36 months by using the Vineland Adaptive Behavior Scales (VABS). Vineland Adaptive Behavior Scales scores were within normal range. There was no significant difference between VABS score in symmetric versus asymmetric IVM (101.7 vs. 101.6, respectively; p = 0.94), and the VABS score of mild IVM was comparable with that of moderate IVM (101.8 vs. 101; p = 0.8). Only five cases (3.8%) were found to have an abnormal score (<85). There was no significant difference in the rate of abnormal scores between mild and moderate IVM (2.8% vs. 8.3%, respectively; p = 0.22). In cases of isolated ventriculomegaly, a normal neurodevelopmental outcome is to be expected; moreover, the outcome does not appear to be affected by the severity or asymmetry of the ventriculomegaly. Thus, following a meticulous workup, patients can be given reassuring counseling regarding the child's prognosis. © 2017 John Wiley & Sons, Ltd. © 2017 John Wiley & Sons, Ltd.

  12. 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).

  13. 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.

  14. 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.

  15. The prospects for urban densification: a place-based study

    NASA Astrophysics Data System (ADS)

    Schmidt-Thomé, Kaisa; Haybatollahi, Mohammad; Kyttä, Marketta; Korpi, Jari

    2013-06-01

    Study of the environmental outcomes of urban densification is a highly context-dependent task. Our study shows that collecting and processing place-based survey data by means of the softGIS method is clearly helpful here. With the map-based internet questionnaire each response remains connected to both the physical environment and the everyday life of the respondent. In our study of the Kuninkaankolmio area (located in the Helsinki metropolitan region) the survey data were combined with urban density variables calculated from register-based data on the existing built environment. The regression analysis indicated that the participants in the survey preferred the same density factors for their future residence as they enjoyed in their current neighbourhood. In the second analysis we related the densities of planned infill developments with the interest respondents had shown in these projects. The results show that new and even quite dense infill developments have been found to be rather attractive, with them often being viewed as interesting supplements to the current urban texture. These findings contribute to the ongoing scientific discussion on the feasibility of densification measures and encourage the Kuninkaankolmio planners to proceed, albeit carefully, with the planned infill developments.

  16. A Prospective Study of Fitness, Fatness, and Depressive Symptoms

    PubMed Central

    Becofsky, Katie M.; Sui, Xuemei; Lee, Duck-chul; Wilcox, Sara; Zhang, Jiajia; Blair, Steven N.

    2015-01-01

    Being overweight or obese might be a risk factor for developing depression. It is also possible that low cardiorespiratory fitness, rather than overweight or obesity, is the better predictor of depressive symptom onset. Adults in the Aerobics Center Longitudinal Study (Dallas, Texas) underwent fitness and fatness assessments between 1979 and 1998 and later completed a questionnaire about depressive symptoms in 1990, 1995, or 1999. Separate logistic regression models were used to test the associations between 3 fatness measures (body mass index, waist circumference, and percentage of body fat) and the onset of depressive symptoms. Analyses were repeated using fitness as the predictor variable. Additional analyses were performed to study the joint association of fatness and fitness with the onset of depressive symptoms. After controlling for fitness, no measure of fatness was associated with the onset of depressive symptoms. In joint analyses, low fitness was more strongly associated with the onset of elevated depressive symptoms than was fatness, regardless of the measure of fatness used. Overall, results from the present study suggest that low fitness is more strongly associated with the onset of elevated depressive symptoms than is fatness. To reduce the risk of developing depression, individuals should be encouraged to improve their fitness regardless of body fatness. PMID:25693775

  17. 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

  18. Clinical Profile of Leprosy Patients: A Prospective Study

    PubMed Central

    Thakkar, Sejal; Patel, Sangita V

    2014-01-01

    Introduction: Early diagnosis and early adequate drug treatment is very important aspect to reduce the load in cases of leprosy. So, correct labeling of paucibacillary and multibacillary cases is a prerequisite for the adequate treatment. Confirmation of diagnosis is an important indication for histopathological examination in doubtful cases. Objectives: The present study was carried out to know the clinical profile of leprosy patients, concordance between clinical and histopathological diagnosis in cases of leprosy, and to assess the therapeutic efficacy of antileprosy therapy. Study Design: Two hundred and fifty clinically diagnosed leprosy patients attending skin outdoor patient department (OPD) were included in the study. Slit skin smear was performed in all the cases. In that case concordance between clinical and histology can be determined only in 30 cases. All the patients were treated with MDT (multidrug therapy) as per WHO guideline. Results: A total of 250 patients attended the clinic with male to female ratio of 1.7:1. The highest incidence was noted in 17-40 years of age group. In the clinical disease spectrum, 40% patients were in the borderline spectrum followed by tuberculoid leprosy (TT) (29.2%), lepromatous leprosy (LL) (26.8%), and 3.9% of indeterminate leprosy (IL). A total of 18% of patients were of primary neuritic leprosy. A total of 8.3% patients had definite history of contact in the family or neighborhood. Clinicopathological correlation was noted in 60% of patients with maximum disparity (52.9%) in the borderline group of patients. A total of 52.8% were MB (Multibacillary) and 47.2% were PB (Paucibacillary) cases. Morphological index became negative after 6 months in all patients. Mean fall of bacteriological index after 6 months was 0.19, while after 1 year, it was 1.05. Conclusion: Timely diagnosis and adequate treatment of cases with MDT is most effective. Histopathological examination is must in doubtful cases of leprosy. PMID:24700934

  19. Concussion symptoms in youth motocross riders: a prospective, observational study.

    PubMed

    Luo, T David; Clarke, Michelle J; Zimmerman, Amy K; Quinn, Michael; Daniels, David J; McIntosh, Amy L

    2015-03-01

    Action motorsports, including motocross, have been gaining popularity among children and adolescents, raising concerns for increased risk of concussions in participating youth. The authors undertook this study to test the following hypotheses: 1) that there is a high rate of concussion symptoms associated with a number of preventable or adjustable risk factors, and 2) that a high percentage of these symptoms are not be reported to adults and medical personnel. The authors identified all motocross riders under the age of 18 at a regional racetrack during the riding season between May and October 2010. The participants completed questionnaires pertaining to demographic characteristics and variables associated with motocross. The questionnaire results were compared with the incidence of self-reported concussion symptoms. Two hundred two riders were identified who met the criteria for participation in the study, and 139 of them completed the study questionnaire. Of these 139 riders, 67 (48%) reported at least 1 concussion symptom during the season. The majority of riders (98%) reported "always" wearing a helmet, and 72% received professional help with fitting of their helmets. Proper helmet fitting was associated with a 41% decreased risk of concussion symptoms (RR 0.59, 95% CI 0.44-0.81, p < 0.01). Sixty-six riders (47%) reported having received sponsor support for motocross participation. Sponsor support conferred a relative risk for concussion symptoms of 1.48 (95% CI 1.05-2.08, p = 0.02). Nearly half of all motocross competitors under the age of 18 reported concussion symptoms. Preventive measures are necessary to limit the negative impact from concussions. The risk of concussive injury can be decreased for pediatric motocross riders if they receive professional help with proper helmet fitting and through implementation of stricter guidelines regarding sponsorship.

  20. Designing a prospective study when randomization is not feasible.

    PubMed

    Linden, Ariel

    2011-06-01

    When conducting a randomized controlled trial (RCT) is unfeasible, the goal is to replicate the randomization process by creating a control group that is essentially equivalent to the treatment group on known pre-intervention characteristics and assume that the remaining unknown characteristics will not bias the results. The strategies proposed in this article are based on the thesis that since only pre-intervention characteristics are used for adjustment, a comparable control group can be established as soon as the participant group is identified. Consequently, outcomes can be observed immediately after launching the initiative rather than waiting until study completion. The benefit is that significant treatment effects can be observed as they occur, or alternatively, the initiative can be cancelled if treatment effects are not attained by a certain time point. Although these methods can never ensure the same level of validity as in an RCT, they are considered robust alternatives when randomization is impractical, and therefore a compelling study design for many commercial initiatives, such as disease management programs, benefit design changes, and pay-for-performance efforts. An obvious constraint is that treated participants must first be identified before suitable controls can be found. The preferred strategy is to enroll the entire treatment group within a narrow time frame. An alternative option is to have periodic enrollment periods with their respective treatment and control cohorts. The concept proposed in this article is intended to offer a robust alternative to the inadequate strategies currently being used in many health care settings where study findings may not be trusted, and thus decision makers remain uninformed as to whether an initiative is worth continuing or cancelled.

  1. 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.).

  2. 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.

  3. AWARE-AWAreness during REsuscitation-a prospective study.

    PubMed

    Parnia, Sam; Spearpoint, Ken; de Vos, Gabriele; Fenwick, Peter; Goldberg, Diana; Yang, Jie; Zhu, Jiawen; Baker, Katie; Killingback, Hayley; McLean, Paula; Wood, Melanie; Zafari, A Maziar; Dickert, Neal; Beisteiner, Roland; Sterz, Fritz; Berger, Michael; Warlow, Celia; Bullock, Siobhan; Lovett, Salli; McPara, Russell Metcalfe Smith; Marti-Navarette, Sandra; Cushing, Pam; Wills, Paul; Harris, Kayla; Sutton, Jenny; Walmsley, Anthony; Deakin, Charles D; Little, Paul; Farber, Mark; Greyson, Bruce; Schoenfeld, Elinor R

    2014-12-01

    Cardiac arrest (CA) survivors experience cognitive deficits including post-traumatic stress disorder (PTSD). It is unclear whether these are related to cognitive/mental experiences and awareness during CPR. Despite anecdotal reports the broad range of cognitive/mental experiences and awareness associated with CPR has not been systematically studied. The incidence and validity of awareness together with the range, characteristics and themes relating to memories/cognitive processes during CA was investigated through a 4 year multi-center observational study using a three stage quantitative and qualitative interview system. The feasibility of objectively testing the accuracy of claims of visual and auditory awareness was examined using specific tests. The outcome measures were (1) awareness/memories during CA and (2) objective verification of claims of awareness using specific tests. Among 2060 CA events, 140 survivors completed stage 1 interviews, while 101 of 140 patients completed stage 2 interviews. 46% had memories with 7 major cognitive themes: fear; animals/plants; bright light; violence/persecution; deja-vu; family; recalling events post-CA and 9% had NDEs, while 2% described awareness with explicit recall of 'seeing' and 'hearing' actual events related to their resuscitation. One had a verifiable period of conscious awareness during which time cerebral function was not expected. CA survivors commonly experience a broad range of cognitive themes, with 2% exhibiting full awareness. This supports other recent studies that have indicated consciousness may be present despite clinically undetectable consciousness. This together with fearful experiences may contribute to PTSD and other cognitive deficits post CA. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. 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.

  5. 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

  6. Studying the history of Indonesian astronomy: future prospects and possibilities

    NASA Astrophysics Data System (ADS)

    Orchiston, Wayne

    2017-08-01

    In this paper I identify a number of research topoics relating to Indonesian astronomical history that I feel are of international importance. Through these studies, Indonesia can make a valuable contribution to international history of astronomy. I also will discuss the role of SEAAN's new Working Group on Astronomical History and Heritage, and the values of the Journal of Astronomical History and Heritage and proceedings of the ICOA conferences as outlets for papers about Indonesian astronomical history. Finally, I mention chapters about Indonesia that will appear in a forthcoming book on the early development of astrophysics in Asia.

  7. 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.

  8. [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.

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

    PubMed

    Harrison, Margaret B; Graham, Ian D; van den Hoek, Joan; Dogherty, Elizabeth J; Carley, Meg E; Angus, Valerie

    2013-05-08

    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. 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. 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. 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 is about the product (adapted guideline

  10. [Intraoperative floppy iris syndrome--a prospective study].

    PubMed

    Nicula, Cristina; Nicula, D; Popescu, Raluca

    2013-01-01

    is to evaluate the incidence and typical signs of floppy iris syndrome intraoperatory revealed in patients diagnosed with cataracts. We studied a total of 15 eyes diagnosed with cataracts, belonging to 14 patients who had been treated chronically with Tamsulosin for benign prostatic hyperplasia. In 80% of cases we have seen a preoperative semimidriasis which required iris hooks in 5 eyeballs. On 1 eye preoperative semimidriasis was sufficient for capsulorhexis, but later pupil became miotic, requiring iris hooks. On 4 eye flaccid iris was noticed, that prolabated in corneal incision. floppy iris syndrome occurs in patients treated with Tamsulosin for benign prostatic hyperplasia, generating a series of difficulties during cataract surgery.

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

    PubMed

    Shrier, Ian; Raglin, John S; Levitan, Emily B; Mittleman, Murray A; Steele, Russell J; Powell, Janette

    2014-06-11

    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. 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. 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. 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.

  13. 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.

  14. 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

  15. Dry needling in lateral epicondylitis: a prospective controlled study.

    PubMed

    Uygur, Esat; Aktaş, Birol; Özkut, Afşar; Erinç, Samet; Yilmazoglu, Emime Gül

    2017-08-21

    Lateral epicondylitis (LE), a common disease, especially in middle age, causes decreased productivity and economic losses. The first-line treatment for LE is conservative and consists of topical and oral anti-inflammatory drugs, ice application, and brace use. If the first-line treatment fails, second-line treatment modalities, which are generally invasive, are offered. Second-line therapeutic regimens include saline, corticosteroid, or platelet-rich plasma injections. Dry needling is relatively new. We hypothesized that dry needling would be at least as effective as first-line treatment for LE. We compared the outcomes of first-line treatment and dry needling. The study allocated 110 patients into groups using online randomization software. After completing the Patient-rated Tennis Elbow Evaluation (PRTEE), patients in group I received dry needling, whereas those in group II received first-line treatment, consisting of ibuprofen 100 mg twice a day and a proximal forearm brace. The patients were evaluated after three weeks and six months. The study ultimately analyzed 92 patients. Although both treatment methods were effective at three weeks, dry needling was significantly more effective than the first-line treatment at six months. Because of the low complication rate, dry needling is a safe method, and it might be an effective treatment option for LE.

  16. Childhood social hardships and fertility: a prospective cohort study.

    PubMed

    Harville, Emily W; Boynton-Jarrett, Renée

    2013-12-01

    To examine the effect of lifetime social hardships on fertility. 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. In total, 6477 women reported on whether they had become pregnant by 41 years, 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. 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 that 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. The relationship between childhood adversity and adult fertility is complex. Future research should investigate pathways between characteristics of adversities and fertility. 2013 Elsevier Inc. All rights reserved.

  17. 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.

  18. 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.

  19. 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.

  20. Emotion Dysregulation and Adolescent Psychopathology: A Prospective Study

    PubMed Central

    Hatzenbuehler, Mark L.; Nolen-Hoeksema, Susan

    2011-01-01

    Background Emotion regulation deficits have been consistently linked to psychopathology in cross-sectional studies. However, the direction of the relationship between emotion regulation and psychopathology is unclear. This study examined the longitudinal and reciprocal relationships between emotion regulation deficits and psychopathology in adolescents. Methods Emotion dysregulation and symptomatology (depression, anxiety, aggressive behavior, and eating pathology) were assessed in a large, diverse sample of adolescents (N = 1,065) at two time points separated by seven months. Structural equation modeling was used to examine the longitudinal and reciprocal relationships between emotion dysregulation and symptoms of psychopathology. Results The three distinct emotion processes examined here (emotional understanding, dysregulated expression of sadness and anger, and ruminative responses to distress) formed a unitary latent emotion dysregulation factor. Emotion dysregulation predicted increases in anxiety symptoms, aggressive behavior, and eating pathology after controlling for baseline symptoms but did not predict depressive symptoms. In contrast, none of the four types of psychopathology predicted increases in emotion dysregulation after controlling for baseline emotion dysregulation. Conclusions Emotion dysregulation appears to be an important transdiagnostic factor that increases risk for a wide range of psychopathology outcomes in adolescence. These results suggest targets for preventive interventions during this developmental period of risk. PMID:21718967

  1. Postpoliomyelitis muscle weakness: a prospective study of quadriceps strength.

    PubMed

    Munin, M C; Jaweed, M M; Staas, W E; Satinsky, A R; Gutierez, G; Herbison, G J

    1991-09-01

    The objective of this study was to evaluate the presence of progressive postpoliomyelitis muscle weakness (PPMW) in affected individuals 20 to 40 years after the initial polio infection. Over a three-year period, the isometric and isokinetic strength of the quadriceps femoris muscle was studied in seven symptomatic patients with previous poliomyelitis (mean = 38.3 years from infection) to determine if quadriceps strength decreased during the three years. Each patient had a quadriceps affected by polio on one side and a clinically nonaffected quadriceps on the contralateral limb. The maximal isometric force and the peak isokinetic force of the affected quadriceps (AQ) and nonaffected quadriceps (NQ) muscles were tested on a computerized isokinetic dynamometer machine at six-month intervals. Isometric force increased significantly, by 29% per year (p less than .02) in the AQ and by 14% per year (p less than .05) in the NQ. Paired analysis to determine the change in strength between the affected and nonaffected muscles for the isometric data showed a mean nonsignificant increase in the AQ of 14% per year (p = .01). The change in peak isokinetic force demonstrated a significant increase in the AQ of 35% per year (p less than .05); whereas, the NQ peak isokinetic force increased 15% per year which was not statistically significant. Paired analysis to determine the change in strength between the affected and nonaffected muscles for the isokinetic data showed a nonsignificant relative increase in the AQ of 20% per year (p less than .06).(ABSTRACT TRUNCATED AT 250 WORDS)

  2. 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

  3. 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.

  4. Postmenopausal hormone therapy and Alzheimer disease: A prospective cohort study.

    PubMed

    Imtiaz, Bushra; Tuppurainen, Marjo; Rikkonen, Toni; Kivipelto, Miia; Soininen, Hilkka; Kröger, Heikki; Tolppanen, Anna-Maija

    2017-03-14

    To explore the association between postmenopausal hormone therapy (HT) and Alzheimer disease (AD). Twenty-year follow-up data from the Kuopio Osteoporosis Risk Factor and Prevention study cohort were used. Self-administered questionnaires were sent to all women aged 47-56 years, residing in Kuopio Province starting in 1989 until 2009, every 5th year. Register-based information on HT prescriptions was available since 1995. Probable AD cases, based on DSM-IV and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria, were identified from the special reimbursement register (1999-2009). The study population included 8,195 women (227 cases of incident AD). Postmenopausal estrogen use was not associated with AD risk in register-based or self-reported data (hazard ratio/95% confidence interval 0.92/0.68-1.2, 0.99/0.75-1.3, respectively). Long-term self-reported postmenopausal HT was associated with reduced AD risk (0.53/0.31-0.91). Similar results were obtained with any dementia diagnosis in the hospital discharge register as an outcome. Our results do not provide strong evidence for a protective association between postmenopausal HT use and AD or dementia, although we observed a reduced AD risk among those with long-term self-reported HT use. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  5. UK Prospective Diabetes Study (UKPDS). VIII. Study design, progress and performance.

    PubMed

    1991-12-01

    The UK Prospective Diabetes Study (UKPDS) is a multi-centre, prospective, randomised, intervention trial of 5100 newly-diagnosed patients with Type 2 (non-insulin-dependent) diabetes mellitus which aims to determine whether improved blood glucose control will prevent complications and reduce the associated morbidity and mortality. Newly presenting Type 2 diabetic patients aged 25-65 years inclusive, median age 53 years, median body mass index 28 kg/m2 and median fasting plasma glucose 11.3 mmol/l, were recruited and treated initially by diet. Ninety five percent remained hyperglycaemic (fasting plasma glucose greater than 6 mmol/l) and were randomly allocated to different therapies. In the main randomisation, those who were asymptomatic and had fasting plasma glucose under 15 mmol/l were allocated either to diet policy, or to active policy with either insulin or sulphonylurea aiming to reduce the fasting plasma glucose to under 6 mmol/l. Over 3 years, the median fasting plasma glucose in those allocated to diet policy was 8.9 mmol/l compared with 7.0 mmol/l in those allocated to active policy. The Hypertension in Diabetes Study has been included in a factorial design to assess whether improved blood pressure control will be advantageous. Patients with blood pressure greater than or equal to 160/90 mm Hg were randomly allocated to tight control aiming for less than 150/85 mm Hg with either an angiotensin-converting enzyme inhibitor or a Beta-blocker or to less tight control aiming for less than 200/105 mm Hg. The endpoints of the studies are major clinical events which affect the life and well-being of patients, such as heart attacks, angina, strokes, amputations, blindness and renal failure. To date, 728 patients have had at least one clinical endpoint. Surrogate endpoints include indices of macrovascular and microvascular disease detected by ECG with Minnesota Coding, retinal colour photography and microalbuminuria. The studies also aim to evaluate potential risk

  6. A comparison of the results of prospective and retrospective cohort studies in the field of digestive surgery.

    PubMed

    Ukai, Tomohiko; Shikata, Satoru; Nakayama, Takeo; Takemura, Yousuke C

    2017-07-01

    We compared the results of prospective and retrospective cohort studies in the field of digestive surgery to clarify whether the results of prospective cohort studies were more similar to those of randomized controlled trials (RCTs). We conducted a secondary analysis of the results to compare the results of RCTs with those of cohort studies in meta-analyses of 18 digestive surgical topics. The data from the prospective and retrospective cohort studies were combined. The summary estimates of each design were compared with those of RCTs. We used the Z score to investigate discrepancies. Twenty-nine outcomes of 11 topics were investigated in 289 cohort studies (prospective, n = 69; retrospective, n = 220). These were compared with the outcomes of 123 RCTs. In comparison to retrospective studies, the summary estimates of the prospective cohort studies were more similar to those of the RCTs [19/29 (prospective) vs. 10/29 (retrospective), P = 0.035). Five of the 29 outcomes of prospective studies and 6 of 29 outcomes of retrospective studies (P = 0.99) showed significant discrepancies in comparison to RCTs. In the digestive surgical field, the results of prospective cohort studies tended to be more similar to those of RCTs than retrospective studies; however, there were no significant discrepancies between the two types of cohort study.

  7. Leisure time computer use and overweight development in young adults--a prospective study.

    PubMed

    Thomée, Sara; Lissner, Lauren; Hagberg, Mats; Grimby-Ekman, Anna

    2015-09-02

    The prevalence of overweight among Swedish young adults has nearly doubled since the 1980s. The weight increase has been paralleled by the increased use of computers at work, at school, and at leisure time. The aim was to examine leisure time computer use for gaming, and for emailing/chatting, in relation to overweight development in young adults. A prospective cohort study with Swedish young adults (20-24 years at baseline) who responded to a questionnaire at baseline (n = 6735), and after 1 year (n = 3928) and 5 years (n = 2593). Exposure variables were average daily time spent on leisure time computer gaming and emailing/chatting. Logistic regression was performed for cross-sectional analyses with overweight (BMI ≥ 25) and obesity (BMI ≥ 30) as the outcomes, and for prospective analyses with new cases of overweight at the 1- and 5-year follow-ups. Change in BMI from baseline to 5 year-follow-up was analyzed with linear regression. There were cross-sectional and prospective associations between computer gaming and overweight (BMI ≥ 25) in women, after adjusting for age, occupation, physical activity, sleep, social support, and total computer use. For the men, only cross-sectional associations could be seen. Spending more than 2 h daily for emailing and chatting was related cross-sectionally to overweight in the women. No clear prospective associations were found for emailing/chatting and overweight development in either sex. We have identified a new risk group for overweight development: young adult female computer gamers. Leisure time computer gaming was a prospective risk factor for overweight in women even after adjusting for demographic and lifestyle factors, but not in men. There were no clear prospective associations between computer use for emailing/chatting and overweight in either sex.

  8. 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

  9. Stressful social relations and mortality: a prospective cohort study.

    PubMed

    Lund, Rikke; Christensen, Ulla; Nilsson, Charlotte Juul; Kriegbaum, Margit; Hulvej Rod, Naja

    2014-08-01

    Few studies have examined the relationship between stressful social relations in private life and all-cause mortality. To evaluate the association between stressful social relations (with partner, children, other family, friends and neighbours, respectively) and all-cause mortality in a large population-based study of middle-aged men and women. Further, to investigate the possible modification of this association by labour force participation and gender. We used baseline data (2000) from The Danish Longitudinal Study on Work, Unemployment and Health, including 9875 men and women aged 36-52 years, linked to the Danish Cause of Death Registry for information on all-cause mortality until 31 December 2011. Associations between stressful social relations with partner, children, other family, friends and neighbours, respectively, and all-cause mortality were examined using Cox proportional hazards models adjusted for age, gender, cohabitation status, occupational social class, hospitalisation with chronic disorder 1980-baseline, depressive symptoms and perceived emotional support. Modification by gender and labour force participation was investigated by an additive hazards model. Frequent worries/demands from partner or children were associated with 50-100% increased mortality risk. Frequent conflicts with any type of social relation were associated with 2-3 times increased mortality risk. Interaction between labour force participation and worries/demands (462 additional cases per 100,000 person-years, p=0.05) and conflicts with partner (830 additional cases per 100,000 person-years, p<0.01) was suggested. Being male and experiencing frequent worries/demands from partner produced 135 extra cases per 100,000 person-years, p=0.05 due to interaction. Stressful social relations are associated with increased mortality risk among middle-aged men and women for a variety of different social roles. Those outside the labour force and men seem especially vulnerable to exposure

  10. Simultaneous bilateral cochlear implantation: prospective study in adults.

    PubMed

    Koch, Dawn Burton; Soli, Sigfrid D; Downing, Mark; Osberger, Mary Joe

    2010-06-01

    Normal-hearing listeners gain important everyday benefits from having two ears, particularly for determining where sounds come from and for understanding speech in noisy environments. Users of two cochlear implants may have the opportunity to experience some of these bilateral advantages. The primary aim of this study was to document bilateral versus unilateral listening benefit in 15 postlinguistically deafened adults implanted simultaneously with two Harmony(®) (HiRes 90K(®)) cochlear implants. Speech perception (in quiet and in noise) and localization accuracy were assessed for each ear alone and both ears together. Subjects showed improved sound localization and better speech perception in quiet and in noise when using two implants compared with using one implant alone.

  11. Prospects for ALMA Studies of the Solar-Stellar Connection

    NASA Astrophysics Data System (ADS)

    Linsky, Jeffrey

    2016-07-01

    ALMA provides a splendid opportunity to observe a wide range of star types at millimeter wavelengths to investigate the solar-stellar connection. I will compare the sensitivities and wavelength coverages of ALMA and the JVLA to highlight the discovery space that ALMA has for stellar astronomy. At millimeter wavelengths, ALMA will be able to detect thermal and gyroresonance emission from nearby stellar chromospheres and transition regions. Comparison of millimeter fluxes from ALMA with centimeter fluxes from JVLA may be able to separate thermal from gyrosynchrotron emission from stellar coronae and thereby measure magnetic field strengths in stellar coronae. Measurements of stellar wind mass-loss rates are feasible with ALMA for giants but will be difficult for main sequence stars. The study of stellar flares should be an active area of research with ALMA.

  12. Psychosexual adjustment following sterilization: a prospective study on Chinese women.

    PubMed

    Tang, C S; Chung, T K

    1997-02-01

    The present study aimed to identify significant predictors of Chinese women's psychosexual adjustment after sterilization. One hundred fifteen multiparous Chinese women, aged 25-51 years, were interviewed before and after elective laparoscopic or postpartum sterilization. Eight-seven women were also interviewed about their pshychosexual adjustment at 1 year after sterilization. Results showed that the fear of negative evaluation by others, family cohesion and adaptability, and preoperative psychological distress were robust predictors of adverse psychosexual outcome immediately and 1 year after sterilization. There was significant improvement in women's mental health following sterilization, and their sexual adjustment such as coital frequency and sexual satisfaction were not adversely affected at 1 year follow-up. Women with either elective or postpartum sterilization had similar adjustment throughout, except the latter group tended to experience more physical discomfort at 1 year follow-up. About 3.4% of the women experienced regret at 12 months after sterilization.

  13. A prospective study of delirium in hospitalized elderly.

    PubMed

    Francis, J; Martin, D; Kapoor, W N

    1990-02-23

    The prevalence, risk factors, and outcomes of delirium were studied in 229 elderly patients. Fifty patients (22%) met criteria for delirium; nondelirious elderly constituted the control group. Abnormal sodium levels, illness severity, dementia, fever or hypothermia, psychoactive drug use, and azotemia were associated with risk of delirium. Patients with three or more risk factors had a 60% rate of delirium. Delirious patients stayed 12.1 days in the hospital vs 7.2 days for controls and were more likely to die (8% vs 1%) or be institutionalized (16% vs 3%). Illness severity predicted 6-month mortality, but the effect of delirium was not significant. Delirium occurs commonly in hospitalized elderly, is associated with chronic and acute problems, and identifies elderly at risk for death, longer hospitalization, and institutionalization. The increased mortality associated with delirium appears to be explained by greater severity of illness.

  14. Intergenerational Transmission of Relationship Aggression: A Prospective Longitudinal Study

    PubMed Central

    Cui, Ming; Durtschi, Jared A.; Donnellan, M. Brent; Lorenz, Frederick O.; Conger, Rand D.

    2012-01-01

    The present study examined whether physical and verbal aggression in the family of origin were associated with similar patterns of aggression in young adult couples. Hypotheses were tested using a sample of 213 focal individuals who were followed from adolescence to adulthood. Results suggested that aggression in the family when focal participants were adolescents predicted aggression with romantic partners when participants were adults. The association between interparental aggression and later aggression in adult romantic unions was partially mediated through parents’ aggression to focal participants when they were adolescents. Both physical and verbal aggression revealed the same pattern of findings. All together, these findings are consistent with a developmental-interactional perspective (Capaldi & Gorman-Smith, 2003) concerning the developmental origins of aggression in intimate relationships. PMID:21171767

  15. [Sialorrhea in patients with Parkinson. A six year prospective study].

    PubMed

    Serrano-Dueñas, M

    The sialorrhea has been recognised as one of the manifestations of Parkinson's disease, with a frequency of up to 80%. The evolution of patients with sialorrhea is unknown. We study 26 male and 17 female patients with Parkinson's disease and sialorrhea. Evaluation at three years showed that sialorrhea had persisting in 18 of them, at six years showed that persisted in 8 patients. We found significant impairment in the sialorrhea group. If we accept the principle, that sialorrhea are levodopa-resistant disorders as non nigrostriatal symptoms, secondary to a diffuser and more extended cerebral stem degeneration, we could assume that in these patients with sialorrhea cortical-sub cortical circuits are more widely involved leading to motor and cognitive impairment and depression.

  16. Primiparas with or without oxytocin augmentation: a prospective descriptive study.

    PubMed

    Svärdby, Karin; Nordström, Lennart; Sellström, Eva

    2007-01-01

    The aim of this study was to determine during which phase of delivery augmentation is started when used and to establish any correlation that might exist between the oxytocin infusion and the evaluations by primiparas themselves of their labour pain, strength of contractions and fatigue. In addition, we wanted to determine any differences in duration between labour with and labour without augmentation. We finally wanted to measure the incidence of instrumental deliveries, perineal trauma and neonatal outcome among the augmented vs. the non-augmented groups. The most commonly diagnosed complication in primiparas is ineffective contractions or protracted labour, otherwise known as dystocia, which literally means arrested or prolonged labour. Different treatments have been tried during the active phase of labour as well as the second stage of labour. The most common treatment today is amniotomy, often used in combination with an intravenous oxytocin infusion. The study was conducted at the hospital in Ostersund in central Sweden from August 1998 to September 1999. Consecutive primiparas giving birth at full-term were selected to the study. The inclusion criteria were an uncomplicated pregnancy and a spontaneous single delivery with head presentation. The total number of participants was 164. The results showed that 50 of 164 primiparas needed no augmentation, while 88 were augmented during the active phase and 26 during the second stage of labour. The duration of the active phase [median (md) 4 hours 45 minutes, 6 hours 49 minutes and 6 hours 20 minutes respectively for the diff