Acute health care utilization and outcomes for outpatient-treated urinary tract infections in children.

PubMed

Copp, Hillary L; Hanley, Janet; Saigal, Christopher S; Saperston, Kara

2016-08-01

The majority of urinary tract infections (UTIs) in children are treated in the ambulatory setting. The goal of this study is to describe the course of outpatient UTI management, including health services utilization, antibiotic switching (change from empirically prescribed antibiotic to another antibiotic), and antibiotic side effects. Using a large claims database, Truven Health MarketScan Research Database, we analyzed all children younger than 18 years old who had an antibiotic prescribed for an outpatient UTI from 2002 to 2010. We evaluated health services utilization and antibiotic switching in the 21-day period after UTI diagnosis. We compared side effects with rates in patients receiving narrow versus broad-spectrum antibiotic treatment. Chi-square analysis was used for descriptive statistics. We identified 242,819 outpatient, antibiotic-treated, UTI episodes. During the 21-day period after presentation, 26% required more than one visit for UTI management and <1% required hospital admission (Figure). Most children did not have imaging within 21 days of UTI: renal bladder ultrasound in 6%, VCUG in 2.6%, and DMSA in 0.05%. Broad-spectrum antibiotics were empirically prescribed to 34% of patients. Antibiotic switching occurred in only 8% of UTI episodes, indicating that empiric prescription covered the offending uropathogen the majority of the time. Antibiotic side effects occurred in 8% of UTI episodes. The most common side effects were gastrointestinal (∼3% of UTI episodes). All other side effects occurred in <1% of UTI episodes. Although there were statistically significant differences in side effects between broad- and narrow-spectrum antibiotics, these differences were not clinically relevant. Most outpatient UTIs in children do not require more than one healthcare visit, hospital admission, or change in empiric antibiotic therapy. This study supports the fact that pediatric UTIs can be effectively treated in the ambulatory setting. Copyright © 2016. Published by Elsevier Ltd.

Psychiatric side effects of ketamine in hospitalized medical patients administered subanesthetic doses for pain control.

PubMed

Rasmussen, Keith G

2014-08-01

To assess the psychiatric side effects of ketamine when administered in subanesthetic doses to hospitalized patients. It is hypothesized that such effects occur frequently. In this retrospective study, the medical records of 50 patients hospitalized on medical and surgical units at our facility who had continuous intravenous infusions of ketamine for pain or mild sedation were reviewed. Patient progress in the days following the start of ketamine infusion was reviewed and response to ketamine was noted. Twenty-two percent of the patients were noted to have some type of psychiatric reaction to ketamine, including agitation, confusion, and hallucinations. These reactions were relatively short lived, namely, occurring during or shortly after the infusions. No association was found between patient response to ketamine and gender, age, or infusion rate. Awareness of the psychiatric side effects of ketamine is an important consideration for clinicians administering this medication either for pain control or for depressive illness.

Skin Cancer Screening

MedlinePlus

... may have serious side effects . False-negative test results can occur. Screening test results may appear to ... even if there are symptoms. False-positive test results can occur. Screening test results may appear to ...

[Cardiovascular side effects of non-steroidal anti-inflammatory drugs in the light of recent recommendations. Diclofenac is not more dangerous].

PubMed

Horváth, Viktor József; Tabák, Gy Ádám; Szabó, Gergely; Putz, Zsuzsanna; Koós, Csaba Géza; Lakatos, Péter

2015-03-29

Among their beneficial effects, non-steroidal anti-inflammatory drugs may also exert several side effects which depend on the dosage and the type of these medications. The most frequent gastrointestinal side effects usually develop shortly after the beginning of their administration, but others such as cardiovascular interactions (which are present much less frequently than gastrointestinal side effects) can also occur after the beginning of drug administration without a latency period. For a long-term treatment, non-steroidal anti-inflammatory drugs are most frequently used in the elderly population where patients typically have high cardiovascular risk and take other medicines, e.g. low dose acetylsalicylic acid that can interact with non-steroidal anti-inflammatory drugs; in this aspect diclofenac may cause less side effects. In this review, the authors briefly review cardiovascular side effects of non-steroidal anti-inflammatory drugs, the processes which potentially influence them, therapeutic consequences and their interaction with acetylsalicylic acid.

Risks of Skin Cancer Screening

MedlinePlus

... may have serious side effects . False-negative test results can occur. Screening test results may appear to ... even if there are symptoms. False-positive test results can occur. Screening test results may appear to ...

Focal cryotherapy of localized prostate cancer: a systematic review of the literature.

PubMed

Shah, Taimur Tariq; Ahmed, Hashim; Kanthabalan, Abi; Lau, Benjamin; Ghei, Maneesh; Maraj, Barry; Arya, Manit

2014-11-01

Radical/whole gland treatment for prostate cancer has significant side-effects. Therefore focal treatments such as cryotherapy have been used to treat localized lesions whilst aiming to provide adequate cancer control with minimal side-effects. We performed a systematic review of Pubmed/Medline and Cochrane databases' to yield 9 papers for primary focal prostate cryotherapy and 2 papers for focal salvage treatment (radio-recurrent). The results of 1582 primary patients showed biochemical disease-free survival between 71-93% at 9-70 months follow-up. Incontinence rates were 0-3.6% and ED 0-42%. Recto-urethral fistula occurred in only 2 patients. Salvage focal cryotherapy had biochemical disease-free survival of 50-68% at 3 years. ED occurred in 60-71%. Focal cryotherapy appears to be an effective treatment for primary localized prostate cancer and compares favorably to radical/whole gland treatments in medium-term oncological outcomes and side-effects. Although more studies are needed it is also effective for radio-recurrent cancer with a low complications rates.

Autoradiographic and biochemical observations on the distribution of non-steroid anti-inflammatory drugs.

PubMed

Rainsford, K D; Schweitzer, A; Brune, K

1981-04-01

A comparison has been made of the distribution of some new radioactively-labelled non-steroid anti-inflammatory (NSAI) drugs or pro-drugs with their respective progenitors and/or standard acidic NSAI drugs (i.e. aspirin, indomethacin and phenylbutazone), using whole body autoradiography and scintillation counting. The object of this study was to establish if the distribution of these new NSAI drugs may contribute to changes in their side-, or therapeutic effects compared with the older drugs. All the NSAI drugs accumulated in those tissues wherein the principle therapeutic and side-effects are manifest. The accumulation in inflamed tissues occurs regardless of the structural type of NSAI drugs, i.e. with specific accumulation occurring in this tissue of the acidic drugs or their acidic metabolites. New aspects of the distribution of the acetyl moiety of aspirin are reported which may be significant in relation to the side-effects induced by this drug.

Sediment sorting at a side channel bifurcation

NASA Astrophysics Data System (ADS)

van Denderen, Pepijn; Schielen, Ralph; Hulscher, Suzanne

2017-04-01

Side channels have been constructed to reduce the flood risk and to increase the ecological value of the river. In various Dutch side channels large aggradation in these channels occurred after construction. Measurements show that the grain size of the deposited sediment in the side channel is smaller than the grain size found on the bed of the main channel. This suggest that sorting occurs at the bifurcation of the side channel. The objective is to reproduce with a 2D morphological model the fining of the bed in the side channel and to study the effect of the sediment sorting on morphodynamic development of the side channel. We use a 2D Delft3D model with two sediment fractions. The first fraction corresponds with the grain size that can be found on the bed of the main channel and the second fraction corresponds with the grain size found in the side channel. With the numerical model we compute several side channel configurations in which we vary the length and the width of the side channel, and the curvature of the upstream channel. From these computations we can derive the equilibrium state and the time scale of the morphodynamic development of the side channel. Preliminary results show that even when a simple sediment transport relation is used, like Engelund & Hansen, more fine sediment enters the side channel than coarse sediment. This is as expected, and is probably related to the bed slope effects which are a function of the Shields parameter. It is expected that by adding a sill at the entrance of the side channel the slope effect increases. This might reduce the amount of coarse sediment which enters the side channel even more. It is unclear whether the model used is able to reproduce the effect of such a sill correctly as modelling a sill and reproducing the correct hydrodynamic and morphodynamic behaviour is not straightforward in a 2D model. Acknowledgements: This research is funded by STW, part of the Dutch Organization for Scientific Research under grant number P12-P14 (RiverCare Perspective Programme) project number 13516.

Safety of Adrenaline Use in Anaphylaxis: A Multicentre Register.

PubMed

Cardona, Victòria; Ferré-Ybarz, Laia; Guilarte, Mar; Moreno-Pérez, Nuria; Gómez-Galán, Catalina; Alcoceba-Borràs, Eva; Delavalle, Maria Belén; Garriga-Baraut, Teresa

2017-01-01

The use of intramuscular adrenaline to treat anaphylaxis is suboptimal, despite being the first-line treatment recommended by national and international anaphylaxis guidelines. Fear of potentially severe side effects may be one of the underlying factors. The aim of this study was to assess the incidence and severity of adverse side effects after the use of adrenaline in anaphylaxis, as well as potential risk factors. Observational study based on a multicenter online registry of cases of adrenaline administration for suspected anaphylaxis. 277 registered valid cases were included: 138 (51.49%) female, median age 29 years (12-47), and 6 children under 2 years with a median age of 9 months (1-21). Side effects occurred in 58 cases (21.64%), with tremors, palpitations, and anxiety being the most frequent. There was a significant association of developing side effects with older age, higher dose of adrenaline, or use of the intravenous route. Potentially severe adverse effects (high blood pressure, chest discomfort, or ECG alterations) occurred only in 8 cases (2.99%); in these cases, no differences were found according to age or adrenaline dose, but again, intravenous administration was associated with more severe adverse events. This study shows that side effects affect less than 1 in 5 patients who receive adrenaline for an anaphylactic reaction, and are usually mild and transient. Therefore, in an emergency situation such as anaphylaxis, restricting adrenaline administration due to potential adverse effects would, in general, not be justified. © 2017 S. Karger AG, Basel.

Evidence from neglect dyslexia for morphological decomposition at the early stages of orthographic-visual analysis

PubMed Central

Reznick, Julia; Friedmann, Naama

2015-01-01

This study examined whether and how the morphological structure of written words affects reading in word-based neglect dyslexia (neglexia), and what can be learned about morphological decomposition in reading from the effect of morphology on neglexia. The oral reading of 7 Hebrew-speaking participants with acquired neglexia at the word level—6 with left neglexia and 1 with right neglexia—was evaluated. The main finding was that the morphological role of the letters on the neglected side of the word affected neglect errors: When an affix appeared on the neglected side, it was neglected significantly more often than when the neglected side was part of the root; root letters on the neglected side were never omitted, whereas affixes were. Perceptual effects of length and final letter form were found for words with an affix on the neglected side, but not for words in which a root letter appeared in the neglected side. Semantic and lexical factors did not affect the participants' reading and error pattern, and neglect errors did not preserve the morpho-lexical characteristics of the target words. These findings indicate that an early morphological decomposition of words to their root and affixes occurs before access to the lexicon and to semantics, at the orthographic-visual analysis stage, and that the effects did not result from lexical feedback. The same effects of morphological structure on reading were manifested by the participants with left- and right-sided neglexia. Since neglexia is a deficit at the orthographic-visual analysis level, the effect of morphology on reading patterns in neglexia further supports that morphological decomposition occurs in the orthographic-visual analysis stage, prelexically, and that the search for the three letters of the root in Hebrew is a trigger for attention shift in neglexia. PMID:26528159

Perceived risk of tamoxifen side effects: a study of the use of absolute frequencies or frequency bands, with or without verbal descriptors.

PubMed

Knapp, Peter; Gardner, Peter H; Raynor, David K; Woolf, Elizabeth; McMillan, Brian

2010-05-01

To investigate the effectiveness of presenting medicine side effect risk information in different forms, including that proposed by UK guidelines [[1] Medicines and Healthcare products Regulatory Agency. Always read the leaflet-Getting the best information with every medicine. (Report of the Committee on Safety of Medicines Working Group on Patient Information). London: The Stationery Office, 2005.]. 134 Cancer Research UK (CRUK) website users were recruited via a 'pop-up'. Using a 2x2 factorial design, participants were randomly allocated to one of four conditions and asked to: imagine they had to take tamoxifen, estimate the risks of 4 side effects, and indicate a presentation mode preference. Those presented with absolute frequencies demonstrated greater accuracy in estimating 2 of 4 side effects, and of any side effect occurring, than those presented with frequency bands. Those presented with combined descriptors were more accurate at estimating the risk of pulmonary embolism than those presented with numeric descriptors only. Absolute frequencies outperform frequency bands when presenting side effect risk information. However, presenting such exact frequencies for every side effect may be much less digestible than all side effects listed under 5 frequency bands. Combined numerical and verbal descriptors may be better than numeric only descriptors when describing infrequent side effects. Information about side effects should be presented in ways that patients prefer, and which result in most accurate risk estimates. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Ocular side-effects associated with imatinib mesylate (Gleevec).

PubMed

Fraunfelder, Frederick W; Solomon, Jonathan; Druker, Brian J; Esmaeli, Bita; Kuyl, Jennifer

2003-08-01

This retrospective case series describes ocular side-effects associated with imatinib mesylate (Gleevec) and the clinical characteristics of these adverse reactions. A chart review of 104 patients on imatinib mesylate therapy from Oregon Health & Science University's Cancer Center were studied with regard to ocular side-effects. In addition, spontaneous reports from the Food and Drug Administration, the World Health Organization, and the National Registry of Drug-Induced Ocular Side-Effects databases were reviewed, including a Medline literature search. Seventy-three (70%) of the patients at OHSU developed periorbital edema and 19 patients (18%) developed epiphora after receiving imatinib mesylate. Average dose was 407.5+/-60 mg. Periorbital edema occurred an average of 68+/-48 days after initiation of therapy. WHO classification of side-effects is as follows: certain: periorbital edema; probable: epiphora; possible: extraocular muscle palsy, ptosis, blepharoconjunctivitis; unlikely: glaucoma, papilledema, retinal hemorrhage, photosensitivity, abnormal vision, and increased intraocular pressure. Periorbital edema and epiphora are the two most common ocular side-effects related to imatinib mesylate therapy. Clinical characteristics of imatinib mesylate induced periorbital edema are described. Management of ocular side-effects is conservative except in very rare cases of visually significant periorbital edema.

Use of a 22-gauge Whitacre needle to reduce the incidence of side effects after lumbar myelography: a prospective randomised study comparing Whitacre and Quincke spinal needles.

PubMed

Pedersen, O N

1996-01-01

In a prospective study lumbar iohexol myelography was performed in 107 consecutive patients, randomised for lumbar puncture with a Quincke or Whitacre spinal needle. All patients answered a questionnaire about possible side effects. Data from 100 patients (58 men, 42 women) were evaluated. In the Quincke group (n = 53), 23 (43%) reported no side effects. In the 30 patients who reported various side effects, post-dural puncture headache (PDPH) occurred in 22 (42%), of whom 9 had mild, 6 moderate and 7 (13%) severe cephalalgia, 18 (34%) reported increased low back pain/sciatica, 5 nausea and 7 dizziness. In the Whitacre group (n = 47), 33 (70%) had no side effects. PDPH was reported by 9 patients (19%), of whom 2 had mild, 6 moderate and only 1 (2%) severe cephalalgia, 4 (9%) reported increased low back pain/sciatica, 5 nausea and 4 dizziness. The conclusion drawn from this study is that lumbar myelography performed with the Whitacre spinal needle reduces postspinal side effects.

Side effects induced by the acute levodopa challenge in Parkinson's Disease and atypical parkinsonisms.

PubMed

Vasta, Rosario; Nicoletti, Alessandra; Mostile, Giovanni; Dibilio, Valeria; Sciacca, Giorgia; Contrafatto, Donatella; Cicero, Calogero Edoardo; Raciti, Loredana; Luca, Antonina; Zappia, Mario

2017-01-01

Acute levodopa challenge may be performed to predict levodopa chronic responsiveness. The aim of the study was to investigate frequency of side effects during the acute levodopa challenge in PD and atypical parkinsonisms. We enrolled 34 de novo PD patients and 29 patients affected by atypical parkinsonisms (Multiple System Atrophy, MSA, n = 10; Progressive Supranuclear Palsy, PSP, n = 12 and Corticobasal Degeneration, CBD, n = 7) who underwent an acute levodopa challenge. Side effects occurring during test were recorded. Side effects were more frequent among atypical parkinsonisms as unique group when compared to PD patients (64.3% versus 23.5%; p-value 0.002) with an adjusted OR of 4.36 (95%CI 1.40-13.5). Each atypical parkinsonisms showed almost double occurrence of side effects (MSA 90%, PSP 41.7% and CBD 57%). Side effects during acute levodopa challenge may be frequent in atypical parkinsonisms. This information could be useful in order to better prepare the patient for the test. Furthermore, it could represent a useful cue in differential diagnosis with PD.

Side Effects of Virtual Environments: A Review of the Literature

DTIC Science & Technology

2004-05-01

Cybersickness symptoms are the unintended psychophysiological side effects of participation in virtual environments. Symptoms can occur both during...induced motion sickness, cybersickness is believed to result from sensory and perceptual mismatches between the visual and vestibular systems, and can...and the task carried out, can affect either incidence or severity of cybersickness . Taking account of these factors may avoid or minimize symptoms. This

Possible Side-Effects from Vaccines

MedlinePlus

... 1 child in 50) These problems generally occur 1-3 days after the shot. Moderate Problems (Uncommon) Seizure (jerking or staring) (about ... problems occur, they usually begin soon after the shot and last 1 or 2 days. Your doctor can tell you ...

A survey of gas-side fouling in industrial heat-transfer equipment

NASA Astrophysics Data System (ADS)

Marner, W. J.; Suitor, J. W.

1983-11-01

Gas-side fouling and corrosion problems occur in all of the energy intensive industries including the chemical, petroleum, primary metals, pulp and paper, glass, cement, foodstuffs, and textile industries. Topics of major interest include: (1) heat exchanger design procedures for gas-side fouling service; (2) gas-side fouling factors which are presently available; (3) startup and shutdown procedures used to minimize the effects of gas-side fouling; (4) gas-side fouling prevention, mitigation, and accommodation techniques; (5) economic impact of gas-side fouling on capital costs, maintenance costs, loss of production, and energy losses; and (6) miscellaneous considerations related to gas-side fouling. The present state-of-the-art for industrial gas-side fouling is summarized by a list of recommendations for further work in this area.

A survey of gas-side fouling in industrial heat-transfer equipment

NASA Technical Reports Server (NTRS)

Marner, W. J.; Suitor, J. W.

1983-01-01

Gas-side fouling and corrosion problems occur in all of the energy intensive industries including the chemical, petroleum, primary metals, pulp and paper, glass, cement, foodstuffs, and textile industries. Topics of major interest include: (1) heat exchanger design procedures for gas-side fouling service; (2) gas-side fouling factors which are presently available; (3) startup and shutdown procedures used to minimize the effects of gas-side fouling; (4) gas-side fouling prevention, mitigation, and accommodation techniques; (5) economic impact of gas-side fouling on capital costs, maintenance costs, loss of production, and energy losses; and (6) miscellaneous considerations related to gas-side fouling. The present state-of-the-art for industrial gas-side fouling is summarized by a list of recommendations for further work in this area.

Oesophagus side effects related to the treatment of oesophageal cancer or radiotherapy of other thoracic malignancies.

PubMed

Adebahr, Sonja; Schimek-Jasch, Tanja; Nestle, Ursula; Brunner, Thomas B

2016-08-01

The oesophagus as a serial organ located in the central chest is frequent subject to "incidental" dose application in radiotherapy for several thoracic malignancies including oesophageal cancer itself. Especially due to the radiosensitive mucosa severe radiotherapy induced sequelae can occur, acute oesophagitis and strictures as late toxicity being the most frequent side-effects. In this review we focus on oesophageal side effects derived from treatment of gastrointestinal cancer and secondly provide an overview on oesophageal toxicity from conventional and stereotactic fractionated radiotherapy to the thoracic area in general. Available data on pathogenesis, frequency, onset, and severity of oesophageal side effects are summarized. Whereas for conventional radiotherapy the associations of applied doses to certain volumes of the oesophagus are well described, the tolerance dose to the mediastinal structures for hypofractionated therapy is unknown. The review provides available attempts to predict the risk of oesophageal side effects from dosimetric parameters of SBRT. Copyright © 2016 Elsevier Ltd. All rights reserved.

Post-transplant Medications

MedlinePlus

... Coping with anxiety Helping kids adjust Pregnancy Precautions Fertility Labor and delivery Breastfeeding Risks Camps People to ... phases of the immune response to minimize side effects and produce effective immunosuppression. Clinical immunosuppression usually occurs ...

Empowering Children with Adaptive Technology Skills: Careful Engagement in the Digital Information Age

ERIC Educational Resources Information Center

Huda, Miftachul; Jasmi, Kamarul Azmi; Mustari, Mohd Ismail; Basiron, Bushrah; Hehsan, Aminudin; Shahrill, Masitah; Gassama, Saikou Kawsu

2017-01-01

The technological advancement occurring in the world today has a potency to create positive and negative side effects especially on children. The positive side may entail increased empathy and acceptance of diversity through modelling the prosocial behaviours, while the negative can be manifest in aggressive behaviour, risky sexual behaviour, and…

Gravitational effects on plant growth hormone concentration

NASA Technical Reports Server (NTRS)

Bandurski, R. S.; Schulze, A.

1983-01-01

Dolk's (1936) finding that more growth hormone diffuses from the lower side of a gravity-stimulated plant shoot than from the upper side is presently confirmed by means of both an isotope dilution assay and selected ion monitoring-gas chromatography-mass spectrometry, and it is established that the asymmetrically distributed hormone is indole-3-acetic acid (IAA). This is the first physicochemical demonstration that there is more IAA on the lower sides of a geostimulated plant shoot. It is also found that free IAA primarily occurs in the conductive vascular tissues of the shoot, while IAA esters predominate in the growing cortical cells. A highly sensitive gas chromatographic isotope dilution assay shows that the hormone asymmetry also occurs in the nonvascular tissue.

Does contraceptive treatment in wildlife result in side effects? A review of quantitative and anecdotal evidence.

PubMed

Gray, Meeghan E; Cameron, Elissa Z

2010-01-01

The efficacy of contraceptive treatments has been extensively tested, and several formulations are effective at reducing fertility in a range of species. However, these formulations should minimally impact the behavior of individuals and populations before a contraceptive is used for population manipulation, but these effects have received less attention. Potential side effects have been identified theoretically and we reviewed published studies that have investigated side effects on behavior and physiology of individuals or population-level effects, which provided mixed results. Physiological side effects were most prevalent. Most studies reported a lack of secondary effects, but were usually based on qualitative data or anecdotes. A meta-analysis on quantitative studies of side effects showed that secondary effects consistently occur across all categories and all contraceptive types. This contrasts with the qualitative studies, suggesting that anecdotal reports are insufficient to investigate secondary impacts of contraceptive treatment. We conclude that more research is needed to address fundamental questions about secondary effects of contraceptive treatment and experiments are fundamental to conclusions. In addition, researchers are missing a vital opportunity to use contraceptives as an experimental tool to test the influence of reproduction, sex and fertility on the behavior of wildlife species.

Dose-dependent valproate-induced alopecia in patients with mental disorders.

PubMed

Tomita, Takashi; Goto, Hidekazu; Yoshida, Tadashi; Tanaka, Katsuya; Sumiya, Kenji; Kohda, Yukinao

2015-01-01

Drug-induced hair loss may occur as a side effect in patients treated with valproate. However, few studies have reported a relationship between the blood levels of valproate and the occurrence of hair loss. We report three cases of alopecia that occurred in patients who received sodium valproate for mental disorders. In all three cases, alopecia appeared after long-term valproate exposure with a plasma concentration of 100 µg/ml approximately. However, the alopecia resolved in all cases after dose reduction or treatment discontinuation. Therefore, alopecia may develop in patients with chronic exposure to high plasma concentrations of valproate. Based on these findings, we believe that patients with high plasma concentrations of valproate should be closely monitored for the occurrence of side effects, particularly alopecia.

Improving Adherence to Endocrine Therapy in Women With HR-Positive Breast Cancer.

PubMed

Brockway, Julia P; Shapiro, Charles L

2018-05-15

Aromatase inhibitors (AIs) are the standard treatment for postmenopausal women with hormone receptor-positive breast cancers. One of the most common side effects of AIs is joint pain; it is also the most frequently cited reason for nonadherence and discontinuation before completion of the prescribed treatment course. Nonadherence and, in particular, discontinuation, can lead to increased rates of breast cancer mortality. The prevalence of AI-induced arthralgias is about 50%, and there are several interventions, including switching to a different AI, that can increase adherence. The healthcare professional plays a part in fostering adherence by communicating the side effects of AIs to patients before the initiation of treatment, as well as explaining the strategies for addressing these side effects, should they occur.

An Investigation of the Facets for Converting Military Authorizations for Maintenance Personnel to Civilian Positions

DTIC Science & Technology

1984-03-01

have a significant effect on the worker whether military or civilian, but the primary impact 4 may occur while both types work side by side. Performance ...32 - . - - have important consequences for the organization’s members (3:226). Performance appraisals can effect the worker at any time but the impact ... employee (3:227). There are a large number of variables related to personnel performance including "training, experience, skill-level and rank distribution

[Curative Effects of Hydroxyurea on the Patients with β-thalassaemia Intermadia].

PubMed

Huang, Li; Yao, Hong-Xia

2016-06-01

To investigate the clinical features of β-thalassaemia intermediate (TI) patients and the curative effect and side reactions of hydroxyurea therapys. Twenty nine patients with TI were divided into hydroxyurea therapy group and no hydroxyurea therapy group; the curative effect and side reactions in 2 groups were compared; the situation of blood transfusion in the 2 groups was evaluated. In hydroxyurea therapy group, the hemoglobin level increased after treatment for 3 months; the reticulocyte percentage obviously decreased after treatment for 12 months; the serum ferritin had been maintained at a low level; while in no hydroxyurea therapy group, the levels of hemoglobin and reticulocytes were not significantly improved after treatment, the serum ferritin level gradually increased. In hydroxyurea therapy group, 12 cases were out of blood transfusion after treatment for 12 months, effective rate of treatment was 85.71%; while in no hydroxyurea therapy group, the blood transfusion dependency was not improved after treatment. No serious side reactions were found in all the hydroxyurea treated patients. The hydroxyurea shows a better curative effect on TI patients, no serious side reactions occur in all the patients treated with hydroxyurea, but the long-term curative effect and side reactions should be observed continuously.

Local and Systemic Therapies for Breast Cancer Patients: Reducing Short-term Symptoms with the Methods of Integrative Medicine

PubMed Central

Hack, C. C.; Voiß, P.; Lange, S.; Paul, A. E.; Conrad, S.; Dobos, G. J.; Beckmann, M. W.; Kümmel, S.

2015-01-01

With improved prognosis due to advances in the diagnosis and therapy of breast cancer, physicians and therapists now focus on aspects such as quality of life and the management of side effects from breast cancer treatment. Therapy- and disease-related side effects often reduce the patientʼs quality of life and can place a further burden on patients, with non-compliance or discontinuation of therapy a potential consequence. Study data have shown that therapy- and disease-related side effects can be reduced using the methods of integrative medicine. Reported benefits include improving patientsʼ wellbeing and quality of life, reducing stress, and improving patientsʼ mood, sleeping patterns and capacity to cope with disease. Examining the impact of integrative medicine on the side effects of cancer treatment would be beyond the scope of this review. This article therefore looks at short-term side effects of cancer treatment which are usually temporary and occur during or after local and systemic therapy. The focus is on mind-body medicine, acupuncture and classic naturopathic treatments developed by Sebastian Kneipp as complementary therapies. The latter includes hydrotherapy, phytotherapy, nutritional therapy, exercise therapy and a balanced lifestyle. PMID:26257404

Acute Hepatotoxicity of Intravenous Amiodarone: Case Report and Review of the Literature.

PubMed

Chen, Chia-Chi; Wu, Chien-Chih

2016-01-01

Amiodarone is a class III antiarrhythmic drug widely used for the treatment of both supraventricular and ventricular arrhythmias in intensive care unit. Hepatotoxicity of amiodarone is usually mild and delayed onset. Acute hepatotoxicity is a rare side effect and usually correlated to intravenous form use. In this case, acute hepatocellular injury occurred within 24 hours after the administration of intravenous amiodarone. Liver enzyme significantly improved after holding intravenous amiodarone use. Because ventricular arrhythmia persisted and side effects occurred to alternative therapy, low dose of oral amiodarone was resumed and hepatotoxicity did not occur afterward. Acute hepatotoxicity of intravenous amiodarone is possibly related to polysorbate 80, the solubilizer of amiodarone infusion or higher dose. As a result, when intravenous amiodarone is prescribed, closely monitoring liver enzyme is highly suggested. If acute hepatitis takes place secondary to intravenous amiodarone, oral therapy should not be resumed afterward. If there is no alternative treatment, lower dose of oral amiodarone (≤200 mg/d) could be tried and should monitor liver function regularly.

Comparison of side effects of pentagastrin test and calcium stimulation test in patients with increased basal calcitonin concentration: the gender-specific differences.

PubMed

Ubl, Philipp; Gincu, Tatiana; Keilani, Mohammad; Ponhold, Lothar; Crevenna, Richard; Niederle, Bruno; Hacker, Marcus; Li, Shuren

2014-08-01

The aim of this study was to compare the side effects of the pentagastrin test and the calcium stimulation test in patients with increased basal calcitonin concentration, especially the gender-specific differences of side effects. A total of 256 patients (123 females and 133 males, mean age of 56 ± 27 years, range 21-83 years) had both pentagastrin and calcium stimulation tests. All patients filled in a questionnaire regarding the side effects within 30 min after completion of the stimulation tests. The differences of side effects between female and male patients as well as between the pentagastrin stimulation test and the calcium stimulation test were evaluated. Warmth feeling was the most frequent occurring side effect in all patients who had both pentagastrin and calcium stimulation tests, followed by nausea, altered gustatory sensation, and dizziness. The incidences of urgency to micturate (p < 0.05) and dizziness (p < 0.05) were significantly increased in the female patients as compared to male patients by calcium stimulation test. Significant higher incidences of urgency to micturate (p < 0.05) and warmth feeling (p < 0.05) were found by calcium stimulation test as compared with those by pentagastrin test in female patients. The incidences of nausea (p < 0.05) and abdominal cramping (p < 0.05) in male patients were significantly higher by pentagastrin stimulation test than by calcium stimulation test. There is a significant gender-specific difference in side effects induced by calcium stimulation test. Female patients have fewer side effects by pentagastrin test than by calcium stimulation test. Male patients may tolerate the calcium stimulation test better than the pentagastrin test.

The effects of repetitious topical use of mitomycin C on antrostomy patency in maxillary antrostomy created rabbit model.

PubMed

Kavuzlu, Ali; Arslan, Necmi; Tastan, Eren; Islam, Ahmet; Ustun, Huseyin; Aydogan, Filiz

2011-11-01

The aim of our study was to investigate the effect of the topical use of mitomycin C (MMC) intraoperatively in single dose and intra-postoperatively in two doses on the narrowing of antrostomy in maxillary rabbit sinus antrostomies created experimentally. And also to determine the local and systemic side effects of topical MMC. With this objective, 0.6 mg/ml MMC was used to the first group at single dose and to the second group intraoperatively and on third day postoperatively in two doses topically for 5 min. After 8 weeks, although the mean area of antrostomy was larger than that in the control side in the first group, which received single dose MMC, the difference was not statistically significant (p = 0.287). The second group received two doses, and the antrostomy areas were found to be significantly larger than the controls (p = 0.05). Overall, the sides that received MMC were significantly larger (p = 0.029). From the point of histopathological examination of the tissue, it was seen that two-dose MMC increased the edema indicating inflammation and antrostomy resolved with normal respiratory tract epithelium. It was shown by measuring the blood values that nephrotoxic and myelosupressant effect of MMC occurring in systemic use did not occur with single or double dose topical use. Our results demonstrate that even if the number of cases was low, two doses of topical MMC usage prevent the narrowing of antrostomy while single dose MMC does not. And two-dose topical MMC usage does not have local and systemic side effects.

The proper effect site concentration of remifentanil for prevention of myoclonus after etomidate injection

PubMed Central

Ri, Hyun Su; Kim, Tae Kyun; Baik, Seung Wan; Yoon, Ji Uk; Byeon, Gyeong Jo

2011-01-01

Background Etomidate frequently induces myoclonus when administered intravenously with bolus injection during anesthetic induction. This can be bothersome for the anesthesiologist. The dose of remifentanil appropriate for preventing myoclonus without side effects was investigated. Methods All patients with American Society of Anesthesiologists (ASA) physical status I-III were divided into three groups (n = 33 per group) according to the pretreatment effect site concentration of remifentanil (Ultiva, Glaxo-Wellcome, München, Germany) of 0, 2 or 4 ng/ml (Group N: 0 ng/ml, Group R: 2 ng/ml, Group Q: 4 ng/ml) by a target controlled infusion (TCI) system. After a 0.3 mg/kg dose of etomidate was injected intravenously for over 1 minute for anesthetic induction, myoclonus was observed. Before the etomidate injection, the patients were pretreated with remifentanil and their side effects were monitored. Results The number of patients showing myoclonus was significantly different among the groups. The incidence of myoclonus was 81%, 12% and 0% (groups N, R, and Q, respectively, P < 0.01). Side effects including bradycardia and hypotension did not occur in either Group R or Q. Chest wall rigidity occured in 45% of patients in Group Q. Conclusions Administration with a 2 ng/ml effect site concentration of remifentanil could reduce the incidence of myoclonus caused by etomidate bolus injection without chest wall rigidity. PMID:21927682

Haloperidol, risperidone, olanzapine and aripiprazole in the management of delirium: A comparison of efficacy, safety, and side effects.

PubMed

Boettger, Soenke; Jenewein, Josef; Breitbart, William

2015-08-01

The aim of this study was to compare the efficacy and side-effect profile of the typical antipsychotic haloperidol with that of the atypical antipsychotics risperidone, olanzapine, and aripiprazole in the management of delirium. The Memorial Delirium Assessment Scale (MDAS), the Karnofsky Performance Status (KPS) scale, and a side-effect rating were recorded at baseline (T1), after 2-3 days (T2), and after 4-7 days (T3). Some 21 cases were case-matched by age, preexisting dementia, and baseline MDAS scores, and subsequently analyzed. The baseline characteristics of the medication groups were not different: The mean age of the patients ranged from 64.0 to 69.6 years, dementia was present in between 23.8 and 28.6%, and baseline MDAS scores were 19.9 (haloperidol), 18.6 (risperidone), 19.4 (olanzapine), and 18.0 (aripiprazole). The doses of medication at T3 were 5.5 mg haloperidol, 1.3 mg risperidone, 7.1 mg olanzapine, and 18.3 mg aripiprazole. Over one week, the decline in MDAS scores between medications was equal, and no differences between individual MDAS scores existed at T2 or T3. After one week, the MDAS scores were 6.8 (haloperidol), 7.1 (risperidone), 11.7 (olanzapine), and 8.3 (aripiprazole). At T2, delirium resolution occurred in 42.9-52.4% of cases and at T3 in 61.9-85.7%; no differences in assessments between medications existed. Recorded side effects were extrapyramidal symptoms (EPSs) in haloperidol- and risperidone-managed patients (19 and 4.8%, respectively) and sedation with olanzapine (28.6%). Haloperidol, risperidone, aripiprazole, and olanzapine were equally effective in the management of delirium; however, they differed in terms of their side-effect profile. Extrapyramidal symptoms were most frequently recorded with haloperidol, and sedation occurred most frequently with olanzapine.

Gastrointestinal Side Effects of the Radioiodine Therapy for the Patients with Differentiated Thyroid Carcinoma Two Days after Prescription.

PubMed

Pashnehsaz, Mehran; Takavar, Abbas; Izadyar, Sina; Zakariaee, Seyed Salman; Mahmoudi, Mahmoud; Paydar, Reza; Geramifar, Parham

2016-09-01

Iodine-131 (I-131) therapy is one of the conventional approaches in the treatment of patients with differentiated thyroid carcinoma (DTC). The radioiodine agents also accumulate in the other organs that cause pain and damage to the patients. Radioiodine therapy is associated with various gastrointestinal (GI) toxicities. In this study, GI side effects of the radioiodine therapy were investigated. GI toxicities of the radioiodine therapy were studied in 137 patients with histologically proven DTC in Jun-Nov 2014. All the patients were treated by radioiodine agents in the research institute of Shariati Hospital, Tehran, Iran. The patients were examined 48 h after prescription (before discharge) and their GI side effects were registered. Correlation of the age, gender, administered dose, administered dose per body weight as the independent factors, and GI side effects were analyzed using the Pearson correlation test with Statistical Package for the Social Sciences (SPSS) version 20. Regression coefficients and linearity of the variable were investigated by MATLAB software. Line fitting was performed using MATLAB curve-fitting toolbox. From the subjects, 38 patients had GI complaints (30.4%). Significant factors influencing GI side effects were dose per body weight and administered doses. There was no significant correlation between age and gender as the independent parameters and GI complaints. The most prevalent GI side effect was nausea that occurs in 26.4% of the patients. From the results, it could be concluded that the GI side effects could be prevented by administering a safe radioiodine dose value less than 5,550 MBq.

Targeted Therapy for Cancer

Cancer.gov

Targeted therapy is a type of cancer treatment that targets the changes in cancer cells that help them grow, divide, and spread. Learn how targeted therapy works against cancer and about side effects that may occur.

Ear Infection Treatment: Do Alternative Therapies Work?

MedlinePlus

... Abdominal pain and diarrhea are common side effects. Probiotics. Certain strains of these "good" bacteria, which occur ... children. Studies have been done on both oral probiotics and nasal sprays with mixed results. Probiotics generally ...

Reducing Negative Effects from Virtual Environments: Implications for Just-In-Time Training

DTIC Science & Technology

2003-02-01

ability to perform mission- critical tasks following VE exposure. For instance, a group of side effects collectively known as cybersickness can be...detracting, such as visual motor coordination and balance disturbances. Cybersickness occurs in approximately 80-95% of individuals receiving virtual

Long-term potentiation and depression after unilateral labyrinthectomy in the medial vestibular nucleus of rats.

PubMed

Pettorossi, Vito Enrico; Dutia, Mayank; Frondaroli, Adele; Dieni, Cristina; Grassi, Silvarosa

2003-01-01

We previously demonstrated in rat brainstem slices that high-frequency stimulation (HFS) of the vestibular afferents induces long-term potentiation (LTP) in the ventral part (Vp) of the medial vestibular nucleus (MVN) and long-term depression (LTD) in the dorsal part (Dp). Both LTP and LTD depend on N-methyl-D-aspartate receptor activation, which increases synaptic efficacy; however, in the Dp, LTP reverses to LTD because of the activation of gamma-aminobutyric acid-ergic neurons. Here we show that the probability of inducing long-term effects in the MVN of rat brainstem slices is altered after unilateral labyrinthectomy (UL). In fact, LTP occurs less frequently in the ventral contra-lesional side compared with sham-operated rats. In the dorsal ipsi-lesional side, LTD is reduced and LTP enhanced, while the opposite occurs in the dorsal contra-lesional side. These changes in synaptic plasticity may be useful for re-balancing the tonic discharge of the MVN of the two sides during vestibular compensation, and for enhancing the dynamic responses of the deafferented MVN neurons in the long term.

Low-fluence Q-switched Nd: YAG 1064-nm laser and intense pulsed light for the treatment of melasma.

PubMed

Vachiramon, V; Sirithanabadeekul, P; Sahawatwong, S

2015-07-01

Low-fluence Q-switched Nd:YAG 1064 nm laser (LFQS) and intense pulsed light (IPL) have been shown to be effective in the treatment of melasma. LFQS can target deeper pigment, while IPL can target a wide range of cutaneous structures. However, there is limited information on efficacy and side-effects of the combined treatment. To compare the efficacy and safety of combined LFQS and IPL therapy with LFQS monotherapy in the treatment of melasma. Twenty female patients with mixed-type melasma on both cheeks were treated with LFQS on full face for five sessions at 1-week intervals. One side of the face was randomly assigned to receive additional three sessions of IPL treatments at 2-week intervals. Patients were evaluated 12 weeks after the last treatment. Outcome measures include the assessment by colorimeter and calculated as relative lightness index (R*LI), modified Melasma Area and Severity Index (mMASI), patient satisfaction and adverse effects. Eighteen patients completed the study. Both sides of the face showed significant improvement of R*LI and mMASI. A more rapid improvement of R*LI and mMASI was observed on combined side. At the end of treatment, 55% improvement and 37% improvement of R*LI was observed on combined side and monotherapy side respectively. The overall patients' satisfaction was in favour of the combined side. Recurrence occurred on both sides but there was still a significant decrease compared to baseline. No serious side effect was noted. The combination of LFQS and IPL results in faster clearance of melasma and is more effective than LFQS alone for melasma treatment. However, recurrence is still inevitable. © 2014 European Academy of Dermatology and Venereology.

Pycnogenol may alleviate adverse effects in oncologic treatment.

PubMed

Belcaro, G; Cesarone, M R; Genovesi, D; Ledda, A; Vinciguerra, G; Ricci, A; Pellegrini, L; Gizzi, G; Ippolito, E; Dugall, M; Cacchio, M; Di Renzo, A; Stuard, S

2008-09-01

A large variety of adverse reactions are well known to frequently occur during chemotherapy and radiotherapy in oncology. Specific medications exist to target individual side effects. The aim of this study was to explore in a pilot trial whether supplementation with French maritime pine bark extract Pycnogenol could alleviate side effects and improve patient's quality of life. Cancer patients who previously underwent surgery and who were in view of their pathology in relatively good condition, both physically and psychologically, were recruited for this study and divided into two groups. These patients received their first cycle of radiotherapy or chemotherapy, which lasted from 10 days up to 1 month. Then one group of patients received 150 mg Pycnogenol, the control group comparable placebo in a single-blinded fashion. The authors studied the occurrence of side effects and made attempts to judge their severity on a semi-quantitative visual analogue scale over a 2 months period starting after patients completed their first cycle of chemo- or radiotherapy, respectively. Twenty five radiotherapy patients receiving Pycnogenol showed a decreased frequency of essentially all investigated side-effects as compared to 21 patients receiving placebo, though in many categories the difference was limited. The most apparent improvements of acute side effects related to decreased soreness and ulceration in the mouth and throat as well as less dryness of the mouth and the eyes. A decreased incidence of nausea /vomiting, diarrhoea, edema and weakness was noticed, which was reflected by semi-quantitative evaluation suggesting that severity was only half or even less pronounced than in the control group. Only one case of deep vein thrombosis occurred in the Pycnogenol group whereas 2 cases of superficial vein thromboses and one case of deep vein thrombosis occurred in the control group (2.9% vs 10%). Thirty four chemotherapy patients were supplemented with Pycnogenol and another 30 patients were in the control group. For all patients this was the first chemotherapy treatment period. The Pycnogenol group presented with a lowered incidence of all investigated side effects as compared to the control group, though in many cases to a limited extent. The most prominent improvements were found for nausea, vomiting, diarrhoea and weight loss. Semi-quantitative evaluation showed that here again symptom severity was half or less pronounced than in the control group. Various further symptoms improved such as cognitive impairment and also cardiotoxicity and neutropenia. Effects on anemia could not be investigated as several patients received erythrocyte transfusion. In the Pycnogenol group one case of superficial vein thrombosis was indentified while 3 cases of superficial vein thromboses and one deep vein thrombosis were detected in the control group (4% vs 19%). In both chemotherapy and radiotherapy patients Pycnogenol lowered the requirement for medication to address side effects. This was reflected by less days of hospitalisation the patients required. The authors did not investigate a possible interference with the anti-neoplastic efficacy of chemo- and radiotherapy. This possibility requires attention in future studies with Pycnogenol. From their previous clinical experience the authors suggest that alleviation of side effects described in this study results from Pycnogenol activities related to endothelial protection, and anti-inflammatory anti-edema activities. The results of this pilot trial warrant further prospective studies with larger number of patients to validate benefits more specifically with regard to type of malignancy and treatment regimen.

Balsalazide

MedlinePlus

Side effects from balsalazide can occur. Tell your doctor if any of these symptoms are severe or do not go away: headache abdominal pain upset stomach diarrhea vomiting joint pain difficulty falling or staying asleep tiredness gas runny nose muscle or back ...

Questionnaire about the adverse events and side effects following botulinum toxin A treatment in patients with cerebral palsy.

PubMed

Blaszczyk, Izabela; Foumani, Nazli Poorsafar; Ljungberg, Christina; Wiberg, Mikael

2015-11-06

Botulinum toxin A (BoNT-A) injections for treatment of spasticity in patients with cerebral palsy (CP) have been used for about two decades. The treatment is considered safe but a low frequency of adverse events (AE) has been reported. A good method to report AEs is necessary to verify the safety of the treatment. We decided to use an active surveillance of treatment-induced harm using a questionnaire we created. We studied the incidence of reported AEs and side effects in patients with CP treated with BoNT-A. We investigated the relationship between the incidence of AEs or side effects and gender, age, weight, total dose, dose per body weight, Gross Motor Function Classification System (GMFCS) and number of treated body parts. Seventy-four patients with CP participated in our study. In 54 (51%) of 105 BoNT-A treatments performed in 45 (61%) patients, there were 95 AEs and side effects reported, out of which 50 were generalized and/or focal distant. Severe AEs occurred in three patients (4%), and their BoNT-A treatment was discontinued. Consecutive collection of the AE and side-effect incidence using our questionnaire can increase the safety of BoNT-A treatment in patients with CP.

Seed distribution of four co-occurring grasses around Artemisia halodendron shrubs in a sandy habitat

NASA Astrophysics Data System (ADS)

Li, Feng-Rui; Zhao, Wen-Zhi; Kang, Ling-Fen; Liu, Ji-Liang; Huang, Zhi-Gang; Wang, Qi

2009-05-01

In a natural population of the perennial semi-shrub Artemisia halodendron in a shifting sandy habitat in the Horqin Desert of eastern Inner Mongolia, six isolated adult A. halodendron individuals of similar canopy size were chosen as target plants. The density of seeds in the top 5 cm soil depth around shrubs was measured using transects aligned to the four main wind directions and at different distances from the shrub base on both the windward and leeward sides. The effects of shrub presence on seed distribution of four co-occurring grasses were examined by linking seed distribution to seed traits. Of the four species, Setaris viridis and Eragrostis pilosa had small but similar seed mass, while Chloris virgata and Aristida adscensionis had large but similar seed mass. The species were grouped into two cohorts: small-seeded vs. large-seeded cohorts, and shrub presence effects on seed distribution of both cohorts were examined. We found marked difference in the seed distribution pattern among species, especially between the small-seeded and large-seeded cohorts. The small-seeded cohort had significantly higher seed accumulation on the windward than the leeward sides in the most and least prevailing wind directions and much higher seed accumulation on the leeward than the windward sides in the second and third most prevailing wind directions, while opposite patterns occurred in the large-seeded cohort. Four species also showed marked variation in the seed distribution pattern among transects and between windward and leeward sides of each transect. This study provided further evidence that shrubs embedded in a matrix of herbaceous plants is a key cause of spatial heterogeneity in seed availability of herbaceous species. However, seed distribution responses to the presence of shrubs will vary with species as well as with wind direction, sampling position (windward vs. leeward sides of the shrub) and distance from the shrub.

77 FR 3646 - Products Containing Imidazolines Equivalent to 0.08 Milligrams or More

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

... congestion and/or ophthalmic irritation. Products containing imidazolines can cause serious adverse reactions... unpredictable, idiosyncratic reaction (i.e., a drug effect that occurs in a small number of people due to age..., and death associated with cardiac reactions in adults. Other systemic side effects can include...

Nonlinear side effects of fs pulses inside corneal tissue during photodisruption

NASA Astrophysics Data System (ADS)

Heisterkamp, A.; Ripken, T.; Mamom, T.; Drommer, W.; Welling, H.; Ertmer, W.; Lubatschowski, H.

In order to evaluate the potential for refractive surgery, fs laser pulses of 150-fs pulse duration were used to process corneal tissue of dead and living animal eyes. By focusing the laser radiation down to spot sizes of several microns, very precise cuts could be achieved inside the treated cornea, accompanied with minimum collateral damage to the tissue by thermal or mechanical effects. During histo-pathological analysis by light and transmission electron microscopy considerable side effects of fs photodisruption were found. Due to the high intensities at the focal region several nonlinear effects occurred. Self-focusing, photodissociation, UV-light production were observed, leading to streak formation inside the cornea.

Ocular side effects following intravitreal injection therapy for retinoblastoma: a systematic review.

PubMed

Smith, Stephen J; Smith, Brian D; Mohney, Brian G

2014-03-01

To describe the ocular side effects in patients receiving intravitreal injection therapy (IViT) for retinoblastoma. PubMed (1946-present), Scopus (all years), Science Citation Index (1900-present) and Conference Proceedings Citation Index-Science (1990-present) electronic databases were searched to identify all published reports of therapeutic intravitreal injections for retinoblastoma in humans. Ten studies with original IViT ocular side effect data were included in this systematic review. In these combined reports, a total of 1287 intravitreal injections were given to 306 eyes of 295 patients, with a mean follow-up of 74.1 months. Two hundred sixty-one (88.5%) patients received comparatively standard melphalan IViT doses (8-30 mcg). Ocular side effects occurred in 38 patients (17 significant, 21 minor). The proportion of patients experiencing potentially significant ocular side effects following standard melphalan IViT regimens was 0.031 (8/261; 95% CI 0.013 to 0.06). The side effects of these eight included iris atrophy in three, two each with chorioretinal atrophy and vitreous haemorrhage and one with retinal detachment. Of the other nine patients with significant complications, five experienced sight-threatening complications following dramatic dose escalations (four with melphalan, one with thiotepa), three experienced complications that are commonly associated with concurrent therapies given to these patients and one had a retinal detachment. Of the 61 patients receiving IViT via safety-enhancing injection techniques, all six significant side effects were either attributed to the therapeutic dose or confounded by concurrent treatments. Significant ocular complications following IViT for retinoblastoma are uncommon, and this risk may be reduced further by the use of careful injection technique and standard dosing regimens. Care must be taken in the dosing of intravitreal treatments to avoid potentially irreversible vision loss.

Epilepsy and Other Seizure Disorders in Children: Drug Management

ERIC Educational Resources Information Center

Thomas, John A.; Knotts, Glenn R.

1976-01-01

A teacher can be valuable in aiding the recognition of seizure patterns in children and in providing further insight into possible side effects of anticonvulsant therapy, which might occur to the child in the classroom. (JD)

Neuroendocrine tumor of cecum in patient treated with imatinib mesylate for blastic phase of chronic myeloid leukemia.

PubMed

Novaković, Sabina; Kovač Peić, Anamarija; Holik, Hrvoje; Coha, Božena

2017-12-01

Imatinib mesylate (IM), a tyrosine kinase inhibitor, is the treatment of choice in patients with chronic myeloid leukemia (CML). It is considered a very safe drug, with mostly mild and reversible side effects. Lately, it has been suggested that adverse events may occur after a long term. We report a case of a 72-year-old woman diagnosed with blastic phase of Philadelphia chromosome positive CML treated with IM for 28 months. The patient presented first with ascites as a side effect of the drug. When the ascites re-occurred, it was caused by neuroendocrine tumor (NET) with peritoneal carcinomatosis. We believe this is the first case of a NET as a secondary malignancy (SM) after IM treatment. SM have been described in patients on IM before. It is unclear whether these tumors are caused by imatinib or found more easily because of close follow-up.

[Side effects of the HMG-CoA reductase inhibitors (statins). Lupus erythematosus induced by Atorvastatin therapy].

PubMed

Hydzik, Piotr; Szpak, Dorota

2011-01-01

The paper describes the case of 56 years old woman admitted to the Toxicology Department because of skin lesions, joint and muscle pain and elevated activity of transaminases and creatine phosfokinase as well in biochemical analysis. The symptoms occurred after 6 days of the Atorvastatin therapy. The clinical picture indicated side effects of the hipolipemic therapy, but the presence of the skin lesions suggested drug induced collagenosis (lupus erythrematosus, dermatomyositis). Immunological studies confirmed association with antinuclear antibodies (ANA) and anti-Mi-2 autoantibodies in the serum. Immunosuppressive therapy was ordered with clinical and biochemical improvement.

[Pharmacotherapy of hyperthyreosis--adverse drug reactions].

PubMed

Perger, Ludwig; Bürgi, Ulrich; Fattinger, Karin

2011-06-01

The antithyroid drugs mainly include thioimidazole (carbimazole, methimazole=thiamazole) and propylthiouracil. After absorption, carbimazole is rapidly metabolized to methimazole and thus switching between these two drugs should not be considered in case of side effects. Furthermore, in case of side effects, sometimes even cross reactions between thioimidazoles and propylthiouracil occur. Common and typical adverse reactions of antithyroid drugs include dose dependent hypothyroidism and thus thyroid function should be repeatedly checked while the patient is on antithyroid drugs. Furthermore, pruritus and rash may develop. In this case, one might try to switch from thioimidazoles to propylthiouracil or vice versa. Antithyroid drugs may cause mild dose dependent neutropenia or severe allergy-mediated agranulocytosis, which typically occurs during the first three months of treatment, has an incidence of 3 per 10,000 patients and cross reactivity between thioimidazoles to propylthiouracil may occur. Rarely, antithyroid drugs can cause aplastic anemia. Mainly propylthiouracil, but sometimes also methimazole may lead to an asymptomatic transient increase in liver enzymes or to severe, even lethal liver injury of cholestatic or hepatocellular pattern. Since propylthiouracil associated liver injury was observed increasingly among children and adolescent, it has been suggested to prefer thioimidazoles for these patients. Because of these potential serious adverse effects, physicians should advise patients to immediately seek medical help if they get a fever or sore throat or malaise, abdominal complaints or jaundice, respectively. Furthermore, arthralgias may develop in 1-5% of patients under both antithyroid drugs. Since arthralgias may be the first symptom of more serious immunologic side effects, it is recommended to stop the antithyroid drug in this case. Drug induced polyarthritis mainly develops during the first month of therapy, whereas ANCA-positive vasculitis is generally observed only after long term exposure to propylthiouracil or very rarely with the thioimidazoles. The teratogenic risk of the thioimidazoles is somewhat higher (Aplasia cutis congenita), that is why one generally recommends preferring propylthiouracil during pregnancy. During breast feeding both, thioimidazoles or propylthiouracil, may be administered. Nowadays, perchlorate is only used short term in case of latent hyperthyroidism before administering iodine-containing contrast agents. Therefore, the known side effects, which usually are only observed after long term treatment, are not an issue any more.

Evaluation of an ultra-low-dose oral contraceptive for dysmenorrhea: a placebo-controlled, double-blind, randomized trial.

PubMed

Harada, Tasuku; Momoeda, Mikio

2016-12-01

To evaluate the efficacy and safety of an ultra-low-dose oral contraceptive (NPC-01; 0.02 mg ethinyl estradiol and 1 mg norethisterone) in subjects with dysmenorrhea. Placebo-controlled, double-blind, randomized trial. Clinical trial sites. Two hundred fifteen subjects with dysmenorrhea. Subjects were randomly assigned to receive NPC-01, placebo, or IKH-01 (0.035 mg ethinyl estradiol and 1 mg norethisterone) for four cycles. Total dysmenorrhea score (verbal rating scale) assessing pain on the basis of limited ability to work and need for analgesics. The reductions of total dysmenorrhea score and visual analog scale score after the treatment were significantly higher in the NPC-01 group than in the placebo group. Furthermore, the efficacy of NPC-01 was comparable to that of IKH-01. The overall incidence of side effects was significantly higher in the NPC-01 group than in the placebo group. All side effects that occurred in the NPC-01 group were previously reported in patients receiving IKH-01. No serious side effects occurred. The ultra-low-dose contraceptive NPC-01 relieved dysmenorrhea as effectively as IKH-01. Thus, NPC-01 could represent a new option for long-term treatment of dysmenorrhea. NCT01129102. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Long-term experience with Enovid among clinic patients: results after 2 and one-half to 6 years of individual patient use.

PubMed

Sturtevant, R P

1970-08-01

64 women clients of Planned Parenthood of Evansville (Indiana) used Enovid (5 mg norethynodrel and .075 mg mestranol, combined) for 2 1/2 to 6 years. A "25-Month Club" card and free pills were given to encourage continuation in the study, and 33 women (52%) remained until study termination. The group ranged in age from 18-40 years, mean 27 years, and in parity 0 to 12, mean 4. No pregnancies, cancer of reproductive organs or thromboembolism occurred. Side effects, recorded by interview according to a standard form, included: cervicitis 48%, vaginal discharge 42%; dysmenorrhea 61% pretreatment, 42% improved, 11% new symptoms; breast complaints 33%; 2-15 lb weight gain 19%. 12% reported no side effects, although the author commented that the 25-Month Club policy might have discouraged reporting of side effects.

Hypersensitivity lo local anesthetics.

PubMed

Grzanka, Alicja; Wasilewska, Iwona; Śliwczyńska, Magdalena; Misiołek, Hanna

2016-01-01

Using local anaesthetics in daily practice, particularly by anaesthetists and dentists, is connected with the risk of side effects. Therefore, the observation of side effects, carrying out detailed research (according to the chart proposed in this study) and conducting specialist examinations is of the highest importance. There is a variety of side effects that could occur during local anaesthesia procedures, with the intensity ranging from clinically unimportant to life threatening. Clinicians' major concerns are the appearance of various hypersensitivity reactions, including anaphylaxis. Healthcare providers responsible for the administration of local anaesthetics should be able to detect hypersensitivity reactions to implement appropriate treatment and then choose highly selected diagnostic procedures. The final diagnosis should be based on specific medical history; documentation, including a description of the case and measurement of tryptase activity; skin tests; and provocation trials. Screening tests are not recommended in populations without hypersensitivity to local anaesthestics in their medical history.

[Theoretical and practical considerations in rational polytherapy for epilepsy].

PubMed

Rajna, Péter

2011-11-30

Author analyses the consideration of rational polytherapy for epilepsy. Among the theoretical aspects he points the different effect of seizure inhibitory drugs on the epilepsy models but didn't find data enough for the basis of any successful combination. Combinations of compounds having different way of action are more promising. Rational polytherapy can serve also the epileptic patients' tailored therapy in the daily routine. There have already been some proved synergisms concerning drug interactions. Based on detailed analysis of side effects a possibility occurs for neutralization of side effects when anticonvulsants with side effects of opposite nature are combined. Considering both the side effect profiles and the different (somatic and psychic) habits of the patients we can create a special list of favourable combinations. Co-morbid states and their treatments play a significant role in the application of rational polytherapy. Combination of anticonvulsants of lower potential but without drug-interactions can be the choice in these cases. The non-epileptic indications of the anticonvulsants can also be utilized in polymorbid patients. Based on the theoretical and practical considerations the author defines the ten-step-cognitive-preparation-process in planning the optimal (poly)therapy. On speculative basis he suggests eight beneficial versions of seizure inhibitory rational polytherapy.

Field efficacy of moxidectin in dogs and rabbits naturally infested with Sarcoptes spp., Demodex spp. and Psoroptes spp. mites.

PubMed

Wagner, R; Wendlberger, U

2000-11-10

The efficacy of moxidectin 1% injectable for cattle was evaluated in dogs and rabbits with naturally acquired sarcoptic, demodectic or psoroptic mites. Twenty-two dogs with generalised demodicosis were orally treated with 0.4mg/kg moxidectin daily. Forty-one dogs suffering from sarcoptic mange were treated with 0.2-0.25mg/kg moxidectin either orally or subcutaneously every week for three to six times. Seven rabbits were treated orally with 0.2mg/kg moxidectin twice 10 days apart. Of the 22 dogs with demodicosis, 14% were stopped treatment because of side effects, 14% were lost and of the remaining 72% all were cured (mean therapy duration 2.4 months). Thirty-seven of the sarcoptic mange-infected dogs finished treatment and were cured. In 17% of dogs, side effects were noted. All seven rabbits treated for psoroptic mange were cured and did not show any side effect. Our results indicate that moxidectin is effective and a good alternative for the treatment of demodicosis and scabies in dogs and psoroptic mange in rabbits. Side effects seem to occur more frequently if applied subcutaneously, therefore the oral route should be preferred.

Stem Cell Transplants in Cancer Treatment

Cancer.gov

Stem cell transplants are procedures that restore blood-forming stem cells in cancer patients who have had theirs destroyed by very high doses of chemotherapy or radiation therapy. Learn about the types of transplants and side effects that may occur.

Vaccinating Your Preteen: Addressing Common Concerns

MedlinePlus

... to sit for 15 minutes after getting any​ shot in case your child faints (syncope). Staying seated for 15 ... mild side effects that can occur after receiving shots. Why is more than one dose of vaccine needed? HPV vaccine: It is ...

Acetylcholinesterase inhibitors for electroconvulsive therapy-induced cognitive side effects: a systematic review.

PubMed

Henstra, Marieke J; Jansma, Elise P; van der Velde, Nathalie; Swart, Eleonora L; Stek, Max L; Rhebergen, Didi

2017-05-01

Electroconvulsive therapy (ECT) is an effective treatment for severe late-life depression; however, ECT-induced cognitive side effects frequently occur. The cholinergic system is thought to play an important role in the pathogenesis. We systematically reviewed the evidence for acetylcholinesterase inhibitors (Ache-I) to prevent or reduce ECT-induced cognitive side effects. A systematic search was performed in Pubmed, EMBASE, PsychINFO, and the Cochrane database to identify clinical trials investigating the effect of Ache-I on ECT-induced cognitive side effects. Key search terms included all synonyms for ECT and Ache-I. Risk of bias assessment was conducted by using the Cochrane Collaboration's tool. Five clinical trials were eligible for inclusion. All studies focused on cognitive functioning as primary endpoint, but assessment of cognitive functioning varied widely in time point of assessment and in cognitive tests that were used. There was also great variety in study medication, route and time of administration and dosages, duration of drug administration, and ECT techniques. Finally, only two out of five studies were considered at low risk of bias. Despite the aforementioned shortcomings, without exception, all studies demonstrated significantly better cognitive performance in individuals treated with Ache-I. Despite large heterogeneity in studies, Ache-I appear to have beneficial effects on ECT-induced cognitive side effects, supporting an association with the cholinergic system in ECT-induced cognitive impairment. Methodological sound studies controlling for putative confounders are warranted. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

Failure Mechanisms and Evolution Assessment of the Excavation Damaged Zones in a Large-Scale and Deeply Buried Underground Powerhouse

NASA Astrophysics Data System (ADS)

Li, Hai-bo; Liu, Ming-chang; Xing, Wan-bo; Shao, Shuai; Zhou, Jia-wen

2017-07-01

The Jinping I underground powerhouse is deeply buried and is one of the largest underground powerhouses in China. As a result of high levels of in situ stress, complex geological conditions and the effects of excavation in adjacent caverns, the surrounding rock mass has been severely deformed and broken, and excavation damaged zones (EDZs) have become major obstacles to the design of cavern excavation and support. Field investigations and monitoring data indicated that there are two main modes of failure: high tangential stress induced failure and progressive failure, which have occurred on the mountain side and the river valley side of the Jinping I underground powerhouse. These two main modes of failure were due to strong secondary principal stress forces in the sub-parallel directions and sub-vertical directions, acting on the axes of the main powerhouse on the mountain side and on the river valley side, respectively. Deformations and EDZs on the river valley side were generally larger than those found along the mountain side, and the distribution of deformations was consistent with the distribution of EDZs. The evolution of the EDZ on the river valley side has clearly been time dependent, especially along the downstream arch abutment, and the EDZ was considerably enlarged with further excavation. Additionally, the deformation of the surrounding rock mass was first initiated from the edge of the excavation area and gradually extended to deeper areas away from the opening. However, the EDZ on the mountain side was enlarged only during the first two phases of excavation. The extension of pre-existing cracks and the creation of new fractures has mainly occurred in the oldest EDZ section, and the HDZ has been visibly enlarged, whereas the EDZ has shown little change in other excavation phases.

Oxidation of Peptides by Methyl(trifluoromethyl)dioxirane: the Protecting Group Matters

PubMed Central

Rella, Maria Rosaria; Williard, Paul G.

2011-01-01

Representative Boc protected and acetyl protected peptide methyl esters bearing alkyl side chains undergo effective oxidation using methyl(trifluoromethyl)dioxirane (1b) under mild conditions. We observe a protecting group dependency in the chemoselectivity displayed by the dioxirane 1b. N-hydroxylation occurs in the case of the Boc protected peptides, side chain hydroxylation takes place in the case of acetyl protected peptides. Both are attractive transformations since they yield derivatized peptides that serve as valuable synthons. PMID:17221970

The side effects and complications of percutaneous iodine-125 seeds implantation under CT-guide for patients with advanced pancreatic cancer.

PubMed

Lv, Wei-Fu; Lu, Dong; Xiao, Jing-Kun; Mukhiya, Gauri; Tan, Zhong-Xiao; Cheng, De-Lei; Zhou, Chun-Ze; Zhang, Xing-Min; Zhang, Zheng-Feng; Hou, Chang-Long

2017-12-01

The present study investigates the side effects and complications of computed tomography (CT)-guided percutaneous iodine-125 (I-125) seeds implantation for advanced pancreatic cancer. The clinical data were retrospectively analyzed for patients treated with implantation of I-125 seeds under CT-guide in our hospital from May 2010 to April 2015. The side effects and complications were collected and their possible reasons were analyzed. A total of 78 patients were enrolled. The side effects were categorized as fever in 29 cases (37.18%), abdominal pain in 26 cases (33.33%), nausea and vomiting in 9 cases (11.54%), diarrhea in 5 cases (6.41%), and constipation in 4 cases (5.13%). Complications were composed of pancreatitis in 9 cases (11.54%), infection in 5 cases (6.41%), seed migration in 2 cases (2.56%), intestinal perforation in 1 case (1.28%), and intestinal obstruction in 1 case. The incidence of complication was 23.08% (18/78). The difference in incidence of complication was statistically significant between patients implanted with ≤27 seeds and those with >27 seeds (P = .032). The side effects and complications frequently occur in implantation of I-125 seeds for patients with advanced pancreatic cancer. More concern should be given to the patients treated by this technique. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Laser treatment of primary axillary hyperhidrosis: a review of the literature.

PubMed

Cervantes, Jessica; Perper, Marina; Eber, Ariel E; Fertig, Raymond M; Tsatalis, John P; Nouri, Keyvan

2018-04-01

Hyperhidrosis o`ccurs when the body produces sweat beyond what is essential to maintain thermal homeostasis. The condition tends to occur in areas marked by high-eccrine density such as the axillae, palms, and soles and less commonly in the craniofacial area. The current standard of care is topical aluminum chloride hexahydrate antiperspirant (10-20%), but other treatments such as anticholinergics, clonidine, propranolol, antiadrenergics, injections with attenuated botulinum toxin, microwave technology, and surgery have been therapeutically implicated as well. Yet, many of these treatments have limited efficacy, systemic side effects, and may be linked with significant surgical morbidity, creating need for the development of new and effective therapies for controlling excessive sweating. In this literature review, we examined the use of lasers, particularly the Neodynium:Yttrium-Aluminum-Garnet (Nd:YAG) and diode lasers, in treating hyperhidrosis. Due to its demonstrated effectiveness and limited side effect profile, our review suggests that Nd:YAG laser may be a promising treatment modality for hyperhidrosis. Nevertheless, additional large, randomized controlled trials are necessary to confirm the safety and efficacy of this treatment option.

Side Effects of Chemotherapy and Radiation (For Parents)

MedlinePlus

... weight based on his or her medical needs. Hair Loss During chemo, hair thinning and hair loss may occur all over the body. Radiation therapy to the head and neck may cause hair loss in that area; however, radiation anywhere else ...

Distribution of very low frequency earthquakes in the Nankai accretionary prism influenced by a subducting-ridge

NASA Astrophysics Data System (ADS)

Toh, Akiko; Obana, Koichiro; Araki, Eiichiro

2018-01-01

We investigated the distribution of very low frequency earthquakes (VLFEs) that occurred in the shallow accretionary prism of the eastern Nankai trough during one week of VLFE activity in October 2015. They were recorded very close from the sources by an array of broadband ocean bottom seismometers (BBOBSs) equipped in Dense Oceanfloor Network system for Earthquakes and Tsunamis 1 (DONET1). The locations of VLFEs estimated using a conventional envelope correlation method appeared to have a large scatter, likely due to effects of 3D structures near the seafloor and/or sources that the method could not handle properly. Therefore, we assessed their relative locations by introducing a hierarchal clustering analysis based on patterns of relative peak times of envelopes within the array measured for each VLFE. The results suggest that, in the northeastern side of the network, all the detected VLFEs occur 30-40 km landward of the trench axis, near the intersection of a splay fault with the seafloor. Some likely occurred along the splay fault. On the other hand, many VLFEs occur closer to the trench axis in the southwestern side, likely along the plate boundary, and the VLFE activity in the shallow splay fault appears less intense, compared to the northeastern side. Although this could be a snap-shot of activity that becomes more uniform over longer-term, the obtained distribution can be reasonably explained by the change in shear stresses and pore pressures caused by a subducting-ridge below the northeastern side of DONET1. The change in stress state along the strike of the plate boundary, inferred from the obtained VLFE distribution, should be an important indicator of the strain release pattern and localised variations in the tsunamigenic potential of this region.

Comparison of molindone and tranylcypromine in the treatment of refractory depression.

PubMed

Small, J G; Kellams, J J; Dennis, J L; Milstein, V

1981-01-01

A single-blind parallel study of 20 treatment-resistant hospitalized depressed patients showed that 10-30 mg/day molindone was more effective and less toxic than 20-30 mg tranylcypromine. Molindone-treated patients responded during the first week with particular improvement in anxiety symptoms and agitation. Extrapyramidal symptoms developed in half of the patients on molindone, which were effectively managed with amantadine. Early termination from the study because of clinical worsening or side effects occurred in seven patients on tranylcypromine and in none on molindone. These results suggest that molindone in low dosage may be helpful in the management of refractory depression and may have the further advantage of producing a more rapid response to treatment with fewer disabling side effects.

Infrared coagulation: a new treatment for hemorrhoids

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

Leicester, R.J.; Nicholls, R.J.; Mann, C.V.

Many methods, which have effectively reduced the number of patients requiring hospital admission, have been described for the outpatient treatment of hemorrhoids. However, complications have been reported, and the methods are often associated with unpleasant side effects. In 1977 Neiger et al. described a new method that used infrared coagulation, which produced minimal side effects. The authors have conducted a prospective, randomized trial to evaluate infrared coagulation compared with more traditional methods of treatment. The authors' results show that it may be more effective than injection sclerotherapy in treating non-prolapsing hemorrhoids and that it compares favorably with rubber band ligationmore » in most prolapsing hemorrhoids. No complications occurred, and significantly fewer patients experienced pain after infrared coagulation (P . less than 0.001).« less

Modified liver hanging maneuver focusing on outflow control in pure laparoscopic left-sided hepatectomy.

PubMed

Kim, Ji Hoon

2018-04-01

Outflow control during laparoscopic liver resection necessitates the use of technically demanding procedures since the hepatic veins are fragile and vulnerable to damage during parenchymal transection. The liver hanging maneuver reduces venous backflow bleeding during deep parenchymal transection. The present report describes surgical outcomes and a technique to achieve outflow control during application of the modified liver hanging maneuver in patients undergoing laparoscopic left-sided hepatectomy. A retrospective review was performed of clinical data from 29 patients who underwent laparoscopic left-sided hepatectomy using the modified liver hanging maneuver between February 2013 and March 2017. For this hanging technique, the upper end of the hanging tape was placed on the lateral aspect of the left hepatic vein. The tape was then aligned with the ligamentum venosum. The position of the lower end of the hanging tape was determined according to left-sided hepatectomy type. The hanging tape gradually encircled either the left hepatic vein or the common trunk of the left hepatic vein and middle hepatic vein. The surgical procedures comprised: left lateral sectionectomy (n = 10); left hepatectomy (n = 17); and extended left hepatectomy including the middle hepatic vein (n = 2). Median operative time was 210 min (range 90-350 min). Median intraoperative blood loss was 200 ml (range 60-600 ml). Two intraoperative major hepatic vein injuries occurred during left hepatectomy. Neither patient developed massive bleeding or air embolism. Postoperative major complications occurred in one patient (3.4%). Median postoperative hospital stay was 7 days (range 4-15 days). No postoperative mortality occurred. The present modified liver hanging maneuver is a safe and effective method of outflow control during laparoscopic left-sided hepatectomy.

The small miracle.

PubMed

Tiranti, D

1979-09-01

Although the standard argument for distributing birth control pills throughout the Third World is that they are less dangerous than pregnancy or abortion, irregular use of the pill increases riks of both. The irregularity of use can be attributed to both poor delivery systems and side effects. Side effects occur because of poor screening and lack of alternative dosages. Because of the lower price of buying in bulk, family planning groups distribute only 1 kind of pill. The woman who experiences side effects, e.g. headache, dizziness, weight gain, depression, has no choice but to discontinue use. Few women are screened by having their blood pressure taken, therefore the pill exacerbates illness in those with circulation problems. Breast-feeding mothers who take the pill provide less sustenance from their breastmilk, which can increase infant mortality rates. In Bangladesh a USAID-funded study on contractive distribution found that the "trained" family planning workers did not know what advice to give a woman who missed her pill on 5 consecutive days, or what type of side effects might be anticipated, or how many days after the onset of menstruation a woman should begin the pill. A more level headed approach to delivery of contraceptives in developing countries is needed.

Inhibitors of Acetylcholinesterase Derived from 7-Methoxytacrine and Their Effects on the Choline Transporter CHT1.

PubMed

Kristofikova, Zdenka; Ricny, Jan; Soukup, Ondrej; Korabecny, Jan; Nepovimova, Eugenie; Kuca, Kamil; Ripova, Daniela

2017-01-01

Reversible acetylcholinesterase inhibitors are used in Alzheimer disease therapy. However, tacrine and its derivatives have severe side effects. Derivatives of the tacrine analogue 7-methoxytacrine (MEOTA) are less toxic. We evaluated new derivatives of 7-MEOTA (2 homodimers linked by 2 C4-C5 chains and 5 N-alkylated C4-C8 side chain derivatives) in vitro, using the rat hippocampal choline transporter CHT1. Some derivatives were effective inhibitors of rat acetylcholinesterase and comparable with 7-MEOTA. All derivatives were able to inhibit CHT1, probably via quaternary ammonium, and this interaction could be involved in the enhancement of their detrimental side effects and/or in the attenuation of their promising effects. Under conditions of disrupted lipid rafts, the unfavorable effects of some derivatives were weakened. Only tacrine was probably able to stereospecifically interact with the naturally occurring amyloid-β isoform and to simultaneously stimulate CHT1. Some derivatives, when coincubated with amyloid β, did not influence CHT1. All derivatives also increased the fluidity of the cortical membranes. The N-alkylated derivative of 7-MEOTA bearing from C4 side chains appears to be the most promising compound and should be evaluated in future in vivo research. © 2016 S. Karger AG, Basel.

Effect of defect creation and migration on hump characteristics of a-InGaZnO thin film transistors under long-term drain bias stress with light illumination

NASA Astrophysics Data System (ADS)

Cho, Yong-Jung; Kim, Woo-Sic; Lee, Yeol-Hyeong; Park, Jeong Ki; Kim, Geon Tae; Kim, Ohyun

2018-06-01

We investigated the mechanism of formation of the hump that occurs in the current-voltage I-V characteristics of amorphous InGaZnO (a-IGZO) thin film transistors (TFTs) that are exposed to long-term drain bias stress under illumination. Transfer characteristics showed two-stage degradation under the stress. At the beginning of the stress, the I-V characteristics shifted in the negative direction with a degradation of subthreshold slope, but the hump phenomenon developed over time in the I-V characteristics. The development of the hump was related to creation of defects, especially ionized oxygen vacancies which act as shallow donor-like states near the conduction-band minimum in a-IGZO. To further investigate the hump phenomenon we measured a capacitance-voltage C-V curve and performed two-dimensional device simulation. Stretched-out C-V for the gate-to-drain capacitance and simulated electric field distribution which exhibited large electric field near the drain side of TFT indicated that VO2+ were generated near the drain side of TFT, but the hump was not induced when VO2+ only existed near the drain side. Therefore, the degradation behavior under DBITS occurred because VO2+ were created near the drain side, then were migrated to the source side of the TFT.

Relapsed hydroxychloroquine induced thrombocytopenia in a systemic lupus erythematosus patient.

PubMed

Antón Vázquez, Vanesa; Pascual, Luis; Corominas, Héctor; Giménez Torrecilla, Isabel

Hydroxychloroquine is used in the long-term therapy of systemic lupus erythematosus (SLE). Although considered to be a safe treatment, side effects have been documented. An uncommon side effect is thrombocytopenia. In order to establish the diagnosis of thrombocytopenia secondary to Hydroxychloroquine, non-pharmacological causes must be ruled out and it is necessary to determine a recurrence after re-exposure to the drug. We present one case of severe thrombocytopenia occurring in a patient with SLE undergoing treatment with Hydroxychloroquine. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Severe neurotoxicity following intrathecal methotrexate with nitrous oxide sedation in a child with acute lymphoblastic leukemia.

PubMed

Löbel, U; Trah, J; Escherich, G

2015-03-01

Systemic and intrathecal methotrexate is widely used in treatment protocols for childhood acute lymphoblastic leukemia. Its side effects vary in characteristics, intensity and time of onset, and depend on the administration route. Interactions with several drugs are known. Side effects of nitrous oxide sedation, often used for moderately painful procedures, typically occur after long time use and include neurological symptoms. We present a child who experienced a severe and long-lasting neurotoxicity after the third intrathecal application of methotrexate with short sedation by nitrous oxide during induction therapy for acute lymphoblastic leukemia. Symptoms completely resolved after 12 months. © 2014 Wiley Periodicals, Inc.

Family Caregiver Knowledge, Patient Illness Characteristics, and Unplanned Hospital Admissions in Older Adults With Cancer.

PubMed

Geddie, Patricia I; Wochna Loerzel, Victoria; Norris, Anne E

2016-07-01

To explore factors related to unplanned hospital admissions and determine if one or more factors are predictive of unplanned hospital admissions for older adults with cancer.
. A prospective longitudinal design and a retrospective chart review.
. Adult oncology outpatient infusion centers and inpatient units at Orlando Regional Medical Center in Florida.
. A convenience sample of 129 dyads of older adults with cancer and their family caregivers. 
. Family caregiver demographic and side effect knowledge data were collected prospectively during interviews with family caregivers using a newly developed tool, the Nurse Assessment of Family Caregiver Knowledge and Action Tool. Patient demographic and clinical data were obtained through a retrospective chart review. Descriptive statistics and logistic regression analyses were used to evaluate data and examine relationships among variables.
. Patient illness characteristics; impaired function; side effects, such as infection, fever, vomiting, and diarrhea; family caregiver knowledge; and unplanned hospital admissions.
. Unplanned hospital admissions were more likely to occur when older adults had impaired function and side effects, such as infection, fever, vomiting, and diarrhea. Impaired function and family caregiver knowledge did not moderate the effects of these side effects on unplanned hospital admissions. 
. Findings suggest that the presence of impaired function and side effects, such as infection, fever, vomiting, and diarrhea, predict unplanned hospital admissions in older adults with cancer during the active treatment phase. Side effects may or may not be related to chemotherapy and may be related to preexisting comorbidities. 
. Nurses can conduct targeted assessments to identify older adults and their family caregivers who will need additional follow-up and support during the cancer treatment trajectory. Information gained from these assessments will assist nurses to provide practical and tailored strategies to reduce the risk for unplanned admissions.

Association of Type D personality to perceived side effects and adherence in CPAP-treated patients with OSAS.

PubMed

Broström, Anders; Strömberg, Anna; Mårtensson, Jan; Ulander, Martin; Harder, Lena; Svanborg, Eva

2007-12-01

Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but side effects are common and long-term adherence low. The Type D (distressed) personality is defined as a combination of negative affectivity and social inhibition. The association of Type D personality with adherence has not been studied in CPAP-treated patients with OSAS. This study aimed to describe the prevalence of Type D personality in OSAS patients with CPAP treatment longer than 6 months and the association with self-reported side effects and adherence. A cross-sectional descriptive design was used. A total of 247 OSAS patients with a mean use of CPAP treatment for 55 months (6-182 months) were included. Data collection was achieved by two questionnaires; the Type D scale 14 (DS14) (Type D personality), SECI (side effects of CPAP), as well as from medical records (clinical variables and objective adherence to CPAP treatment). Type D personality occurred in 30% of the patients with OSAS and significantly (P < 0.05-0.001) increased the perceived frequency and severity of a broad range of side effects. The objective adherence was significantly lower (P < 0.001) for OSAS patients with Type D compared to OSAS patients without Type D, both with regard to a mean use of 4 h per night and 85% of the self-rated sleep time per night. The additional effect of a Type D personality on perceived side effects and adherence to CPAP treatment found in this study could be used by healthcare personnel when evaluating patients waiting for treatment.

Factors affecting the open-circuit voltage and electrode kinetics of some iron/titanium/redox flow cells

NASA Technical Reports Server (NTRS)

Reid, M. A.; Gahn, R. F.

1977-01-01

The effect of acid concentration on the performance of the iron-titanium redox flow cell was studied. When the acidity was increased, open-circuit voltages decreased on the titanium side but load voltages increased due to decreased polarization. The best load voltage occurs when there is high acidity on the titanium side coupled with low acidity on the iron side, but such cells show voltage losses with repeated cycling because of the diffusion of acid through the membrane. No membrane tested has been found capable of maintaining the differences in acidity. Chelating agents show some promise in reducing polarization at the Ti electrode and thus improving energy efficiency.

Hot Flashes and Night Sweats (PDQ®)—Patient Version

Cancer.gov

Hot flashes and night sweats can be a side effect of cancer or its treatment and can occur in both women and men. Learn more about hot flashes and night sweats and ways to treat them in this expert-reviewed summary.

Contact Burn with Blister Formation in Children Treated with Sennosides.

PubMed

Cogley, Kimberly; Echevarria, Andrea; Correa, Catalina; De la Torre-Mondragón, Luis

2017-03-01

Eight children treated for severe constipation with sennosides unexpectedly developed contact burns with blisters secondary to the use of these laxatives. All patients wore diapers, and the injuries occurred overnight. To avoid this side effect, we recommend that patients treated with sennosides, especially those in diapers, receive the medication at a time that allows for bowel movements to occur during the day and not overnight. © 2017 Wiley Periodicals, Inc.

Prevention and Treatment of Breast Cancer

DTIC Science & Technology

2016-08-01

naturally occurring protein of pregnancy (α- fetoprotein) which is largely responsible for the lifetime reduction in risk of breast cancer that occurs as a...result of pregnancy . The scope of this translational project entails essential work that will move AFPep beyond discovery and position it to enter...side effect.  For the MNU/SD model, we treated rats for only 23 days, a duration chosen to mimic pregnancy . Because AFPep has its origins in

SAPS-associated explosive brightening on the dusk-side: A new type of onset-like disturbance: A new type of onset-like disturbance

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

Henderson, M. G.; Morley, S. K.; Kepko, L. E.

Quasi-periodic energetic particle injections have been observed at geosynchronous orbit on the dusk-side during a steady magnetospheric convection event. Here, we examine high resolution auroral imager data and ground magnetometer data associated with the first of these injections and conclude that it was not associated with classical substorm signatures. It is proposed that these injections are caused by the explosive non-linear growth of a shear-flow-ballooning instability in the region where sub-auroral polarization streams (SAPS) also occur. It is suggested that interchange will occur preferentially in the low-conductivity SAPS region since the magnetic Richardson number is lowest there and the ‘line-tying’more » effect will also be least stabilizing there. We also propose that the observed particle injection signatures and auroral morphology constitute a new type of SAPS-associated explosive ‘onset-like’ disturbance that can occur during intervals of strong convection.« less

SAPS-associated explosive brightening on the dusk-side: A new type of onset-like disturbance: A new type of onset-like disturbance

DOE PAGES

Henderson, M. G.; Morley, S. K.; Kepko, L. E.

2017-12-06

Quasi-periodic energetic particle injections have been observed at geosynchronous orbit on the dusk-side during a steady magnetospheric convection event. Here, we examine high resolution auroral imager data and ground magnetometer data associated with the first of these injections and conclude that it was not associated with classical substorm signatures. It is proposed that these injections are caused by the explosive non-linear growth of a shear-flow-ballooning instability in the region where sub-auroral polarization streams (SAPS) also occur. It is suggested that interchange will occur preferentially in the low-conductivity SAPS region since the magnetic Richardson number is lowest there and the ‘line-tying’more » effect will also be least stabilizing there. We also propose that the observed particle injection signatures and auroral morphology constitute a new type of SAPS-associated explosive ‘onset-like’ disturbance that can occur during intervals of strong convection.« less

GraphSAW: a web-based system for graphical analysis of drug interactions and side effects using pharmaceutical and molecular data.

PubMed

Shoshi, Alban; Hoppe, Tobias; Kormeier, Benjamin; Ogultarhan, Venus; Hofestädt, Ralf

2015-02-28

Adverse drug reactions are one of the most common causes of death in industrialized Western countries. Nowadays, empirical data from clinical studies for the approval and monitoring of drugs and molecular databases is available. The integration of database information is a promising method for providing well-based knowledge to avoid adverse drug reactions. This paper presents our web-based decision support system GraphSAW which analyzes and evaluates drug interactions and side effects based on data from two commercial and two freely available molecular databases. The system is able to analyze single and combined drug-drug interactions, drug-molecule interactions as well as single and cumulative side effects. In addition, it allows exploring associative networks of drugs, molecules, metabolic pathways, and diseases in an intuitive way. The molecular medication analysis includes the capabilities of the upper features. A statistical evaluation of the integrated data and top 20 drugs concerning drug interactions and side effects is performed. The results of the data analysis give an overview of all theoretically possible drug interactions and side effects. The evaluation shows a mismatch between pharmaceutical and molecular databases. The concordance of drug interactions was about 12% and 9% of drug side effects. An application case with prescribed data of 11 patients is presented in order to demonstrate the functionality of the system under real conditions. For each patient at least two interactions occured in every medication and about 8% of total diseases were possibly induced by drug therapy. GraphSAW (http://tunicata.techfak.uni-bielefeld.de/graphsaw/) is meant to be a web-based system for health professionals and researchers. GraphSAW provides comprehensive drug-related knowledge and an improved medication analysis which may support efforts to reduce the risk of medication errors and numerous drastic side effects.

Review: Modelling of meniscus of knee joint during soccer kicking

NASA Astrophysics Data System (ADS)

Azrul Hisham Mohd Adib, Mohd; Firdaus Jaafar, Mohd

2013-12-01

Knee is a part of the body that located between thigh and shank is one of the most complicated and largest joints in the human body. The common injuries that occur are ligaments, meniscus or bone fracture. During soccer games, the knee is the most critical part that will easily injure due to the shock from an external impact. Torn meniscus is one of the effects. This study will investigate the effect towards the meniscus within the knee joint during soccer ball kicking. We conduct a literary review of 14 journals that discuss the general view of meniscus and also soccer kicking. The selected topics for this review paper are meniscal function, meniscal movement, meniscal tears and also instep kick. As a finding, statistics show that most meniscal tears (73%) occurred in athletes who were soccer players, basketball players or skiers. The tear is frequently happening at the medial side rather than lateral side with a percentage of 70%.

Systemic hypertension and the right-sided cardiovascular system: a review of the available evidence.

PubMed

Pedrinelli, Roberto; Dell'Omo, Giulia; Talini, Enrica; Canale, Maria Laura; Di Bello, Vitantonio

2009-02-01

Abnormal vasoconstriction of the lesser circulation characterizes a subset of patients with essential hypertension, a possible effect of mechanisms, such as enhanced sympathetic tone, increased delivery of blood-borne vasoconstrictor substances or abnormal local release of vasoactive factors, acting on both sides of the circulation or to backward transmission of increased pressure due to stiffer left ventricles with more advanced diastolic dysfunction. Elevated systemic pressure also associates with thickening of the right ventricle, a central element of the low-pressure system. Right ventricular remodelling develops in parallel with a similar process occurring at the left side, likely as a result of ventricular interdependence under the influence of trophic factors targeting both ventricles, though other mechanisms, including increased pulmonary afterload, may also be operative. By and large independent of the extent of structural remodelling of both ventricles, systemic hypertension also conditions an impaired filling rate of the right ventricle that accompanies a similar phenomenon at the left side. Thus, quite in contrast with the common and simplistic assumption of a separate behaviour of the two ventricles, the right-sided cardiovascular system is not immune to the effect of systemic hypertension, a concept whose clinical and pathophysiological implications require further studies.

Psychosis induced by the interaction between disulfiram and methylphenidate may be dose dependent.

PubMed

Grau-López, Lara; Roncero, Carlos; Navarro, Maria C; Casas, Miquel

2012-01-01

There are few studies describing psychiatric symptoms occurring when methylphenidate and disulfiram are used together. The authors report a case of disulfiram and methylphenidate interaction in which psychotic symptoms could be dose dependent. The patient, diagnosed of alcohol and cocaine dependence and attention deficit hyperactivity disorder (ADHD), started treatment with methylphenidate increasing doses and disulfiram 250 mg/day over 4 weeks. During the first 2 weeks at doses of 36 mg/day of methylphenidate and maintaining disulfiram, side effects were not observed. However, by increasing to 54 mg/day, psychotic symptoms were detected. The authors reported that the effects are dose dependent. This is the first report about dose-dependent side effects in substance use disorder with ADHD.

[Therapy of intermediate uveitis].

PubMed

Doycheva, D; Deuter, C; Zierhut, M

2014-12-01

Intermediate uveitis is a form of intraocular inflammation in which the vitreous body is the major site of inflammation. Intermediate uveitis is primarily treated medicinally and systemic corticosteroids are the mainstay of therapy. When recurrence of uveitis or side effects occur during corticosteroid therapy an immunosuppressive treatment is required. Cyclosporine A is the only immunosuppressive agent that is approved for therapy of uveitis in Germany; however, other immunosuppressive drugs have also been shown to be effective and well-tolerated in patients with intermediate uveitis. In severe therapy-refractory cases when conventional immunosuppressive therapy has failed, biologics can be used. In patients with unilateral uveitis or when the systemic therapy is contraindicated because of side effects, an intravitreal steroid treatment can be carried out. In certain cases a vitrectomy may be used.

Movement side effects of antipsychotic drugs in adults with and without intellectual disability: UK population-based cohort study.

PubMed

Sheehan, Rory; Horsfall, Laura; Strydom, André; Osborn, David; Walters, Kate; Hassiotis, Angela

2017-08-03

To measure the incidence of movement side effects of antipsychotic drugs in adults with intellectual disability and compare rates with adults without intellectual disability. Cohort study using data from The Health Improvement Network. UK primary care. Adults with intellectual disability prescribed antipsychotic drugs matched to a control group of adults without intellectual disability prescribed antipsychotic drugs. New records of movement side effect including acute dystonias, akathisia, parkinsonism, tardive dyskinaesia and neuroleptic malignant syndrome. 9013 adults with intellectual disability and a control cohort of 34 242 adults without intellectual disability together contributed 148 709 person-years data. The overall incidence of recorded movement side effects was 275 per 10 000 person-years (95% CI 256 to 296) in the intellectual disability group and 248 per 10 000 person-years (95% CI 237 to 260) in the control group. The incidence of any recorded movement side effect was significantly greater in people with intellectual disability compared with those without (incidence rate ratio 1.30, 95% CI 1.18 to 1.42, p<0.001, after adjustment for potential confounders), with parkinsonism and akathisia showing the greatest difference between the groups. Neuroleptic malignant syndrome, although occurring infrequently, was three times more common in people with intellectual disability-prescribed antipsychotic drugs (incidence rate ratio 3.03, 95% CI 1.26 to 7.30, p=0.013). Differences in rates of movement side effects between the groups were not due to differences in the proportions prescribed first and second-generation antipsychotic drugs. This study provides evidence to substantiate the long-held assumption that people with intellectual disability are more susceptible to movement side effects of antipsychotic drugs. Assessment for movement side effects should be integral to antipsychotic drug monitoring in people with intellectual disability. Regular medication review is essential to ensure optimal prescribing in this group. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Numerical simulation of steady state three-dimensional groundwater flow near lakes

USGS Publications Warehouse

Winter, Thomas C.

1978-01-01

Numerical simulation of three-dimensional groundwater flow near lakes shows that the continuity of the boundary encompassing the local groundwater flow system associated with a lake is the key to understanding the interaction of a lake with the groundwater system. The continuity of the boundary can be determined by the presence of a stagnation zone coinciding with the side of the lake nearest the downgradient side of the groundwater system. For most settings modeled in this study the stagnation zone underlies the lakeshore, and it generally follows its curvature. The length of the stagnation zone is controlled by the geometry of the lake's drainage basin divide on the side of the lake nearest the downgradient side of the groundwater system. In the case of lakes that lose water to the groundwater system, three-dimensional modeling also allows for estimating the area of lake bed through which outseepage takes place. Analysis of the effects of size and lateral and vertical distribution of aquifers within the groundwater system on the outseepage from lakes shows that the position of the center point of the aquifer relative to the littoral zone on the side of the lake nearest the downgradient side of the groundwater system is a critical factor. If the center point is downslope from this part of the littoral zone, the local flow system boundary tends to be weak or outseepage occurs. If the center point is upslope from this littoral zone, the stagnation zone tends to be stronger (to have a higher head in relation to lake level), and outseepage is unlikely to occur.

Herbs in dentistry.

PubMed

Taheri, Jamile B; Azimi, Somayyeh; Rafieian, Nasrin; Zanjani, Hosein Akhavan

2011-12-01

Herbs have been used for centuries to prevent and control disease. Herbal extracts are effective because they interact with specific chemical receptors within the body and are in a pharmacodynamic sense, drugs themselves. By using herbal medicines, patients have averted the many side effects that generally come with traditional medicines, but this does not mean that side effects do not occur. Only knowledgeable practitioners can prescribe the right herb and its proper dosage. Herbal medicines had been considered in every culture, however, pharmaceutical companies overturned this type of thinking. Now, pharmaceuticals are called traditional and herbs are libeled as the 'alternative'. The biggest challenge and problem is lack of information about the effect of herbs in oral tissues, mechanism of effect, and side effects. Several popular conventional drugs on the market are derived from herbs. These include aspirin (from white willow bark), digitalis (from foxglove), and sudafed (modelled after a component in the plant ephedra). Herbal products can vary in their potency. Therefore, care must be taken in selecting herbs, even so, herbal medicines have dramatically fewer side effects and are safer to use than conventional medications. The herbs described in this article are Bloodroot, Caraway, Chamomile, Echinacea, Myrrh, Peppermint, Rosemary, Sage, Thyme, Aloe Vera, Propolis, and a summary of other herbs that are useful in dentistry. Herbs may be good alternatives to current treatments for oral health problems but it is clear that we need more research. © 2011 FDI World Dental Federation.

Simulator study of the effect of visual-motion time delays on pilot tracking performance with an audio side task

NASA Technical Reports Server (NTRS)

Riley, D. R.; Miller, G. K., Jr.

1978-01-01

The effect of time delay was determined in the visual and motion cues in a flight simulator on pilot performance in tracking a target aircraft that was oscillating sinusoidally in altitude only. An audio side task was used to assure the subject was fully occupied at all times. The results indicate that, within the test grid employed, about the same acceptable time delay (250 msec) was obtained for a single aircraft (fighter type) by each of two subjects for both fixed-base and motion-base conditions. Acceptable time delay is defined as the largest amount of delay that can be inserted simultaneously into the visual and motion cues before performance degradation occurs. A statistical analysis of the data was made to establish this value of time delay. Audio side task provided quantitative data that documented the subject's work level.

Acute hemifacial dystonia possibly induced by clebopride.

PubMed

Bosco, Domenico; Plastino, Massimiliano; Marcello, Maria Giovanna; Mungari, Pasquale; Fava, Antonietta

2009-01-01

Dystonic reactions produce twisting and repetitive movements or abnormal posturing. Severe dystonic reactions have been shown to occur in concert with numerous medications. This report details the case of a patient who developed hemifacial dystonia as acute side reaction from administration of clebopride for dyspeptic prophylaxis. When the drug was immediately stopped, the dystonic posture disappeared completely within 2 weeks. The use of clebopride may be associated with not only a reversible or persistent parkinsonism syndrome but also hemifacial dystonia; therefore, attention must be drawn to this possible side effect.

The macroeconomics of demographic unemployment.

PubMed

Carlberg, M

1990-02-01

"What are the macroeconomic consequences of an increase in labour supply? In the short run, unemployment occurs, due to both lack of aggregate demand and capital shortage. Demand-side policy and money wage restraint prove to be ineffective in this situation, owing to capital shortage. On the other hand, a reduction in working hours without wage compensation as well as a policy mix of both demand-side policy and investment policy turn out to be effective. The reduction in working hours lowers individual income and raises individual leisure, as compared to the policy mix." (SUMMARY IN GER) excerpt

Life-threatening complications of ibogaine: three case reports.

PubMed

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

2012-11-01

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

Do peak torque angles of muscles change following anterior cruciate ligament reconstruction using hamstring or patellar tendon graft?

PubMed

Yosmaoğlu, Hayri Baran; Baltacı, Gül; Sönmezer, Emel; Özer, Hamza; Doğan, Deha

2017-12-01

This study aims to compare the effects of anterior cruciate ligament (ACL) reconstruction using autogenous hamstring or patellar tendon graft on the peak torque angle. The study included 132 patients (103 males, 29 females; mean age 29±9 year) who were performed ACL reconstruction with autogenous hamstring or patellar tendon graft. The peak torque angles in the quadriceps and hamstring muscles were recorded using an isokinetic dynamometer. Angle of peak knee flexion torque occurred significantly earlier within the range of motion on the operated side than nonoperated side at 180°/second in the hamstring tendon group. Angle of peak knee extension torque occurred significantly earlier within the range of motion on the operated side than nonoperated side at 180°/second in the patellar tendon group. There were no statistically significant differences in the flexion and extension peak torque angles between the operated and nonoperated knees at 60°/second in both groups. The angle of peak torque at relatively high angular velocities is affected after ACL reconstruction in patients with hamstring or patellar tendon grafts. The graft donor site directly influences this parameter. This finding may be important for clinicians in terms of preventing re-injury.

Dark side of predation: Blind side in biocontrol research

USDA-ARS?s Scientific Manuscript database

Predation of pests by arthopod predators (insects and spiders) occurs around the clock. Yet little effort has been made to characterize the 24-hour pattern of predation on insect pests in the field, particularly events that occur nocturnally. The few round-the-clock observations in various ecosyst...

Demarcating Circulation Regimes of Synchronously Rotating Terrestrial Planets within the Habitable Zone

NASA Astrophysics Data System (ADS)

Haqq-Misra, Jacob; Wolf, Eric. T.; Joshi, Manoj; Zhang, Xi; Kopparapu, Ravi Kumar

2018-01-01

We investigate the atmospheric dynamics of terrestrial planets in synchronous rotation within the habitable zone of low-mass stars using the Community Atmosphere Model. The surface temperature contrast between the day and night hemispheres decreases with an increase in incident stellar flux, which is opposite the trend seen in gas giants. We define three dynamical regimes in terms of the equatorial Rossby deformation radius and the Rhines length. The slow rotation regime has a mean zonal circulation that spans from the day to the night sides, which occurs for planets around stars with effective temperatures of 3300–4500 K (rotation period > 20 days), with both the Rossby deformation radius and the Rhines length exceeding the planetary radius. Rapid rotators have a mean zonal circulation that partially spans a hemisphere and with banded cloud formation beneath the substellar point, which occurs for planets orbiting stars with effective temperatures of less than 3000 K (rotation period < 5 days), with the Rossby deformation radius less than the planetary radius. In between is the Rhines rotation regime, which retains a thermally direct circulation from the day side to the night side but also features midlatitude turbulence-driven zonal jets. Rhines rotators occur for planets around stars in the range of 3000–3300 K (rotation period ∼5–20 days), where the Rhines length is greater than the planetary radius but the Rossby deformation radius is less than the planetary radius. The dynamical state can be observationally inferred from a comparison of the morphologies of the thermal emission phase curves of synchronously rotating planets.

Special coverage of 41st IDSA conference. Study: Syphilitic hepatitis connected to liver disease. Diagnosis is uncommon, but does occur.

PubMed

2003-12-01

Investigators in Washington, DC, have discovered cases of HIV patients who have significant liver dysfunction that is caused by secondary syphilis instead of the usual suspects--hepatitis C, medication side effects, and substance abuse.

Left Sided Amyand's Hernia, A Rare Occurance: A Case Report.

PubMed

Ravishankaran, Praveen; Mohan, G; Srinivasan, A; Ravindran, G; Ramalingam, A

2013-06-01

This is a case report about a 35 year old man admitted with complains of obstructed left sided inguinal hernia. On exploration of the left inguinal canal to our surprise a normal appendix was found in addition to a gangrenous omentum. Resection of the gangrenous omentum was done. Appendectomy was done. This case is reported for its rare occurance as only three such cases of left sided amyand's hernia has been reported so far in literature[4-6].

Sequential segmental terminal lenticular side-cut dissection for safe and effective small-incision lenticule extraction in thin lenticules.

PubMed

Jacob, Soosan; Agarwal, Amar; Mazzotta, Cosimo; Agarwal, Athiya; Raj, John Michael

2017-04-01

Small-incision lenticule extraction may be associated with complications such as partial lenticular dissection, torn lenticule, lenticular adherence to cap, torn cap, and sub-cap epithelial ingrowth, some of which are more likely to occur during low-myopia corrections. We describe sequential segmental terminal lenticular side-cut dissection to facilitate minimally traumatic and smooth lenticular extraction. Anterior lamellar dissection is followed by central posterior lamellar dissection, leaving a thin peripheral rim and avoiding the lenticular side cut. This is followed by sequential segmental dissection of the lenticular side cut in a manner that fixates the lenticule and provides sufficient resistance for smooth and complete dissection of the posterior lamellar cut without undesired movements of the lenticule. The technique is advantageous in thin lenticules, where the risk for complications is high, but can also be used in thick lenticular dissection using wider sweeps to separate the lenticular side cut sequentially. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Assessment of the efficacy and safety of a combination of 2 topical retinoids (RetinSphere) in maintaining post-treatment response of acne to oral isotretinoin.

PubMed

Truchuelo, M T; Jiménez, N; Mavura, D; Jaén, P

2015-03-01

The high rate of relapse of acne lesions following oral isotretinoin treatment is a common problem which remains unsolved. To avoid or minimize relapses, topical retinoids have been used for many years as maintenance treatment. However, adverse effects frequently occur. To determine the efficacy and safety of a new retinoid combination (Retinsphere technology) in maintaining post-treatment response to oral isotretinoin. Prospective, randomized, double-blind and vehicle-controlled study of 30 patients with acne previously treated with isotretinoin. Treatment with the retinoid combination was applied to one side of the face and vehicle was applied to the other, once daily, for 3 months. Standardized photographs were taken using RBX technology at baseline, 1.5 months and 3 months. The primary efficacy endpoint was the appearance of relapse on the treated side compared to the vehicle-treated side. Other endpoints included lesion count, investigator-reported improvement, patient-reported improvement, impact on quality-of-life, and side effects. Although the majority of patients did not reach the total target dose of oral isotretinoin, the relapse rate was significantly lower on the retinoid-treated side compared to the vehicle-treated side. Likewise, improved lesion count and excellent tolerance were observed. This new retinoid combination (Retinsphere technology) were effective and safe as maintenance therapy after post-treatment response to oral isotretinoin in patients with acne. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

Summary of geologic effects of the Boxcar event, Nevada Test Site

USGS Publications Warehouse

Dickey, Dayton Delbert; McKeown, F.A.; Ellis, William L.

1969-01-01

A high-yield underground nuclear explosion at the U20i site, formed a sink 1,000 feet in diameter above the explosion point. Fractures opened as far as 20,000 feet from the explosion and rock-falls occurred as far as 15 miles. Most fractures were coincidental with north-trending naturally occurring faults. Maximum displacement along a fault was 3 feet vertically with the downthrown side the same as that on the original fault.

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

Riggs, J.B.

An experimental test model, which is dynamically similar to an actual UCC (Underground Coal Conversion) system, was used to determine fluid-flow patterns and local heat transfer that occur in the UCC burn cavity. This study was designed to provide insight into the little understood mechanisms (i.e., heat transfer and oxygen transport to the cavity walls) that control maximum cavity width, and therefore resource recovery during UCC. The experimental studies will be designed to study the effects of a growing cavity upon the transport to the side walls of a UCG cavity. The flow model will be used to study themore » effects of rubble pile shape changes upon the transport to the side walls.« less

Herbs and nutrients in the treatment of depression, anxiety, insomnia, migraine, and obesity.

PubMed

Brown, R P; Gerbarg, P L

2001-03-01

Although a multitude of pharmaceutical agents are available for the treatment of mood disorders, anxiety and insomnia, many patients have difficulty tolerating the side effects, do not respond adequately, or eventually lose their response. Many therapeutic herbs and nutrients have far fewer side effects and may provide an alternative treatment or can be used to enhance the effect of prescription medications. In the article, the authors review the quality of the evidence supporting the clinical effects of a number of commonly used types of complementary/alternative medicine (CAM) for mood disorders, anxiety, and insomnia. They review data on the use of St. John's Wort, S-adenosyl-methionine (SAM-e), B vitamins, inositol, omega-3 fatty acids, and choline for mood disorders; data on the use of kava and other herbal agents and fish extract for anxiety and insomnia; and data on valerian and melatonin for insomnia. The authors also discuss the use of CAM to treat migraines, which may be comorbid with mood and anxiety disorders, and obesity, which can occur as a side effect of psychotropic medications. They consider the data on feverfew and butterbur for migraines and on chromium picolinate and the combination of ephedrine and caffeine for obesity. The authors also review issues related to comorbid medical illness, side effects, drug interactions, dosage, and brand selection.

Infantile hemangioma: treatment with short course systemic corticosteroid therapy as an alternative for propranolol.

PubMed

Nieuwenhuis, Klaske; de Laat, Peter C J; Janmohamed, Sherief R; Madern, Gerard C; Oranje, Arnold P

2013-01-01

Infantile hemangiomas (IHs) are increasingly being treated with propranolol or other beta-blockers, but before this therapeutic option was available, oral glucocorticosteroids (GCSs) were the criterion standard treatment and are still the alternative modality in problematic cases. Nevertheless, there is no standard treatment protocol for the dose and duration of GCSs. Long-term treatment with GCSs is associated with unwanted side effects such as growth suppression, behavioral changes, and reflux. Twenty-one children with troublesome IHs were treated according to an algorithm with 3 mg/kg/day of oral prednisolone divided three times per day with varying duration and number of GCS courses. Two blinded investigators independently interpreted therapy results using the Hemangioma Activity Score (HAS). Side effects were determined according to reports in patient charts and parental questionnaires. The median duration of a short course of GCSs was 2 weeks (range 1-6 weeks). The number of courses was 2 (range 1-5). The median cumulative dose was 91 mg/kg. Growth stabilized in all patients, with a good response (>50% reduction in HAS) in 62% and a favorable response (30-50% reduction is HAS) in 23%. Twelve of the 21 children (57%) had minor side effects. Persistent side effects did not occur. Intermittent short course, systemic, high-dose GCS therapy is an effective and safe treatment modality for IH, with a substantially lower cumulative dose of GCSs compared to prolonged therapy and no major side effects. This treatment is an alternative in cases in which propranolol fails or is contraindicated. © 2012 Wiley Periodicals, Inc.

Spin-bowling in cricket re-visited: model trajectories for various spin-vector angles

NASA Astrophysics Data System (ADS)

Robinson, Garry; Robinson, Ian

2016-08-01

In this paper we investigate, via the calculation of model trajectories appropriate to slow bowling in cricket, the effects on the flight path of the ball before pitching due to changes in the angle of the spin-vector. This was accomplished by allowing the spin-vector to vary in three ways. Firstly, from off-spin, where the spin-vector points horizontally and directly down the pitch, to top-spin where it points horizontally towards the off-side of the pitch. Secondly, from off-spin to side-spin where, for side-spin, the spin-vector points vertically upwards. Thirdly, where the spin-vector points horizontally and at 45° to the pitch (in the general direction of ‘point’, as viewed by the bowler), and is varied towards the vertical, while maintaining the 45° angle in the horizontal plane. It is found that, as is well known, top-spin causes the ball to dip in flight, side-spin causes the ball to move side-ways in flight and, perhaps most importantly, off-spin can cause the ball to drift to the off-side of the pitch late in its flight as it begins to fall. At a more subtle level it is found that, if the total spin is kept constant and a small amount of top-spin is added to the ball at the expense of some off-spin, there is little change in the side-ways drift. However, a considerable reduction in the length at which the ball pitches occurs, ˜25 cm, an amount that batsmen can ignore at their peril. On the other hand, a small amount of side-spin introduced to a top-spin delivery does not alter the point of pitching significantly, but produces a considerable amount of side-ways drift, ˜10 cm or more. For pure side-spin the side-ways drift is up to ˜30 cm. When a side-spin component is added to the spin of a ball bowled with a mixture of off-spin and top-spin in equal proportions, significant movement occurs in both the side-ways direction and in the point of pitching, of the order of a few tens of centimetres.

Do patients with chronic unilateral orofacial pain due to a temporomandibular disorder show increased attending to somatosensory input at the painful side of the jaw?

PubMed

Van Damme, Stefaan; Vanden Bulcke, Charlotte; Van Den Berghe, Linda; Poppe, Louise; Crombez, Geert

2018-01-01

Patients with chronic orofacial pain due to temporomandibular disorders (TMD) display alterations in somatosensory processing at the jaw, such as amplified perception of tactile stimuli, but the underlying mechanisms remain unclear. This study investigated one possible explanation, namely hypervigilance, and tested if TMD patients with unilateral pain showed increased attending to somatosensory input at the painful side of the jaw. TMD patients with chronic unilateral orofacial pain ( n  = 20) and matched healthy volunteers ( n  = 20) performed a temporal order judgment (TOJ) task indicated which one of two tactile stimuli, presented on each side of the jaw, they had perceived first. TOJ methodology allows examining spatial bias in somatosensory processing speed. Furthermore, after each block of trials, the participants rated the perceived intensity of tactile stimuli separately for both sides of the jaw. Finally, questionnaires assessing pain catastrophizing, fear-avoidance beliefs, and pain vigilance, were completed. TMD patients tended to perceive tactile stimuli at the painful jaw side as occurring earlier in time than stimuli at the non-painful side but this effect did not reach conventional levels of significance ( p  = .07). In the control group, tactile stimuli were perceived as occurring simultaneously. Secondary analyses indicated that the magnitude of spatial bias in the TMD group is positively associated with the extent of fear-avoidance beliefs. Overall, intensity ratings of tactile stimuli were significantly higher in the TMD group than in the control group, but there was no significant difference between the painful and non-painful jaw side in the TMD patients. The hypothesis that TMD patients with chronic unilateral orofacial pain preferentially attend to somatosensory information at the painful side of the jaw was not statistically supported, although lack of power could not be ruled out as a reason for this. The findings are discussed within recent theories of pain-related attention.

Preliminary studies into the effects of the human pharmaceutical Clofibric acid on sperm parameters in adult Fathead minnow.

PubMed

Runnalls, Tamsin J; Hala, David N; Sumpter, John P

2007-08-15

The effects of Clofibric acid (a persistent environmental metabolite of Clofibrate, a human pharmaceutical), on Fathead minnows were studied. Fibrates are used to prevent cardiovascular disease through their antilipidemic activity. In a series of experiments, in which fish were exposed to waterborne Clofibric acid, no convincing, reproducible antilipidemic effects were observed. In contrast, in three separate experiments, Clofibric acid affected the reproductive axis of fish. Spermatogenesis was apparently impaired, leading to a marked reduction in sperm count in two of the three experiments. Various measures of sperm motility were also reduced, although only significantly so at the highest concentration of Clofibric acid tested (1mg/L). There were also indications that plasma androgen concentrations were reduced. These effects of Clofibric acid on the reproductive axis of fish are similar to those that occur in some mammals as a side-effect of the drug. Taken together, a weight-of-evidence argument would suggest that the main discernable effect of Clofibric acid on fish is likely to be a reproductive, not an antilipidemic, one. Although some of these reproductive effects of Clofibric acid occurred only at a high concentration (1mg/L), others occurred at lower concentrations (microg/litre), near or similar to those reported in the aquatic environment (ng to low microg/litre range). Although we recognise that this is not a definitive study of the effects of Clofibric acid on fish reproduction, the results strongly suggest that Clofibric acid could adversely affect sperm parameters and androgen concentrations in adult Fathead minnows. Further studies are warranted. This may be an example of a drug in which an accidentally discovered side-effect found in mammals turns out to be the most important effect in a different vertebrate group, namely fish.

Phase separation of comb polymer nanocomposite melts.

PubMed

Xu, Qinzhi; Feng, Yancong; Chen, Lan

2016-02-07

In this work, the spinodal phase demixing of branched comb polymer nanocomposite (PNC) melts is systematically investigated using the polymer reference interaction site model (PRISM) theory. To verify the reliability of the present method in characterizing the phase behavior of comb PNCs, the intermolecular correlation functions of the system for nonzero particle volume fractions are compared with our molecular dynamics simulation data. After verifying the model and discussing the structure of the comb PNCs in the dilute nanoparticle limit, the interference among the side chain number, side chain length, nanoparticle-monomer size ratio and attractive interactions between the comb polymer and nanoparticles in spinodal demixing curves is analyzed and discussed in detail. The results predict two kinds of distinct phase separation behaviors. One is called classic fluid phase boundary, which is mediated by the entropic depletion attraction and contact aggregation of nanoparticles at relatively low nanoparticle-monomer attraction strength. The second demixing transition occurs at relatively high attraction strength and involves the formation of an equilibrium physical network phase with local bridging of nanoparticles. The phase boundaries are found to be sensitive to the side chain number, side chain length, nanoparticle-monomer size ratio and attractive interactions. As the side chain length is fixed, the side chain number has a large effect on the phase behavior of comb PNCs; with increasing side chain number, the miscibility window first widens and then shrinks. When the side chain number is lower than a threshold value, the phase boundaries undergo a process from enlarging the miscibility window to narrowing as side chain length increases. Once the side chain number overtakes this threshold value, the phase boundary shifts towards less miscibility. With increasing nanoparticle-monomer size ratio, a crossover of particle size occurs, above which the phase separation is consistent with that of chain PNCs. The miscibility window for this condition gradually narrows while the other parameters of the PNCs system are held constant. These results indicate that the present PRISM theory can give molecular-level details of the underlying mechanisms of the comb PNCs. It is hoped that the results can be used to provide useful guidance for the future design control of novel, thermodynamically stable comb PNCs.

Operational Resilience For 2040

DTIC Science & Technology

2014-04-01

changes and disruptions occur for both sides. This force will achieve an “ antifragile ” response in relative effectiveness. Antifragile , a term coined...by Nassim Taleb, is defined as something that benefits from shocks, volatility, randomness, disorder, and stressors.23 The antifragile response...21. 12. Taleb, Antifragile , 5. 13. Joint Operational Access Concept, ii. 14

Evaluating Observational Learning in a Competitive Two-Sided Crowdsourcing Market: A Bayesian Inferential Approach

ERIC Educational Resources Information Center

Ayaburi, Emmanuel Wusuhon Yanibo

2017-01-01

This dissertation investigates the effect of observational learning in crowdsourcing markets as a lens to identify appropriate mechanism(s) for sustaining this increasingly popular business model. Observational learning occurs when crowdsourcing participating agents obtain knowledge from signals they observe in the marketplace and incorporate such…

16 CFR 1301.3 - Findings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... containers, refuse bins, buckets, boxes or hoppers, with actual internal volumes of one cubic yard or greater... containers indicate that most accidents have occurred with slant-sided metal refuse bins which are used by.... 20207. (c) Need of the public for the product and effects on utility, cost, and availability. (1) The...

Flagellate dermatitis after consumption of Shiitake mushrooms

PubMed Central

Kreft, Burkhard; Marsch, Wolfgang Ch.

2014-01-01

Flagellate dermatitis occurs in patients who have eaten Shiitake mushrooms. We are reporting on a 55-year-old man, who developed whiplash-striped, severely itching efflorescences on the trunk 3 days after eating Lentinula edodes. Flagellate dermatitis is also known as a cutaneous side effect of bleomycin therapy. PMID:25097492

Comparison of therapeutic effects of liposomal Tranexamic Acid and conventional Hydroquinone on melasma.

PubMed

Banihashemi, Mahnaz; Zabolinejad, Naghmeh; Jaafari, Mahmoud Reza; Salehi, Maryam; Jabari, Asma

2015-09-01

Melasma is one of the most common cosmetic disorders with skin darkening. Although several treatment modalities are available, none is satisfactorily used in management of this condition. Tranexamic acid (TA), a plasmin inhibitor, is reported to improve melasma when injected locally or used as oral and topical forms. The aim of this study was to compare therapeutic effects of liposomal tranexamic acid and conventional hydroquinone on melasma. Thirty women with bilateral melasma were enrolled in a split-face trial lasting 12 weeks. Patients blindly applied 5% topical liposomal TA and 4% hydroquinone cream, to the designated sides of the face twice daily in addition to the assigned sunscreen in the morning. Skin pigmentation was measured using MASI (Melasma Area and Severity Index) at each visit separately for each side at the base line and every month until one month after treatment course. Data were obtained from patients file and were analyzed statistically using SPSS software, paired samples t-test, and repeated measured ANOVA. Twenty-three patients completed the study. The mean MASI scores significantly reduced in both treated sides (P < P = 0.001) after 12 week. A greater decrease was observed with 5% liposomal TA, although this difference was not statistically significant. Irritation occurred in three patients with hydroquinone, while no serious adverse events occurred with TA. On the basis of these results, topical liposomal TA can be used as a new, effective, safe, and promising therapeutic agent in melasma. © 2015 Wiley Periodicals, Inc.

Efficient immunization strategies to prevent financial contagion

NASA Astrophysics Data System (ADS)

Kobayashi, Teruyoshi; Hasui, Kohei

2014-01-01

Many immunization strategies have been proposed to prevent infectious viruses from spreading through a network. In this work, we study efficient immunization strategies to prevent a default contagion that might occur in a financial network. An essential difference from the previous studies on immunization strategy is that we take into account the possibility of serious side effects. Uniform immunization refers to a situation in which banks are ``vaccinated'' with a common low-risk asset. The riskiness of immunized banks will decrease significantly, but the level of systemic risk may increase due to the de-diversification effect. To overcome this side effect, we propose another immunization strategy, called counteractive immunization, which prevents pairs of banks from failing simultaneously. We find that counteractive immunization can efficiently reduce systemic risk without altering the riskiness of individual banks.

Using aggregated, de-identified electronic health record data for multivariate pharmacosurveillance: a case study of azathioprine.

PubMed

Patel, Vishal N; Kaelber, David C

2014-12-01

To demonstrate the use of aggregated and de-identified electronic health record (EHR) data for multivariate post-marketing pharmacosurveillance in a case study of azathioprine (AZA). Using aggregated, standardized, normalized, and de-identified, population-level data from the Explore platform (Explorys, Inc.) we searched over 10 million individuals, of which 14,580 were prescribed AZA based on RxNorm drug orders. Based on logical observation identifiers names and codes (LOINC) and vital sign data, we examined the following side effects: anemia, cell lysis, fever, hepatotoxicity, hypertension, nephrotoxicity, neutropenia, and neutrophilia. Patients prescribed AZA were compared to patients prescribed one of 11 other anti-rheumatologic drugs to determine the relative risk of side effect pairs. Compared to AZA case report trends, hepatotoxicity (marked by elevated transaminases or elevated bilirubin) did not occur as an isolated event more frequently in patients prescribed AZA than other anti-rheumatic agents. While neutropenia occurred in 24% of patients (RR 1.15, 95% CI 1.07-1.23), neutrophilia was also frequent (45%) and increased in patients prescribed AZA (RR 1.28, 95% CI 1.22-1.34). After constructing a pairwise side effect network, neutropenia had no dependencies. A reduced risk of neutropenia was found in patients with co-existing elevations in total bilirubin or liver transaminases, supporting classic clinical knowledge that agranulocytosis is a largely unpredictable phenomenon. Rounding errors propagated in the statistically de-identified datasets for cohorts as small as 40 patients only contributed marginally to the calculated risk. Our work demonstrates that aggregated, standardized, normalized and de-identified population level EHR data can provide both sufficient insight and statistical power to detect potential patterns of medication side effect associations, serving as a multivariate and generalizable approach to post-marketing drug surveillance. Copyright © 2013 Elsevier Inc. All rights reserved.

Prevention of palmar-plantar erythrodysesthesia with an antiperspirant in breast cancer patients treated with pegylated liposomal doxorubicin (SAKK 92/08).

PubMed

Templeton, Arnoud J; Ribi, Karin; Surber, Christian; Sun, Hong; Hsu Schmitz, Shu-Fang; Beyeler, Michael; Dietrich, Daniel; Borner, Markus; Winkler, Annette; Müller, Andreas; von Rohr, Lukas; Winterhalder, Ralph C; Rochlitz, Christoph; von Moos, Roger; Zaman, Khalil; Thürlimann, Beat J K; Ruhstaller, Thomas

2014-06-01

Elevated concentrations of doxorubicin are found in eccrine sweat glands of the palms and soles. We therefore evaluated an antiperspirant as preventive treatment for palmar-plantar erythrodysesthesia (hand-foot syndrome) in patients with metastatic breast cancer treated with pegylated liposomal doxorubicin. An antiperspirant containing aluminum chlorohydrate or placebo cream was applied to the left or right hand and foot in a double-blinded manner (intra-patient randomization). The primary endpoint was the rate of grade 2 or 3 palmar-plantar erythrodysesthesia. A secondary endpoint was the patient-reported symptom burden (tingling, numbness, pain, or skin problems). Using McNemar's matched pairs design, 53 patients were needed to detect a 20% difference between the treatment and placebo sides with a significance level of 5% and power of 90%. Grade 2 or 3 PPE occurred in 30 (58%) of 52 evaluable patients; in six patients adverse effects occurred on the placebo side but not on the treatment side, whereas one patient developed palmar-plantar erythrodysesthesia on the treatment side only (P = 0.07). Four patients developed grade 2 or 3 palmar-plantar erythrodysesthesia on their foot on the placebo side but not on the treatment side (P = 0.05). In the cohort with grade 2 or 3 palmar-plantar erythrodysesthesia there was a trend towards fewer dermatologic symptomatologies with the active treatment (P = 0.05), and no difference for other adverse events. Using topical aluminum chlorohydrate as an antiperspirant appears to reduce the incidence of grade 2 or 3 palmar-plantar erythrodysesthesia following pegylated liposomal doxorubicin chemotherapy for metastatic breast cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

The effect of acute hypoxia on short-circuit current and epithelial resistivity in biopsies from human colon.

PubMed

Carra, Graciela E; Ibáñez, Jorge E; Saraví, Fernando D

2013-09-01

In isolated colonic mucosa, decreases in short-circuit current (ISC) and transepithelial resistivity (RTE) occur when hypoxia is either induced at both sides or only at the serosal side of the epithelium. We assessed in human colon biopsies the sensitivity to serosal-only hypoxia and mucosal-only hypoxia and whether Na, K-ATPase blockade with ouabain interacts with hypoxia. Biopsy material from patients undergoing colonoscopy was mounted in an Ussing chamber for small samples (1-mm2 window). In a series of experiments we assessed viability and the electrical response to the mucolytic, dithiothreitol (1 mmol/l). In a second series, we explored the effect of hypoxia without and with ouabain. In a third series, we evaluated the response to a cycle of hypoxia and reoxygenation induced at the serosal or mucosal side while keeping the oxygenation of the opposite side. 1st series: Dithiothreitol significantly decreased the unstirred layer and ISC but increased RTE. 2nd series: Both hypoxia and ouabain decreased ISC, but ouabain increased RTE and this effect on RTE prevailed even during hypoxia. 3rd series: Mucosal hypoxia caused lesser decreases of ISC and RTE than serosal hypoxia; in the former, but not in the latter, recovery was complete upon reoxygenation. In mucolytic concentration, dithiothreitol modifies ISC and RTE. Oxygen supply from the serosal side is more important to sustain ISC and RTE in biopsy samples. The different effect of hypoxia and Na, K-ATPase blockade on RTE suggests that their depressing effect on ISC involves different mechanisms.

Immediate versus delayed self-reporting of symptoms and side effects during chemotherapy: does timing matter?

PubMed

Coolbrandt, Annemarie; Van den Heede, Koen; Vanhove, Ellen; De Bom, Ann; Milisen, Koen; Wildiers, Hans

2011-04-01

The aim of this study was to examine how patients recall symptoms at a delayed self-report. Accurate insight into toxicity symptoms during chemotherapy is essential so that nurses and doctors can assess therapeutic tolerance and adjust supportive care accordingly. A non-experimental, longitudinal design was employed. Using the Therapy-Related Symptoms Checklist (TRSC), respondents (n = 142) reported their initial symptoms during the first 7 days of the chemotherapy cycle at two different times: (1) each day of the first seven days after the chemotherapy administration (immediate self-report), and (2) at their next hospital visit for chemotherapy (delayed self-report). We compared the number and severity of symptoms and side effects reported in the immediate and delayed self-reports. Respondents reported significantly fewer symptoms and fewer severe symptoms in the delayed self-report. For 22 out of 25 symptoms the delayed-reported grade was significantly lower than the immediate-reported maximum grade. Compared to the immediate-reported median grade, significant differences occurred in only 10 out of the 25 symptoms. In all cases, except fatigue, the delayed-reported grade was significantly higher than the immediate-reported median grade. This study indicates that delayed self-report of chemotherapy side effects is not an appropriate measure of actual symptoms and side effects experienced by patients. Delayed self-report gives a weaker insight into actual symptom burden. Fatigue is at particular risk to be minimized at the delayed self-report. Therefore it is recommended to assess chemotherapy-related symptoms and side effects by means of immediate self-report. Copyright © 2010 Elsevier Ltd. All rights reserved.

Comparison of the discontinuation rates and side-effect profiles of pilocarpine and cevimeline for xerostomia in primary Sjögren's syndrome.

PubMed

Noaiseh, Ghaith; Baker, Joshua F; Vivino, Frederick B

2014-01-01

There are currently no head-to-head comparisons of sialagogues for Primary Sjögren's syndrome (pSS). We compared the tolerability and side effect profile of pilocarpine and cevimeline in patients with pSS and determined clinical, laboratory and pathological variables associated with therapeutic failure. We retrospectively reviewed the use of pilocarpine and cevimeline in 118 patients with pSS who fulfilled the 2002 American European Consensus Group criteria in a University-based setting. Clinical, laboratory and pathological baseline variables were collected. Failure of therapy was defined as the clinician or patient's decision to stop treatment either due to lack of efficacy or side effects. Cevimeline was associated with lower failure rates compared to pilocarpine among first-time users: 27% vs. 47% (p=0.02), and all users: 32% vs. 61% (p<0.001). Severe sweating was the most frequent side effect leading to cessation of therapy and occurred more frequently in pilocarpine (25%) than cevimeline (11%) users (p=0.02). Patients who previously failed one secretagogue were less likely to discontinue treatment with the other agent, 52% of first-time users vs. 27% of second-time users (p=0.004). Only ANA positivity was associated with failure: [59% vs. 38%] (p=0.03). pSS patients were more likely to continue cevimeline than pilocarpine long-term due to fewer reported side effects with cevimeline. Therapeutic failure of one secretagogue did not predict similar results with the other since second time users were more likely to continue long-term treatment.

Managing Element Interactivity in Equation Solving

ERIC Educational Resources Information Center

Ngu, Bing Hiong; Phan, Huy P.; Yeung, Alexander Seeshing; Chung, Siu Fung

2018-01-01

Between two popular teaching methods (i.e., balance method vs. inverse method) for equation solving, the main difference occurs at the operational line (e.g., +2 on both sides vs. -2 becomes +2), whereby it alters the state of the equation and yet maintains its equality. Element interactivity occurs on both sides of the equation in the balance…

A Bird and Bee Problem in House Siding

Treesearch

Louis F. Wilson; Henry A. Huber

1976-01-01

Plywood house siding made to simulate reverse board-and-batten design is sometimes attacked by woodpeckers because leaf-cutting bees, their prey, make nests in holes in the plywood core. The problem can be prevented by plugging the holes before nesting occurs. If nesting does occur, the nest should be destroyed and then the holes plugged.

Management of sexual side effects of antidepressant therapy.

PubMed

Hirschfeld, R M

1999-01-01

Sexual dysfunction occurs in over one third of the general population and has many causes, including psychosocial factors, general medical illness, nonpsychiatric medication, psychiatric disorders, and psychotropic medications. Psychosocial causes are the most prevalent, but many frequently used medications, such as diuretics, beta-blockers, and H2-blockers, can also cause sexual dysfunction. Sexual dysfunctions occur in many psychiatric disorders, including mood disorders, schizophrenia, substance abuse, and anxiety disorders. In addition, over half the patients with major depression will have some sexual dysfunction. Although much attention has been paid to sexual dysfunction associated with the selective serotonin reuptake inhibitors (SSRIs), many other commonly used psychotropics are associated with a variety of sexual dysfunction, including haloperidol, benzodiazepines, stimulants, and drugs of abuse. With regard to SSRIs, sexual dysfunction occurs in 50% or more of such patients, which is substantially higher than the rates reported in the Physicians' Desk Reference. The reason for this discrepancy is that patients will not spontaneously report sexual problems and must be questioned about such problems directly. A variety of strategies exist to manage antidepressant-induced sexual dysfunction, including waiting, reducing the antidepressant dose, use of drug holidays, use of adjunctive pharmacotherapy, and switching antidepressants. Use of an antidepressant with a low prevalence of sexual side effects, such as bupropion, nefazodone, and mirtazapine, may also be considered.

Effects of side group functionality and molecular weight on the activity of synthetic antimicrobial polypeptides.

PubMed

Engler, Amanda C; Shukla, Anita; Puranam, Sravanthi; Buss, Hilda G; Jreige, Nina; Hammond, Paula T

2011-05-09

The rapid emergence of antibiotic-resistant bacteria along with increasing difficulty in biofilm treatment has caused an immediate need for the development of new classes of antimicrobial therapeutics. We have developed a library of antimicrobial polypeptides, prepared by the ring-opening polymerization of γ-propargyl-L-glutamate N-carboxyanhydride and the alkyne-azide cycloaddition click reaction, which mimic the favorable characteristics of naturally occurring antimicrobial peptides (AmPs). AmPs are known not to cause drug resistance as well as prevent bacteria attachment on surfaces. The ease and scale of synthesis of the antimicrobial polypeptides developed here are significantly improved over the traditional Merrifield synthetic peptide approaches needed for naturally occurring antimicrobial peptides and avoids the unique challenges of biosynthetic pathways. The polypeptides range in length from 30 to 140 repeat units and can have varied side group functionality, including primary, secondary, tertiary, and quaternary amines with hydrocarbon side chains ranging from 1 to 12 carbons long. Overall, we find these polypeptides to exhibit broad-spectrum activity against both Gram positive and Gram negative bacteria, namely, S. aureus and E. coli , while having very low hemolytic activity. Many of the polypeptides can also be used as surface coatings to prevent bacterial attachment. The polypeptide library developed in this work addresses the need for effective biocompatible therapeutics for drug delivery and medical device coatings.

Transient Three-Dimensional Side Load Analysis of a Film Cooled Nozzle

NASA Technical Reports Server (NTRS)

Wang, Ten-See; Guidos, Mike

2008-01-01

Transient three-dimensional numerical investigations on the side load physics for an engine encompassing a film cooled nozzle extension and a regeneratively cooled thrust chamber, were performed. The objectives of this study are to identify the three-dimensional side load physics and to compute the associated aerodynamic side load using an anchored computational methodology. The computational methodology is based on an unstructured-grid, pressure-based computational fluid dynamics formulation, and a transient inlet history based on an engine system simulation. Ultimately, the computational results will be provided to the nozzle designers for estimating of effect of the peak side load on the nozzle structure. Computations simulating engine startup at ambient pressures corresponding to sea level and three high altitudes were performed. In addition, computations for both engine startup and shutdown transients were also performed for a stub nozzle, operating at sea level. For engine with the full nozzle extension, computational result shows starting up at sea level, the peak side load occurs when the lambda shock steps into the turbine exhaust flow, while the side load caused by the transition from free-shock separation to restricted-shock separation comes at second; and the side loads decreasing rapidly and progressively as the ambient pressure decreases. For the stub nozzle operating at sea level, the computed side loads during both startup and shutdown becomes very small due to the much reduced flow area.

Cutaneous Side-effects of Immunomodulators in MS.

PubMed

Lebrun, C; Bertagna, M; Cohen, M

2011-09-01

Local skin reactions to subcutaneous injections of interferon beta (IFNB) or glatiramer acetate (GA) in multiple sclerosis (MS) are frequent, while severe cutaneous toxicity is rare. Both IFNB and GA are immunomodulatory drugs that have excellent safety profiles and are currently used for treatment of MS. They are administered by SC injection every other day for IFNB-1b, three times a week for IFNB-1a or daily for 20 mg for GA. The most common adverse effects, which occur in approximately 20-60% of patients, include pain, inflammation and induration at the injection sites. Another adverse effect is frank panniculitis followed by localized lipoatrophy at the injection sites, which has been described in half of the patients receiving GA injections but is also described with Subcutaneous IFNB-1b. No guidelines have yet been established for the treatment of skin reactions, which is a frequent point for discussion between neurologists and dermatologists. In addition, no treatment has been found for established lipoatrophy. The prevention and management of cutaneous side-effects include patient education, regular examination and manual palpation of all injection sites. Non-steroid antiinflammatory gels, local corticosteroids or endermology can help patients to resolve side-effects and to continue immunomodulatory treatment.

Identifying and managing the adverse effects of immune checkpoint blockade

PubMed Central

Winer, Arthur; Bodor, J. Nicholas

2018-01-01

Immunotherapy has revolutionized the field of oncology. By inhibiting the cytotoxic T-lymphocyte-associated protein (CTLA-4) and programmed death-1 (PD-1) immune checkpoint pathways, multiple studies have demonstrated greatly improved survival in locally advanced and metastatic cancers including melanoma, renal, lung, gastric, and hepatocellular carcinoma. Trials in other malignancies are ongoing, and undoubtedly the number of drugs in this space will grow beyond the six currently approved by the Food and Drug Administration. However, by altering the immune response to fight cancer, a new class of side effects has emerged known as immune-related adverse events (irAEs). These adverse events are due to overactivation of the immune system in almost any organ of the body, and can occur at any point along a patient’s treatment course. irAEs such as endocrinopathies (thyroiditis), colitis, and pneumonitis may occur more commonly. However, other organs such as the liver, heart, or brain may also be affected by immune overactivation and any of these side effects may become life threatening. This review presents an approach to promptly recognize and manage these toxicities, to hopefully minimize morbidity and mortality from irAEs. PMID:29593893

Adenosine-Associated Delivery Systems

PubMed Central

Kazemzadeh-Narbat, Mehdi; Annabi, Nasim; Tamayol, Ali; Oklu, Rahmi; Ghanem, Amyl; Khademhosseini, Ali

2016-01-01

Adenosine is a naturally occurring purine nucleoside in every cell. Many critical treatments such as modulating irregular heartbeat (arrhythmias), regulation of central nervous system (CNS) activity, and inhibiting seizural episodes can be carried out using adenosine. Despite the significant potential therapeutic impact of adenosine and its derivatives, the severe side effects caused by their systemic administration have significantly limited their clinical use. In addition, due to adenosine’s extremely short half-life in human blood (less than 10 s), there is an unmet need for sustained delivery systems to enhance efficacy and reduce side effects. In this paper, various adenosine delivery techniques, including encapsulation into biodegradable polymers, cell-based delivery, implantable biomaterials, and mechanical-based delivery systems, are critically reviewed and the existing challenges are highlighted. PMID:26453156

Psychiatric and behavioral side effects of antiepileptic drugs in adults with epilepsy.

PubMed

Chen, Baibing; Choi, Hyunmi; Hirsch, Lawrence J; Katz, Austen; Legge, Alexander; Buchsbaum, Richard; Detyniecki, Kamil

2017-11-01

Psychiatric and behavioral side effects (PBSEs) are common, undesirable effects associated with antiepileptic drug (AED) use. The objective of the study was to compare the PBSE profiles of older and newer AEDs in a large specialty practice-based sample of patients diagnosed with epilepsy. As part of the Columbia and Yale AED Database Project, we reviewed patient records including demographics, medical history, AED use, and side effects for 4085 adult patients (age: 18 years) newly started on an AED regimen. Psychiatric and behavioral side effects were determined by patient or physician report in the medical record, which included depressive mood, psychosis, anxiety, suicidal thoughts, irritability, aggression, and tantrum. Significant non-AED predictors of PBSE rate were first determined from 83 variables using logistic regression. Predictors were then controlled for in the comparison analysis of the rate of PBSEs and intolerable PBSEs (PBSEs that led to dosage reduction or discontinuation) between 18 AEDs. Psychiatric and behavioral side effects occurred in 17.2% of patients and led to intolerability in 13.8% of patients. History of psychiatric condition(s), secondary generalized seizures, absence seizures, and intractable epilepsy were associated with increased incidence of PBSE. Levetiracetam (LEV) had the greatest PBSE rate (22.1%). This was statistically significant when compared with the aggregate of the other AEDs (P<0.001, OR=6.87). Levetiracetam was also significantly (P<0.001) associated with higher intolerability rate (17.7%), dose decreased rate (9.4%), and complete cessation rate (8.3%), when compared with the aggregate of the other AEDs. Zonisamide (ZNS) was also significantly associated with a higher rate of PBSE (9.7%) and IPBSE (7.9%, all P<0.001). On the other hand, carbamazepine (CBZ), clobazam (CLB), gabapentin (GBP), lamotrigine (LTG), oxcarbazepine (OXC), phenytoin (PHT), and valproate (VPA) were significantly associated with a decreased PBSE rates (P<0.001). Carbamazepine, GBP, LTG, PHT, and VPA were also associated with lower IPBSE rates when compared individually with the aggregate of other AEDs. All other AEDs were found to have intermediate rates that were not either increased or decreased compared with other AEDs. When each AED was compared to LTG, only CBZ had a significantly lower PBSE rate. The main limitations of this study were that the study design was retrospective and not blinded, and the AEDs were not randomly assigned to patients. Psychiatric and behavioral side effects occur more frequently in patients taking LEV and ZNS than any other AED and led to higher rates of intolerability. Lower PBSE rates were seen in patients taking CBZ, CLB, GBP, LTG, OXC, PHT, and VPA. Our findings may help facilitate the AED selection process. Copyright © 2017 Elsevier Inc. All rights reserved.

Biomechanical evaluation of various suture configurations in side-to-side tenorrhaphy.

PubMed

Wagner, Emilio; Ortiz, Cristian; Wagner, Pablo; Guzman, Rodrigo; Ahumada, Ximena; Maffulli, Nicola

2014-02-05

Side-to-side tenorrhaphy is increasingly used, but its mechanical performance has not been studied. Two porcine flexor digitorum tendon segments of equal length (8 cm) and thickness (1 cm) were placed side by side. Eight tenorrhaphies (involving sixteen tendons) were performed with each of four suture techniques (running locked, simple eight, vertical mattress, and pulley suture). The resulting constructs underwent cyclic loading on a tensile testing machine, followed by monotonically increasing tensile load if failure during cyclic loading did not occur. Clamps secured the tendons on each side of the repair, and specimens were mounted vertically. Cyclic loading varied between 15 N and 35 N, with a distension rate of 1 mm/sec. Cyclic loading strength was determined by applying a force of 70 N. The cause of failure and tendon distension during loading were recorded. All failures occurred in the monotonic loading phase and resulted from tendon stripping. No suture or knot failure was observed. The mean loads resisted by the configurations ranged from 138 to 398 N. The mean load to failure, maximum load resisted prior to 1 cm of distension, and load resisted at 1 cm of distension were significantly lower for the vertical mattress suture group than for any of the other three groups (p < 0.031). All four groups sustained loads well above the physiologic loads expected to occur in tendons in the foot and ankle (e.g., in tendon transfer for tibialis posterior tendon insufficiency). None of the four side-to-side configurations distended appreciably during the cyclic loading phase. The vertical mattress suture configuration appeared to be weaker than the other configurations. For surgeons who advocate immediate loading or motion of a side-to-side tendon repair, a pulley, running locked, or simple eight suture technique appears to provide a larger safety margin compared with a vertical mattress suture technique.

College Teaching and Synchronicity: Exploring the Other Side of Teachable Moments

ERIC Educational Resources Information Center

White, Stephen R.; Maycock, George A.

2012-01-01

This study examined 144 experienced community college teachers' perceptions of teachable moments. Our proposition is that a teachable moment, rather than being an objective predetermined cause-and-effect pedagogy, is a highly subjective-reflective event or intuitive learning process that occurs at unanticipated moments. We believe that Jung's…

Faculty Retirement and Recruitment in the Community Colleges

ERIC Educational Resources Information Center

Kisker, Carrie B.

2004-01-01

Several recent studies have shown that a large-scale turnover is likely to occur among community college instructors over the next several years, as veteran faculty retire in large numbers. As colleges begin to experience this mass retirement, researchers and administrators must consider the side effects of a faculty turnover, especially in…

Crime and Corruption

NASA Astrophysics Data System (ADS)

Duong, Deborah; Turner, Robert; Selke, Karl

Like intergroup violence (Chap. 7) and insurgency (Chap. 8), crime and ­corruption are nearly inevitable companions of an international intervention. Both contribute to the reasons why the intervention occurs, and both may even grow and fester as side-effects of an intervention. Moreover, crime and corruption frequently serve as obstacles to a successful termination of an intervention.

77 FR 43178 - Airworthiness Directives; The Boeing Company Airplanes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-24

... eddy current high frequency (ETHF) inspections for cracking on the aft side of the left and right wing... NPRM proposed to require repetitive eddy current high frequency (ETHF) inspections for cracking on the...,000 flight cycles after the effective date of this AD, whichever occurs later, do an eddy current high...

When 1+1=1: the unification of independent actors revealed through joint Simon effects in crossed and uncrossed effector conditions.

PubMed

Welsh, Timothy N

2009-12-01

The "Simon effect" describes a pattern of reaction times (RTs) where responses to symbolic information are shorter when the information is presented on the same side of space as the desired response than when it is on the opposite side of space. For example, if right hand responses are required for green targets and left hand responses for red targets, RTs with the right hand are shorter when the green target appears on the right side than on the left side. It has been reported that Simon effects also appear when two individuals perform independent components of a Simon effect task. It has been suggested that such joint Simon effects occur because participants represent the action of their partner. It is unclear, however, if the joint Simon effect emerges because: (1) each partner represents the other's action; (2) each partner is using the other person or their response as an environmental reference; or (3) an intra-hemispheric processing advantage due to the lateralized cerebral organization of perceptual and motor systems. The present study distinguished between these possibilities by asking pairs of participants to perform in conditions in which they crossed their arms into the other person's space. Consistent with within-person Simon effects, joint Simon effects were observed in uncrossed- and crossed limb conditions. These results support a response co-representation explanation of joint Simon effects. It is suggested that the processes underlying the evoked representations have developed to allow two independent agents to form temporary synergies to facilitate efficient task completion. 2009 Elsevier B.V. All rights reserved.

A multicentre study of vigabarin for drug-resistant epilepsy

PubMed Central

Browne, T. R.; Mattson, R. H.; Penry, J. K.; Smith, D. B.; Treiman, D. M.; Wilder, B. J.; Ben-Menachem, E.; Miketta, R. M.; Sherry, K. M.; Szabo, G. K.

1989-01-01

1 Vigabatrin (GVG) was given in a single-blind fashion to 89 patients with complex partial seizures (CPS) refractory to conventional drugs. 2 The median number of CPS per month decreased from 11.0 to 5.0 after addition of GVG, and 51% of patients had a 50% or greater decrease in CPS frequency (P < 0.001). 3 Side effects (principally drowsiness, ataxia, headache) occurred mainly during the initiation of therapy and decreased during therapy. After 12 weeks on GVG side effects significantly interfered with functioning in only 13% of patients, and the efficacy: toxicity ratio warranted continued administration in 74% of patients. 4 Co-administration of GVG resulted in a mean decrease of 20% in phenytoin serum concentration (P < 0.001). 5 Sixty-six patients having a favourable response to GVG during the single-blind study have been followed for 6-54 (median 33) months on GVG. Only 17 patients have dropped out of long-term follow-up due to break through seizures and/or side effects. No serious systemic or neurological toxicity has been detected. PMID:2667606

Is By-passing the Stomach a Means to Optimise Sodium Bicarbonate Supplementation? A Case-study With a Post-Bariatric Surgery Individual.

PubMed

de Oliveira, Luana Farias; Saunders, Bryan; Artioli, Guilherme Giannini

2018-05-03

Sodium bicarbonate (SB) is an ergogenic supplement shown to improve high-intensity exercise via increased blood bicarbonate buffering. Substantial amounts of the ingested bicarbonate are neutralised in the stomach. Bariatric surgery results in a small gastric pouch which dramatically reduces exposure time of any ingested food in the stomach. The aim of this study was to examine the pharmacokinetics of orally ingested SB in a post-gastric bypass individual to determine the magnitude of changes in blood bicarbonate and associated side-effects. We hypothesized that SB supplementation in a gastric bypass model would result in greater blood bicarbonate increases and less side-effects than in healthy individuals due to minimal bicarbonate losses in the stomach. One post-bariatric male ingested 0.3 g·kg -1 BM of SB on three occasions (SB1, SB2, SB3) and 0.3 g·kg -1 BM of placebo (PL) on a further occasion. Blood bicarbonate was determined before and every 10-min following supplement ingestion for 3 h and then every 20 min for a further 1 h. Side-effects were reported using an adapted questionnaire at identical time points. Maximal increases in blood bicarbonate with SB were +20.0, +15.2 and +12.6 mM, resulting in maximal bicarbonate concentrations of 42.8, 39.3 and 36.2 mM. Area under the curve was SB1: 8328, SB2: 7747, SB3: 7627 mM·min -1 and 6436 mM·min -1 for PL. Side-effects with SB were scarce. Maximal bicarbonate increases were well above those shown previously, with minimal side-effects, indicative of minimal neutralisation of bicarbonate in the stomach. The large increases in circulating bicarbonate and minimal side-effects experienced by our post-gastric surgery patient are indicative that minimising neutralisation of bicarbonate in the stomach, as would occur with enteric coated capsules, may optimise SB supplementation and thus warrants investigation.

Cutaneous mucormycosis caused by Rhizopus microsporus in an immunocompetent patient: A case report and review of literature.

PubMed

Wang, Yilun; Zhu, Min; Bao, Yunqi; Li, Li; Zhu, Liping; Li, Feng; Xu, Jinhua; Liang, Jun

2018-06-01

Cutaneous mucormycosis is an uncommon disease and occurs rarely in immunocompetent patients. We reported the case of a 37-year-old man presenting with a skin lesion on the left side of the chest wall with no history of trauma or primary diseases. He was firstly misdiagnosed as tuberculosis and the proper treatment was thus delayed. Histopathological examination and fungal culture of the lesion confirmed cutaneous mucormycosis. The isolate was identified as Rhizopus microspores by ITS sequencing. The patient was treated with oral posaconazole 400 mg bid for 150 days. The patient recovered satisfactorily. No recurrence was found during the follow-up and no side effect of liver function was found. This case helps doctors to consider the possibility of serious fungal infection in immunocompetent patients. It also suggested that posaconazole could be an alternative choice for the treatment of mucormycosis considering the severe side effect of Amphotericin B.

Tranexamic Acid in the Treatment of Melasma: A Review of the Literature.

PubMed

Perper, Marina; Eber, Ariel Eva; Fayne, Rachel; Verne, Sebastian Hugo; Magno, Robert James; Cervantes, Jessica; ALharbi, Mana; ALOmair, Ibrahim; Alfuraih, Abdulkarem; Nouri, Keyvan

2017-06-01

Melasma is a common acquired pigmentary disorder marked by irregular hyperpigmented macules or patches and most commonly occurs in women of darker skin color. It is a chronic often-relapsing condition that causes negative psychosocial effects in those affected. Current treatments such as hydroquinone, kojic acid, and retinoids, among others, demonstrate variable efficacy and side-effect profiles. We conducted a comprehensive literature review examining the use of tranexamic acid (TA), a well-known anti-fibrinolytic agent, in the treatment of melasma. TA delivered orally, topically, and through physical methods works via the inhibition of ultraviolet (UV)-induced plasmin activity in keratinocytes. Predefined search terms were entered into PubMed. Articles were then independently screened by two authors to include only those written in the English language and relating to human subjects with at least mild melasma. The search identified 28 articles, 15 of which met the criteria for full review. The review revealed that TA treatment for melasma is equally effective or more effective than other standard therapies and may induce fewer side effects. Our comprehensive review suggests that TA may be a promising treatment option for melasma because of its demonstrated effectiveness alone and in combination with other modalities as well as its limited side-effect profile.

High Speed Gear Sized and Configured to Reduce Windage Loss

NASA Technical Reports Server (NTRS)

Kunz, Robert F. (Inventor); Medvitz, Richard B. (Inventor); Hill, Matthew John (Inventor)

2013-01-01

A gear and drive system utilizing the gear include teeth. Each of the teeth has a first side and a second side opposite the first side that extends from a body of the gear. For each tooth of the gear, a first extended portion is attached to the first side of the tooth to divert flow of fluid adjacent to the body of the gear to reduce windage losses that occur when the gear rotates. The gear may be utilized in drive systems that may have high rotational speeds, such as speeds where the tip velocities are greater than or equal to about 68 m/s. Some embodiments of the gear may also utilize teeth that also have second extended portions attached to the second sides of the teeth to divert flow of fluid adjacent to the body of the gear to reduce windage losses that occur when the gear rotates.

Effects of cattle grazing, glyphosate, and prescribed burning on fountaingrass fuel loading in Hawai`i

Treesearch

J.M. Castillo; G. Enriques; M. Nakahara; D. Weise; L. Ford; R. Moraga; R. Vihnanek

2007-01-01

Crimson fountaingrass (Pennisetum setaceum) is a nonnative invasive grass that has occupied a significant portion of the western side of the island of Hawai`i. As a result, several fires in excess of 4,049 ha have occurred in the area over the past 20 y. We are studying the effectiveness of cattle grazing, aerial application of glyphosate herbicide, and prescribed...

Perceptual load in central and peripheral regions and its effects on driving performance: advertizing billboards.

PubMed

Marciano, Hadas; Yeshurun, Yaffa

2012-01-01

A broadened version of the perceptual load model was utilized to explore systematically the influence of four variables on driver's behavior: a. levels of load on the road; b. levels of load at the sides of the road; c. event's initial location (on the road vs. at the sides of the road); and d. the presence and size of advertizing billboards. 18 participants participated in two experimental sessions in a driving simulator. One of the sessions contained advertizing billboards and the other session did not. The results indicated that billboards can have a considerable effect on various aspects of driving like the time required responding to a potentially dangerous event or simply the number of accidents occurring during driving, but importantly the effect of billboards on driving was modulated by the levels of perceptual load.

Pupillary correlates of covert shifts of attention during working memory maintenance.

PubMed

Unsworth, Nash; Robison, Matthew K

2017-04-01

The pupillary light reflex (PLR) was used to track covert shifts of attention to items maintained in visual working memory (VWM). In three experiments, participants performed a change detection task in which rectangles appeared on either side of fixation and at test participants indicated if the cued rectangle changed its orientation. Prior to presentation or during the delay, participants were cued to the light or dark side of the screen. When cued to the light side, the pupil constricted, and when cued to the dark side, the pupil dilated, suggesting that the PLR tracked covert shifts of attention. Similar covert shifts of attention were seen when the target stimuli remained onscreen and during a blank delay period, suggesting similar effects for attention to perceptual stimuli and attention to stimuli maintained in VWM. Furthermore, similar effects were demonstrated when participants were pre-cued or retro-cued to the prioritized location, suggesting that shifts of covert attention can occur both before and after target presentation. These results are consistent with prior research, suggesting an important role of covert shifts of attention during VWM maintenance and that the PLR can be used to track these covert shifts of attention.

The combined use of oral medroxyprogesterone acetate and methyltestosterone in a male contraceptive trial programme.

PubMed

Bain, J; Rachlis, V; Robert, E; Khait, Z

1980-04-01

A male contraceptive trial was undertaken in 23 men using a combination of oral medroxyprogesterone acetate (MPA) and oral methyltestosterone (MeT). The men were divided into four groups according to varying drug dosages and were followed for 15 months (control - 3 months, treatment - 6 months, follow-up - 6 months). The parameters assessed included sperm count and motility, serum gonadotropins and sex steroids, and several biochemical and hematological tests. A questionnaire dealing with side-effects and changes in sexual function was administered intermittently. Although sperm count was suppressed (most dramatically at the highest drug doses, MPA 20mg,MeT 20mg), it was not suppressed to infertile levels. Sperm motility was unaltered; LH was modestly suppressed, FSH was not suppressed; testosterone was suppressed even at low doses; dihydrotestosterone responses were inconsistent. No significant biochemical abnormalities or side-effects occurred although some men experienced mild transient acne, gynecomastia and decreased testicular size. We conclude that in the doses used in this trial, the combination of MPA and MeT is not effective for male contraceptive, purposes and that higher doses may induce severe and undesirable side-effects.

Psychodermatology: A Guide to Understanding Common Psychocutaneous Disorders

PubMed Central

Jafferany, Mohammad

2007-01-01

Objective: This review focuses on classification and description of and current treatment recommendations for psychocutaneous disorders. Medication side effects of both psychotropic and dermatologic drugs are also considered. Data Sources: A search of the literature from 1951 to 2004 was performed using the MEDLINE search engine. English-language articles were identified using the following search terms: skin and psyche, psychiatry and dermatology, mind and skin, psychocutaneous, and stress and skin. Data Synthesis: The psychotropic agents most frequently used in patients with psychocutaneous disorders are those that target anxiety, depression, and psychosis. Psychiatric side effects of dermatologic drugs can be significant but can occur less frequently than the cutaneous side effects of psychiatric medications. In a majority of patients presenting to dermatologists, effective management of skin conditions requires consideration of associated psychosocial factors. For some dermatologic conditions, there are specific demographic and personality features that commonly associate with disease onset or exacerbation. Conclusions: More than just a cosmetic disfigurement, dermatologic disorders are associated with a variety of psychopathologic problems that can affect the patient, his or her family, and society together. Increased understanding of biopsychosocial approaches and liaison among primary care physicians, psychiatrists, and dermatologists could be very useful and highly beneficial. PMID:17632653

Randomized clinical trial assessing the side-effects of glyceryl trinitrate and diltiazem hydrochloride in the treatment of chronic anal fissure.

PubMed

Kocher, H M; Steward, M; Leather, A J M; Cullen, P T

2002-04-01

Glyceryl trinitrate (GTN) ointment (0 small middle dot2 per cent) has an efficacy of up to 68 per cent in healing chronic anal fissure, but with headache as a major side-effect. Diltiazem hydrochloride (DTZ) cream (2 per cent) is expected to have fewer side-effects. A prospective double-blind randomized two-centre trial requiring at least 26 patients in each group (alpha = 0.05, beta = 0.9) was instituted after approval of the local ethics committee, to compare the incidence of side-effects (primary endpoint) with 0.2 per cent GTN ointment and 2 per cent DTZ cream in the treatment of chronic anal fissure. Treatments were applied perianally, twice daily for 6-8 weeks. All patients gave written informed consent. Both groups were comparable in patient demographics and clinical characteristics. Twelve patients violated the protocol, withdrew or did not attend follow-up. There were more side-effects with GTN (21 of 29 patients) than with DTZ (13 of 31) (relative risk (RR) 1.84 (95 per cent confidence interval (c.i.) 1.11 to 3.04), P = 0.01). In particular, more headaches occurred with GTN (17 of 29 patients) than with DTZ (eight of 31) (RR 2.06 (95 per cent c.i. 1.18 to 3.59), P = 0.01). There were no significant differences in healing and symptomatic improvement rates between patients receiving GTN (25 of 29) and DTZ (24 of 31). DTZ cream caused substantially fewer headaches than GTN ointment. There was no significant difference in the healing or improvement of chronic anal fissure between the treatments. DTZ may be the preferred first-line treatment for chronic anal fissure.

Comparative toxicity of pesticides in three phytoseiid mites with different life-style occurring in citrus: Euseius stipulatus, Neoseiulus californicus and Phytoseiulus persimilis.

PubMed

Argolo, Poliane Sá; Jacas, Josep A; Urbaneja, Alberto

2014-01-01

Conservation and augmentative biological control strategies have been developed to take full advantage of the natural enemies that occur in Spanish citrus orchards. Among them, the predatory mites Euseius stipulatus, Neoseiulus californicus and Phytoseiulus persimilis play an important role in the biological control of tetranychid mites. However, these predatory mites are often affected by pesticides and information about the side-effects of these products against these beneficial arthropods is essential to guarantee their efficacy. The side-effects of some pesticides remain unknown and the primary aim of this study was to fill this gap. We have further used this information and that collected from other sources to compare the response of these three mite species to pesticides. Based on this information, E. stipulatus has the most tolerant species, followed by N. californicus and P. persimilis. Therefore, using E. stipulatus as an indicator species in citrus may have led to the paradox of selecting presumed selective pesticides resulting in excessive impact on N. californicus and, especially on P. persimilis. Because these two latter species are considered key for the biological control of T. urticae in citrus, especially clementines, in Spain, we propose to use P. persimilis as the relevant indicator of such effects on predacious mites occurring in citrus instead of E. stipulatus. This change could have a dramatic impact on the satisfactory control of tetranychid mites in citrus in the near future.

Knee Injuries

MedlinePlus

... when bending, extending, or lifting a leg. Meniscus Tears Damage to the menisci is a really common ... side-to-side movements can cause them to tear. Meniscus injuries often occur together with severe sprains, ...

Odd-even effect on the formation of aqueous biphasic systems formed by 1-alkyl-3-methylimidazolium chloride ionic liquids and salts

NASA Astrophysics Data System (ADS)

Belchior, Diana C. V.; Sintra, Tânia E.; Carvalho, Pedro J.; Soromenho, Mário R. C.; Esperança, José M. S. S.; Ventura, Sónia P. M.; Rogers, Robin D.; Coutinho, João A. P.; Freire, Mara G.

2018-05-01

This work provides a comprehensive evaluation of the effect of the cation alkyl side chain length of the 1-alkyl-3-methylimidazolium chloride series ([CnC1im]Cl, n = 2-14) of ionic liquids (ILs) on their capability to form aqueous biphasic systems (ABSs) with salts and self-aggregation derived properties. The liquid-liquid phase behavior of ternary systems composed of [CnC1im]Cl, water, and K3PO4 or K2CO3 and the respective Setschenow salting-out coefficients (ks), a quantitative measure of the two-phase formation ability, were determined. An odd-even effect in the ks values along the number of methylene groups of the longest IL cation alkyl side chain was identified for the ABS formed by K2CO3, a weaker salting-out agent where the phenomenon is clearly identified. In general, cations with even alkyl side chains, being likely to display higher molar volumes, are more easily salted-out and thus more prone to undergo phase separation. The odd-even effect in the ks values is, however, more significant in ILs up to n = 6, where the nanostructuration/nanosegregation of ILs plays a less relevant role. Still, with the [CnC1im]Cl (n = 7-14) series of ILs, an odd-even effect was also identified in the ILs' ionization degree, molar conductivity, and conductivity at infinite dilution. In summary, it is shown here that the ILs' odd-even effect occurs in IL aqueous solutions and not just in neat ILs, an already well-established phenomenon occurring in a series of ILs' properties described as a result of the orientation of the terminal methyl groups to the imidazolium ring cation and consequent effect in the ILs' cohesive energy.

Chylothorax after left side pneumothorax surgery managed by OK-432 pleurodesis: an effective alternative.

PubMed

Huang, Sheng-Yang; Yeh, Chou-Ming; Chou, Chia-Man; Chen, Hou-Chuan

2014-12-01

Chylothorax, a relatively rare complication of thoracic surgery, mostly occurs on the right side. We present a 16-year-old male who received thoracoscopic surgery for left spontaneous pneumothorax. Chylothorax developed on the postoperative 2(nd) day and resolved after diet control on the 4(th) day. Unfortunately, chylothorax recurred 2 weeks later. Chest drainage and nil per os with total parental nutrition were given but in vain. Thereafter, chemical pleurodesis with OK-432 was performed. Chylothorax resolved on the next day. The relevant literature is reviewed and possible pathogenesis clarified. Copyright © 2014. Published by Elsevier Taiwan.

Impact cratering experiments in brittle targets with variable thickness: Implications for deep pit craters on Mars

NASA Astrophysics Data System (ADS)

Michikami, T.; Hagermann, A.; Miyamoto, H.; Miura, S.; Haruyama, J.; Lykawka, P. S.

2014-06-01

High-resolution images reveal that numerous pit craters exist on the surface of Mars. For some pit craters, the depth-to-diameter ratios are much greater than for ordinary craters. Such deep pit craters are generally considered to be the results of material drainage into a subsurface void space, which might be formed by a lava tube, dike injection, extensional fracturing, and dilational normal faulting. Morphological studies indicate that the formation of a pit crater might be triggered by the impact event, and followed by collapse of the ceiling. To test this hypothesis, we carried out laboratory experiments of impact cratering into brittle targets with variable roof thickness. In particular, the effect of the target thickness on the crater formation is studied to understand the penetration process by an impact. For this purpose, we produced mortar targets with roof thickness of 1-6 cm, and a bulk density of 1550 kg/m3 by using a mixture of cement, water and sand (0.2 mm) in the ratio of 1:1:10, by weight. The compressive strength of the resulting targets is 3.2±0.9 MPa. A spherical nylon projectile (diameter 7 mm) is shot perpendicularly into the target surface at the nominal velocity of 1.2 km/s, using a two-stage light-gas gun. Craters are formed on the opposite side of the impact even when no target penetration occurs. Penetration of the target is achieved when craters on the opposite sides of the target connect with each other. In this case, the cross section of crater somehow attains a flat hourglass-like shape. We also find that the crater diameter on the opposite side is larger than that on the impact side, and more fragments are ejected from the crater on the opposite side than from the crater on the impact side. This result gives a qualitative explanation for the observation that the Martian deep pit craters lack a raised rim and have the ejecta deposit on their floor instead. Craters are formed on the opposite impact side even when no penetration occurs. Penetration is achieved when craters of both sides are connected. Crater diameter on the opposite side is larger than that on the impact side. More fragments are ejected from the opposite side than from the impact side. We present a qualitative explanation for the shapes of Martian deep pit craters.

Biometry of the hypospadic penis after hormone therapy (testosterone and estrogen): A randomized, double-blind controlled trial.

PubMed

Paiva, Kelly Christina de Castro; Bastos, André Netto; Miana, Laura Pimenta; Barros, Eveline de Souza; Ramos, Plínio Santos; Miranda, Lara Meneguelli; Faria, Natália Maia; Avarese de Figueiredo, André; de Bessa, José; Netto, José Murillo B

2016-08-01

The use of preoperative hormonal stimulation before hypospadias surgery aims to increase penile size and achieve better surgical results; however, the rules are not clear in the literature. We evaluated the effects of topical testosterone and estrogen in the hypospadic penis regarding biometric measures, side effects, and serum hormonal levels. To our knowledge, this is the first study using estradiol prior to hypospadias surgery. Sixty-nine children with hypospadias were randomly divided into three study groups: a control group (CG) of 17 children given placebo cream; a testosterone group (TG) of 28 children who used 1% testosterone propionate; and an estradiol group (EG) of 24 children using 0.01% estradiol. All subjects applied the topical ointment on the entire penis, twice daily for 30 days before surgical correction. Biometric evaluation of the penis included penile length and diameter, glans diameter, distance from the urethral meatus to the tip, and the width of the urethral plate. These measurements as well as serum hormone level, and side effects were evaluated prior to hormone use, and 30 and 90 days after. After 30 days an increase in penile diameter and length and diameter of the glans were observed in TG (p < 0.05). The width of the urethral plate and distance from meatus to the tip increased in TG, although not significantly. The most frequent side effects were appearance of pubic hair and darkening of the genital skin, mainly in TG, but these were transient and disappeared after 90 days of treatment. No significant variations were seen in serum hormonal levels (Table). As in previous studies, an increase in penile length and diameter, and glans diameter was observed with the use of testosterone. Proximal urethral plate width and distance from the meatus to the tip of the penis had a tendency to increase also in TG. Estradiol did not change biometric measure of the penis. Few side effects occurred after both hormones, and any that did improved after 90 days follow-up and did not change hormone serum levels. Preoperative use of topical testosterone increases penile size, diameter of the penis and glans. The use of estradiol does not change penile biometry. Side effects occur mainly with the use of testosterone and are transient. No significant and persistent hormonal changes were observed. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Systematic screen of chemotherapeutics in Drosophila stem cell tumors

PubMed Central

Markstein, Michele; Dettorre, Samantha; Cho, Julio; Neumüller, Ralph A.; Craig-Müller, Sören; Perrimon, Norbert

2014-01-01

Here we report the development of an in vivo system to study the interaction of stem cells with drugs using a tumor model in the adult Drosophila intestine. Strikingly, we find that some Food and Drug Administration-approved chemotherapeutics that can inhibit the growth of Drosophila tumor stem cells can paradoxically promote the hyperproliferation of their wild-type counterparts. These results reveal an unanticipated side effect on stem cells that may contribute to tumor recurrence. We propose that the same side effect may occur in humans based on our finding that it is driven in Drosophila by the evolutionarily conserved Janus kinase-signal transducers and activators of transcription (JAK-STAT) pathway. An immediate implication of our findings is that supplementing traditional chemotherapeutics with anti-inflammatories may reduce tumor recurrence. PMID:24616500

A Review of Atomoxetine Effects in Young People with Developmental Disabilities

PubMed Central

Aman, Michael G.; Smith, Tristram; Arnold, L. Eugene; Corbett-Dick, Patricia; Rameshwari.Tumuluru; Hollway, Jill A.; Hyman, Susan L.; Mendoza-Burchamm, Marissa; Pan, Xueliang; Mruzek, Daniel W.; Lecavalier, Luc; Levato, Lynne; Silverman, Laura B.; Handen, Benjamin

2014-01-01

This review summarizes the pharmacokinetic characteristics, pharmacodynamic properties, common side effects, and clinical advantages and disadvantages associated with atomoxetine (ATX) treatment in typically developing children and adults with ADHD. Then the clinical research to date in developmental disabilities (DD), including autism spectrum disorders (ASD), is summarized and reviewed. Of the 11 relevant reports available, only two were placebo-controlled randomized clinical trials, and both focused on a single DD population (ASD). All trials but one indicated clinical improvement in ADHD symptoms with ATX, although it was difficult to judge the magnitude and validity of reported improvement in the absence of placebo controls. Effects of ATX on co-occurring behavioral and cognitive symptoms were much less consistent. Appetite decrease, nausea, and irritability were the most common adverse events reported among children with DD; clinicians should be aware that, as with stimulants, irritability appears to occur much more commonly in persons with DD than in typically developing individuals. Splitting the dose initially, starting below the recommended starting dose, and titrating slowly may prevent or ameliorate side effects. Patience is needed for the slow build-up of benefit. Conclusions: ATX holds promise for managing ADHD symptoms in DD, but properly controlled, randomized clinical trials of atomoxetine in intellectual disability and ASD are sorely needed. Clinicians and researchers should be vigilant for emergence of irritability with ATX treatment. Effects of ATX on cognition in DD are virtually unstudied. PMID:24732041

Orienting attention in visual space by nociceptive stimuli: investigation with a temporal order judgment task based on the adaptive PSI method.

PubMed

Filbrich, Lieve; Alamia, Andrea; Burns, Soline; Legrain, Valéry

2017-07-01

Despite their high relevance for defending the integrity of the body, crossmodal links between nociception, the neural system specifically coding potentially painful information, and vision are still poorly studied, especially the effects of nociception on visual perception. This study investigated if, and in which time window, a nociceptive stimulus can attract attention to its location on the body, independently of voluntary control, to facilitate the processing of visual stimuli occurring in the same side of space as the limb on which the visual stimulus was applied. In a temporal order judgment task based on an adaptive procedure, participants judged which of two visual stimuli, one presented next to either hand in either side of space, had been perceived first. Each pair of visual stimuli was preceded (by 200, 400, or 600 ms) by a nociceptive stimulus applied either unilaterally on one single hand, or bilaterally, on both hands simultaneously. Results show that, as compared to the bilateral condition, participants' judgments were biased to the advantage of the visual stimuli that occurred in the same side of space as the hand on which a unilateral, nociceptive stimulus was applied. This effect was present in a time window ranging from 200 to 600 ms, but importantly, biases increased with decreasing time interval. These results suggest that nociceptive stimuli can affect the perceptual processing of spatially congruent visual inputs.

Technical feasibility and revision efficacy of the sequential deployment of endoscopic bilateral side-by-side metal stents for malignant hilar biliary strictures: a multicenter prospective study.

PubMed

Lee, Tae Hoon; Park, Do Hyun; Lee, Sang Soo; Choi, Hyun Jong; Lee, Jun Kyu; Kim, Tae Hyeon; Kim, Jong Hyeok; Jeong, Seok; Park, Sang-Heum; Moon, Jong Ho

2013-02-01

Theoretically, the side-by-side bilateral placement of metal stents may be technically easier than stent-in-stent bilateral placement in stent revision. However, side-by-side placement can be technically challenging, as the deployment of the first stent can preclude the passage of the second stent. We explored the technical feasibility and revision efficacy of endoscopic bilateral side-by-side stent placement for malignant hilar biliary strictures. Forty-four patients with Bismuth type II or higher malignant hilar biliary strictures were enrolled in seven academic tertiary referral centers. Endoscopic placement of side-by-side bilateral metal stents with 7F thin delivery shaft was performed. The outcome measurements were the technical and functional success, adverse events, endoscopic revision success rate, and stent patency. Overall, the technical and functional success rates were 91 % (40/44), and 98 % (39/40), respectively. Two of the failed patients were converted successfully with subsequent contralateral stent-in-stent placement, and the other patients underwent percutaneous intervention. Early stent-related adverse events occurred in 10 %. The endoscopic revision rate due to stent malfunction during follow-up (median: 180 days) was 45 % (18/40; tumor ingrowth in 4 and in-stent sludge impaction/stone formation in 14 patients). The endoscopic revision success rate was 92 % (12/13). Five patients with comorbidity underwent initial percutaneous intervention. The median survival and stent patency periods were 180 and 157 days, respectively. The sequential placement of a metal stent with a 7F thin delivery shaft in bilateral side-by-side procedures may be feasible and effective for malignant hilar biliary strictures and for endoscopic stent revision.

An Analysis of the Effects of Phenytoin in Treating Motion Sickness and the Effects of Motion Sickness on the Human Electroencephalogram

DTIC Science & Technology

1990-12-01

ears ( tinnitus ) and/or a reduced auditory acuity resulted from the dosing. These side effects have been shown to 29 occur in some subjects as a result of...examinations. 5. Complete blood count (CBC). 6. Blood biochemistry screen (Chem 18 including liver function tests). 7. Blood cholesterol and lipids . 8. Chest X...blood lipids and cholesterol, chest X-ray, urinalysis, visual acuity test, vestibular evaluation and liver function studies. Subjects will then take

Effect of same-sided and cross-body load carriage on 3D back shape in young adults.

PubMed

O'Shea, C; Bettany-Saltikov, J A; Warren, J G

2006-01-01

Regular carriage of heavy loads such as backpacks, satchels and mailbags results in a variety of acute medical problems and increased potential for back injury. There is a paucity of information about the specific changes in back posture that occur in response to asymmetrical loading. The purpose of this study was to examine the changes in back shape that occurred in response to asymmetrical load carriage, either on one shoulder (same-side) or across the body (cross-body), in healthy young adults. A convenience sample of 21 physiotherapy students randomly performed three trials (unloaded, same-side loaded, cross-body loaded) in standing with a 15% body load. The Microscribe 3DX digitiser (Immersion Group Ltd) recorded the three dimensional coordinates of 15 Key anatomical landmarks on the back in the three conditions. A one-way ANOVA with repeated measures and post-hoc tests was implemented to highlight statistical differences in the data collected (p<0.05). Significant differences were found in the x, y and z coordinates of the anatomical landmarks in the upper back between unloaded and loaded conditions. Results demonstrated significantly less impact on spinal posture from cross-body loading as compared to same-sided loading. This study confirms that there are significant three-dimensional changes in back shape in response to asymmetrical loading. Further work is needed to evaluate the optimal carriage type and maximal body load that results in the least spinal impact and injury potential in young adults.

Hemosuccus Pancreaticus following a Puestow Procedure in a Patient with Chronic Pancreatitis

PubMed Central

Okamoto, Hirotaka; Miura, Kazuo; Fujii, Hideki

2011-01-01

Hemosuccus pancreaticus is an unusual cause of gastrointestinal bleeding that occurs as a complication of chronic or acute pancreatitis. We report a case of extremely acute-onset hemosuccus pancreaticus occurring in a patient with chronic pancreatitis over a long-term follow-up after a Puestow procedure (side-to-side pancreaticojejunostomy). The patient was admitted to our hospital due to severe anemia and tarry stools indicative of gastrointestinal bleeding. Emergent endoscopy, including gastrointestinal fiberscopy and colon fiberscopy, showed no abnormal findings. Abdominal contrast-enhanced computed tomography and hemorrhagic scintigraphy did not detect a hemorrhagic lesion. Although interventional radiology was considered for diagnosis and treatment, conservative therapy seemed sufficient to affect hemostasis. Two weeks later, however, acute intestinal bleeding with hemodynamic shock occurred, and exploration was performed without delay. Intraoperative endoscopy through an incision of the reconstructed jejunal loop in the close proximal end revealed a site of active bleeding from the side-to-side anastomotic pancreatic duct. Following a longitudinal incision of the jejunal loop, a bleeding point was sutured and ligated on direct inspection. The patient showed a good postoperative course. PMID:21960948

Hemosuccus Pancreaticus following a Puestow Procedure in a Patient with Chronic Pancreatitis.

PubMed

Okamoto, Hirotaka; Miura, Kazuo; Fujii, Hideki

2011-05-01

Hemosuccus pancreaticus is an unusual cause of gastrointestinal bleeding that occurs as a complication of chronic or acute pancreatitis. We report a case of extremely acute-onset hemosuccus pancreaticus occurring in a patient with chronic pancreatitis over a long-term follow-up after a Puestow procedure (side-to-side pancreaticojejunostomy). The patient was admitted to our hospital due to severe anemia and tarry stools indicative of gastrointestinal bleeding. Emergent endoscopy, including gastrointestinal fiberscopy and colon fiberscopy, showed no abnormal findings. Abdominal contrast-enhanced computed tomography and hemorrhagic scintigraphy did not detect a hemorrhagic lesion. Although interventional radiology was considered for diagnosis and treatment, conservative therapy seemed sufficient to affect hemostasis. Two weeks later, however, acute intestinal bleeding with hemodynamic shock occurred, and exploration was performed without delay. Intraoperative endoscopy through an incision of the reconstructed jejunal loop in the close proximal end revealed a site of active bleeding from the side-to-side anastomotic pancreatic duct. Following a longitudinal incision of the jejunal loop, a bleeding point was sutured and ligated on direct inspection. The patient showed a good postoperative course.

Are Stupid Dice Necessary?

ERIC Educational Resources Information Center

Bermudez, Frank; Medina, Anthony; Rosin, Amber; Scott, Eren

2013-01-01

A pair of 6-sided dice cannot be relabeled to make the sums 2, 3,...., 12 equally likely. It is possible to label seven, 10-sided dice so that the sums 7. 8,..., 70 occur equally often. We investigate such relabelings for "pq"-sided dice, where "p" and "q" are distinct primes, and show that these relabelings usually…

Bone mineral density in relation to efficacy and side effects of budesonide and prednisolone in Crohn's disease.

PubMed

Schoon, Erik J; Bollani, Simona; Mills, Peter R; Israeli, Eran; Felsenberg, Dieter; Ljunghall, Sverker; Persson, Tore; Haptén-White, Louise; Graffner, Hans; Bianchi Porro, Gabriele; Vatn, Morten; Stockbrügger, Reinhold W

2005-02-01

Osteoporosis frequently occurs in Crohn's disease, often because of corticosteroids. Budesonide as controlled release capsules is a locally acting corticosteroid with low systemic bioavailability. We investigated its effects on bone compared with prednisolone. In 34 international centers, 272 patients with Crohn's disease involving ileum and/or colon ascendens were randomized to once daily treatment with budesonide or prednisolone for 2 years at doses adapted to disease activity. One hundred eighty-one corticosteroid-free patients had active disease (98 had never received corticosteroids, corticosteroid naive; 83 had received corticosteroids previously, corticosteroid exposed), and 90 had quiescent disease, receiving long-term low doses of corticosteroids, corticosteroid-dependent; in 1 patient, no efficacy data were obtained. Bone mineral density and fractures were assessed in a double-blinded fashion; disease activity, side effects, and quality of life were monitored. Neither the corticosteroid-free nor the corticosteroid-dependent patients treated with budesonide differed significantly in bone mineral density from those receiving prednisolone. However, corticosteroid-naive patients receiving budesonide had smaller reductions in bone mineral density than those on prednisolone (mean, -1.04% vs -3.84%; P = .0084). Treatment-emergent corticosteroid side effects were less frequent with budesonide. Efficacy was similar in both groups. Treatment with budesonide is associated with better preserved bone mass compared with prednisolone in only the corticosteroid-naive patients with active ileocecal Crohn's disease. In both the corticosteroid-free and corticosteroid-dependent groups, budesonide and prednisolone were equally effective for up to 2 years, but budesonide caused fewer corticosteroid side effects.

[Ketamine as anesthetic agent in electroconvulsion therapy].

PubMed

Janke, C; Bumb, J M; Aksay, S S; Thiel, M; Kranaster, L; Sartorius, A

2015-05-01

Electroconvulsive therapy (ECT) is a well-established, safe and effective treatment for severe psychiatric disorders. Ketamine is known as a core medication in anesthesiology and has recently gained interest in ECT practice as there are three potential advantages: (1) ketamine has no anticonvulsive actions, (2) according to recent studies ketamine could possess a unique intrinsic antidepressive potential and (3) ketamine may exhibit neuroprotective properties, which again might reduce the risk of cognitive side effects associated with ECT. The use of ketamine in psychiatric patients has been controversially discussed due to its dose-dependent psychotropic and psychotomimetic effects. This study was carried out to test if the occurrence of side effects is comparable and if seizure quality is better with ketamine when compared to thiopental. This retrospective study analyzed a total of 199 patients who received ketamine anesthesia for a total of 2178 ECT sessions. This cohort was compared to patients who were treated with thiopental for 1004 ECT sessions. A repeated measurement multiple logistic regression analysis revealed significant advantages in the ketamine group for seizure concordance and postictal suppression (both are surrogates for central inhibition). S-ketamin also necessitated the use of a higher dose of urapidil and a higher maximum postictal heart frequency. Clinically relevant psychiatric side effects were rare in both groups. No psychiatric side effects occurred in the subgroup of patients with schizophrenia (ketamine: n = 30). The mean dose of S-ketamine used increased in the first years but stabilized at 63 mg per patient in 2014. From these experiences it can be concluded that S-ketamine can be recommended at least as a safe alternative to barbiturates.

Water hammer reduces fouling during natural water ultrafiltration.

PubMed

Broens, F; Menne, D; Pothof, I; Blankert, B; Roesink, H D W; Futselaar, H; Lammertink, R G H; Wessling, M

2012-03-15

Today's ultrafiltration processes use permeate flow reversal to remove fouling deposits on the feed side of ultrafiltration membranes. We report an as effective method: the opening and rapid closing of a valve on the permeate side of an ultrafiltration module. The sudden valve closure generates pressure fluctuations due to fluid inertia and is commonly known as "water hammer". Surface water was filtrated in hollow fiber ultrafiltration membranes with a small (5%) crossflow. Filtration experiments above sustainable flux levels (>125 l (m2h)(-1)) show that a periodic closure of a valve on the permeate side improves filtration performance as a consequence of reduced fouling. It was shown that this effect depends on flux and actuation frequency of the valve. The time period that the valve was closed proved to have no effect on filtration performance. The pressure fluctuations generated by the sudden stop in fluid motion due to the valve closure are responsible for the effect of fouling reduction. High frequency recording of the dynamic pressure evolution shows water hammer related pressure fluctuations to occur in the order of 0.1 bar. The pressure fluctuations were higher at higher fluxes (higher velocities) which is in agreement with the theory. They were also more effective at higher fluxes with respect to fouling mitigation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Influence of short incompatible practice on the Simon effect: transfer along the vertical dimension and across vertical and horizontal dimensions.

PubMed

Conde, Erick F Q; Fraga-Filho, Roberto Sena; Lameira, Allan Pablo; Mograbi, Daniel C; Riggio, Lucia; Gawryszewski, Luiz G

2015-11-01

In spatial compatibility and Simon tasks, the response is faster when stimulus and response locations are on the same side than when they are on opposite sides. It has been shown that a spatial incompatible practice leads to a subsequent modulation of the Simon effect along the horizontal dimension. It has also been reported that this modulation occurs both along and across vertical and horizontal dimensions, but only after intensive incompatible training (600 trials). In this work, we show that this modulatory effect can be obtained with a smaller number of incompatible trials, changing the spatial arrangement of the vertical response keys to obtain a stronger dimensional overlap between the spatial codes of stimuli and response keys. The results of Experiment 1 showed that 80 incompatible vertical trials abolished the Simon effect in the same dimension. Experiment 2 showed that a modulation of the vertical Simon effect could be obtained after 80 horizontal incompatible trials. Experiment 3 explored whether the transfer effect can also occur in a horizontal Simon task after a brief vertical spatial incompatibility task, and results were similar to the previous experiments. In conclusion, we suggest that the spatial arrangement between response key and stimulus locations may be critical to establish the short-term memory links that enable the transfer of learning between brief incompatible practices and the Simon effects, both along the vertical dimension and across vertical and horizontal dimensions.

Patient communication in hormone therapy.

PubMed

Schnare, S M

2001-01-01

Common regimens of HRT therapy are reviewed, including common routes of hormone administration. Inconsistent patterns of HRT use are discussed, including the reasons women most often give for discontinuing hormone therapies. Specific issues related to misperceptions and fears regarding HRT are clarified, and specific, focused patient education formats are discussed to address women's common concerns about HRT. Obstacles to HRT use are elucidated, with suggestions for clinicians about how to communicate more effectively with women: clinicians must focus on emotional and physical aspects of HRT choices and tailor therapies to the individual patient. Discussing frankly the very serious concerns of women regarding the association between lobular breast cancer and endometrial cancer is important; discussing and preparing women for possible side effects helps patients cope better if and when side effects occur. Finally, offering a wide variety of HRT therapies provides women with a broader choice if an initial regimen is unsuccessful.

Polyamines are Inhibitors of Gastric Acid Secretion

NASA Astrophysics Data System (ADS)

Ray, Tushar K.; Nandi, Jyotirmoy; Pidhorodeckyj, Nykolai; Meng-Ai, Zhou

1982-03-01

The naturally occurring organic polycations such as spermine and spermidine inhibit histamine-stimulated gastric acid secretion by bullfrog gastric mucosa in vitro; spermine is much more potent than spermidine. Unlike the H2 receptor antagonists, the polyamines are completely ineffective from the nutrient side and are effective only from the secretory side of the chambered mucosa. The polyamine effects could be reversed by increasing K+ concentration in the secretory solution. Studies with isolated gastric microsomal vesicles demonstrate that the polyamines do not inhibit the gastric H+,K+-ATPase but greatly decrease the ATPase-mediated uptake of H+ under appropriate conditions. For the latter effects the presence of polyamine within the vesicle interior was found to be essential. Our data strongly suggest an uncoupling of the gastric H+,K+-ATPase system by the polyamines. The therapeutic potential of these and similar compounds in the treatment of hyperacidity and peptic ulcer is discussed.

Clinical outcome and prognosis of carbon ion radiotherapy on thoracic malignant tumors

NASA Astrophysics Data System (ADS)

Li, Sha

Objective To evaluate the therapeutic efficacy and side-response of high-LET carbon ion radiotherapy on thoracic malignant tumors. Methods Ten patients with pathological confirmed thoracic malignant tumors received treatment using heavy ion accelerator, which included 6 cases with non-small lung cancer, one case with small lung cancer, 2 cases with metastatic sarcomas and one case with invasive thymoma. The applied regimen included fractioned dose (5.5-6.8GyE/Fraction), one faction/day, and 7 fractions/week. The total dose ranged from 55 to 70 GyE. Results The short-term results showed that the response rate (the complete response (CR) rate +the partial response (PR) rate) was 10% at the first month, 40% at the third month and 90% at the sixth month. The overall response rate was 90% and the rate of stable disease was 10%. There was no relation between the response rate and tumor pathology (P>0.05) while significance between the response rate and the tumor volume.At median follow-up of 27 months (range, 6 to 36 months), the local control rate and free-disease rate were respectively 100% an 90% at the first year, 90% and 80% at the secondary year, 80% and 70% at the third year. The death rate due to disease progression was 20% and the non-specific death rate was 10%. Side and toxicity effects: Grade I skin effect occurred in three cases and Grade I lung effect occurred in two cases. The blood counts didn’t reach significance among pre-radiation course, peri-radiation course and post-radiation course (P>0.05). The subgoups of T cells detected in humoral immunity and cytoimmunity didn’t change between pre-radiation and post radiation(P>0.05). Conclusions Carbon ion radiotherapy is effective and safe in the management of patients with thoracic malignant tumors. There were no obvious side effects. The long term of clinical outcome and the late effect need to be further observed.

[Effectiveness comparison of anatomical single-bundle and over-the-top single-bundle reconstruction of anterior cruciate ligament].

PubMed

Dong, Yu; Chen, Shiyi; Li, Yunxia; Chen, Jiwu; Hua, Yinghui

2011-08-01

To compare the effectiveness of anatomical single-bundle (ASB) and over-the-top single-bundle (OSB) reconstruction of the anterior cruciate ligament (ACL). Between January 2008 and June 2008, 64 patients with ACL injury underwent arthroscopic ACL reconstruction. ASB ACL reconstruction was performed in 28 cases (ASB group) and OSB ACL reconstruction in 36 cases (OSB group). There was no significant difference in gender, age, disease duration, International Knee Documentation Committee (IKDC) score, Lysholm score, and side-to-side difference between 2 groups (P > 0.05). All incisions healed by first intention; no infection or other complications occurred. All cases were followed up 20-24 months (mean, 21.5 months). There were significant differences in the IKDC score, Lysholm score, and the side-to-side difference between last follow-up and preoperation in 2 groups (P < 0.05), but there was no significant difference between 2 groups at last follow-up (P > 0.05). Significant differences were found in negative rate of the pivot shift test between last follow-up and preoperation in ASB group and between 2 groups at last follow-up (P < 0.05), but there was no significant difference between last follow-up and preoperation in OSB group (P > 0.05). The effectiveness of arthroscopic ASB ACL reconstruction is better than that of arthroscopic OSB ACL reconstruction, especially in controlling rotational stability.

Droplet breakup driven by shear thinning solutions in a microfluidic T-junction

NASA Astrophysics Data System (ADS)

Chiarello, Enrico; Gupta, Anupam; Mistura, Giampaolo; Sbragaglia, Mauro; Pierno, Matteo

2017-12-01

Droplet-based microfluidics turned out to be an efficient and adjustable platform for digital analysis, encapsulation of cells, drug formulation, and polymerase chain reaction. Typically, for most biomedical applications, the handling of complex, non-Newtonian fluids is involved, e.g., synovial and salivary fluids, collagen, and gel scaffolds. In this study, we investigate the problem of droplet formation occurring in a microfluidic T-shaped junction, when the continuous phase is made of shear thinning liquids. At first, we review in detail the breakup process, providing extensive, side-by-side comparisons between Newtonian and non-Newtonian liquids over unexplored ranges of flow conditions and viscous responses. The non-Newtonian liquid carrying the droplets is made of Xanthan solutions, a stiff, rodlike polysaccharide displaying a marked shear thinning rheology. By defining an effective Capillary number, a simple yet effective methodology is used to account for the shear-dependent viscous response occurring at the breakup. The droplet size can be predicted over a wide range of flow conditions simply by knowing the rheology of the bulk continuous phase. Experimental results are complemented with numerical simulations of purely shear thinning fluids using lattice Boltzmann models. The good agreement between the experimental and numerical data confirm the validity of the proposed rescaling with the effective Capillary number.

Ablative fractional lasers (CO(2) and Er:YAG): a randomized controlled double-blind split-face trial of the treatment of peri-orbital rhytides.

PubMed

Karsai, Syrus; Czarnecka, Agnieszka; Jünger, Michael; Raulin, Christian

2010-02-01

Ablative fractional lasers were introduced for treating facial rhytides in an attempt to achieve results comparable to traditional ablative resurfacing but with fewer side effects. However, there is conflicting evidence on how well this goal has generally been achieved as well as on the comparative value of fractional CO(2) and Er:YAG lasers. The present study compares these modalities in a randomized controlled double-blind split-face study design. Twenty-eight patients were enrolled and completed the entire study. Patients were randomly assigned to receive a single treatment on each side of the peri-orbital region, one with a fractional CO(2) and one with a fractional Er:YAG laser. The evaluation included the profilometric measurement of wrinkle depth, the Fitzpatrick wrinkle score (both before and 3 months after treatment) as well as the assessment of side effects and patient satisfaction (1, 3, 6 days and 3 months after treatment). Both modalities showed a roughly equivalent effect. Wrinkle depth and Fitzpatrick score were reduced by approximately 20% and 10%, respectively, with no appreciable difference between lasers. Side effects and discomfort were slightly more pronounced after Er:YAG treatment in the first few days, but in the later course there were more complaints following CO(2) laser treatment. Patient satisfaction was fair and the majority of patients would have undergone the treatment again without a clear preference for either method. According to the present study, a single ablative fractional treatment session has an appreciable yet limited effect on peri-orbital rhytides. When fractional CO(2) and Er:YAG lasers are used in such a manner that there are comparable post-operative healing periods, comparable cosmetic improvement occurs. Multiple sessions may be required for full effect, which cancels out the proposed advantage of fractional methods, that is, fewer side effects and less down time.

Diagnosing the Causes and Severity of One-sided Message Contention

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

Tallent, Nathan R.; Vishnu, Abhinav; van Dam, Hubertus

Two trends suggest network contention for one-sided messages is poised to become a performance problem that concerns application developers: an increased interest in one-sided programming models and a rising ratio of hardware threads to network injection bandwidth. Unfortunately, it is difficult to reason about network contention and one-sided messages because one-sided tasks can either decrease or increase contention. We present effective and portable techniques for diagnosing the causes and severity of one-sided message contention. To detect that a message is affected by contention, we maintain statistics representing instantaneous (non-local) network resource demand. Using lightweight measurement and modeling, we identify themore » portion of a message's latency that is due to contention and whether contention occurs at the initiator or target. We attribute these metrics to program statements in their full static and dynamic context. We characterize contention for an important computational chemistry benchmark on InfiniBand, Cray Aries, and IBM Blue Gene/Q interconnects. We pinpoint the sources of contention, estimate their severity, and show that when message delivery time deviates from an ideal model, there are other messages contending for the same network links. With a small change to the benchmark, we reduce contention up to 50% and improve total runtime as much as 20%.« less

Electrical and optical characterization of n-InAsSb/n-GaSb heterojunctions

NASA Astrophysics Data System (ADS)

Lackner, D.; Martine, M.; Cherng, Y. T.; Steger, M.; Walukiewicz, W.; Thewalt, M. L. W.; Mooney, P. M.; Watkins, S. P.

2010-01-01

We report the electrical properties of n-InAsSb/n-GaSb heterojunctions as a function of the GaSb doping concentration. Because of the staggered type II band alignment, strong electron accumulation occurs on the InAsSb side. For low GaSb doping, depletion occurs on the GaSb side resulting in a Schottky-like junction as previously reported. As the GaSb doping increases, the built-in voltage as well as depletion width decreases as shown using self-consistent simulations. For GaSb doping levels above 5×1017 cm-3, the junction loses its rectifying properties due to tunneling. Under zero and reverse bias voltage, the photoresponse of these diodes is solely due to the photovoltaic effect in the GaSb depletion region. For forward bias voltages >400 mV, we also observed a photoconductive response from the InAsSb layer. The proposed physical mechanism is quite different from the one suggested in a recent paper.

Lost in laterality: interpreting ''preferred side of the head during mobile phone use and risk of brain tumour'' associations.

PubMed

Schüz, Joachim

2009-08-01

Due to the highly localized exposure from mobile phones, the preferred side of the head during their use is important information when investigating a possible link with brain tumour risk, but at the same time, error and bias hamper the assessment of this information in case-control studies. Current studies provide evidence of reporting bias insofar as cases appear to over-report the side of the head where the tumour occurred as the one that they preferred in the past when using mobile phones. More refined methods of analysis among only cases or prospective studies with an assessment of the laterality of mobile phone use before the diagnosis of disease are needed to evaluate whether associations seen in some studies are entirely due to reporting bias or a mixture of reporting bias and a causal effect.

Splenic trauma as an adverse effect of torso-protecting side airbags: biomechanical and case evidence.

PubMed

Hallman, Jason J; Brasel, Karen J; Yoganandan, Narayan; Pintar, Frank A

2009-10-01

Injury mechanisms from frontal airbags, first identified in anecdotal reports, are now well documented for pediatric, small female, and out-of-position occupants. In contrast, torso side airbags have not yet been consistently associated with specific injury risks in field assessments. To determine possible torso side airbag-related injuries, the present study identified crashes involving side airbags from reports within the CIREN, NASS, and SCI databases. Injury patterns were compared to patterns from lateral crashes in absence of side airbag. Splenic trauma (AIS 3+) was found present in five cases of torso side airbag deployment at lower impact severity (as measured by velocity change and compartment intrusion) than cases of splenic trauma without side airbag. Five additional cases were found to contain similar injury patterns but occurred with greater crash severity. To supplement case analyses, full scale sled tests were conducted with a THOR-NT dummy and cadaveric specimen. Four THOR tests with door- and seat-mounted torso side airbags confirmed that out-of-position (early inflation stage) airbag contact elevated thoracic injury metrics compared to optimal (fully inflated) contact. Out-of-position seat-mounted airbag deployment also produced AIS 3 splenic trauma in the cadaveric specimen. Due to potentially sudden or delayed onset of intraperitoneal hemorrhage and hypovolemic shock following splenic trauma, further biomechanical investigation of this anecdotal evidence is essential to identify injury mechanisms, prevention techniques, and methods for early diagnosis.

Splenic Trauma as an Adverse Effect of Torso-Protecting Side Airbags: Biomechanical and Case Evidence

PubMed Central

Hallman, Jason J.; Brasel, Karen J.; Yoganandan, Narayan; Pintar, Frank A.

2009-01-01

Injury mechanisms from frontal airbags, first identified in anecdotal reports, are now well documented for pediatric, small female, and out-of-position occupants. In contrast, torso side airbags have not yet been consistently associated with specific injury risks in field assessments. To determine possible torso side airbag-related injuries, the present study identified crashes involving side airbags from reports within the CIREN, NASS, and SCI databases. Injury patterns were compared to patterns from lateral crashes in absence of side airbag. Splenic trauma (AIS 3+) was found present in five cases of torso side airbag deployment at lower impact severity (as measured by velocity change and compartment intrusion) than cases of splenic trauma without side airbag. Five additional cases were found to contain similar injury patterns but occurred with greater crash severity. To supplement case analyses, full scale sled tests were conducted with a THOR-NT dummy and cadaveric specimen. Four THOR tests with door- and seat-mounted torso side airbags confirmed that out-of-position (early inflation stage) airbag contact elevated thoracic injury metrics compared to optimal (fully inflated) contact. Out-of-position seat-mounted airbag deployment also produced AIS 3 splenic trauma in the cadaveric specimen. Due to potentially sudden or delayed onset of intraperitoneal hemorrhage and hypovolemic shock following splenic trauma, further biomechanical investigation of this anecdotal evidence is essential to identify injury mechanisms, prevention techniques, and methods for early diagnosis. PMID:20184829

Mood alterations during interferon-alfa therapy in patients with chronic hepatitis C: evidence for an overlap between manic/hypomanic and depressive symptoms.

PubMed

Constant, Aymery; Castera, Laurent; Dantzer, Robert; Couzigou, Patrice; de Ledinghen, Victor; Demotes-Mainard, Jacques; Henry, Chantal

2005-08-01

Psychiatric side effects are common during interferon-alfa (IFN-alfa) therapy and often responsible for early treatment discontinuation, thus limiting its therapeutic potential. Depression is considered the hallmark of these side effects. However, irritability, anger/hostility, and manic/hypomanic episodes have also been reported, suggesting that these symptoms are important features of IFN-alfa-induced neuropsychiatric side effects. The aim of this prospective study was to use item-by-item analysis to thoroughly characterize neuropsychiatric symptoms occurring during early IFN-alfa therapy in a large cohort of patients with chronic hepatitis C. Ninety-three previously IFN-alfa-naive patients treated with pegylated IFN-alfa plus ribavirin for chronic hepatitis C were studied. Neuropsychiatric assessments were conducted before initiation and after weeks 4 and 12 of antiviral therapy. They included the Mini-International Neuropsychiatric Interview, the 10-item Montgomery-Asberg Depression Rating Scale, the State-Trait Anxiety Inventory, and the Brief Fatigue Inventory. Psychiatric events occurred in 30 patients (32%). They consisted of mood disorders in all cases: mania in 3 cases (10%), irritable hypomania in 15 cases (50%), and depressive mixed states in 12 cases (40%). Neurovegetative symptoms appeared within 4 weeks in most patients. In patients who developed mood disorders, sadness and depressive thoughts were present but minimal in severity. In contrast, inner tension and anxiety symptoms increased significantly over time only in these patients. Our results suggest that IFN-alfa-induced mood disorders are common and consist of an overlap between depressive and manic symptoms rather than a mere depression. The impact of such findings on therapeutic management should be investigated.

Neglect dyslexia: a review of the neuropsychological literature.

PubMed

Vallar, Giuseppe; Burani, Cristina; Arduino, Lisa S

2010-10-01

Neglect dyslexia (ND) is reviewed, based on published single-patient and group studies. ND is frequently associated with right hemispheric damage and unilateral spatial neglect (USN), and typically involves the left side of the letter string. Left-brain-damaged patients showing ND, ipsilateral (left) or contralateral (right) to the side of the left-sided hemispheric lesion, have also been reported, as well as a few patients with bilateral damage, with more frequently left than right ND. As USN, ND is temporarily ameliorated by lateralized stimulations (vestibular caloric, visual prism adaptation). ND may occur independent of USN, suggesting the damage to specific visuospatial representational/attentional systems, supporting reading. ND errors comprise omission, substitution, and, less frequently, addition of letters on one side of the stimulus, resulting in words or nonwords, also with reference to the stimulus' linguistic features. Patients with ND may show preserved lexical-morphological effects and implicit processing, up to the semantic level, of the misread string. This preserved processing is a feature of ND, shared with the USN syndrome. The mechanisms modulating error type and lexical-morphological effects are partly independent of each other. Different levels of representation of the letter string may be affected, giving rise to egocentric, stimulus-centred, and word-centred patterns of impairment. The anatomical correlates of ND include the temporo-parieto-occipital regions.

Yellow fever vaccination in organ transplanted patients: is it safe? A multicenter study.

PubMed

Azevedo, L S; Lasmar, E P; Contieri, F L C; Boin, I; Percegona, L; Saber, L T S; Selistre, L S; Netto, M V P; Moreira, M C V; Carvalho, R M; Bruno, R M; Ferreira, T C A; David-Neto, E

2012-06-01

Yellow fever (YF) may be very serious, with mortality reaching 50%. Live attenuated virus YF vaccine (YFV) is effective, but may present, although rare, life-threatening side effects and is contraindicated in immunocompromised patients. However, some transplant patients may inadvertently receive the vaccine. A questionnaire was sent to all associated doctors to the Brazilian Organ Transplantation Association through its website, calling for reports of organ transplanted patients who have been vaccinated against YF. Twelve doctors reported 19 cases. None had important side effects. Only one had slight reaction at the site of YFV injection. Eleven patients were male. Organs received were 14 kidneys, 3 hearts, and 2 livers. Twelve patients received organs from deceased donors. Mean age at YFV was 45.6 ± 13.6 years old (range 11-69); creatinine: 1.46 ± 0.62 mg/dL (range 0.8-3.4); post-transplant time: 65 ± 83.9 months (range 3-340); and time from YFV at the time of survey: 45 ± 51 months (range 3-241). Immunosuppression varied widely with different drug combinations: azathioprine (7 patients), cyclosporine (8), deflazacort (1), mycophenolate (10), prednisone (11), sirolimus (3), and tacrolimus (4). YFV showed no important side effects in this cohort of solid organ transplanted patients. However, owing to the small number of studied patients, it is not possible to extend these findings to the rest of the transplanted population, assuring safety. Therefore, these data are not strong enough to safely recommend YFV in organ transplanted recipients, as severe, even life-threatening side effects may occur. © 2011 John Wiley & Sons A/S.

Low dose mTHPC photodynamic therapy for cholangiocarcinoma

NASA Astrophysics Data System (ADS)

Stepp, Herbert; Kniebühler, Gesa; Pongratz, Thomas; Betz, Christian S.; Göke, Burkhard; Sroka, Ronald; Schirra, Jörg

2013-06-01

Objective: Demonstration of whether a low dose of mTHPC (temoporfin , Foscan) is sufficient to induce an efficient clinical response in palliative PDT of non-resectable cholangiocarcinoma (CC), while showing a low side effect profile as compared to the standard Photofrin PDT. Materials and Methods: 13 patients (14 treatment sessions) with non-resectable CC were treated with stenting and PDT (3 mg Foscan per treatment, 0.032-0.063 mg/kg body weight, 652 nm, 50 J/cm). Fluorescence measurements were performed with a single bare fiber for 5/13 patients prior to PDT at the tumor site to determine the fluorescence contrast. For another 7/13 patients, long-term fluorescence-kinetics were measured on the oral mucosa to determine the time of maximal relative fluorescence intensity. Results: Foscan fluorescence could clearly be identified spectroscopically as early as 20 hours after administration. It was not significantly different between lesion and normal tissue within the bile duct. Fluorescence kinetics assessed at the oral mucosa were highest at 72-96 hours after administration. The DLI was therefore extended from 20 hours to approx. 70 hours for the last 5 patients treated. The treatment effect was promising with a median survival of 11 months for the higher grade tumors (Bismuth types III and IV). Local side effects occurred in one patient (pancreatitis), systemic side effects were much reduced compared to prior experience with Photofrin. Conclusion: Combined stenting and photodynamic therapy (PDT) performed with a low dose of Foscan results in comparable survival times relative to standard Photofrin PDT, while lowering the risk of side effects significantly.

A comparison between monophasic levonorgestrel-ethinyl estradiol 150/30 and triphasic levonorgestrel-ethinyl estradiol 50-75-125/30-40-30 contraceptive pills for side effects and patient satisfaction: a study in Iran.

PubMed

Kashanian, Maryam; Shahpourian, Farangis; Zare, Omolbanin

2010-05-01

Oral contraceptive pills (OCPs) are one of the most effective reversible and accessible contraceptives, and patient acceptance for their use depends partly on the unfavorable adverse effects. The present study compared the two kinds of OCPs (monophasic; levonorgestrel (LNG)-ethinyl estradiol (EE) 150/30 versus triphasic; LNG-EE 50-75-125/30-40-30) for adverse effects and patient satisfaction. A randomized clinical trial was performed on 314 women who used OCPs for the first time, as their contraception, for 6 months. Overall, 1884 cycles were studied. In the monophasic group (n=159 who finally finished the study), monophasic pills LNG-EE 150/30mcg, and in the triphasic group (n=155 who finally finished the study), triphasic pills LNG-EE 50-75-125/30-40-30 mcg were used. Statistical analysis was performed using SPSS 10: Chi square test, Fisher exact test and Student's t-test were used. There were no significant differences between the two groups for common side effects, including nausea, headache, nervousness, facial hyperpigmentation (chloasma), and body weight (increase or decrease) but breakthrough bleeding and spotting (BTB/S) were less in the triphasic group, occurring in 30 cycles (18.86%) versus 10 cycles (6.45%), P=0.009*. Patient satisfaction for the two OCPs was similar and high. The rates of side effects were low. It seems that the monophasic and triphasic pills are similar according to patient satisfaction and side effects; therefore there is no benefit of one over the other except for BTB/S, for which triphasic is superior. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

Experimental static aerodynamics of a regular hexagonal prism in a low density hypervelocity flow

NASA Technical Reports Server (NTRS)

Guy, R. W.; Mueller, J. N.; Lee, L. P.

1972-01-01

A regular hexagonal prism, having a fineness ratio of 1.67, has been tested in a wind tunnel to determine its static aerodynamic characteristics in a low-density hypervelocity flow. The prism tested was a 1/4-scale model of the graphite heat shield which houses the radioactive fuel for the Viking spacecraft auxiliary power supply. The basic hexagonal prism was also modified to simulate a prism on which ablation of one of the six side flats had occurred. This modified hexagonal prism was tested to determine the effects on the aerodynamic characteristics of a shape change caused by ablation during a possible side-on stable reentry.

Effect of pH on ion current through conical nanopores

NASA Astrophysics Data System (ADS)

Chander, M.; Kumar, R.; Kumar, S.; Kumar, N.

2018-05-01

Here, we examined ionic current behavior of conical nanopores at different pH and a fixed ion concentration of potassium halide (KCl). Conical shaped nanopores have been developed by chemical etching technique in polyethylene terephthalate (PET) membrane/foil of thickness 12 micron. For this we employed a self-assembled electrochemical cell having two chambers and the foil was fitted in the centre of cell. The nanopores were produced in the foil using etching and stopping solutions. The experimental results show that ionic current rectification (ICR) occurs through synthesized conical nanopores. Further, ion current increases significantly with increase of voltage from the base side of nanopores to the tip side at fixed pH of electrolyte.

Surgical excision and immediate postoperative radiotherapy versus cryotherapy and intralesional steroids in the management of keloids: a prospective clinical trial.

PubMed

Emad, Maryam; Omidvari, Shapour; Dastgheib, Ladan; Mortazavi, Afshin; Ghaem, Haleh

2010-01-01

To compare the efficacy and tolerability of surgical excision and radiotherapy with those of cryotherapy and intralesional steroid treatment of keloids. Twenty-six patients with a total of 76 keloids were enrolled in this study. Nineteen patients with 44 keloids underwent surgical excision combined with immediate 12-Gy irradiation (group A) while the remaining 9 patients with 32 keloids received multiple sessions of intralesional steroid treatment after cryotherapy which continued until flattening of lesion(s) occurred (group B). Two patients were included in both treatment groups. All patients were followed up at regular intervals for at least 1 year. In both treatment groups, keloids responded well without any major side effect. While patients of group A were all satisfied, those of group B (with a mean number of treatment sessions of 5.84 +/- 2.51) experienced more side effects, a more prolonged course, a higher recurrence rate and less satisfaction. This study showed that surgery plus immediate postoperative irradiation was an effective and relatively safe choice for treatment of keloids. Although cryotherapy combined with intralesional steroids was associated with more side effects and higher relapse rates, it could be a good choice for small and newly formed keloids. Copyright 2010 S. Karger AG, Basel.

Treatment of chronic recurrent juvenile parotitis using sialendoscopy.

PubMed

Mikolajczak, Stefanie; Meyer, Moritz Friedo; Beutner, Dirk; Luers, Jan Christoffer

2014-05-01

The combination of sialendoscopy and an intraductal application of corticosteroids can be recommended for children with chronic recurrent juvenile parotitis (CRJP) as there is growing evidence for a positive effect in the absence of side effects. CRJP is a disorder with painful, episodic swelling of the parotid gland in children. The majority of cases have a self-limiting character within 5-10 years, but the disease may also continue into adulthood. CRJP can occur on one or both sides and up to now the etiology has been unclear. The aim of this study was to analyze the therapeutic effect of a sialendoscopic application of corticosteroids on the clinical course of patients with CRJP. We retrospectively analyzed the clinical course of 9 children with 10 parotid glands affected by CRJP, who all underwent sialendoscopy and intraductal application of corticosteroids. In all cases the procedure was conducted under general anesthesia. The average follow-up period was 15 months. There were no side effects associated with the sialendoscopy. All duct systems showed signs of chronic inflammation with an atrophic or thickened epithelium. At the follow-up visit, CRJP symptoms had completely resolved in eight children. One child still showed slight parotid swellings without the need for antibiotics. None of the parents reported that symptoms had continued at an equal level or worsened after sialendoscopy.

Geologic effects of hurricanes

NASA Astrophysics Data System (ADS)

Coch, Nicholas K.

1994-08-01

Hurricanes are intense low pressure systems of tropical origin. Hurricane damage results from storm surge, wind, and inland flooding from heavy rainfall. Field observations and remote sensing of recent major hurricanes such as Hugo (1989), Andrew (1992) and Iniki (1992) are providing new insights into the mechanisms producing damage in these major storms. Velocities associated with hurricanes include the counterclockwise vortex winds flowing around the eye and the much slower regional winds that steer hurricane and move it forward. Vectorial addition of theseof these two winds on the higher effective wind speed than on the left side. Coast-parallel hurricane tracks keep the weaker left side of the storm against the coast, whereas coast-normal tracks produce a wide swath of destruction as the more powerful right side of the storm cuts a swath of destruction hundreds of kilometers inland. Storm surge is a function of the wind speed, central pressure, shelf slope, shoreline configuration, and anthropogenic alterations to the shoreline. Maximum surge heights are not under the eye of the hurricane, where the pressure is lowest, but on the right side of the eye at the radius of maximum winds, where the winds are strongest. Flood surge occurs as the hurricane approaches land and drives coastal waters, and superimposed waves, across the shore. Ebb surge occurs when impounded surface water flows seaward as the storm moves inland. Flood and ebb surge damage have been greatly increased in recent hurricanes as a result of anthropogenic changes along the shoreline. Hurricane wind damage occurs on three scales — megascale, mesoscale and microscale. Local wind damage is a function of wind speed, exposure and structural resistance to velocity pressure, wind drag and flying debris. Localized extreme damage is caused by gusts that can locally exceed sustained winds by a factor of two in areas where there is strong convective activity. Geologic changes occuring in hurricanes include beach erosion, dune erosion, inlet formation from flood and ebb surge, landscape changes through tree destruction by wind and nearshore channeling and sedimentation resulting from ebb surge. Multi-decadal wet and dry cycles in West Africa seem to be associated with increases (wet periods) and decreases (dry periods) in the frequency of Atlantic Coast landfalling hurricanes. Coastalzone population and development has increased markedly in a time of low hurricane frequency in the 24 year dry cycle from1970 to the present. However, no previous climatic cycle in this century has exceeded 26 years. We may entering a multi-decadal cycle of greater hurricane activity, placing these highly urbanized shorelines in considerable danger.

Central nervous system considerations in the use of beta-blockers, angiotensin-converting enzyme inhibitors, and thiazide diuretics in managing essential hypertension.

PubMed

Gengo, F M; Gabos, C

1988-07-01

The most common mild side effects occurring with use of beta-blockers, thiazide diuretics, and angiotensin-converting enzyme inhibitors for blood pressure control are central nervous system symptoms, specifically lethargy, sedation, and fatigue. These symptoms affect 5% to 10% of patients taking these drugs. The mechanism by which beta-blockers may induce central nervous system effects is uncertain. Relative lipophilicity as a factor affecting penetrance of the blood-brain barrier has not proved to be a reliable predictor of whether the drug will cause such disturbances. Comparisons of atenolol (hydrophilic) and metoprolol (lipophilic) have shown no differences between these drugs with respect to side effects of the central nervous system. The incidence of central nervous system effects with angiotensin-converting enzyme inhibitors is similar to that for most beta-blockers. The precise role of the angiotensin-converting enzyme in the central nervous system is not well defined. Most thiazide diuretics are not associated with major complications of the central nervous system, although electrolyte imbalance may occasionally lead to complaints of neurologic symptoms. Because the incidence of central nervous system effects with these three classes of drugs is so low, concern for the side effects of the central nervous system is not a prime consideration in the choice of an initial antihypertensive agent.

Investigation of the Effects of High-Intensity, Intermittent Exercise and Unanticipation on Trunk and Lower Limb Biomechanics During a Side-Cutting Maneuver Using Statistical Parametric Mapping.

PubMed

Whyte, Enda F; Richter, Chris; OʼConnor, Siobhan; Moran, Kieran A

2018-06-01

Whyte, EF, Richter, C, O'Connor, S, and Moran, KA. Investigation of the effects of high-intensity, intermittent exercise and unanticipation on trunk and lower limb biomechanics during a side-cutting maneuver using statistical parametric mapping. J Strength Cond Res 32(6): 1583-1593, 2018-Anterior cruciate ligament (ACL) injuries frequently occur during side-cutting maneuvers when fatigued or reacting to the sporting environment. Trunk and hip biomechanics are proposed to influence ACL loading during these activities. However, the effects of fatigue and unanticipation on the biomechanics of the kinetic chain may be limited by traditional discrete point analysis. We recruited 28 male, varsity, Gaelic footballers (21.7 ± 2.2 years; 178.7 ± 14.6 m; 81.8 ± 11.4 kg) to perform anticipated and unanticipated side-cutting maneuvers before and after a high-intensity, intermittent exercise protocol (HIIP). Statistical parametric mapping (repeated-measures analysis of varience) identified differences in phases of trunk and stance leg biomechanics during weight acceptance. Unanticipation resulted in less trunk flexion (p < 0.001) and greater side flexion away from the direction of cut (p < 0.001). This led to smaller (internal) knee flexor and greater (internal) knee extensor (p = 0.002-0.007), hip adductor (p = 0.005), and hip external rotator (p = 0.007) moments. The HIIP resulted in increased trunk flexion (p < 0.001) and side flexion away from the direction of cut (p = 0.038), resulting in smaller (internal) knee extensor moments (p = 0.006). One interaction effect was noted demonstrating greater hip extensor moments in the unanticipated condition post-HIIP (p = 0.025). Results demonstrate that unanticipation resulted in trunk kinematics considered an ACL injury risk factor. A subsequent increase in frontal and transverse plane hip loading and sagittal plane knee loading was observed, which may increase ACL strain. Conversely, HIIP-induced trunk kinematic alterations resulted in reduced sagittal plane knee and subsequent ACL loading. Therefore, adequate hip and knee control is important during unanticipated side-cutting maneuvers.

Variation in xylem formation of Viburnum odoratissimum var. awabuki: growth strain and related anatomical features of branches exhibiting unusual eccentric growth.

PubMed

Wang, Yue; Gril, Joseph; Sugiyama, Junji

2009-05-01

Growth strains (GSs) and growth eccentricity in the branches of Viburnum odoratissimum var. awabuki (K. Koch) Zabel were measured. A pronounced growth promotion occurred on the lower side of some branches. Although the GS of the branches was similar to that of normal wood, a larger GS was observed on the upper side of the branches. Thus, eccentric growth occurred on the side opposite to the larger GS. In addition, there was a strong negative relationship between f-back bending and eccentric growth, indicating that eccentric growth largely precluded correction to the vertical position. To understand the function of eccentric growth on the lower side of the branches, we examined several anatomical features of the branches and found that (1) the cell walls of both sides lacked the gelatinous layer, (2) the microfibril angle measured by X-ray diffraction and polarizing light was small on both the upper and the lower sides and (3) the vessel number and the cell wall area did not change to a large extent. The anatomical features of the xylem did not differ obviously between the upper and the lower sides of the branches; however, the fibers were longer on the lower side than on the upper side. These results suggest that the growth stress pattern and formation of branch architecture in V. odoratissimum differ from those observed in other woody angiosperms.

A density functional theory study on peptide bond cleavage at aspartic residues: direct vs cyclic intermediate hydrolysis.

PubMed

Sang-aroon, Wichien; Amornkitbamrung, Vittaya; Ruangpornvisuti, Vithaya

2013-12-01

In this work, peptide bond cleavages at carboxy- and amino-sides of the aspartic residue in a peptide model via direct (concerted and step-wise) and cyclic intermediate hydrolysis reaction pathways were explored computationally. The energetics, thermodynamic properties, rate constants, and equilibrium constants of all hydrolysis reactions, as well as their energy profiles were computed at the B3LYP/6-311++G(d,p) level of theory. The result indicated that peptide bond cleavage of the Asp residue occurred most preferentially via the cyclic intermediate hydrolysis pathway. In all reaction pathways, cleavage of the peptide bond at the amino-side occurred less preferentially than at the carboxy-side. The overall reaction rate constants of peptide bond cleavage of the Asp residue at the carboxy-side for the assisted system were, in increasing order: concerted < step-wise < cyclic intermediate.

Clozapine Associated with Autoimmune Reaction, Fever and Low Level Cardiotoxicity – A Case Report

PubMed Central

GERASIMOU, CHARILAOS; PHAEDRA VITALI, GEORGIA; D. VAVOUGIOS, GEORGE; PAPAGEORGIOU, CHARALABOS; DOUZENIS, ATHANASIOS; I. KOKORIS, STYLIANI; LIAPPAS, IOANNIS; RIZOS, EMMANOUIL

2017-01-01

Background: Clozapine is a second-generation antipsychotic drug used in treatment-resistant schizophrenia. Fever induced by clozapine is a rather frequent side-effect which usually occurs in the first 4 weeks of treatment. Despite its effectiveness, there are potentially life-threatening adverse effects, such as cardiotoxicity. Case Report: We present the case of a 31- year-old caucasian male with refractory schizophrenia who developed benign fever, increase of C-reactive protein and high troponin levels, without presenting any other signs to myocarditis, on the 13th day under clozapine treatment, which declined progressively upon discontinuation of the drug. Discussion: This case hints at the presence of initially subclinical cardiotoxicity as an underlying factor in patients developing fever. Conclusion: Taking advantage of more sensitive methods for measuring troponin, clinicians would be promptly aware of this possible side-effect. This would allow for significant reduction of the risk of cardiac dysfunction, further attained by carefully monitoring the patient. PMID:28064233

Clozapine Associated with Autoimmune Reaction, Fever and Low Level Cardiotoxicity - A Case Report.

PubMed

Gerasimou, Charilaos; Vitali, Georgia Phaedra; Vavougios, George D; Papageorgiou, Charalabos; Douzenis, Athanasios; Kokoris, Styliani I; Liappas, Ioannis; Rizos, Emmanouil

2017-01-02

Clozapine is a second-generation antipsychotic drug used in treatment-resistant schizophrenia. Fever induced by clozapine is a rather frequent side-effect which usually occurs in the first 4 weeks of treatment. Despite its effectiveness, there are potentially life-threatening adverse effects, such as cardiotoxicity. We present the case of a 31-year-old caucasian male with refractory schizophrenia who developed benign fever, increase of C-reactive protein and high troponin levels, without presenting any other signs to myocarditis, on the 13th day under clozapine treatment, which declined progressively upon discontinuation of the drug. This case hints at the presence of initially subclinical cardiotoxicity as an underlying factor in patients developing fever. Taking advantage of more sensitive methods for measuring troponin, clinicians would be promptly aware of this possible side-effect. This would allow for significant reduction of the risk of cardiac dysfunction, further attained by carefully monitoring the patient. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Synchronized vortex shedding and sound radiation from two side-by-side rectangular cylinders of different cross-sectional aspect ratios

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

Octavianty, Ressa, E-mail: ressa-octavianty@ed.tmu.ac.jp; Asai, Masahito, E-mail: masai@tmu.ac.jp

Synchronized vortex shedding from two side-by-side cylinders and the associated sound radiation were examined experimentally at Reynolds numbers of the order of 10{sup 4} in low-Mach-number flows. In addition to a pair of square cylinders, a pair of rectangular cylinders, one with a square cross section (d × d) and the other with a rectangular cross section (d × c) having a cross-sectional aspect ratio (c/d) of 1.2–1.5, was considered. The center-to-center distance between the two cylinders L/d was 3.6, 4.5, and 6.0; these settings were within the non-biased flow regime for side-by-side square cylinders. In case of a squaremore » cylinder pair, anti-phase synchronized vortex shedding occurring for L/d = 3.6 and 4.5 generated a quadrupole-like sound source which radiated in-phase, planar-symmetric sound in the far field. Synchronized vortex shedding from the two rectangular cylinders with different c/d also occurred with almost the same frequency as the characteristic frequency of the square-cylinder wake in the case of the small center-to-center distance, L/d = 3.6, for all the cylinder pairs examined. The synchronized sound field was anti-phase and asymmetric in amplitude, unlike the case of a square cylinder pair. For larger spacing L/d = 4.5, synchronized vortex shedding and anti-phase sound still occurred, but only for close cross-sectional aspect ratios (c/d = 1.0 and 1.2), and highly modulated sound was radiated with two different frequencies due to non-synchronized vortex shedding from the two cylinders for larger differences in c/d. It was also found that when synchronized vortex shedding occurred, near-wake velocity fluctuations exhibited high spanwise-coherency, with a very sharp spectral peak compared with the single-cylinder case.« less

Low doses of haloperidol combined with ondansetron are not effective for prophylaxis of postoperative nausea and vomiting in susceptible patients.

PubMed

Veiga-Gil, Leonor; López-Olaondo, Luis; Pueyo, Javier; Callejas, Raquel; Duque, Paula; Carrascosa, Francisco

2015-02-01

In this observational study we reviewed the efficacy and side effects of different antiemetic combinations used in our hospital for postoperative nausea and vomiting (PONV) prophylaxis in high-risk women undergoing highly emetogenic surgery. After reviewing retrospectively the medical records of patients undergoing highly emetogenic elective surgeries under general anaesthesia, we selected 368 women whose Apfel risk score was ≥ 3 and receiving a combination of 2 antiemetics for PONV prophylaxis. We analysed the incidence of PONV at 2, 6, 12 and 24h after surgery, antiemetic rescue requirements, pattern of occurrence of PONV, side effects and level of sedation were also assessed. The main goal was complete response defined as no PONV within 24h after surgery. Ondansetron 4mg i.v. plus dexamethasone 8mg i.v. (O&Dex), haloperidol 1mg i.v. (O&Hal1), haloperidol 2mg i.v. (O&Hal2) or droperidol 1.25mg i.v. (O&Dro) were the combinations most frequently used. The complete response was better in groups O&Dex: 68.5% (CI: 58-78), O&Hal2: 64.1% (CI: 53-74) and O&Dro 63% (CI: 52-73) than in group O&Hal1: 41.3% (CI: 31-52) (p<0,01). Peak incidence of PONV occurred within the 2-6h period. The incidence of side effects was higher in group O&Hal2. In high risk patients for PONV who underwent highly emetogenic surgeries, the efficacy of low-dose haloperidol (1mg) in combination is limited. Higher doses (2mg) are more effective but its use is associated with a high incidence of side effects. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Azithromycin induced hepatocellular toxicity and hepatic encephalopathy in asymptomatic dilated cardiomyopathy

PubMed Central

Das, Bidyut Kumar

2011-01-01

Azithromycin is a widely used macrolide derivative and has generally been considered to be a very safe medication. Though gastrointestinal symptoms and reversible hearing loss are common, potentially serious side effects including angioedema and cholestatic jaundice occurred in less than one percent of patients. We report a case of asymptomatic dilated cardiomyopathy with Azithromycin induced severe hepatocellular toxicity and hepatic encephalopathy. PMID:22144789

Transition to the Wired World: A Model for the Study of Potential Side-Effects of Information Inequity.

ERIC Educational Resources Information Center

Salvaggio, Jerry L.; Trettevik, Susan K.

The possibility that industrial nations will become "global villages" or comprise a "wired world" with a common information system appears possible in light of technology, but there are five major reasons why such an information society will not occur for some decades, particularly in the United States. The reasons are as follows: (1) there is no…

In vivo systemic chlorogenic acid therapy under diabetic conditions: Wound healing effects and cytotoxicity/genotoxicity profile.

PubMed

Bagdas, Deniz; Etoz, Betul Cam; Gul, Zulfiye; Ziyanok, Sedef; Inan, Sevda; Turacozen, Ozge; Gul, Nihal Yasar; Topal, Ayse; Cinkilic, Nilufer; Tas, Sibel; Ozyigit, Musa Ozgur; Gurun, Mine Sibel

2015-07-01

Oxidative stress occurs following the impairment of pro-oxidant/antioxidant balance in chronic wounds and leads to harmful delays in healing progress. A fine balance between oxidative stress and endogenous antioxidant defense system may be beneficial for wound healing under redox control. This study tested the hypothesis that oxidative stress in wound area can be controlled with systemic antioxidant therapy and therefore wound healing can be accelerated. We used chlorogenic acid (CGA), a dietary antioxidant, in experimental diabetic wounds that are characterized by delayed healing. Additionally, we aimed to understand possible side effects of CGA on pivotal organs and bone marrow during therapy. Wounds were created on backs of streptozotocin-induced diabetic rats. CGA (50 mg/kg/day) was injected intraperitoneally. Animals were sacrificed on different days. Biochemical and histopathological examinations were performed. Side effects of chronic antioxidant treatment were tested. CGA accelerated wound healing, enhanced hydroxyproline content, decreased malondialdehyde/nitric oxide levels, elevated reduced-glutathione, and did not affect superoxide dismutase/catalase levels in wound bed. While CGA induced side effects such as cyto/genotoxicity, 15 days of treatment attenuated blood glucose levels. CGA decreased lipid peroxidation levels of main organs. This study provides a better understanding for antioxidant intake on diabetic wound repair and possible pro-oxidative effects. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impact of physical exercise in cancer survivors during and after antineoplastic treatments

PubMed Central

Ferioli, Martina; Zauli, Giorgio; Martelli, Alberto M.; Vitale, Marco; McCubrey, James A.; Ultimo, Simona; Capitani, Silvano; Neri, Luca M.

2018-01-01

Cancer patients experience symptoms and adverse effects of treatments that may last even after the end of treatments. Exercise is a safe, non-pharmacological and cost-effective therapy that can provide several health benefits in cancer patient and survivors, reducing cancer symptoms and cancer treatment side effects. The purpose of this review is to describe how the physical exercise is capable to reduce cancer symptoms and cancer treatment side effects. We realized a pragmatic classification of symptoms, dividing them into physical, psychological and psycho-physical aspects. For each symptom we discuss causes, therapies, we analyse the effects of physical exercise and we summarize the most effective type of exercise to reduce the symptoms. This review also points out what are the difficulties that patients and survivors face during the practice of physical activity and provides some solutions to overcome these barriers. Related to each specific cancer, it emerges that type, frequency and intensity of physical exercise could be prescribed and supervised as a therapeutic program, like it occurs for the type, dose and duration of a drug treatment. PMID:29568412

Continuous growth of single-wall carbon nanotubes using chemical vapor deposition

DOEpatents

Grigorian, Leonid [Raymond, OH; Hornyak, Louis [Evergreen, CO; Dillon, Anne C [Boulder, CO; Heben, Michael J [Denver, CO

2008-10-07

The invention relates to a chemical vapor deposition process for the continuous growth of a carbon single-wall nanotube where a carbon-containing gas composition is contacted with a porous membrane and decomposed in the presence of a catalyst to grow single-wall carbon nanotube material. A pressure differential exists across the porous membrane such that the pressure on one side of the membrane is less than that on the other side of the membrane. The single-wall carbon nanotube growth may occur predominately on the low-pressure side of the membrane or, in a different embodiment of the invention, may occur predominately in between the catalyst and the membrane. The invention also relates to an apparatus used with the carbon vapor deposition process.

Continuous growth of single-wall carbon nanotubes using chemical vapor deposition

DOEpatents

Grigorian, Leonid; Hornyak, Louis; Dillon, Anne C; Heben, Michael J

2014-09-23

The invention relates to a chemical vapor deposition process for the continuous growth of a carbon single-wall nanotube where a carbon-containing gas composition is contacted with a porous membrane and decomposed in the presence of a catalyst to grow single-wall carbon nanotube material. A pressure differential exists across the porous membrane such that the pressure on one side of the membrane is less than that on the other side of the membrane. The single-wall carbon nanotube growth may occur predominately on the low-pressure side of the membrane or, in a different embodiment of the invention, may occur predominately in between the catalyst and the membrane. The invention also relates to an apparatus used with the carbon vapor deposition process.

12. OVERALL NORTH SIDE. THIS PART OF BUILDING 9 IS ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. OVERALL NORTH SIDE. THIS PART OF BUILDING 9 IS NOT ASSOCIATED WITH THE SIGNIFICANT RESEARCH THAT OCCURRED IN THE SOUTH WING. - U.S. Geological Survey, Rock Magnetics Laboratory, 345 Middlefield Road, Menlo Park, San Mateo County, CA

The electrophysiologic properties of esmolol, a short acting beta-blocker.

PubMed

Greenspan, A M; Spielman, S R; Horowitz, L N; Laddu, A; Senior, S

1988-04-01

Although beta-blockers have established efficacy in treating ventricular ectopy and PSVT, their applicability for acute antiarrhythmic interventions in patients with organic heart disease or COPD, is frequently limited by negative inotropic or bronchospastic side effects. The development of an ultrashort acting beta-blocker with rapid reversibility of its side effects would widen their applicability. Therefore, we tested the electrophysiologic properties of such a new short acting beta-blocker, esmolol, in 14 patients (10 with organic heart disease) with a mean EF of 47.6 +/- 17%, undergoing standard clinical electrophysiologic studies for various indications. Like most other beta-blockers, esmolol's major direct effects were on sinus node function and AV nodal conduction characteristics; significantly prolonging sinus cycle length, cycle length to Wenckebach and AH interval in sinus rhythm and at a paced cycle length of 600 ms. In contrast to most other beta-blockers, following termination of its infusion, esmolol shortened parameters of sinus node function and AV nodal refractoriness, with respect to the control values, suggesting a possible rebound phenomena. These effects occurred within 5 min of terminating the intravenous drug infusion. Esmolol had no significant effect on systolic blood pressure, electrocardiographic intervals and had rare adverse reactions. We conclude that esmolol is an ultra-short acting beta-blocker, with typical direct electrophysiologic effects on sinus node and AV nodal function, and a possible rebound phenomena following its discontinuation that may make it particularly suited to acute antiarrhythmic interventions in patients susceptible to adverse beta-blocker side effects.

The local and systemic side-effects of venom and inhaled-allergen subcutaneous immunotherapy.

PubMed

Adamic, Katja; Zidarn, Mihaela; Bajrovic, Nissera; Erzen, Renato; Kopac, Peter; Music, Ema

2009-01-01

Although immunotherapy is effective in allergic rhinitis, conjunctivitis, asthma and stinging insect hypersensitivity, it carries a risk of anaphylactic reactions. In a 4-year retrospective survey, we investigated 1257 adult patients who had received venom or inhaled-allergen subcutaneous immunotherapy. The dose-increase phase was performed as the 2-day rush protocol for venom immunotherapy and the 6-week protocol for inhaled-allergen immunotherapy. A total of 904 patients received venom immunotherapy and 353 patients inhaled-allergen immunotherapy. The prevalence of systemic reactions was 13.6%. The frequency of systemic reactions was higher during the maintenance phase than in the dose-increase phase (9.6% vs. 5.9%) and was highest in both phases of treatment with honeybee venom (P < 0.001). The majority of systemic reactions were mild. Five (0.4%) patients had reaction with a fall of blood pressure and were treated with adrenaline. There was no fatal outcome. The systemic side-effects during the dose-increase phase of venom immunotherapy occurred at a median dose of 46 microg (range 2-100 microg). Large local reactions occurred in 13.9% of patients without any significant difference between the allergens. We have shown that systemic reactions are not rare even during maintenance phase in patients with a well tolerated dose-increase phase of treatment. The most prominent risk factor for systemic reactions was immunotherapy with honeybee extract.

Cigar burning under different smoking intensities and effects on emissions.

PubMed

Dethloff, Ole; Mueller, Christian; Cahours, Xavier; Colard, Stéphane

2017-12-01

The effect of smoking intensity on cigar smoke emissions was assessed under a range of puff frequencies and puff volumes. In order to potentially reduce emissions variability and to identify patterns as accurately as possible, cigar weights and diameters were measured, and outliers were excluded prior to smoking. Portions corresponding to 25%, 50%, 75% and 100% of the cigar, measured down to the butt length, were smoked under several smoking conditions, to assess nicotine, CO and water yields. The remaining cigar butts were analysed for total alkaloids, nicotine, and moisture. Results showed accumulation effects during the burning process having a significant impact on smoke emission levels. Condensation and evaporation occur and lead to smoke emissions dependent on smoking intensity. Differences were observed for CO on one side as a gas phase compound and nicotine on the other side as a particulate phase compound. For a given intensity, while CO emission increases linearly as the cigar burns, nicotine and water emissions exhibited an exponential increase. Our investigations showed that a complex phenomena occurs during the course of cigar smoking which makes emission data: difficult to interpret, is potentially misleading to the consumer, and inappropriate for exposure assessment. The results indicate that, tobacco content and physical parameters may well be the most robust basis for product characterisation and comparison rather than smoke emission. Copyright © 2017 Elsevier Inc. All rights reserved.

Rescue pre-operative treatment with Lugol's solution in uncontrolled Graves' disease.

PubMed

Calissendorff, Jan; Falhammar, Henrik

2017-05-01

Graves' disease is a common cause of hyperthyroidism. Three therapies have been used for decades: pharmacologic therapy, surgery and radioiodine. In case of adverse events, especially agranulocytosis or hepatotoxicity, pre-treatment with Lugol's solution containing iodine/potassium iodide to induce euthyroidism before surgery could be advocated, but this has rarely been reported. All patients hospitalised due to uncontrolled hyperthyroidism at the Karolinska University Hospital 2005-2015 and treated with Lugol's solution were included. All electronic files were carefully reviewed manually, with focus on the cause of treatment and admission, demographic data, and effects of iodine on thyroid hormone levels and pulse frequency. Twenty-seven patients were included. Lugol's solution had been chosen due to agranulocytosis in 9 (33%), hepatotoxicity in 2 (7%), other side effects in 11 (41%) and poor adherence to medication in 5 (19%). Levels of free T4, free T3 and heart rate decreased significantly after 5-9 days of iodine therapy (free T4 53-20 pmol/L, P  = 0.0002; free T3 20-6.5 pmol/L, P  = 0.04; heart rate 87-76 beats/min P  = 0.0007), whereas TSH remained unchanged. Side effects were noted in 4 (15%) (rash n  = 2, rash and vomiting n  = 1, swelling of fingers n  = 1). Thyroidectomy was performed in 26 patients (96%) and one was treated with radioiodine; all treatments were without serious complications. Treatment of uncontrolled hyperthyroidism with Lugol's solution before definitive treatment is safe and it decreases thyroid hormone levels and heart rate. Side effects were limited. Lugol's solution could be recommended pre-operatively in Graves' disease with failed medical treatment, especially if side effects to anti-thyroid drugs have occurred. © 2017 The authors.

Chronic neuropathic facial pain after intense pulsed light hair removal. Clinical features and pharmacological management.

PubMed

Gay-Escoda, Cosme; Párraga-Manzol, Gabriela; Sánchez-Torres, Alba; Moreno-Arias, Gerardo

2015-10-01

Intense Pulsed Light (IPL) photodepilation is usually performed as a hair removal method. The treatment is recommended to be indicated by a physician, depending on each patient and on its characteristics. However, the use of laser devices by medical laypersons is frequent and it can suppose a risk of damage for the patients. Most side effects associated to IPL photodepilation are transient, minimal and disappear without sequelae. However, permanent side effects can occur. Some of the complications are laser related but many of them are caused by an operator error or mismanagement. In this work, we report a clinical case of a patient that developed a chronic neuropathic facial pain following IPL hair removal for unwanted hair in the upper lip. The specific diagnosis was painful post-traumatic trigeminal neuropathy, reference 13.1.2.3 according to the International Headache Society (IHS). Neuropathic facial pain, photodepilation, intense pulse light.

Sweet proteins – Potential replacement for artificial low calorie sweeteners

PubMed Central

Kant, Ravi

2005-01-01

Exponential growth in the number of patients suffering from diseases caused by the consumption of sugar has become a threat to mankind's health. Artificial low calorie sweeteners available in the market may have severe side effects. It takes time to figure out the long term side effects and by the time these are established, they are replaced by a new low calorie sweetener. Saccharine has been used for centuries to sweeten foods and beverages without calories or carbohydrate. It was also used on a large scale during the sugar shortage of the two world wars but was abandoned as soon as it was linked with development of bladder cancer. Naturally occurring sweet and taste modifying proteins are being seen as potential replacements for the currently available artificial low calorie sweeteners. Interaction aspects of sweet proteins and the human sweet taste receptor are being investigated. PMID:15703077

Aripiprazole-induced transient myopia: A rare entity.

PubMed

Praveen Kumar, K V; Chiranjeevi, P; Alam, Md Shahid

2018-01-01

Aripiprazole is a new drug for the treatment of adults with schizophrenia. Ocular side effects of aripiprazole are very rare. Review of literature revealed few cases of aripiprazole-induced myopia. We report a rare case of aripiprazole-induced transient myopia. A 22-year-old female patient presented to the department of psychiatry with worsening of symptoms of schizophrenia and was started on aripiprazole. She presented with complaints of blurring of vision in both eyes for 1 week which started on the 3rd day following the use of aripiprazole. Anterior segment examination revealed a shallow anterior chamber and narrow angles. Intraocular pressure was normal. A diagnosis of aripiprazole-induced acute myopia was made and the treating psychiatrist was advised to stop the medication. At 2-week follow-up, the unaided visual acuity improved to 20/20 in both the eyes. Ophthalmologists should be aware of the myopic shift that may occur as an ocular side effect with aripiprazole.

Topical zinc oxide vs. salicylic acid-lactic acid combination in the treatment of warts.

PubMed

Khattar, Joe A; Musharrafieh, Umayya M; Tamim, Hala; Hamadeh, Ghassan N

2007-04-01

Warts are a common dermatologic problem. Treatment is painful, prolonged, and can cause scarring. To evaluate topical zinc oxide for the treatment of warts. This was a randomized, double-blind controlled trial of 44 patients. Twenty-two patients were given topical zinc oxide 20% ointment, and the other 22 received salicylic acid 15% + lactic acid 15% ointment twice daily. All patients were followed up for 3 months or until cure, whichever occurred first. All patients were observed for side-effects. Sixteen patients in the zinc group and 19 in the salicylic acid-lactic acid group completed the study. In the zinc oxide-treated group, 50% of the patients showed complete cure and 18.7% failed to respond, compared with 42% and 26%, respectively, in the salicylic acid-lactic acid-treated group. No patients developed serious side-effects. Topical zinc oxide is an efficacious, painless, and safe therapeutic option for wart treatment.

Acute myositis: an unusual and severe side effect of docetaxel: a case report and literature review.

PubMed

Rochigneux, Philippe; Schleinitz, Nicolas; Ebbo, Mikael; Aymonier, Marie; Pourroy, Bertrand; Boissier, Romain; Salas, Sébastien; Deville, Jean-Laurent

2018-06-01

Docetaxel is an antimicrotubules cytotoxic agent prescribed widely by medical oncologists in multiple tumor types (breast, lung, prostate, stomach, head, and neck). However, the side effects of docetaxel are numerous (cytopenia, peripheral edema, myalgia, arthralgia, alopecia, and sensitive neuropathy) and recent concerns have been raised about neutropenic enterocolitis in France. Here, we report the case of a 57-year-old patient with metastatic prostatic cancer, who developed a severe myositis and fasciitis grade IV 1 week after his second docetaxel infusion. We reviewed the five cases of docetaxel-related myositis described in the literature, and found that most of them occurred in patients with diabetes (n=5/5) or hypertension (n=4/5). A vascular toxicity may explain this severe complication, and patients with diabetes or hypertension should be monitored closely in the context of a docetaxel chemotherapy.

The effect of side motion in the dynamics of interacting molecular motors

NASA Astrophysics Data System (ADS)

Midha, Tripti; Gupta, Arvind Kumar; Kolomeisky, Anatoly B.

2017-07-01

To mimic the collective motion of interacting molecular motors, we propose and discuss an open two-lane symmetrically coupled interactive TASEP model that incorporates interaction in the thermodynamically consistent fashion. We study the effect of both repulsive and attractive interaction on the system’s dynamical properties using various cluster mean field analysis and extensive Monte Carlo simulations. The interactions bring correlations into the system, which were found to be reduced due to the side motion of particles. We produce the steady-state phase diagrams for symmetrically split interaction strength. The behavior of the maximal particle current with respect to the interaction energy E is analyzed for different coupling rates and interaction splittings. The results suggest that for strong coupling and large splittings, the maximal flow of the motors occurs at a weak attractive interaction strength which matches with the known experimental results on kinesin motor protein.

Translation failure and medical reversal: Two sides to the same coin.

PubMed

Prasad, Vinay

2016-01-01

Translation failure occurs when the results of preclinical, observational and/or early phase studies fail to predict the results of well done (i.e. appropriately controlled, adequately powered, and properly conducted) phase III or randomised clinical trials. Some failures occur when promising basic science findings fail to replicate in human studies, while others happen when promising uncontrolled trial data show an exaggerated effect that vanishes in the setting of a randomised trial. Medical reversals occur when the results of preclinical, observational and/or early phase studies fail to predict the results of subsequent randomized clinical trials, but the practice has already gained widespread acceptance. Oncologic examples include bevacizumab and the use of autologous stem cell transplant in metastatic breast cancer. In a well-intentioned effort to reduce the rate of translation failure, oncologists must be careful that changes to regulatory processes and clinical trial design do not actually work to increase the approval of ineffective compounds. By trying to cure translation failure, we should be careful to avoid medical reversal. The rise of surrogate end-points and role of hard-wired bias in oncology trials suggest that we may be currently ignoring the simple fact that translation failure and medical reversal are two sides to the same coin. Published by Elsevier Ltd.

Terrorism, civil war, one-sided violence and global burden of disease.

PubMed

Kerridge, Bradley T; Khan, Maria R; Sapkota, Amir

2012-01-01

Armed conflict and related violence, including terrorism and one-sided violence, has profound effects on people's health and lives. The purpose of this study was to determine the relationship between deaths due to terrorism, civil war and one-sided violence from 1994-2000 and disability-adjusted life years (DALYs) occurring in 2002 attributable to all causes and specific communicable and noncommunicable diseases. Deaths resulting from terrorism, war and one-sided violence were positively associated with all cause as well as a number of communicable and noncommunicable disease-specific DALYs across the majority of sex and age subgroups of the populace, controlling for an array of economic factors empirically shown to affect public health. Overall, a 1.0% increase in deaths due to terrorism, civil war and one-sided violence from 1994-2000 was associated with a 0.16% increase in DALYs lost to all causes in 2002 in the total world population. There was little variation in the magnitude of these associations between males and females and between communicable and noncommunicable diseases. The results of the present study can begin to guide post-conflict recovery by focusing on interventions targeting both noncommunicable as well as communicable diseases, thereby highlighting the full health costs of war and ultimately providing a strong rationale for promoting peace.

Intra- and postoperative application of Mitomycin C in the middle meatus reduces adhesions and antrostomy stenosis after FESS.

PubMed

Konstantinidis, I; Tsakiropoulou, E; Vital, I; Triaridis, S; Vital, V; Constantinidis, J

2008-06-01

Obstruction of the osteomeatal complex is the commonest anatomic finding in revision endoscopic sinus surgery. This study assesses the efficacy of topical mitomycin C in the middle meatus, intra- and postoperatively in the prevention of adhesion formation and restenosis of the maxillary sinus antrostomy. At the end of endoscopic surgery for chronic rhinosinusitis and four weeks postoperatively 30 patients received a pledget soaked with 1 ml of mitomycin C (0.5 mg/ml) in the middle meatus for 5 minutes while a pledget soaked in saline was placed in the contralateral side. Patients were assessed at least 6 months postoperatively by a blinded observer for the presence of synechiae and antrostomy stenosis. Medical records were reviewed for episodes of recurrent sinusitis. Adhesions were observed in 8 patients. All adhesions rated as moderate to severe (4 patients) were observed in the control side (p = 0.043). Restenosis was observed in 2 sides treated with mitomycin C and in 9 control sides (p = 0.032). Recurrent symptoms of sinusitis occurred in three patients on the saline side. Mitomycin C is safe and effective in the prevention of severe adhesions and antrostomy stenosis when applied twice, during surgery and the early postoperative period.

Side Object Detection Systems Evaluation : Final Evaluation Report.

DOT National Transportation Integrated Search

2008-12-15

Nearly 46 percent of bus accidents across the United States each year occur on the left or right side of the bus. These collisions result in property damage, and they can negatively impact on revenue operations and public perception. The first commer...

Effect of processing on nutritive values of milk protein.

PubMed

Borad, Sanket G; Kumar, Anuj; Singh, Ashish K

2017-11-22

Milk is an essential source of nutritionally excellent quality protein in human, particularly in vegan diet. Before consumption, milk is invariably processed depending upon final product requirement. This processing may alter the nutritive value of protein in a significant manner. The processing operations like thermal treatment, chemical treatment, biochemical processing, physical treatments, nonconventional treatments, etc. may exert positive or negative influence on nutritional quality of milk proteins. On one side, processing enhances the nutritive and therapeutic values of protein while on other side intermediate or end products generated during protein reactions may cause toxicity and/or antigenicity upon consumption at elevated level. The review discusses the changes occurring in nutritive quality of milk proteins under the influence of various processing operations.

Development of a 2 MHz Sonar Sensor for Inspection of Bridge Substructures.

PubMed

Park, Chul; Kim, Youngseok; Lee, Heungsu; Choi, Sangsik; Jung, Haewook

2018-04-16

Hydraulic factors account for a large part of the causes of bridge collapse. Due to the nature of the underwater environment, quick and accurate inspection is required when damage occurs. In this study, we developed a 2 MHz side scan sonar sensor module and effective operation technique by improving the limitations of existing sonar. Through field tests, we analyzed the correlation of factors affecting the resolution of the sonar data such as the angle of survey, the distance from the underwater structure and the water depth. The effect of the distance and the water depth and the structure on the survey angle was 66~82%. We also derived the relationship between these factors as a regression model for effective operating techniques. It is considered that application of the developed 2 MHz side scan sonar and its operation method could contribute to prevention of bridge collapses and disasters by quickly and accurately checking the damage of bridge substructures due to hydraulic factors.

Development of a 2 MHz Sonar Sensor for Inspection of Bridge Substructures

PubMed Central

Park, Chul; Lee, Heungsu; Choi, Sangsik; Jung, Haewook

2018-01-01

Hydraulic factors account for a large part of the causes of bridge collapse. Due to the nature of the underwater environment, quick and accurate inspection is required when damage occurs. In this study, we developed a 2 MHz side scan sonar sensor module and effective operation technique by improving the limitations of existing sonar. Through field tests, we analyzed the correlation of factors affecting the resolution of the sonar data such as the angle of survey, the distance from the underwater structure and the water depth. The effect of the distance and the water depth and the structure on the survey angle was 66~82%. We also derived the relationship between these factors as a regression model for effective operating techniques. It is considered that application of the developed 2 MHz side scan sonar and its operation method could contribute to prevention of bridge collapses and disasters by quickly and accurately checking the damage of bridge substructures due to hydraulic factors. PMID:29659557

Treatment of molluscum contagiosum with an East Indian sandalwood oil product.

PubMed

Haque, Malika; Coury, Daniel L

2017-11-22

To evaluate the safety and efficacy of an East Indian sandalwood oil (EISO) product as a topical treatment for molluscum contagiosum. Ten subjects ranging in age from 22 months to 29 years were recruited. Subjects were instructed to apply an EISO product to the lesions twice daily. Subjects were monitored every two to three weeks during the study and were questioned regarding local or systemic side effects. Assessment of response was recorded by counting lesions and documented by photographs. Nine of ten subjects (90%) experienced complete resolution of molluscum lesions within the twelve week study period. Response was unrelated to lesion size or number, how long the molluscum rash had been present, or patient age or gender. There were no complaints of side effects, skin irritation, pain, or other adverse events reported in any subjects. In this pilot open label study, an EISO product proved to be an effective treatment for molluscum contagiosum lesions with resolution of lesions typically occurring within twelve weeks of therapy.

Muscle wasting and sarcopenia in heart failure and beyond: update 2017

PubMed Central

Springer, Joshua‐I.; Anker, Stefan D.

2017-01-01

Abstract Sarcopenia (loss of muscle mass and muscle function) is a strong predictor of frailty, disability and mortality in older persons and may also occur in obese subjects. The prevalence of sarcopenia is increased in patients suffering from chronic heart failure. However, there are currently few therapy options. The main intervention is resistance exercise, either alone or in combination with nutritional support, which seems to enhance the beneficial effects of training. Also, testosterone has been shown to increased muscle power and function; however, a possible limitation is the side effects of testosterone. Other investigational drugs include selective androgen receptor modulators, growth hormone, IGF‐1, compounds targeting myostatin signaling, which have their own set of side effects. There are abundant prospective targets for improving muscle function in the elderly with or without chronic heart failure, and the continuing development of new treatment strategies and compounds for sarcopenia and cardiac cachexia makes this field an exciting one. PMID:29154428

Long Term Follow-up of Botulinum Toxin Therapy for Focal Hand Dystonia: Outcome at 10 or More Years

PubMed Central

Lungu, Codrin; Karp, Barbara I; Alter, Katharine; Zolbrod, Regina; Hallett, Mark

2010-01-01

Background Prior studies have explored the efficacy and safety of BoNT treatment for FHD, but none have followed a large number of patients for 10 or more years. Methods Retrospective study, with benefit and weakness assessed on a 0-4 subjective scale. Demographic, clinical and treatment characteristics were analyzed using t-tests and Pearson correlations. Results 20 FHD patients had 10 years or longer treatment. Inter-injection intervals were variable. Musicians were more likely to wait longer between injections and had less complex dystonia. There was a trend for larger benefit in women and with shorter intervals. The dose increased over time. Dystonia characteristics did not predict response or side-effects, but benefit magnitude predicted longer compliance. No serious side-effects or antibody-mediated resistance occurred. Conclusion This is the longest reported period of BoNT treatment in the largest FHD cohort. BoNT therapy for FHD remains safe and effective after more than a decade of treatment. PMID:21506157

Safety and efficacy of intrathecal ziconotide in the management of severe chronic pain

PubMed Central

Smith, Howard S; Deer, Timothy R

2009-01-01

Ziconotide is a conopeptide intrathecal (IT) analgesic which is approved by the US Food and Drug Administration (FDA) for the management of severe chronic pain. It is a synthetic equivalent of a naturally occurring conopeptide found in the venom of the fish-eating marine cone snail and provides analgesia via binding to N-type voltage-sensitive calcium channels in the spinal cord. As ziconotide is a peptide, it is expected to be completely degraded by endopeptidases and exopeptidases (Phase I hydrolytic enzymes) widely located throughout the body, and not by other Phase I biotransformation processes (including the cytochrome P450 system) or by Phase II conjugation reactions. Thus, IT administration, low plasma ziconotide concentrations, and metabolism by ubiquitous peptidases make metabolic interactions of other drugs with ziconotide unlikely. Side effects of ziconotide which tend to occur more commonly at higher doses may include: nausea, vomiting, confusion, postural hypotension, abnormal gait, urinary retention, nystagmus/amblyopia, drowsiness/somnolence (reduced level of consciousness), dizziness or lightheadedness, weakness, visual problems (eg, double vision), elevation of serum creatine kinase, or vestibular side effects. Initially, when ziconotide was first administered to human subjects, titration schedules were overly aggressive and led to an abundance of adverse effects. Subsequently, clinicians have gained appreciation for ziconotide’s relatively narrow therapeutic window. With appropriate usage multiple studies have shown ziconotide to be a safe and effective intrathecal analgesic alone or in combination with other intrathecal analgesics. PMID:19707262

Sonographic evaluation of the acromiohumeral distance in elite and recreational female overhead athletes.

PubMed

Maenhout, Annelies; van Cingel, Robert; De Mey, Kristof; Van Herzeele, Maarten; Dhooge, Famke; Cools, Ann

2013-05-01

To compare the acromiohumeral distance (AHD) and the change of this distance during abduction between the dominant and nondominant shoulders of female overhead athletes and to compare AHD between elite and recreational female athletes. : Case-control study. Laboratory, institutional. "Side" (dominant and nondominant), "group" (elite and recreational athletes), and "degree of abduction" (0, 45, and 60 degrees). Sixty-two female overhead athletes participated in this study: 29 elite handball players and 33 recreational overhead athletes of different sports disciplines (volleyball, water polo, squash, and badminton). Acromiohumeral distance was measured at 3 positions of abduction using ultrasound: at 0, 45, and 60 degrees of abduction. Acromiohumeral distance measurements showed good test-retest reliability (intraclass correlation coefficients between 0.88 and 0.92). In all overhead athletes, the AHD was significantly larger on the dominant side compared with the nondominant side, at all positions of abduction (mean difference = 0.94 ± 0.18 mm). Significant reduction of the AHD during abduction occurred relative to the initial size at 0 degree of abduction, at both sides. When comparing elite and recreational athletes, the AHD was significantly larger in elite athletes (mean difference = 0.92 ± 0.47 mm). Moreover, significantly less reduction occurred during the first degrees of abduction (0-45 degrees) in elite athletes (9.37% ± 2.17% reduction) compared with the recreational athletes (17.68% ± 2.03% reduction). The AHD is larger on the dominant side compared with the nondominant side and in elite female athletes compared with recreational female athletes. Moreover, less reduction of the AHD occurs in the elite athlete group during the first 45 degrees of abduction.

THORACOLUMBAR RANGE OF MOTION IN BASEBALL PITCHERS AND POSITION PLAYERS

PubMed Central

Lynall, Robert; Williams, Jeffrey G.; Wong, Regan; Onuki, Takashi; Meister, Keith

2013-01-01

Introduction/Background: Optimal baseball throwing mechanics require a significant contribution of thoracolumbar motion, particularly in the sagittal and transverse planes. This motion is key for proper transmission of forces from the lower to upper extremity, thereby minimizing a throwing athlete's risk of injury and maximizing athletic performance. Purpose: To define the active‐assisted thoracolumbar ROM of both baseball pitchers and position players and to compare these motions both within and between groups. Methods: Fifty‐six asymptomatic, collegiate and minor league baseball pitchers and 42 position players volunteered to participate. Active‐assisted thoracolumbar flexion, extension, and bilateral rotation ROM, were measured in a standing position, using two bubble inclinometers. Two‐tailed t tests were used to determine differences in ROM between and within the pitchers and position players. Results: The pitchers had significantly more rotation to the non‐throwing arm side as compared to the position players (p = .007, effect size = .61). The pitchers also had more rotation to the non‐throwing arm side as compared to their throwing side (p = .006, effect size = .47). There were no other significant differences between the pitchers and the position players (p > .53). Furthermore, the position players did not have a side‐to‐side rotation difference (p = .99). Conclusions: Pitchers have a greater amount of rotation ROM towards the non‐throwing arm side as compared to position players. Pitchers also have a greater amount of rotation ROM to the non‐throwing arm side as compared to their throwing side rotation. Because pitchers often present with posterior shoulder tightness and subsequent altered shoulder horizontal adduction and internal rotation ROM, the increase in non‐throwing side rotation ROM may occur in response to these adaptations. More specifically, this increase in non‐throwing side trunk rotation ROM may allow such athletes to bring the arm across the body during the follow‐through phase of the throwing motion despite posterior shoulder tightness. However, future research is necessary to investigate this relationship. Based on these results, clinicians should consider these thoracolumbar ROM adaptations in the prevention, evaluation, and treatment of baseball players. Level of Evidence: 2b PMID:24377063

Indexing and Exploiting a Discourse History to Generate Context-Sensitive Explanations

DTIC Science & Technology

1993-01-01

facility as part of two intelligent systems. The first is a patient education system intended to provide patients with information about their disease...with our patient education system, and is based upon phenomena we observed in nat- urally occurring interviews with physicians. The responses shown in...Elavil has other possible side effects including dry mouth, difficulty urinating, and weight gain. Figure 2: Actual Dialogue with Patient Education System

Neuropsychiatric adverse events after switching from an antiretroviral regimen containing efavirenz without tenofovir to an efavirenz regimen containing tenofovir: a report of nine cases.

PubMed

Allavena, Clotilde; Le Moal, Gwenael; Michau, Christophe; Chiffoleau, Anne; Raffi, François

2006-01-01

The combination of tenofovir (TDF) and efavirenz (EFV) has not been associated with any pharmakokinetic interaction or with enhancement of neuropsychiatric disturbances. We report nine cases of neuropsychiatric intolerance occurring early after a switch from an antiretroviral regimen without TDF to an EFV and TDF-containing regimen. Nine HIV-1-infected patients were treated with an EFV-containing regimen for a median duration of 31 months without any EFV-related central nervous system (CNS) effects. They were switched to an EFV-TDF-containing regimen because of lipodystrophy (n=2) and/or the wish to simplify to a once-daily regimen (n=9). Moderate to severe neuropsychiatric events occurred immediately (<48 hours) after TDF initiation in five patients and 2 weeks to 24 months after the switch in the remaining four patients. Treatment modifications occurred in six patients (switch to EFV-nevirapine [n=3], TDF-zidovudine [n=2] or treatment discontinuation [n=1]), leading to a marked improvement of CNS intolerance. Treatment remained unchanged in three patients; two patients experienced chronic persistent sleeping disorders and one patient underwent a spontaneous improvement of symptoms within 2 weeks. EFV plasma concentrations, which were available in two patients before the switch and in four patients after the switch, remained in the therapeutic range. Although the exact mechanism of these symptoms remains hypothetical, neuropsychiatric disorders could be either a consequence of an unexplained interaction between EFV and TDF or an infrequent TDF-related side effect. The incidence of these side effects needs to be evaluated in large databases or pharmacokinetic studies.

Side Effects of Radiographic Contrast Media: Pathogenesis, Risk Factors, and Prevention

PubMed Central

Tasanarong, Adis

2014-01-01

Radiocontrast media (RCM) are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques. They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy (CIN). We define CIN as acute renal failure occurring within 24–72 hrs of exposure to RCM that cannot be attributed to other causes. It usually occurs in patients with preexisting renal impairment and diabetes. The mechanisms underlying CIN include reduction in medullary blood flow leading to hypoxia and direct tubule cell damage and the formation of reactive oxygen species. Identification of patients at high risk for CIN is important. We have reviewed the risk factors and procedures for prevention, providing a long list of references enabling readers a deep evaluation of them both. The first rule to follow in patients at risk of CIN undergoing radiographic procedure is monitoring renal function by measuring serum creatinine and calculating the eGFR before and once daily for 5 days after the procedure. It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration. In high-risk patients N-acetylcysteine may also be given. PMID:24895606

Mechanisms for anterior cruciate ligament injuries in badminton.

PubMed

Kimura, Yuka; Ishibashi, Yasuyuki; Tsuda, Eiichi; Yamamoto, Yuji; Tsukada, Harehiko; Toh, Satoshi

2010-12-01

A high incidence of anterior cruciate ligament (ACL) injuries related to sports activities has been reported; however, the injury situation of ACL injury in badminton has not been elucidated. This study investigated the mechanism of ACL injury in badminton using a questionnaire. Information on injury mechanism was gathered from interviews with six male and 15 female badminton players who received a non-contact ACL injury playing badminton and underwent ACL reconstruction. The most common injury mechanism (10 of 21 injuries) was single-leg landing after overhead stroke. Nine of 10 players had injured the knee opposite to the racket-hand side. The second most frequent injury mechanism (eight of 21 injuries) was plant-and-cut while side-stepping or backward stepping. All eight players injured the knee of the racket-hand side. Eleven injuries occurred in the rear court, and six of the 11 injuries occurred during single-leg landing after an overhead stroke. The knee opposite to the racket-hand side tended to sustain the ACL injuries during single-leg landing after a backhand overhead stroke, whereas the knee of the racket-hand side tended to be injured by plant-and-cut during side or backward stepping. These injury patterns appear to be due to specific movements during badminton.

No blank slates: Pre-existing schemas about pharmaceuticals predict memory for side effects.

PubMed

Heller, Monika K; Chapman, Sarah C E; Horne, Rob

2017-04-01

Attribution of symptoms as medication side effects is informed by pre-existing beliefs about medicines and perceptions of personal sensitivity to their effects (pharmaceutical schemas). We tested whether (1) pharmaceutical schemas were associated with memory (recall/recognition) for side effect information (2) memory explained the attribution of a common unrelated symptom as a side effect. In this analogue study participants saw the patient leaflet of a fictitious asthma drug listing eight side effects. We measured recall and recognition memory for side effects and used a vignette to test whether participants attributed an unlisted common symptom (headache) as a side effect. Participants who perceived pharmaceuticals as more harmful in general recalled fewer side effects correctly (r Correct Recall  = -.273), were less able to differentiate between listed and unlisted side effects (r Recognition Sensitivity  = -.256) and were more likely to attribute the unlisted headache symptom as a side effect (r side effect attribution  = .381, ps < .01). The effect of harm beliefs on side effect attribution was partially mediated by correct recall of side effects. Pharmaceutical schemas are associated with memory for side effect information. Memory may explain part of the association between pharmaceutical schemas and the attribution of unrelated symptoms as side effects.

Photocathode

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

Opachich, Yekaterina; MacPhee, Andrew

A photocathode designs that leverage the grazing incidence geometry yield improvements through the introduction of recessed structures, such as cones, pyramids, pillars or cavities to the photocathode substrate surface. Improvements in yield of up to 20 times have been shown to occur in grazing incidence geometry disclosed herein due to a larger path length of the X-ray photons which better matches the secondary electron escape depth within the photocathode material. A photocathode includes a substrate having a first side and a second side, the first side configured to receive x-ray energy and the second side opposing the first side. Amore » structured surface is associated with the second side of the substrate such that the structured surface includes a plurality of recesses from the second side of the substrate into the substrate.« less

Genetics Home Reference: UNC80 deficiency

MedlinePlus

... absent, although in some cases individuals have limited communication using body language, gestures, and signs. Seizures, involuntary side-to-side movements of the eyes (nystagmus), eyes that do not point in the same direction (strabismus), and a high-pitched cry can also occur in this disorder. ...

The introduction of strain and its effects on the structure and stability of T4 lysozyme.

PubMed

Liu, R; Baase, W A; Matthews, B W

2000-01-07

In order to try to better understand the role played by strain in the structure and stability of a protein a series of "small-to-large" mutations was made within the core of T4 lysozyme. Three different alanine residues, one involved in backbone contacts, one in side-chain contacts, and the third adjacent to a small cavity, were each replaced with subsets of the larger residues, Val, Leu, Ile, Met, Phe and Trp. As expected, the protein is progressively destabilized as the size of the introduced side-chain becomes larger. There does, however, seem to be a limit to the destabilization, suggesting that a protein of a given size may be capable of maintaining only a certain amount of strain. The changes in stability vary greatly from site to site. Substitution of larger residues for both Ala42 and Ala98 substantially destabilize the protein, even though the primary contacts in one case are predominantly with side-chain atoms and in the other with backbone. The results suggest that it is neither practical nor meaningful to try to separate the effects of introduced strain on side-chains from the effects on the backbone. Substitutions at Ala129 are much less destabilizing than at sites 42 or 98. This is most easily understood in terms of the pre-existing cavity, which provides partial space to accommodate the introduced side-chains. Crystal structures were obtained for a number of the mutants. These show that the changes in structure to accommodate the introduced side-chains usually consist of essentially rigid-body displacements of groups of linked atoms, achieved through relatively small changes in torsion angles. On rare occasions, a side-chain close to the site of substitution may change to a different rotamer. When such rotomer changes occur, they permit the structure to dissipate strain by a response that is plastic rather than elastic. In one case, a surface loop moves 1.2 A, not in direct response to a mutation, but in an interaction mediated via an intermolecular contact. It illustrates how the structure of a protein can be modified by crystal contacts. Copyright 2000 Academic Press.

Unsteady Performance of Finite-Span Pitching Propulsors in Mixtures of Side-by-Side and In-Line Arrangements

NASA Astrophysics Data System (ADS)

Kurt, Melike; Moored, Keith

2016-11-01

Birds, insects, and fish propel themselves by flapping their wings or oscillating their fins in unsteady motions. Many of these animals fly or swim in groups or collectives, typically described as flocks, swarms and schools. The three-dimensional steady flow interactions and the two dimensional unsteady flow interactions that occur in collectives are well characterized. However, the interactions that occur among three-dimensional unsteady propulsors remain relatively unexplored. The aim of the current study is to measure the forces acting on and the energetics of two finite-span pitching wings. The wings are arranged in mixtures of canonical in-line and side-by-side configurations while the phase delay between the pitching wings is varied. The thrust force, fluid-mediated interaction force between the wings and the propulsive efficiency are quantified. The three-dimensional interaction mechanisms are compared and contrasted with previously examined two-dimensional mechanisms. Stereoscopic particle image velocimetry is employed to characterize the three-dimensional flow structures along the span of the pitching wings.

Clinical Implications of Septal Deviation in Lateralized Olfaction

PubMed Central

Choi, Yoon-Seok; Ryu, Yoon-Jong; Rhee, Jihye; Seok, Jungirl; Han, Sungjun; Jin, Hong Ryul; Kim, Dae Woo

2016-01-01

Objectives Results of butanol threshold tests (BTTs) have shown that birhinal olfaction tends to converge toward monorhinal olfaction of the dominant nostril. However, birhinal olfaction may also be worse than dominant-side monorhinal olfaction. The goal of our study was to investigate the effect of deviated nasal septum on birhinal olfaction in patients with lateralized olfaction and to examine the effect of septoplasty in these patients. Methods A retrospective study with planned data collection was conducted in 518 patients who underwent BTTs. Lateralized olfaction was defined as monorhinal BTT scores that differed by >2 between sides. Underestimated birhinal olfaction was defined as a birhinal BTT score >2 lower than the dominant nostril monorhinal BTT score. Patients with lateralized olfaction were divided into 2 groups: group 1, underestimated birhinal olfaction; and group 2, without underestimated birhinal olfaction. Results Among 518 patients, 112 with lateralized olfaction were enrolled in this study. Group 1 included 23 patients (20.5%) and group 2 included 89 patients (79.5%). The severity of septal deviation (ratio of the distance of narrower side to wider side) did not differ between the 2 groups. Septal deviation to the dominant nostril was more common in group 1 than group 2 (73.9% vs. 37.6%; P=0.002). Five patients with septal deviation to the dominant nostril with underestimated birhinal olfaction underwent septoplasty. Improved lateralized olfaction occurred in all 5 patients postoperatively (P=0.041). Conclusion Septal deviation of the dominant nostril in patients with lateralized olfaction is associated with underestimated birhinal olfaction. Septoplasty may improve olfaction by increasing airflow in the dominant olfactory side. PMID:26976025

Changes in superior sagittal sinus blood velocities due to postural alterations and pressure on the head of the newborn infant.

PubMed

Cowan, F; Thoresen, M

1985-06-01

A pulsed Doppler bidirectional ultrasound system has been used to measure alterations in the blood velocities in the superior sagittal sinus of the healthy term newborn infant in response to unilateral and bilateral jugular venous occlusion. These maneuvers were performed with the baby lying in different positions: supine, prone, and on the side (both left and right), the neck flexed or extended, and with the head in the midline or turned 90 degrees to the side (both left and right). Transfontanel pressure was also measured in these positions during occlusions. Results show that turning the head effectively occludes the jugular vein on the side to which the head is turned and that occluding the other jugular vein does not force blood through this functional obstruction. The effect of different forms of external pressure to the head on the superior sagittal sinus velocities was also examined. Alterations in velocities were frequently profound although they varied considerably from baby to baby. This work shows how readily large fluctuations in cranial venous velocities and pressures can occur in the course of normal handling of babies.

Urticaria induced by laser epilation: a clinical and histopathological study with extended follow-up in 36 patients.

PubMed

Landa, Nerea; Corrons, Natalia; Zabalza, Iñaki; Azpiazu, Jose L

2012-07-01

Laser epilation is the most common dermatologic light-based procedure in the world. We describe a unique side effect of the procedure: a delayed persistent urticarial rash. We conducted a retrospective study involving 13,284 patients who received laser epilation at our clinics from January 2006 through March 2010 with 755 nm alexandrite laser (MiniGentleLase, Gentlelase, and GentleMax, Candela). Using patient clinical data and photos that were recorded on a standard side-effect report chart, we identified patients with suspected urticaria. Those patients were then followed for a period that ranged from 12 to 63 months. Only patients who could be diagnosed, treated, and followed by the dermatologist at our clinics were included in the study. Patients diagnosed or treated by other physicians or nurses and those without clinical photos or insufficient follow-up data were not included. We identified 36 patients who developed a severe, itchy, persistent hive rash on the treated area 6-72 hours after treatment. Eruption occurred most often on the legs (31 cases), followed by the groin (11 cases), axillae (eight cases), forearms (one case), and upper lip (one case). The eruption consisted of a hive rash with multiple pruritic perifollicular papules and confluent plaques on the treated area. Most patients required oral corticosteroids to control the symptoms. Lesions resolved in 7-30 days. The urticaria occurred mostly after the first treatment (26 cases), and was recurrent in subsequent treatments. Pretreating with oral corticosteroids prevented or limited the eruption. Thirty-three of the 36 patients reported a history of allergic rhinitis or some other allergy. Skin biopsies on four patients showed edema and a deep, dense dermal infiltrate consistent with lymphocytes mixed with eosinophils in a perivascular and occasionally perifollicular pattern in the mid and lower dermis. Persistent urticaria is a rare side effect of laser epilation. Rupture of the hair follicle by laser heat may trigger a delayed hypersensitivity reaction in a subset of predisposed allergic patients. An antigen from the disrupted hair follicle may be the triggering factor. To prevent this side effect, we recommend that laser epilation in allergic patients be preceded by an extended laser patch test, which should be evaluated 24-48 hours later. Preventive prednisone should be prescribed to patients who develop an urticarial rash on the test area. Copyright © 2012 Wiley Periodicals, Inc.

Patterns of fish assemblage structure and habitat use among main- and side-channel environments in the lower Kootenai River, Idaho

USGS Publications Warehouse

Watkins, Carson J.; Stevens, Bryan S.; Quist, Michael C.; Shepard, Bradley B.; Ireland, Susan C.

2015-01-01

The lower Kootenai River, Idaho, was sampled during the summers of 2012 and 2013 to evaluate its fish assemblage structure at seven sites within main- and side-channel habitats where large-scale habitat rehabilitation was undertaken. Understanding the current patterns of fish assemblage structure and their relationships with habitat is important for evaluating the effects of past and future rehabilitation projects on the river. Species-specific habitat associations were modeled, and the variables that best explained the occurrence and relative abundance of fish were identified in order to guide future habitat rehabilitation so that it benefits native species. The results indicated that the side-channel habitats supported higher species richness than the main-channel habitats and that nonnative fishes were closely associated with newly rehabilitated habitats. This research provides valuable insight on the current fish assemblages in the Kootenai River and the assemblage-level responses that may occur as a result of future rehabilitation activities.

Distraction of the temporomandibular joint condyle in patients with unilateral non-reducing disc displacement: Fact or fiction?

PubMed

Yıldız, Melih; Çağatay Dayan, Süleyman; Şakar, Olcay; Sülün, Tonguç

2017-07-24

This study investigated the distractive effect of a unilateral pivot splint on patients with unilateral disc displacement without reduction. The study group was comprised of 18 patients who had no history of treatment with removable prosthetic restorations of molars, premolars, or canine teeth, and no previous treatment for temporomandibular disorder. Joint spaces measurements made on magnetic resonance images indicated the affected side to be narrower than the healthy side. Unilateral distraction splints were made for all patients. An ultrasonic motion analyzer was used to measure the vertical shift occurring on the affected side as patients closed their mouths with maximal force with the splint in their mouths. Closing with maximal force on the unilateral distraction splint led to a noticeable downward movement of the affected condyle. The findings of this study indicate that the TMJ condyle of patients with unilateral disc displacement without reduction may be unilaterally distracted if the articular space is narrowed.

Classification of ictal and seizure-free HRV signals with focus on lateralization of epilepsy.

PubMed

Behbahani, Soroor; Dabanloo, Nader Jafarnia; Nasrabadi, Ali Motie; Dourado, Antonio

2016-01-01

Epileptic onsets often affect the autonomic function of the body during a seizure, whether it is in ictal, interictal or post-ictal periods. The different effects of localization and lateralization of seizures on heart rate variability (HRV) emphasize the importance of autonomic function changes in epileptic patients. On the other hand, the detection of seizures is of primary interests in evaluating the epileptic patients. In the current paper, we analyzed the HRV signal to develop a reliable offline seizure-detection algorithm to focus on the effects of lateralization on HRV. We assessed the HRV during 5-min segments of continuous electrocardiogram (ECG) recording with a total number of 170 seizures occurred in 16 patients, composed of 86 left-sided and 84 right-sided focus seizures. Relatively high and low-frequency components of the HRV were computed using spectral analysis. Poincaré parameters of each heart rate time series considered as non-linear features. We fed these features to the Support Vector Machines (SVMs) to find a robust classification method to classify epileptic and non-epileptic signals. Leave One Out Cross-Validation (LOOCV) approach was used to demonstrate the consistency of the classification results. Our obtained classification accuracy confirms that the proposed scheme has a potential in classifying HRV signals to epileptic and non-epileptic classes. The accuracy rates for right-sided and left-sided focus seizures were obtained as 86.74% and 79.41%, respectively. The main finding of our study is that the patients with right-sided focus epilepsy showed more reduction in parasympathetic activity and more increase in sympathetic activity. It can be a marker of impaired vagal activity associated with increased cardiovascular risk and arrhythmias. Our results suggest that lateralization of the seizure onset zone could exert different influences on heart rate changes. A right-sided seizure would cause an ictal tachycardia whereas a left-sided seizure would result in an ictal bradycardia.

Two Young Women with Left-sided Pneumothorax Due to Thoracic Endometriosis.

PubMed

Yukumi, Shungo; Suzuki, Hideaki; Morimoto, Masamitsu; Shigematsu, Hisayuki; Okazaki, Mikio; Abe, Masahiro; Kitazawa, Sohei; Nakamura, Kenji; Sano, Yoshifumi

Pneumothorax associated with thoracic endometriosis (TE) generally occurs in women around 30 years old and it usually affects the right pleural cavity. We herein report two cases of TE associated with left-sided pneumothorax in young women. The prevalence of TE in younger patients may be underestimated if these cases are treated as spontaneous pneumothorax. Pneumothorax occurring in younger patients has not been reported to show laterality. TE-related or catamenial pneumothorax in young women must therefore represent a different clinical entity from the condition seen in older patients.

Bilateral increase in expression and concentration of tachykinin in a unilateral rabbit muscle overuse model that leads to myositis

PubMed Central

2013-01-01

Background Tachykinins can have pro-inflammatory as well as healing effects during tissue reorganization and inflammation. Recent studies report an up-regulation in the expression of the substance P (SP)-preferred receptor, the neurokinin-1 receptor, in marked muscle inflammation (myositis). There is, however, only very little information on the expression patterns and levels of tachykinins in this situation. Methods The tachykinin system was analyzed using a rabbit experimental model of muscle overuse, whereby unilateral muscle exercise in combination with electrical stimulation led to muscle derangement and myositis in the triceps surae muscle (experimental length 1–6 weeks). Evaluations were made for both parts of the muscle (soleus and gastrocnemius muscles) in experimental and non-experimental (contralateral) sides. Morphologic evaluation, immunohistochemistry, in situ hybridization and enzyme immunoassay (EIA) analyses were applied. Results Myositis and muscle derangement occurred focally not only in the experimental side but also in the non-experimental side. In the inflammatory areas (focal myositis areas), there were frequent nerve fibers showing tachykinin-like immunoreactivity and which were parts of nerve fascicles and which were freely dispersed in the tissue. Cells in the inflammatory infiltrates showed tachykinin-like immunoreactivity and tachykinin mRNA expression. Specific immunoreactivity and mRNA expression were noted in blood vessel walls of both sides, especially in focally affected areas. With increasing experimental length, we observed an increase in the degree of immunoreactivity in the vessel walls. The EIA analyses showed that the concentration of tachykinin in the tissue on both sides increased in a time-dependent manner. There was a statistical correlation in the concentration of tachykinin and the level of tachykinin immunoreactivity in the blood vessel walls between experimental and non-experimental sides. Conclusions The observations show an up-regulation of the tachykinin system bilaterally during muscle derangement/myositis in response to pronounced unilateral muscle overuse. This up-regulation occurred in inflammatory areas and was related not only to increased tachykinin innervation but also to tachykinin expression in blood vessel walls and inflammatory cells. Importantly, the tachykinin system appears to be an important factor not only ipsilaterally but also contralaterally in these processes. PMID:23587295

Bilateral increase in expression and concentration of tachykinin in a unilateral rabbit muscle overuse model that leads to myositis.

PubMed

Song, Yafeng; Stål, Per S; Yu, Ji-Guo; Forsgren, Sture

2013-04-12

Tachykinins can have pro-inflammatory as well as healing effects during tissue reorganization and inflammation. Recent studies report an up-regulation in the expression of the substance P (SP)-preferred receptor, the neurokinin-1 receptor, in marked muscle inflammation (myositis). There is, however, only very little information on the expression patterns and levels of tachykinins in this situation. The tachykinin system was analyzed using a rabbit experimental model of muscle overuse, whereby unilateral muscle exercise in combination with electrical stimulation led to muscle derangement and myositis in the triceps surae muscle (experimental length 1-6 weeks). Evaluations were made for both parts of the muscle (soleus and gastrocnemius muscles) in experimental and non-experimental (contralateral) sides. Morphologic evaluation, immunohistochemistry, in situ hybridization and enzyme immunoassay (EIA) analyses were applied. Myositis and muscle derangement occurred focally not only in the experimental side but also in the non-experimental side. In the inflammatory areas (focal myositis areas), there were frequent nerve fibers showing tachykinin-like immunoreactivity and which were parts of nerve fascicles and which were freely dispersed in the tissue. Cells in the inflammatory infiltrates showed tachykinin-like immunoreactivity and tachykinin mRNA expression. Specific immunoreactivity and mRNA expression were noted in blood vessel walls of both sides, especially in focally affected areas. With increasing experimental length, we observed an increase in the degree of immunoreactivity in the vessel walls. The EIA analyses showed that the concentration of tachykinin in the tissue on both sides increased in a time-dependent manner. There was a statistical correlation in the concentration of tachykinin and the level of tachykinin immunoreactivity in the blood vessel walls between experimental and non-experimental sides. The observations show an up-regulation of the tachykinin system bilaterally during muscle derangement/myositis in response to pronounced unilateral muscle overuse. This up-regulation occurred in inflammatory areas and was related not only to increased tachykinin innervation but also to tachykinin expression in blood vessel walls and inflammatory cells. Importantly, the tachykinin system appears to be an important factor not only ipsilaterally but also contralaterally in these processes.

Shifting Coronas Around Black Holes Artist Concept

NASA Image and Video Library

2015-10-27

A supermassive black hole is depicted in this artist's concept, surrounded by a swirling disk of material falling onto it. The purplish ball of light above the black hole, a feature called the corona, contains highly energetic particles that generate X-ray light. If you could view the corona with your eyes, it would appear nearly invisible since we can't see its X-ray light. The corona gathers inward (left), becoming brighter, before shooting away from the black hole (middle and right). Astronomers don't know why the coronas shift, but they have learned that this process leads to a brightening of X-ray light that can be observed by telescopes. Normally, before a black hole's corona shifts, there is already an effect at work called relativistic boosting. As X-ray light from the corona reflects off the black hole's surrounding disk of material -- which is traveling near half the speed of light -- the X-ray light becomes brightened, as seen on the left side of the illustration. This boosting occurs on the side of the disk where the material is traveling toward us. The opposite effect, a dimming of the X-ray light, occurs on the other side of the disk moving away from us. Another form of relativistic boosting happens when the corona shoots away from the black hole, and later collapses. Its X-ray light is also brightened as the corona travels toward us at very fast speeds, leading to X-ray flares. In 2014, NASA's Nuclear Spectroscopic Telescope Array, or NuSTAR, and Swift space telescopes witnessed an X-flare from the supermassive black hole in a distant galaxy called Markarian 335. The observations allowed astronomers to link a shifting corona to an X-ray flare for the first time. http://photojournal.jpl.nasa.gov/catalog/PIA20051

Growth dynamics and cytoskeleton organization during stem maturation and gravity-induced stem bending in Zea mays L

NASA Technical Reports Server (NTRS)

Collings, D. A.; Winter, H.; Wyatt, S. E.; Allen, N. S.; Davies, E. (Principal Investigator)

1998-01-01

Characterization of gravitropic bending in the maize stem pulvinus, a tissue that functions specifically in gravity responses, demonstrates that the pulvinus is an ideal system for studying gravitropism. Gravistimulation during the second of three developmental phases of the pulvinus induces a gradient of cell elongation across the non-growing cells of the pulvinus, with the most elongation occurring on the lower side. This cell elongation is spatially and temporally separated from normal internodal cell elongation. The three characterized growth phases in the pulvinus correspond closely to a specialized developmental sequence in which structural features typical of cells not fully matured are retained while cell maturation occurs in surrounding internodal and nodal tissue. For example, the lignification of supporting tissue and rearrangement of transverse microtubules to oblique that occur in the internode when cell elongation ceases are delayed for up to 10 d in the adjacent cells of the pulvinus, and only occurs as a pulvinus loses its capacity to respond to gravistimulation. Gravistimulation does not modify this developmental sequence. Neither wall lignification nor rearrangement of transverse microtubules occurs in the rapidly elongating lower side or non-responsive upper side of the pulvinus until the pulvinus loses the capacity to bend further. Gravistimulation does, however, lead to the formation of putative pit fields within the expanding cells of the pulvinus.

Memantine augmentation in clozapine-refractory schizophrenia: a randomized, double-blind, placebo-controlled crossover study.

PubMed

Veerman, S R T; Schulte, P F J; Smith, J D; de Haan, L

2016-07-01

Dysfunction of neuroplasticity due to N-methyl-d-aspartate (NMDA) receptor hypofunction may be a causal factor for memory and executive dysfunctioning in schizophrenia. Deregulation of NMDA transmission in the prefrontal cortex may also explain negative and positive symptoms. Clozapine augmentation with memantine targets altered NMDA receptor-mediated neurotransmission in schizophrenia and showed substantial beneficial effects on several symptom domains in a small proof-of-concept study. We evaluate effects of memantine add-on treatment to clozapine for memory and executive function, and negative and positive symptoms in schizophrenia. Clozapine-treated patients with refractory schizophrenia were randomly assigned to 12 weeks of double-blind adjunctive treatment with memantine (n = 26) or placebo (n = 26). Crossover occurred after a 2-week placebo wash-out period. Primary endpoints were change from baseline to 12 weeks treatment and 14 weeks to 26 weeks treatment on memory and executive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB), Positive and Negative Syndrome Scale (PANSS), and Clinical Global Impression Severity Scale (CGI-S). Side effects were assessed using the Liverpool University Neuroleptic Side-Effect Rating Scale. When compared with placebo, memantine improved a composite memory score comprising verbal recognition memory and paired associates learning task scores on the CANTAB (effect size = 0.30) and PANSS negative subscale score (effect size = 0.29). Side effects were mild and transient. In patients with clozapine-treated refractory schizophrenia, memantine addition significantly improved verbal and visual memory and negative symptoms without serious adverse effects. These results justify further investigations on long-term memantine augmentation to clozapine in treatment-resistant schizophrenia.

Theoretical study of pyramid sizes and scattering effects in silicon photovoltaic module stacks.

PubMed

Höhn, Oliver; Tucher, Nico; Bläsi, Benedikt

2018-03-19

Front side pyramids are the industrial standard for wafer based monocrystalline silicon solar cells. These pyramids fulfill two tasks: They act as anti-reflective structure on the one hand and as a light-trapping structure on the other hand. In recent development smaller pyramids with sizes below 1 µm attract more and more interest. In this paper an optical analysis of periodically arranged front side pyramids is performed. The impact on the reflectance as well as on the useful absorption within the solar cell is investigated depending on the pyramids size, the amount of additional scattering in the system and the quality of the rear side reflector. In contrast to other investigations not only the solar cell, but the full photovoltaic (PV) module stack is considered. This can strongly influence results, as we show in this paper. The results indicate that in a PV module stack with realistic assumptions for the amount of scattering as well as for the rear side reflectance only small differences for pyramids with sizes above 600 nm occur. Preliminary conclusions for random pyramids deduced from these results for periodically arranged pyramids indicate that these differences could become even smaller.

Asymmetric gibberellin signaling regulates vacuolar trafficking of PIN auxin transporters during root gravitropism.

PubMed

Löfke, Christian; Zwiewka, Marta; Heilmann, Ingo; Van Montagu, Marc C E; Teichmann, Thomas; Friml, Jirí

2013-02-26

Gravitropic bending of plant organs is mediated by an asymmetric signaling of the plant hormone auxin between the upper and lower side of the respective organ. Here, we show that also another plant hormone, gibberellic acid (GA), shows asymmetric action during gravitropic responses. Immunodetection using an antibody against GA and monitoring GA signaling output by downstream degradation of DELLA proteins revealed an asymmetric GA distribution and response with the maximum at the lower side of gravistimulated roots. Genetic or pharmacological manipulation of GA levels or response affects gravity-mediated auxin redistribution and root bending response. The higher GA levels at the lower side of the root correlate with increased amounts of PIN-FORMED2 (PIN2) auxin transporter at the plasma membrane. The observed increase in PIN2 stability is caused by a specific GA effect on trafficking of PIN proteins to lytic vacuoles that presumably occurs downstream of brefeldin A-sensitive endosomes. Our results suggest that asymmetric auxin distribution instructive for gravity-induced differential growth is consolidated by the asymmetric action of GA that stabilizes the PIN-dependent auxin stream along the lower side of gravistimulated roots.

Temporomandibular Disorders: The Habitual Chewing Side Syndrome

PubMed Central

Santana-Mora, Urbano; López-Cedrún, José; Mora, María J.; Otero, Xosé L.; Santana-Penín, Urbano

2013-01-01

Background Temporomandibular disorders are the most common cause of chronic orofacial pain, but, except where they occur subsequent to trauma, their cause remains unknown. This cross-sectional study assessed chewing function (habitual chewing side) and the differences of the chewing side and condylar path and lateral anterior guidance angles in participants with chronic unilateral temporomandibular disorder. This is the preliminary report of a randomized trial that aimed to test the effect of a new occlusal adjustment therapy. Methods The masticatory function of 21 randomly selected completely dentate participants with chronic temporomandibular disorders (all but one with unilateral symptoms) was assessed by observing them eat almonds, inspecting the lateral horizontal movement of the jaw, with kinesiography, and by means of interview. The condylar path in the sagittal plane and the lateral anterior guidance angles with respect to the Frankfort horizontal plane in the frontal plane were measured on both sides in each individual. Results Sixteen of 20 participants with unilateral symptoms chewed on the affected side; the concordance (Fisher’s exact test, P = .003) and the concordance-symmetry level (Kappa coefficient κ = 0.689; 95% confidence interval [CI], 0.38 to 0.99; P = .002) were significant. The mean condylar path angle was steeper (53.47(10.88) degrees versus 46.16(7.25) degrees; P = .001), and the mean lateral anterior guidance angle was flatter (41.63(13.35) degrees versus 48.32(9.53) degrees P = .036) on the symptomatic side. Discussion The results of this study support the use of a new term based on etiology, “habitual chewing side syndrome”, instead of the nonspecific symptom-based “temporomandibular joint disorders”; this denomination is characterized in adults by a steeper condylar path, flatter lateral anterior guidance, and habitual chewing on the symptomatic side. PMID:23593156

The effects of 2 landing techniques on knee kinematics, kinetics, and performance during stop-jump and side-cutting tasks.

PubMed

Dai, Boyi; Garrett, William E; Gross, Michael T; Padua, Darin A; Queen, Robin M; Yu, Bing

2015-02-01

Anterior cruciate ligament injuries (ACL) commonly occur during jump landing and cutting tasks. Attempts to land softly and land with greater knee flexion are associated with decreased ACL loading. However, their effects on performance are unclear. Attempts to land softly will decrease peak posterior ground-reaction force (PPGRF) and knee extension moment at PPGRF compared with a natural landing during stop-jump and side-cutting tasks. Attempts to land with greater knee flexion at initial ground contact will increase knee flexion at PPGRF compared with a natural landing during both tasks. In addition, both landing techniques will increase stance time and lower extremity mechanical work as well as decrease jump height and movement speed compared with a natural landing during both tasks. Controlled laboratory study. A total of 18 male and 18 female recreational athletes participated in the study. Three-dimensional kinematic and kinetic data were collected during stop-jump and side-cutting tasks under 3 conditions: natural landing, soft landing, and landing with greater knee flexion at initial ground contact. Attempts to land softly decreased PPGRF and knee extension moment at PPGRF compared with a natural landing during stop-jump tasks. Attempts to land softly decreased PPGRF compared with a natural landing during side-cutting tasks. Attempts to land with greater knee flexion at initial ground contact increased knee flexion angle at PPGRF compared with a natural landing during both stop-jump and side-cutting tasks. Attempts to land softly and land with greater knee flexion at initial ground contact increased stance time and lower extremity mechanical work, as well as decreased jump height and movement speed during both stop-jump and side-cutting tasks. Although landing softly and landing with greater knee flexion at initial ground contact may reduce ACL loading during stop-jump and side-cutting tasks, the performance of these tasks decreased, as indicated by increased stance time and mechanical work as well as decreased jump height and movement speed. Training effects tested in laboratory environments with the focus on reducing ACL loading may be reduced in actual competition environments when the focus is on athlete performance. The effects of training programs for ACL injury prevention on lower extremity biomechanics in athletic tasks may need to be evaluated in laboratories as well as in actual competitions. © 2014 The Author(s).

Side effects of radiotherapy in breast cancer patients : The Internet as an information source.

PubMed

Janssen, S; Käsmann, L; Fahlbusch, F B; Rades, D; Vordermark, D

2018-02-01

Breast cancer is the most common cancer type among women necessitating adjuvant radiotherapy. As the Internet has become a major source of information for cancer patients, this study aimed to evaluate the quality of websites giving information on side effects of radiotherapy for breast cancer patients. A patients' search for the English terms "breast cancer - radiotherapy - side effects" and the corresponding German terms "Brustkrebs - Strahlentherapie - Nebenwirkungen" was carried out twice (5 months apart) using the search engine Google. The first 30 search results each were evaluated using the validated 16-question DISCERN Plus instrument, the Health on the Net Code of Conduct (HONcode) certification and the Journal of the American Medical Association (JAMA) benchmark criteria. The overall quality (DISCERN score) of the retrieved websites was further compared to queries via Bing and Yahoo search engines. The DISCERN score showed a great range, with the majority of websites ranking fair to poor. Significantly superior results were found for English websites, particularly for webpages run by hospitals/universities and nongovernmental organizations (NGO), when compared to the respective German categories. In general, only a minority of websites met all JAMA benchmarks and was HONcode certified (both languages). We did not determine a relevant temporal change in website ranking among the top ten search hits, while significant variation occurred thereafter. Mean overall DISCERN score was similar between the various search engines. The Internet can give breast cancer patients seeking information on side effects of radiotherapy an overview. However, based on the currently low overall quality of websites and the lack of transparency for the average layperson, we emphasize the value of personal contact with the treating radio-oncologist in order to integrate and interpret the information found online.

[Continuous subcutaneous morphine--treatment of pain in patients with terminal cancer].

PubMed

Nielsen, F B; Clemensen, S E; Olesen, A S; Hole, P

1990-06-11

Nine patients with terminal cancer were treated for pain with continuous subcutaneous injection of morphine via a portable battery-driven injection pump. Treatment was instituted on account of failure of other forms of treatment with oral or epidural morphine derivatives or on account of severe nausea and vomiting which necessitated parenteral administration. Treatment proved reasonably effective and no side effects of significance occurred. Two of the patients could be treated in their homes. The method is thus considered as suitable for treatment of pain in patients with terminal cancer.

Spin analysis of concentrated traction contacts

NASA Technical Reports Server (NTRS)

Loewenthal, S. H.

1983-01-01

Spin, the result of a mismatch in contact radii on either side of the point of rolling, has a detrimental effect on traction contact performance. It occurs in concentrated contacts having conical or contoured rolling elements, such as those in traction drives or angular contact bearings, and is responsible for an increase in contact heating and power loss. The kinematics of spin producing contact geometries and the subsequent effect on traction and power loss are investigated. The influence of lubricant traction characteristics and contact geometries that minimize spin are also addressed.

Amoxicillin-potassium clavulanate: a novel beta-lactamase inhibitor.

PubMed

Smith, B R; LeFrock, J L

1985-06-01

Potassium clavulanate is a novel beta-lactamase inhibitor, which, in combination, expands the spectrum of amoxicillin to include many amoxicillin-resistant organisms. Potassium clavulanate is excreted 30-50 percent unchanged renally and its plasma time-course parallels that of amoxicillin. Several studies suggest that an increased incidence of gastrointestinal side effects may occur with this combination. In the current oral formulation, its greatest utility may be in pediatric infections due to beta-lactamase-producing Haemophilus influenzae and B. cattarhalis. In adults, the combination has not been adequately studied against other effective antibiotics.

Tinnitus retraining therapy for patients with tinnitus and decreased sound tolerance.

PubMed

Jastreboff, Pawel J; Jastreboff, Margaret M

2003-04-01

Our experience has revealed the following: (1) TRT is applicable for all types of tinnitus, as well as for decreased sound tolerance, with significant improvement of tinnitus occurring in over 80% of the cases, and at least equal success rate for decreased sound tolerance. (2) TRT can provide cure for decreased sound tolerance. (3) TRT does not require frequent clinic visits and has no side effects; however, (4) Special training of health providers involved in this treatment is required for this treatment to be effective.

Testing for clinical inertia in medication treatment of bipolar disorder.

PubMed

Hodgkin, Dominic; Merrick, Elizabeth L; O'Brien, Peggy L; McGuire, Thomas G; Lee, Sue; Deckersbach, Thilo; Nierenberg, Andrew A

2016-11-15

Clinical inertia has been defined as lack of change in medication treatment at visits where a medication adjustment appears to be indicated. This paper seeks to identify the extent of clinical inertia in medication treatment of bipolar disorder. A second goal is to identify patient characteristics that predict this treatment pattern. Data describe 23,406 visits made by 1815 patients treated for bipolar disorder during the STEP-BD practical clinical trial. Visits were classified in terms of whether a medication adjustment appears to be indicated, and also whether or not one occurred. Multivariable regression analyses were conducted to find which patient characteristics were predictive of whether adjustment occurred. 36% of visits showed at least 1 indication for adjustment. The most common indications were non-response to medication, side effects, and start of a new illness episode. Among visits with an indication for adjustment, no adjustment occurred 19% of the time, which may be suggestive of clinical inertia. In multivariable models, presence of any indication for medication adjustment was a predictor of receiving one (OR=1.125, 95% CI =1.015, 1.246), although not as strong as clinical status measures. The associations observed are not necessarily causal, given the study design. The data also lack information about physician-patient communication. Many patients remained on the same medication regimen despite indications of side effects or non-response to treatment. Although lack of adjustment does not necessarily reflect clinical inertia in all cases, the reasons for this treatment pattern merit further examination. Copyright © 2016 Elsevier B.V. All rights reserved.

Testing for Clinical Inertia in Medication Treatment of Bipolar Disorder

PubMed Central

Hodgkin, Dominic; Merrick, Elizabeth L.; O'Brien, Peggy L.; McGuire, Thomas G.; Lee, Sue; Deckersbach, Thilo; Nierenberg, Andrew A.

2016-01-01

Background Clinical inertia has been defined as lack of change in medication treatment at visits where a medication adjustment appears to be indicated. This paper seeks to identify the extent of clinical inertia in medication treatment of bipolar disorder. A second goal is to identify patient characteristics that predict this treatment pattern. Method Data describe 23,406 visits made by 1,815 patients treated for bipolar disorder during the STEP-BD practical clinical trial. Visits were classified in terms of whether a medication adjustment appears to be indicated, and also whether or not one occurred. Multivariable regression analyses were conducted to find which patient characteristics were predictive of whether adjustment occurred. Results 36% of visits showed at least 1 indication for adjustment. The most common indications were non-response to medication, side effects, and start of a new illness episode. Among visits with an indication for adjustment, no adjustment occurred 19% of the time, which may be suggestive of clinical inertia. In multivariable models, presence of any indication for medication adjustment was a predictor of receiving one (OR=1.125, 95% CI = 1.015, 1.246), although not as strong as clinical status measures. Limitations The associations observed are not necessarily causal, given the study design. The data also lack information about physician-patient communication. Conclusions Many patients remained on the same medication regimen despite indications of side effects or non-response to treatment. Although lack of adjustment does not necessarily reflect clinical inertia in all cases, the reasons for this treatment pattern merit further examination. PMID:27391267

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

Kahan, A.; Devaux, J.Y.; Amor, B.

In systemic sclerosis, abnormalities of myocardial perfusion are common and may be caused by a disturbance of the coronary microcirculation. We evaluated the long-term effect of captopril (75 to 150 mg per day) on thallium 201 myocardial perfusion in 12 normotensive patients with systemic sclerosis. Captopril significantly decreased the mean (+/- SD) number of segments with thallium 201 myocardial perfusion defects (6.5 +/- 1.9 at baseline and 4.4 +/- 2.7 after 1 year of treatment with captopril; p less than 0.02) and increased the mean global thallium score (9.6 +/- 1.7 at baseline and 11.4 +/- 2.1 after captopril; pmore » less than 0.05). In a control group of eight normotensive patients with systemic sclerosis who did not receive captopril, no significant modification in thallium results occurred. Side effects with captopril included hypotension (six patients), taste disturbances (one patient), and skin rash (one patient). These side effects subsided when the dosage was reduced. These findings demonstrate that captopril improves thallium 201 myocardial perfusion in patients with systemic sclerosis and may therefore have a beneficial effect on scleroderma myocardial disease.« less

[Treatment of keratitis superficialis chronica of the dog with strontium 90].

PubMed

Höcht, Stefan; Grüning, Georg; Allgoewer, Ingrid; Nausner, Martin; Brunnberg, Leo; Hinkelbein, Wolfgang

2002-02-01

Corneal pannus is a disease which, if untreated, nearly always is progressive and may lead to blindness of the affected dog. A therapeutic standard is yet to be defined. Beta-ray irradiation with Sr-90 is often recommended on a casuistic basis, but systematic studies are sparse. The aim of the present study was to evaluate efficacy and to document side effects of radiotherapy with Sr-90. 17 animals were treated. 13 of them received treatment of 15 Gy surface dose twice within 2 days with additional medical therapy with ciclosporin and prednisolon. Only the more affected eye was treated with radiation which was applied with an eye-applicator, the other eye served as control. Four animals with already advanced impairment of vision received keratectomy, afterwards radiation was applied on both sides. Medical treatment alone led to deterioration in vascularization and spread of pigmentation in eleven of 13 (85%) of the control-eyes, density of pigmentation increased in eight of 13 (62%). After radiation therapy, almost all animals showed a marked initial improvement. Even if progressive disease occurred later on, further worsening as it happened in the control-eyes could be stopped in nine resp. ten of 13 eyes (69% and 77%). All animals with keratectomy and radiotherapy regained and preserved adequate vision. Besides short-term blepharospasm, no side effects were recorded. Corneal pannus is responsive to radiation therapy with Sr-90 and long-term benefit can be achieved. Side effects are minimal. Optimal sequencing of therapy and dosage still have to be examined.

A unified frame of predicting side effects of drugs by using linear neighborhood similarity.

PubMed

Zhang, Wen; Yue, Xiang; Liu, Feng; Chen, Yanlin; Tu, Shikui; Zhang, Xining

2017-12-14

Drug side effects are one of main concerns in the drug discovery, which gains wide attentions. Investigating drug side effects is of great importance, and the computational prediction can help to guide wet experiments. As far as we known, a great number of computational methods have been proposed for the side effect predictions. The assumption that similar drugs may induce same side effects is usually employed for modeling, and how to calculate the drug-drug similarity is critical in the side effect predictions. In this paper, we present a novel measure of drug-drug similarity named "linear neighborhood similarity", which is calculated in a drug feature space by exploring linear neighborhood relationship. Then, we transfer the similarity from the feature space into the side effect space, and predict drug side effects by propagating known side effect information through a similarity-based graph. Under a unified frame based on the linear neighborhood similarity, we propose method "LNSM" and its extension "LNSM-SMI" to predict side effects of new drugs, and propose the method "LNSM-MSE" to predict unobserved side effect of approved drugs. We evaluate the performances of LNSM and LNSM-SMI in predicting side effects of new drugs, and evaluate the performances of LNSM-MSE in predicting missing side effects of approved drugs. The results demonstrate that the linear neighborhood similarity can improve the performances of side effect prediction, and the linear neighborhood similarity-based methods can outperform existing side effect prediction methods. More importantly, the proposed methods can predict side effects of new drugs as well as unobserved side effects of approved drugs under a unified frame.

Drug side effect extraction from clinical narratives of psychiatry and psychology patients

PubMed Central

Kocher, Jean-Pierre A; Chute, Christopher G; Savova, Guergana K

2011-01-01

Objective To extract physician-asserted drug side effects from electronic medical record clinical narratives. Materials and methods Pattern matching rules were manually developed through examining keywords and expression patterns of side effects to discover an individual side effect and causative drug relationship. A combination of machine learning (C4.5) using side effect keyword features and pattern matching rules was used to extract sentences that contain side effect and causative drug pairs, enabling the system to discover most side effect occurrences. Our system was implemented as a module within the clinical Text Analysis and Knowledge Extraction System. Results The system was tested in the domain of psychiatry and psychology. The rule-based system extracting side effects and causative drugs produced an F score of 0.80 (0.55 excluding allergy section). The hybrid system identifying side effect sentences had an F score of 0.75 (0.56 excluding allergy section) but covered more side effect and causative drug pairs than individual side effect extraction. Discussion The rule-based system was able to identify most side effects expressed by clear indication words. More sophisticated semantic processing is required to handle complex side effect descriptions in the narrative. We demonstrated that our system can be trained to identify sentences with complex side effect descriptions that can be submitted to a human expert for further abstraction. Conclusion Our system was able to extract most physician-asserted drug side effects. It can be used in either an automated mode for side effect extraction or semi-automated mode to identify side effect sentences that can significantly simplify abstraction by a human expert. PMID:21946242

On the non-equilibrium dynamics of cavitation around the underwater projectile in variable motion

NASA Astrophysics Data System (ADS)

Chen, Y.; Lu, C. J.; Li, J.; Chen, X.; Gong, Z. X.

2015-12-01

In this work, the dynamic behavior of the non-equilibrium cavitation occurring around the underwater projectiles navigating with variable speed was numerically and theoretically investigated. The cavity collapse induced by the decelerating motion of the projectiles can be classified into two types: periodic oscillation and damped oscillation. In each type the evolution of the total mass of vapor in cavity are found to have strict correlation with the pressure oscillation in far field. By defining the equivalent radius of cavity, we introduce the specific kinetic energy of collapse and demonstrate that its change-rate is in good agreement with the pressure disturbance. We numerically investigated the influence of angle of attack on the collapse effect. The result shows that when the projectile decelerates, an asymmetric-focusing effect of the pressure induced by collapse occurs on its pressure side. We analytically explained such asymmetric-focusing effect.

What matters when judging intentionality-moral content or normative status? Testing the rational scientist model of the side-effect.

PubMed

Papadopoulos, C; Hayes, B K

2018-06-01

Previous work has demonstrated a "side-effect effect," such that intentionality is more likely to be attributed to agents who bring about negatively valenced as opposed to positively valenced side effects. The rational-scientist model explains this by suggesting that norm-violating side effects are more informative for inferring intentionality than norm-conforming side effects. In the present study we reexamined this account, addressing limitations of previous empirical tests (e.g., Uttich & Lombrozo, Cognition 116: 87-100, 2010). Side-effect valence and norm status were manipulated factorially, enabling an examination of the impact of norm status on intentionality judgments in both positively and negatively valenced side effects. Additionally, the impact of side-effect norm status on the perceived valences of side effects and agents was examined. Effects of norm status were found for both positive and negative side effects. Violation of an ostensibly neutral norm led to negative perceptions of the side effect. However, a norm status effect on intentionality judgments persisted when these effects were controlled. These results support the view that the side-effect effect is the result of the rational use of social-cognitive evidence.

Wettability, Polarity, and Water Absorption of Holm Oak Leaves: Effect of Leaf Side and Age1[OPEN

PubMed Central

Fernández, Victoria; Sancho-Knapik, Domingo; Guzmán, Paula; Peguero-Pina, José Javier; Gil, Luis; Karabourniotis, George; Khayet, Mohamed; Fasseas, Costas; Heredia-Guerrero, José Alejandro; Heredia, Antonio; Gil-Pelegrín, Eustaquio

2014-01-01

Plant trichomes play important protective functions and may have a major influence on leaf surface wettability. With the aim of gaining insight into trichome structure, composition, and function in relation to water-plant surface interactions, we analyzed the adaxial and abaxial leaf surface of holm oak (Quercus ilex) as a model. By measuring the leaf water potential 24 h after the deposition of water drops onto abaxial and adaxial surfaces, evidence for water penetration through the upper leaf side was gained in young and mature leaves. The structure and chemical composition of the abaxial (always present) and adaxial (occurring only in young leaves) trichomes were analyzed by various microscopic and analytical procedures. The adaxial surfaces were wettable and had a high degree of water drop adhesion in contrast to the highly unwettable and water-repellent abaxial holm oak leaf sides. The surface free energy and solubility parameter decreased with leaf age, with higher values determined for the adaxial sides. All holm oak leaf trichomes were covered with a cuticle. The abaxial trichomes were composed of 8% soluble waxes, 49% cutin, and 43% polysaccharides. For the adaxial side, it is concluded that trichomes and the scars after trichome shedding contribute to water uptake, while the abaxial leaf side is highly hydrophobic due to its high degree of pubescence and different trichome structure, composition, and density. Results are interpreted in terms of water-plant surface interactions, plant surface physical chemistry, and plant ecophysiology. PMID:24913938

Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study

PubMed Central

Haas, Marion; Viney, Rosalie; Pearson, Sallie-Anne; Haywood, Philip; Brown, Chris; Ward, Robyn

2017-01-01

Aim Chemotherapy side effects are often reported in clinical trials; however, there is little evidence about their incidence in routine clinical care. The objective of this study was to describe the frequency and severity of patient-reported chemotherapy side effects in routine care across treatment centres in Australia. Methods We conducted a prospective cohort study of individuals with breast, lung or colorectal cancer undergoing chemotherapy. Side effects were identified by patient self-report. The frequency, prevalence and incidence rates of side effects were calculated by cancer type and grade, and cumulative incidence curves for each side effect computed. Frequencies of side effects were compared between demographic subgroups using chi-squared statistics. Results Side effect data were available for 449 eligible individuals, who had a median follow-up of 5.64 months. 86% of participants reported at least one side effect during the study period and 27% reported a grade IV side effect, most commonly fatigue or dyspnoea. Fatigue was the most common side effect overall (85%), followed by diarrhoea (74%) and constipation (74%). Prevalence and incidence rates were similar across side effects and cancer types. Age was the only demographic factor associated with the incidence of side effects, with older people less likely to report side effects. Conclusion This research has produced the first Australian estimates of self-reported incidence of chemotherapy side effects in routine clinical care. Chemotherapy side effects in routine care are common, continue throughout chemotherapy and can be serious. This work confirms the importance of observational data in providing clinical practice-relevant information to decision-makers. PMID:29016607

Incidence and severity of self-reported chemotherapy side effects in routine care: A prospective cohort study.

PubMed

Pearce, Alison; Haas, Marion; Viney, Rosalie; Pearson, Sallie-Anne; Haywood, Philip; Brown, Chris; Ward, Robyn

2017-01-01

Chemotherapy side effects are often reported in clinical trials; however, there is little evidence about their incidence in routine clinical care. The objective of this study was to describe the frequency and severity of patient-reported chemotherapy side effects in routine care across treatment centres in Australia. We conducted a prospective cohort study of individuals with breast, lung or colorectal cancer undergoing chemotherapy. Side effects were identified by patient self-report. The frequency, prevalence and incidence rates of side effects were calculated by cancer type and grade, and cumulative incidence curves for each side effect computed. Frequencies of side effects were compared between demographic subgroups using chi-squared statistics. Side effect data were available for 449 eligible individuals, who had a median follow-up of 5.64 months. 86% of participants reported at least one side effect during the study period and 27% reported a grade IV side effect, most commonly fatigue or dyspnoea. Fatigue was the most common side effect overall (85%), followed by diarrhoea (74%) and constipation (74%). Prevalence and incidence rates were similar across side effects and cancer types. Age was the only demographic factor associated with the incidence of side effects, with older people less likely to report side effects. This research has produced the first Australian estimates of self-reported incidence of chemotherapy side effects in routine clinical care. Chemotherapy side effects in routine care are common, continue throughout chemotherapy and can be serious. This work confirms the importance of observational data in providing clinical practice-relevant information to decision-makers.

Seasonality, estrous cycle characterization, estrus synchronization, semen cryopreservation, and artificial insemination in the Pacific white-sided dolphin (Lagenorhynchus obliquidens).

PubMed

Robeck, T R; Steinman, K J; Greenwell, M; Ramirez, K; Van Bonn, W; Yoshioka, M; Katsumata, E; Dalton, L; Osborn, S; O'Brien, J K

2009-08-01

The reproductive physiology of the Pacific white-sided dolphin, Lagenorhynchus obliquidens, was characterized to facilitate the development of artificial insemination (AI) using cryopreserved spermatozoa. Specific objectives were to: 1) describe reproductive seasonality of the Pacific white sided dolphins; 2) describe urinary LH and ovarian steroid metabolites during the estrous cycle; 3) correlate LH and ovarian steroidal metabolite patterns to ultrasound-monitored follicular growth and ovulation; and 4) assess the efficacy of synchronizing estrus, sperm collection/cryopreservation, and intrauterine insemination. Ovulations (64%, n=37) and conceptions (83%, n=18) occurred from August to October. Peak mean serum testosterone (24 ng/ml), cross-sectional testicular area (41.6 cm(2)), and sperm concentration (144.3 x 10(7) sperm/ml) occurred in July, August, and September respectively. Spermatozoa were only found in ejaculates from July to October. Estrous cycles (n=22) were 31 d long and were comprised of a 10 d follicular and 21 d luteal phase. Ovulation occurred 31.2 h after the onset of the LH surge and 19.3 h after the LH peak. Follicular diameter and circumference within 12 h of ovulation were 1.52 and 4.66 cm respectively. Estrus synchronization attempts with altrenogest resulted in 17 (22%) ovulatory cycles with ovulation occurring 21 d post-altrenogest. Ten AI attempts using cryopreserved semen resulted in five pregnancies (50%). The mean gestation length was 356 days (range 348-367). These data provide new information on the Pacific white-sided dolphin's reproductive physiology and collectively enabled the first application of AI in this species.

Anapylactoid Reactions Mediated by Autoantibodies to Cholesterol in Miniature Pigs

DTIC Science & Technology

1989-11-01

anaphylatoxins (see Discus- These results show that naturally occurring auto- sion), and the pig therefore serves as a model in which antibodies to cholesterol...ventilator ( model 7200. Pu- also often produced shock-type side effects so that with rltan-Bennett Corp. Los Angeles. CA). The carotid arteries and the...thcrmodilutton catheter ( model 93A- 131-scribed by Sachs and Klopstock (1) was observed inciden- 7F, Edwards Laboratories AMS Del Caribe. Inc.. Anasco

Neutral points of skylight polarization observed during the total eclipse on 11 August 1999.

PubMed

Horváth, Gábor; Pomozi, István; Gál, József

2003-01-20

We report here on the observation of unpolarized (neutral) points in the sky during the total solar eclipse on 11 August 1999. Near the zenith a neutral point was observed at 450 nm at two different points of time during totality. Around this celestial point the distribution of the angle of polarization was heterogeneous: The electric field vectors on the one side were approximately perpendicular to those on the other side. At another moment of totality, near the zenith a local minimum of the degree of linear polarization occurred at 550 nm. Near the antisolar meridian, at a low elevation another two neutral points occurred at 450 nm at a certain moment during totality. Approximately at the position of these neutral points, at another moment of totality a local minimum of the degree of polarization occurred at 550 nm, whereas at 450 nm a neutral point was observed, around which the angle-of-polarization pattern was homogeneous: The electric field vectors were approximately horizontal on both sides of the neutral point.

On the subjective acceptance during cardiovascular magnetic resonance imaging at 7.0 Tesla.

PubMed

Klix, Sabrina; Els, Antje; Paul, Katharina; Graessl, Andreas; Oezerdem, Celal; Weinberger, Oliver; Winter, Lukas; Thalhammer, Christof; Huelnhagen, Till; Rieger, Jan; Mehling, Heidrun; Schulz-Menger, Jeanette; Niendorf, Thoralf

2015-01-01

This study examines the subjective acceptance during UHF-CMR in a cohort of healthy volunteers who underwent a cardiac MR examination at 7.0T. Within a period of two-and-a-half years (January 2012 to June 2014) a total of 165 healthy volunteers (41 female, 124 male) without any known history of cardiac disease underwent UHF-CMR. For the assessment of the subjective acceptance a questionnaire was used to examine the participants experience prior, during and after the UHF-CMR examination. For this purpose, subjects were asked to respond to the questionnaire in an exit interview held immediately after the completion of the UHF-CMR examination under supervision of a study nurse to ensure accurate understanding of the questions. All questions were answered with "yes" or "no" including space for additional comments. Transient muscular contraction was documented in 12.7% of the questionnaires. Muscular contraction was reported to occur only during periods of scanning with the magnetic field gradients being rapidly switched. Dizziness during the study was reported by 12.7% of the subjects. Taste of metal was reported by 10.1% of the study population. Light flashes were reported by 3.6% of the entire cohort. 13% of the subjects reported side effects/observations which were not explicitly listed in the questionnaire but covered by the question about other side effects. No severe side effects as vomiting or syncope after scanning occurred. No increase in heart rate was observed during the UHF-CMR exam versus the baseline clinical examination. This study adds to the literature by detailing the subjective acceptance of cardiovascular magnetic resonance imaging examinations at a magnetic field strength of 7.0T. Cardiac MR examinations at 7.0T are well tolerated by healthy subjects. Broader observational and multi-center studies including patient cohorts with cardiac diseases are required to gain further insights into the subjective acceptance of UHF-CMR examinations.

Interaction of Perceptual Grouping and Crossmodal Temporal Capture in Tactile Apparent-Motion

PubMed Central

Chen, Lihan; Shi, Zhuanghua; Müller, Hermann J.

2011-01-01

Previous studies have shown that in tasks requiring participants to report the direction of apparent motion, task-irrelevant mono-beeps can “capture” visual motion perception when the beeps occur temporally close to the visual stimuli. However, the contributions of the relative timing of multimodal events and the event structure, modulating uni- and/or crossmodal perceptual grouping, remain unclear. To examine this question and extend the investigation to the tactile modality, the current experiments presented tactile two-tap apparent-motion streams, with an SOA of 400 ms between successive, left-/right-hand middle-finger taps, accompanied by task-irrelevant, non-spatial auditory stimuli. The streams were shown for 90 seconds, and participants' task was to continuously report the perceived (left- or rightward) direction of tactile motion. In Experiment 1, each tactile stimulus was paired with an auditory beep, though odd-numbered taps were paired with an asynchronous beep, with audiotactile SOAs ranging from −75 ms to 75 ms. Perceived direction of tactile motion varied systematically with audiotactile SOA, indicative of a temporal-capture effect. In Experiment 2, two audiotactile SOAs—one short (75 ms), one long (325 ms)—were compared. The long-SOA condition preserved the crossmodal event structure (so the temporal-capture dynamics should have been similar to that in Experiment 1), but both beeps now occurred temporally close to the taps on one side (even-numbered taps). The two SOAs were found to produce opposite modulations of apparent motion, indicative of an influence of crossmodal grouping. In Experiment 3, only odd-numbered, but not even-numbered, taps were paired with auditory beeps. This abolished the temporal-capture effect and, instead, a dominant percept of apparent motion from the audiotactile side to the tactile-only side was observed independently of the SOA variation. These findings suggest that asymmetric crossmodal grouping leads to an attentional modulation of apparent motion, which inhibits crossmodal temporal-capture effects. PMID:21383834

Side effects associated with anti-HIV drugs.

PubMed

Highleyman, L

1998-04-01

Many side effects are associated with the use of anti-HIV drugs, impacting the development of drug resistance and the quality of life for HIV-patients. Concern about side effects is a primary factor in deterring people from beginning HIV therapy. Frequency and severity of side effects vary greatly, but they are frequently more common and severe in people who are taking a new drug or who have advanced HIV disease. Information on side effects comes largely from clinical trials; however, many side effects are not discovered until the drug has been approved and used by larger numbers of people. Side effects vary from serious toxicities that require stopping treatment to uncomfortable or annoying side effects that interfere with daily life. A table categorizes the four major side effects (nausea, fever, skin rash, and fatigue) and divides them into grades that describe their intensity. A chart lists the side effects associated with specific anti-HIV drugs. Suggestions for managing side effects are included.

Practical issues in laser cleaning of stone and painted artefacts: optimisation procedures and side effects

NASA Astrophysics Data System (ADS)

Pouli, Paraskevi; Oujja, Mohamed; Castillejo, Marta

2012-02-01

In the last twenty years lasers have acquired an important role in the study and the preservation of Cultural Heritage (CH) objects and Monuments, as they have effectively illuminated a number of complex diagnostic and restoration problems. Their unique properties have enabled their use in a wide range of conservation applications, since they ensure interventions with precise control, material selectivity and immediate feedback. Surface cleaning, based on laser ablation, is a delicate, critical and irreversible process, which, given the multitude of materials that may be present on a CH object and the often fragile or precarious condition of the original surfaces, is fraught with many potential complications. Therefore it is crucial to choose the best possible laser cleaning methodology for each individual case, which involves optimising the laser parameters according to material properties, as well as the thorough knowledge of the ablation mechanisms involved. In this context the systematic investigation and elucidation of potential damage or side effects occurring upon cleaning is essential, as it delineates the possibilities and limitations of laser ablation and allows the fine-tuning of the operating parameters for a successful cleaning intervention. This paper is an overview of studies investigating the mechanisms which are responsible for the laser-induced discoloration effects. Emphasis is given on the yellowing coloration observed on stonework upon infrared (IR) ablation of pollution encrustations, while the various theories introduced to approach the different physical and/or chemical processes and mechanisms responsible for such side effects are discussed. In this respect the different laser cleaning methodologies, which are based on the use of laser systems with different pulse durations and wavelength characteristics, introduced in order to rectify or prevent discoloration on stonework are presented. In parallel, the darkening phenomena which occur upon laser irradiation of painted surfaces are also considered. Studies on series of model paints performed in order to understand the sensitivity of pigments to laser irradiation are critically reviewed. In this respect the importance of the optimal wavelength and pulse-duration selection for a safe and controlled laser cleaning intervention is also addressed.

Side forces on forebodies at high angles of attack and Mach numbers from 0.1 to 0.7: two tangent ogives, paraboloid and cone

NASA Technical Reports Server (NTRS)

Keener, E. R.; Chapman, G. T.; Taleghani, J.; Cohen, L.

1977-01-01

An experimental investigation was conducted in the Ames 12-Foot Wind Tunnel to determine the subsonic aerodynamic characteristics of four forebodies at high angles of attack. The forebodies tested were a tangent ogive with fineness ratio of 5, a paraboloid with fineness ratio of 3.5, a 20 deg cone, and a tangent ogive with an elliptic cross section. The investigation included the effects of nose bluntness and boundary-layer trips. The tangent-ogive forebody was also tested in the presence of a short afterbody and with the afterbody attached. Static longitudinal and lateral/directional stability data were obtained. The investigation was conducted to investigate the existence of large side forces and yawing moments at high angles of attack and zero sideslip. It was found that all of the forebodies experience steady side forces that start at angles of attack of from 20 deg to 35 deg and exist to as high as 80 deg, depending on forebody shape. The side is as large as 1.6 times the normal force and is generally repeatable with increasing and decreasing angle of attack and, also, from test to test. The side force is very sensitive to the nature of the boundary layer, as indicated by large changes with boundary trips. The maximum side force caries considerably with Reynolds number and tends to decrease with increasing Mach number. The direction of the side force is sensitive to the body geometry near the nose. The angle of attack of onset of side force is not strongly influenced by Reynolds number or Mach number but varies with forebody shape. Maximum normal force often occurs at angles of attack near 60 deg. The effect of the elliptic cross section is to reduce the angle of onset by about 10 deg compared to that of an equivalent circular forebody with the same fineness ratio. The short afterbody reduces the angle of onset by about 5 deg.

A simplified chair-side remount technique using customized mounting platforms.

PubMed

Chauhan, Mamta Devendrakumar; Dange, Shankar Pandharinath; Khalikar, Arun Narayan; Vaidya, Smita Padmakar

2012-08-01

Correct occlusal relationships are part of the successful prosthetic treatment for edentulous patients. Fabrication of complete dentures comprises of clinical and laboratory procedures that should be executed accurately for achieving success with fabricated dentures. Errors occurring during the clinical and laboratory procedures of a denture may subsequently lead to the occlusal errors in the final prosthesis. These occlusal errors can be corrected in two ways: i) in patient's mouth ii) by recording new centric relation and remounting dentures on an articulator. The latter method is more feasible because the mobility of denture base on the mucosa in oral cavity does not permit the identification of premature contacts in centric occlusion and tooth guided eccentric excursions. This article describes a modest and effective clinical chair-side remount procedure using customized mounting platforms.

A simplified chair-side remount technique using customized mounting platforms

PubMed Central

Dange, Shankar Pandharinath; Khalikar, Arun Narayan; Vaidya, Smita Padmakar

2012-01-01

Correct occlusal relationships are part of the successful prosthetic treatment for edentulous patients. Fabrication of complete dentures comprises of clinical and laboratory procedures that should be executed accurately for achieving success with fabricated dentures. Errors occurring during the clinical and laboratory procedures of a denture may subsequently lead to the occlusal errors in the final prosthesis. These occlusal errors can be corrected in two ways: i) in patient's mouth ii) by recording new centric relation and remounting dentures on an articulator. The latter method is more feasible because the mobility of denture base on the mucosa in oral cavity does not permit the identification of premature contacts in centric occlusion and tooth guided eccentric excursions. This article describes a modest and effective clinical chair-side remount procedure using customized mounting platforms. PMID:22977726

Thermostructural Evaluation of Joggle Region on the Shuttle Orbiter's Wing Leading Edge

NASA Technical Reports Server (NTRS)

Walker, Sandra P.; Warren, Jerry E.

2012-01-01

An investigation was initiated to determine the cause of coating spallation occurring on the Shuttle Orbiter's wing leading edge panels in the slip-side joggle region. The coating spallation events were observed, post flight, on differing panels on different missions. As part of the investigation, the high re-entry heating occurring on the joggles was considered here as a possible cause. Thus, a thermostructural evaluation was conducted to determine the detailed state-of-stress in the joggle region during re-entry and the feasibility of a laboratory test on a local joggle specimen to replicate this state-of-stress. A detailed three-dimensional finite element model of a panel slip-side joggle region was developed. Parametric and sensitivity studies revealed significant stresses occur in the joggle during peak heating. A critical interlaminar normal stress concentration was predicted in the substrate at the coating interface and was confined to the curved joggle region. Specifically, the high interlaminar normal stress is identified to be the cause for the occurrence of failure in the form of local subsurface material separation occurring in the slip-side joggle. The predicted critical stresses are coincident with material separations that had been observed with microscopy in joggle specimens obtained from flight panels.

Adverse reactions and interactions with beta-adrenoceptor blocking drugs.

PubMed

Lewis, R V; McDevitt, D G

1986-01-01

beta-Blocking drugs are widely used throughout the world and serious adverse reactions are relatively uncommon. Most of those which do occur are pharmacologically predictable and may be avoided by ensuring that patients who are to be given beta-blockers do not have a predisposition to the development of bronchospasm, cardiac failure or peripheral ischaemia. In some situations, the use of a beta 1-selective blocking drug may reduce the risk of a severe adverse reaction, but there is little evidence that other ancillary properties such as partial agonist activity are of relevance in this context. Long term experience with many of the beta-blockers in current use suggests that unpredictable major adverse reactions such as the practolol oculomucocutaneous syndrome are unlikely to be repeated, although some of these drugs may be associated with immunological disturbances and some have been implicated in the development of retroperitoneal fibrosis. beta-Blocking drugs appear to be associated with a number of subjective side effects including muscle fatigue, peripheral coldness and some neurological symptoms. These side effects are highly subjective and are therefore difficult to quantify and it is not known whether they are of major importance in terms of their effect upon patients' overall well-being. It cannot be assumed that simply because such side effects can be elicited that they do, in fact, matter. However, because beta-blockers are often prescribed for patients who have no symptoms and for whom the benefits of therapy are generally small, such side effects would be of considerable importance if they had an overall effect upon quality of life. There are theoretical reasons to suppose that the incidence and severity of such side effects may be related to the ancillary properties of the individual drugs, but there is little evidence that parameters such as beta 1-selectivity, or partial agonist activity are clinically important determinants of the severity of these side effects. Lipophilicity, however, may be associated with an increased incidence of neurological symptoms. beta-Blocking drugs may cause a variety of metabolic disturbances including an increase in serum VLDL-cholesterol concentrations. However, long term studies have not shown that such disturbances are associated with an increased risk of cardiovascular disease, indicating that such metabolic changes may not be of major importance in practice. beta-Blocking drugs may be involved in a number of interactions with other drugs, but few of these have been shown to be of clinical significance.(ABSTRACT TRUNCATED AT 400 WORDS)

Side Effect Perceptions and Their Impact on Treatment Decisions in Women.

PubMed

Waters, Erika A; Pachur, Thorsten; Colditz, Graham A

2017-04-01

Side effects prompt some patients to forego otherwise-beneficial therapies. This study explored which characteristics make side effects particularly aversive. We used a psychometric approach, originating from research on risk perception, to identify the factors (or components) underlying side effect perceptions. Women ( N = 149) aged 40 to 74 years were recruited from a patient registry to complete an online experiment. Participants were presented with hypothetical scenarios in which an effective and necessary medication conferred a small risk of a single side effect (e.g., nausea, dizziness). They rated a broad range of side effects on several characteristics (e.g., embarrassing, treatable). In addition, we collected 4 measures of aversiveness for each side effect: choosing to take the medication, willingness to pay to avoid the side effect (WTP), negative affective attitude associated with the side effect, and how each side effect ranks among others in terms of undesirability. A principal components analysis (PCA) was used to identify the components underlying side effect perceptions. Then, for each aversiveness measure separately, regression analyses were used to determine which components predicted differences in aversiveness among the side effects. The PCA revealed 4 components underlying side effect perceptions: affective challenge (e.g., frightening), social challenge (e.g., disfiguring), physical challenge (e.g., painful), and familiarity (e.g., common). Side effects perceived as affectively and physically challenging elicited the highest levels of aversiveness across all 4 measures. Understanding what side effect characteristics are most aversive may inform interventions to improve medical decisions and facilitate the translation of novel biomedical therapies into clinical practice.

Side Effect Perceptions and their Impact on Treatment Decisions in Women

PubMed Central

Waters, Erika A.; Pachur, Thorsten; Colditz, Graham A.

2016-01-01

Background Side effects prompt some patients to forego otherwise-beneficial therapies. This study explored which characteristics make side effects particularly aversive. Methods We used a psychometric approach, originating from research on risk perception, to identify the factors (or components) underlying side effect perceptions. Women (N=149) aged 40–74 were recruited from a patient registry to complete an online experiment. Participants were presented with hypothetical scenarios in which an effective and necessary medication conferred a small risk of a single side effect (e.g., nausea, dizziness). They rated a broad range of side effects on several characteristics (e.g., embarrassing, treatable). In addition, we collected four measures of aversiveness for each side effect: choosing to take the medication, willingness to pay to avoid the side effect (WTP), negative affective attitude associated with the side effect, and how each side effect ranks among others in terms of undesirability. A principle-components analysis (PCA) was used to identify the components underlying side effect perceptions. Then, for each aversiveness measure separately, regression analyses were used to determine which components predicted differences in aversiveness among the side effects. Results The PCA revealed four components underlying side effect perceptions: affective challenge (e.g., frightening), social challenge (e.g., disfiguring), physical challenge (e.g., painful), and familiarity (e.g., common). Side effects perceived as affectively and physically challenging elicited the highest levels of aversiveness across all four measures. Conclusions Understanding what side effect characteristics are most aversive may inform interventions to improve medical decisions and facilitate the translation of novel biomedical therapies into clinical practice. PMID:27216581

The role of the ipsilesional side in the rehabilitation of post-stroke subjects.

PubMed

Silva, Augusta; Sousa, Andreia S P; Silva, Cláudia Costa; Santos, Rubim; Tavares, João Manuel R S; Sousa, Filipa

2017-09-01

Most stroke lesions occur in the middle cerebral artery territory, presenting a high probability of damage of pathways with predominant ipsilesional disposition, mainly related to postural control. Despite the high probability of bilateral postural control dysfunction based on neuroanatomical fundaments, both research and clinical rehabilitation involving stroke subjects have been focused on contralesional side (also named affected side) impairments, while ipsilesional side (also named non-affected side) impairments have been attributed to an adaptive strategy. This paper aims to present a critical understanding about the state-of-the-art that sustains the hypothesis that stroke subjects with middle cerebral artery territory lesion at the subcortical level show an atypical behaviour in the ipsilateral side associated with the lesion itself and the possible implications.

Effect of Communication Style on Perceptions of Medication Side Effect Risk among Pharmacy Students.

PubMed

Sawant, Ruta V; Beatty, Collin R; Sansgiry, Sujit S

2016-10-25

Objective. To assess the effect of communication style, and frequency and severity of medication side-effects, on pharmacy students' perception of risk of experiencing side effects. Methods. One hundred responses from pharmacy students were obtained using an online survey. Participants were presented with a drug information box containing drug name, drug usage, and one side-effect associated with the drug. Information on side-effect for each drug was presented in one of eight experimental conditions, in a 2 (side-effect frequency: low, high), X2 (side-effect severity: mild, severe) X2 (communication style: verbal, verbal + natural frequency) factorial design. Risk perception of experiencing side effects was measured. Results. Communication style was found to have a significant impact on risk perception depending on the context of frequency and severity associated with the side effect. Conclusion. Communication style plays a significant role in formulating risk perceptions of medication side effects. Training in pharmaceutical counseling should include special emphasis on effective language use.

Ingenol Mebutate for Recalcitrant Chronic Actinic Cheilitis.

PubMed

Tzika, Evangelia; Masouyé, Isabelle; Mühlstädt, Michael; Laffitte, Emmanuel

2016-01-01

We present the case of a healthy 76-year-old man with a whitish, hyperkeratotic lesion of the lower lip diagnosed as actinic cheilitis (AC) previously treated with classic red light photodynamic therapy 5 years ago. Initial treatment with 5% imiquimod cream - also with intensified application - failed. After 2 cycles thrice daily, consecutive applications of 150 μg/g ingenol mebutate gel at 3 weeks' interval, the lesions cleared completely. Surprisingly, no pustular or crusting reaction or other side effect occurred contrary to expectation. Remission was stable for 10 months, when recurrence occurred. Ingenol mebutate proved to be a feasible and safe treatment in this otherwise refractory case of AC. © 2016 S. Karger AG, Basel.

Structural behavior of Tl-exchanged natrolite at high pressure depending on the composition of pressure-transmitting medium

NASA Astrophysics Data System (ADS)

Seryotkin, Yu. V.; Bakakin, V. V.; Likhacheva, A. Yu.; Dementiev, S. N.; Rashchenko, S. V.

2017-10-01

The structural evolution of Tl-exchanged natrolite with idealized formula Tl2[Al2Si3O10]·2H2O, compressed in penetrating (water:ethanol 1:1) and non-penetrating (paraffin) media, was studied up to 4 GPa. The presence of Tl+ with non-bonded electron lone pairs, which can be either stereo-chemically active or passive, determines distinctive features of the high-pressure behavior of the Tl-form. The effective volume of assemblages Tl+(O,H2O) n depends on the E-pairs activity: single-sided coordination correlates with smaller volumes. At ambient conditions, there are two types of Tl positions, only one of them having a nearly single-sided coordination as a characteristic of stereo-activity of the Tl+ E pair. Upon the compression in paraffin, a phase transition occurs: a 5% volume contraction of flexible natrolite framework is accompanied by the conversion of all the Tl+ cations into stereo-chemically active state with a single-sided coordination. This effect requires the reconstruction of all the extra-framework subsystems with the inversion of the cation and H2O positions. The compression in water-containing medium leads to the increase of H2O content up to three molecules pfu through the filling of partly vacant positions. This hinders a single-sided coordination of Tl ions and preserves the configuration of their ion-molecular subsystem. It is likely that the extra-framework subsystem is responsible for the super-structure modulation.

EMBOLIZATION OF DOG PROSTATES WITH YTTRIUM-90 MICROSPHERES

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

Greene, W.M.

1963-10-01

Experiments exploring means for the protection of adjacent normal tissue while delivering a destructive dose of radiation to malignant tissue were conducted. By injection of radioactive ceramic spheres or particles, too large to pass through capillaries or arteriovenous shunts, relatively high doses of radiation can be distributed homogeneously to a circumscribed area. Attempts were made to determine the uniformity of distribution and the radiation effect of varying doses of spheres injected into the arterial supply of the dog prostate. Nonradioactive and radioactive ceramic microspheres of 60 mu dia were used since this size exceeds the diameter of capillaries and arteriovenousmore » shunts. Yttrium-90 microspheres of varying radioactivity were used. Doses injected into right and left hypogastric arteries varied from 0.69 to 28.4 mc/side (92-1260 mc/ g prostate). Homogeneous distribution of radioactivity within the prostate was demonstrated by autoradiography. Distribution to some other organs (rectum, penis, and bladder) occurred because arterial supply to these structures was not isolated and occluded. The amount of radioactivity found in the lungs suggested more venous drainage in some cases than seemed apparent, and because of the infarctions of pelvic organs may have leaked radioactive spheres into the venous circuit. In 6 of the 8 dogs which died prematurely (2 to 7 days after surgery) obvious infarction of the prostate and in some other pelvic structures had occurred. That the radioactivity contributed to the infarction is suggested by the results in the dogs which received large doses of radioactivity (18.9 and 28.4 mc per side) in minimal amounts of spheres (100to 150 mg per side). The intensely concentrated radioactivity within the arteriolar lumens may have caused vasculitis and subsequent thrombosis. Although homogeneous destruction of the prostate gland occurred, the effect of a given dose ranged unpredictably through three groups: no apparent effect at all, destruction of the prostate, and early death with infarction of the prostate and other pelvic organs. It was concluded that with the present technique the range between the dose of radioactivity which caused no obvious response and the dose which is related to acute death is too narrow to allow reasonably predictable results, but that further refinement of technique might increase control over tissue destruction.« less

Direct observation for atomically flat and ordered vertical {111} side-surfaces on three-dimensionally figured Si(110) substrate using scanning tunneling microscopy

NASA Astrophysics Data System (ADS)

Yang, Haoyu; Hattori, Azusa N.; Ohata, Akinori; Takemoto, Shohei; Hattori, Ken; Daimon, Hiroshi; Tanaka, Hidekazu

2017-11-01

A three-dimensional Si{111} vertical side-surface structure on a Si(110) wafer was fabricated by reactive ion etching (RIE) followed by wet-etching and flash-annealing treatments. The side-surface was studied with scanning tunneling microscopy (STM) in atomic scale for the first time, in addition to atomic force microscopy (AFM), scanning electron microscopy (SEM), and low-energy electron diffraction (LEED). AFM and SEM showed flat and smooth vertical side-surfaces without scallops, and STM proved the realization of an atomically-flat 7 × 7-reconstructed structure, under optimized RIE and wet-etching conditions. STM also showed that a step-bunching occurred on the produced {111} side-surface corresponding to a reversely taped side-surface with a tilt angle of a few degrees, but did not show disordered structures. Characteristic LEED patterns from both side- and top-reconstructed surfaces were also demonstrated.

Pulsed Vincristine Therapy in Steroid-Resistant Nephrotic Syndrome

PubMed Central

Thalgahagoda, Shenal; Abeyagunawardena, Shamali; Jayaweera, Heshan; Karunadasa, Umeshi Ishanthika

2017-01-01

Steroid-resistant nephrotic syndrome (SRNS) poses a therapeutic challenge for the paediatric nephrologist. As relentless progression to renal failure occurs with continued proteinuria, such patients will be treated with different cytotoxic medications with variable success rates and side-effects. We present here our findings on administering the anticancer drug vincristine for SRNS patients at a single centre in Sri Lanka. Methods. Between 2002 and 2007, fifty-four children presenting with steroid and cyclophosphamide resistance were treated with vincristine at 1.5 mg/m2 in weekly intravenous pulses for 8 weeks along with a tapering steroid regimen of 6 months. All patients were closely followed up for 5 years. Results. Of the 54 patients 39 were males and 15 were females (age range 3.5–11.6 years, median 6.1 years). At the end of the treatment course, 21 patients achieved complete remission while 7 had partial remission and no response was seen in 26 patients. Sustained remission at 6, 12, 24, and 60 months were 15 (27.78%), 11 (20.37%), 9 (16.67%), and 7 (12.96%), respectively. Most side-effects observed were reversible and no serious side-effects were noted during vincristine therapy. Conclusion. Although its therapeutic mechanisms in nephrotic syndrome are still not elucidated, vincristine appears to be a potent alternative that could be considered for treating SRNS. PMID:28630858

Comparison of safety and immunogenicity of purified chick embryo cell vaccine using Zagreb and Essen regimens in patients with category II exposure in China.

PubMed

Hu, Quan; Liu, Man-Qing; Zhu, Zheng-Gang; Zhu, Ze-Rong; Lu, Sha

2014-01-01

The aim was to compare the safety and immunogenicity of purified chick embryo cell vaccine (PCECV) with Zagreb 2-1-1 and Essen 1-1-1-1-1 regimens in patients with WHO category II exposure in China. Side effects including systemic and local symptoms were recorded for all patients during vaccination with purified chick embryo cell vaccine (PCECV) under Zagreb 2-1-1 or Essen 1-1-1-1-1 regimens, and the rabies neutralization antibody titers in patients' serum at days 0, 7, 14, 45, 365 post-immunization were measured to determine the immunogenicity. Fever and pain were the most common events for systemic and local symptoms respectively, and most side effects (86.78%, 105/121) occurred after the first dose of vaccination. Safety analysis showed differences in side effects in<5-year-old patients between Zagreb and Essen regimens, especially after the first dose of vaccination (P = 0.043). Immunogenicity analysis indicated that Zagreb can achieve higher neutralization antibody titers and a greater seroconversion rate in a shorter time but had less persistence than Essen. When compared with the Essen regimen, the Zagreb regimen had a different immunogenicity in all study subjects, and different safety profile in young children, and a further study with a larger population and longer surveillance is warranted.

Seroprevalence of hepatitis A virus in Mumbai, and immunogenicity and safety of hepatitis A vaccine.

PubMed

Dhawan, P S; Shah, S S; Alvares, J F; Kher, A; Shankaran; Kandoth, P W; Sheth, P N; Kamath, H; Kamath, A; Koppikar, G V; Kalro, R H

1998-01-01

Since epidemiologic trends of hepatitis A are changing worldwide, we studied its seroprevalence in Mumbai, which is thought to be a high-endemicity area. The immunogenicity and safety of a hepatitis A vaccine were also studied. Six hundred and seventy subjects (456 men; age range 6 mo-60 y) answered a questionnaire on social and medical history. Qualitative analysis of total anti-HAV was performed in all subjects by ELISA. One hundred and seven of 147 anti-HAV negative subjects received hepatitis A vaccine at months 0, 1 and 6. Subjects were followed up (months 1, 2, 6, 7) to look for side-effects and seroconversion. The seroprevalence of HAV was 523/670 (78%); 38% of children < 5 years were anti-HAV negative. Seroprevalence rates of 80% were reached by 15 years. Prevalence was lower in the higher socio-economic group (151/234; 64.5%) compared with the lower socio-economic group (372/436; 85%) (p < 0.001). One month after doses 1, 2 and 3 of the hepatitis A vaccine, seropositivity was 92%, 99% and 100%, respectively. Minor self-limited side-effects occurred in 19.5% of subjects; there were no major side-effects. The seroprevalence of anti-HAV is high in Mumbai. Seroprevalence is lower in the higher socio-economic groups. The hepatitis A vaccine is safe and immunogenic.

Small-sided games in team sports training: a brief review.

PubMed

Halouani, Jamel; Chtourou, Hamdi; Gabbett, Tim; Chaouachi, Anis; Chamari, Karim

2014-12-01

Small-sided games (SSGs) incorporating skills, sport-specific movements, at intensities sufficient to promote aerobic adaptations, are being increasingly implemented in professional team sport environments. Small-sided games are often employed by coaches based on the premise that the greatest training benefits occur when training simulates the specific movement patterns and physiological demands of the sport. At present, there is relatively little information regarding how SSG can best be used to improve physical capacities and technical and tactical skills in team sports. It is possible that with some modifications (e.g., number of players, pitch size, coach encouragement, and wrestling), such games may be physiologically beneficial for athletes with relatively high initial aerobic fitness levels. For instance, it has been shown that 3-a-side soccer SSG resulted in higher intensity (i.e., greater overall distance, less jogging and walking, higher heart rate, and more tackling, dribbling, goal attempts, and passes) than 5-a-side SSG. Likewise, when player numbers were kept constant, a larger playing area increased the intensity of the SSG with a smaller playing area having the opposite effect. It has also been demonstrated that energy expenditure was similar between badminton and volleyball courts, but lower than that obtained in a basketball court. Moreover, it has been demonstrated in rugby that wrestling can increase the physical demands of SSG. Consistent coach encouragement can also increase training intensity, although most rule changes have trivial or no effect on exercise intensity. Further research is required to examine the optimal periodization strategies of SSG training for the long-term development of physiological capacity, technical skill, and tactical proficiency, while also minimizing the associated risk of injuries.

A five year review of the complications of progestogen only injectable contraceptive at the University of Port-Harcourt Teaching Hospital.

PubMed

Ojule, J D; Oriji, V K; Okongwu, C

2010-01-01

The injectable progestogen only contraceptive is a widely accepted method of contraception in our environment and very Iittle has been reported on its complications in our environment. The aim of the study was to highlight the complications associated with use of injectable Medroxyprogesterone Acetate and Norethisterone Enanthate in dients at the University of Part-Harcourt Teachng Hospital, Port-Harcou, south-south Nigeria. It was a 5 rear year retrospective study of the clients who accepted and used progestogen only injectable contraceptives (depot medroxyprogesterone acetate noerthistherone enantate) at the family planning units of the University of Port Horcowt Teaching Hospital between 1st January 2000 and 31st December 2004. The case flies of these clients were retrieved and their data extracted. The informolion included the dients sociodemographic characteristics, the types doses of of injectable contraceptives received and the side effects reported at the follow up visits. The data was coded and entered into a data bank and analysed using SPSS for windows 11.0 version. Seven hundred and seventy seven (777) injectable contraceptive acceptors out of the 1720 contraceptive acceptors during the study period. This accounted for 45.17% of the new acceptors over the 5 years period, making the injectable contraceptives the most commonly used method of birth control in UPTH. Five hundred and five (505) clients took depot medroxyprogesterone acetate (DMPA) while 272 used norethesterone enanthate (NE-ET). The mean age of the injectable contraceptive users was 31.31 +/- 5.5 years and the mean parity was 5.5 +/- 2.5 deliveries. The users reported multiple side effects with 579 episodes. Secondary amenorrhea was the commonest side effect occurring in 350 (45.34%) clients. Others were hypertension in 17 (2.94%) and metabolic disturbances in 14 (2.41%). Injectable progestogen only contraceptive is associated with multiple side effects, with secondary amenorrhoea being the most common. The contraceptive failure rate of this method in our women is low. Injectable progestogen only contraceptive is associated with multiple side effects, with secondary amenorrhoea being the most common. The contraceptive failure rate of this method women is low.

In Vivo Analysis of the Role of Metabotropic Glutamate Receptors in the Afferent Regulation of Chick Cochlear Nucleus Neurons

PubMed Central

Carzoli, Kathryn L.; Hyson, Richard L.

2010-01-01

Cochlea removal results in the death of approximately 20-30% of neurons in the chick nucleus magnocellularis (NM). One early event in NM neuronal degradation is the disruption of their ribosomes. This can be visualized in the first few hours following cochlea removal using Y10B, an antibody that recognizes ribosomal RNA. Previous studies using a brain slice preparation suggest that maintenance of ribosomal integrity in NM neurons requires metabotropic glutamate receptor (mGluR) activation. Isolating the brain slice in vitro, however, may eliminate other potential sources of trophic support and only allows for evaluation of the early changes that occur in NM neurons following deafferentation. Consequently, it is not known if mGluR activation is truly required for the maintenance of NM neurons in the intact system. The current experiments evaluated the importance of mGluRs in vivo. The effects of short-term receptor blockade were assessed through Y10B labeling and the effects of long-term blockade were assessed through stereological counting of NM neurons in Nissl-stained tissue. mGluR antagonists or vehicle were administered intracerebroventricularly following unilateral cochlea removal. Vehicle-treated subjects replicated the previously reported effects of cochlea removal, showing lighter Y10B-labeling and fewer Nissl-stained NM neurons on the deafened side of the brain. Blockade of mGluRs prevented the rapid activity-dependent difference in Y10B labeling, and in some cases, had the reverse effect, yielding lighter labeling of NM neurons on the intact side of the brain. Similarly, mGluR blockade over longer survival periods resulted in a reduction in number of cells on both intact and deafferented sides of the brain, and in some cases, yielded a reverse effect of fewer neurons on the intact side versus deafened side. These data are consistent with in vitro findings and suggest that mGluR activation plays a vital role in the afferent maintenance of NM neurons. PMID:21059385

In vivo analysis of the role of metabotropic glutamate receptors in the afferent regulation of chick cochlear nucleus neurons.

PubMed

Carzoli, Kathryn L; Hyson, Richard L

2011-02-01

Cochlea removal results in the death of approximately 20-30% of neurons in the chick nucleus magnocellularis (NM). One early event in NM neuronal degradation is the disruption of their ribosomes. This can be visualized in the first few hours following cochlea removal using Y10B, an antibody that recognizes ribosomal RNA. Previous studies using a brain slice preparation suggest that maintenance of ribosomal integrity in NM neurons requires metabotropic glutamate receptor (mGluR) activation. Isolating the brain slice in vitro, however, may eliminate other potential sources of trophic support and only allows for evaluation of the early changes that occur in NM neurons following deafferentation. Consequently, it is not known if mGluR activation is truly required for the maintenance of NM neurons in the intact system. The current experiments evaluated the importance of mGluRs in vivo. The effects of short-term receptor blockade were assessed through Y10B labeling and the effects of long-term blockade were assessed through stereological counting of NM neurons in Nissl-stained tissue. mGluR antagonists or vehicle were administered intracerebroventricularly following unilateral cochlea removal. Vehicle-treated subjects replicated the previously reported effects of cochlea removal, showing lighter Y10B labeling and fewer Nissl-stained NM neurons on the deafened side of the brain. Blockade of mGluRs prevented the rapid activity-dependent difference in Y10B labeling, and in some cases, had the reverse effect, yielding lighter labeling of NM neurons on the intact side of the brain. Similarly, mGluR blockade over longer survival periods resulted in a reduction in number of cells on both intact and deafferented sides of the brain, and in some cases, yielded a reverse effect of fewer neurons on the intact side versus deafened side. These data are consistent with in vitro findings and suggest that mGluR activation plays a vital role in the afferent maintenance of NM neurons. Copyright © 2010 Elsevier B.V. All rights reserved.

Everolimus-eluting bioresorbable vascular scaffolds implanted in coronary bifurcation lesions: Impact of polymeric wide struts on side-branch impairment.

PubMed

De Paolis, Marcella; Felix, Cordula; van Ditzhuijzen, Nienke; Fam, Jiang Ming; Karanasos, Antonis; de Boer, Sanneke; van Mieghem, Nicolas M; Daemen, Joost; Costa, Francesco; Bergoli, Luis Carlos; Ligthart, Jurgen M R; Regar, Evelyn; de Jaegere, Peter P; Zijlstra, Felix; van Geuns, Robert Jan; Diletti, Roberto

2016-10-15

Limited data are available on bioresorbable vascular scaffolds (BVS) performance in bifurcations lesions and on the impact of BVS wider struts on side-branch impairment. Patients with at least one coronary bifurcation lesion involving a side-branch ≥2mm in diameter and treated with at least one BVS were examined. Procedural and angiographic data were collected and a dedicated methodology for off-line quantitative coronary angiography (QCA) in bifurcation was applied (eleven-segment model), to assess side-branch impairment occurring any time during the procedure. Two- and three-dimensional QCA were used. Optical coherence tomography (OCT) analysis was performed in a subgroup of patients and long-term clinical outcomes reported. A total of 102 patients with 107 lesions, were evaluated. Device- and procedural-successes were 99.1% and 94.3%, respectively. Side-branch impairment occurring any time during the procedure was reported in 13 bifurcations (12.1%) and at the end of the procedure in 6.5%. Side-branch minimal lumen diameter (Pre: 1.45±0.41mm vs Final: 1.48±0.42mm, p=0.587) %diameter-stenosis (Pre: 26.93±16.89% vs Final: 27.80±15.57%, p=0.904) and minimal lumen area (Pre: 1.97±0.89mm(2) vs Final: 2.17±1.09mm(2), p=0.334), were not significantly affected by BVS implantation. Mean malapposed struts at the bifurcation polygon-of-confluence were 0.63±1.11. The results of the present investigation suggest feasibility and relative safety of BVS implantation in coronary bifurcations. BVS wide struts have a low impact on side-branch impairment when considering bifurcations with side-branch diameter≥2mm. Copyright © 2016. Published by Elsevier Ireland Ltd.

Health Related Quality of Life in Patients with Side-Effects after Antimuscarinic Treatment for Overactive Bladder.

PubMed

Kim, Aram; Lee, Kyu-Sung; Jung, Rangrhee; Na, Selee; Kim, Joon-Chul; Kim, Hyeong Gon; Choo, Myung-Soo

2017-09-01

Drug therapy is the mainstay of treatment for overactive bladder (OAB), but antimuscarinic agents possess side-effects. These side-effects decrease the patients' quality of life. We therefore assessed the impact of side-effects on health-related quality of life (HR-QoL) through an analysis of EQ-5D questionnaire. This study was designed to investigate the patients' satisfaction by quality weight of health status as affected by the side-effects of OAB medications. Patients who had OAB symptoms lasting longer than 3 months and have experienced side-effects after any antimuscarinic treatments filled in the EQ-5D questionnaire. The enrolled patients had two EQ-5D questionnaires for two different health statuses, i.e., presence or absence of side-effects. Quality weight was calculated using the ED-5D health status score with Korean tariff. One hundred patients were enrolled and completed the HR-QoL questionnaire. The most prevalent side-effect was dry mouth (61%) and 28% patients had dry mouth and constipation concurrently. Most of the patients with side-effects tried to endure and overcome these side-effects (79%), but 10% desired a change in medication, and 6% stopped medication altogether. The quality weight of EQ-5D without side-effects was 0.863, while the quality weight with side-effects was 0.666 (P < 0.001). The VAS score was 79 in patient without side-effects and 57 in those with side-effects, supporting the results of quality weight assessment. Overactive bladder patients may enjoy a better quality of life if side-effects associated with antimuscarinic therapy are fewer. © 2016 John Wiley & Sons Australia, Ltd.

Numerical Analysis of Flow-Induced Vibrations in Closed Side Branches

NASA Astrophysics Data System (ADS)

KníŽat, Branislav; Troják, Michal

2011-12-01

Vibrations occuring in closed side branches connected to a main pipe are a frequent problem during pipeline system operation. At the design stage of pipeline systems, this problem is sometimes overlooked or underestimated which can later lead to the shortening of the systems life cycle or may even cause injury. The aim of this paper is a numerical analysis of the start of self-induced vibrations on the edge of a closed side branch. Calculation conditions and obtained results are presented within.

Pseudoephedrine and circadian rhythm interaction on neuromuscular performance.

PubMed

Pallarés, J G; López-Samanes, Á; Fernández-Elías, V E; Aguado-Jiménez, R; Ortega, J F; Gómez, C; Ventura, R; Segura, J; Mora-Rodríguez, R

2015-12-01

This study analyzed the effects of pseudoephedrine (PSE) provided at different time of day on neuromuscular performance, side effects, and violation of the current doping cut-off threshold [World Anti-Doping Agency (WADA)]. Nine resistance-trained males carried out bench press and full squat exercises against four incremental loads (25%, 50%, 75%, and 90% one repetition maximum [1RM]), in a randomized, double-blind, cross-over design. Participants ingested either 180 mg of PSE (supra-therapeutic dose) or placebo in the morning (7:00 h; AM(PLAC) and AM(PSE)) and in the afternoon (17:00 h; PM(PLAC) and PM(PSE)). PSE enhanced muscle contraction velocity against 25% and 50% 1RM loads, only when it was ingested in the mornings, and only in the full squat exercise (4.4-8.7%; P < 0.05). PSE ingestion raised urine and plasma PSE concentrations (P < 0.05) regardless of time of day; however, cathine only increased in the urine samples. PSE ingestion resulted in positive tests occurring in 11% of samples, and it rose some adverse side effects such us tachycardia and heart palpitations. Ingestion of a single dose of 180 mg of PSE results in enhanced lower body muscle contraction velocity against low and moderate loads only in the mornings. These mild performance improvements are accompanied by undesirable side effects and an 11% risk of surpassing the doping threshold. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Metabolic syndrome and atypical antipsychotics: Possibility of prediction and control.

PubMed

Franch Pato, Clara M; Molina Rodríguez, Vicente; Franch Valverde, Juan I

Schizophrenia and other psychotic disorders are associated with high morbidity and mortality, due to inherent health factors, genetic factors, and factors related to psychopharmacological treatment. Antipsychotics, like other drugs, have side-effects that can substantially affect the physical health of patients, with substantive differences in the side-effect profile and in the patients in which these side-effects occur. To understand and identify these risk groups could help to prevent the occurrence of the undesired effects. A prospective study, with 24 months follow-up, was conducted in order to analyse the physical health of severe mental patients under maintenance treatment with atypical antipsychotics, as well as to determine any predictive parameters at anthropometric and/or analytical level for good/bad outcome of metabolic syndrome in these patients. There were no significant changes in the physical and biochemical parameters individually analysed throughout the different visits. The baseline abdominal circumference (lambda Wilks P=.013) and baseline HDL-cholesterol levels (lambda Wilks P=.000) were the parameters that seem to be more relevant above the rest of the metabolic syndrome constituents diagnosis criteria as predictors in the long-term. In the search for predictive factors of metabolic syndrome, HDL-cholesterol and abdominal circumference at the time of inclusion were selected, as such that the worst the baseline results were, the higher probability of long-term improvement. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Right recumbent position on gastric emptying of water evidenced by 13C breath testing

PubMed Central

Sanaka, Masaki; Urita, Yoshihisa; Yamamoto, Takatsugu; Shirai, Tsuguru; Kimura, Satoshi; Aoyagi, Hitoshi; Kuyama, Yasushi

2013-01-01

AIM: To compare the impact of the right recumbent position with the sitting position on gastric emptying of water. METHODS: In eight healthy male volunteers, the 13C acetate breath test was performed twice to assess gastric emptying of 100 mL tap water. Subjects were seated in one test and lying on their right side in the other. In both positions, pulmonary 13CO2 exhalation curves were obtained by plotting breath data against time. Percent gastric retention curves were created by analyzing data using the Wagner-Nelson protocol. RESULTS: No significant posture effect was found in pulmonary 13CO2 output curves (P = 0.2150), whereas a significant effect was seen in gastric retention curves (P = 0.0315). The percent retention values at 10 min and 15 min were significantly smaller when subjects were in the right recumbent position compared with the seated position (P < 0.05). Our results verified the accelerating effect of the right recumbent position on gastric emptying of non-nutritive solutions. Concerning clinical implications, this study suggests that placing patients with acute pain on their right side after oral administration of analgesic drugs in solution is justified as an effective practice for rapid pain relief. For patients with gastrointestinal reflux symptoms, sleeping in the right recumbent position may reduce nocturnal symptoms, as delayed gastric emptying can cause reflux symptoms. CONCLUSION: Gastric emptying of water occurs more quickly when a subject lies on the right side compared with sitting. PMID:23372358

A prospective, randomized evaluation of the effects of epidural needle rotation on the distribution of epidural block.

PubMed

Borghi, Battista; Agnoletti, Vanni; Ricci, Alessandro; van Oven, Hanna; Montone, Nicoletta; Casati, Andrea

2004-05-01

We evaluated the effects of turning the tip of the Tuohy needle 45 degrees toward the operative side before threading the epidural catheter (45 degrees -rotation group, n = 24) as compared to a conventional insertion technique with the tip of the Tuohy needle oriented at 90 degrees cephalad (control group, n = 24) on the distribution of 10 mL of 0.75% ropivacaine with 10 microg sufentanil in 48 patients undergoing total hip replacement. The catheter was introduced 3 to 4 cm beyond the tip of the Tuohy needle. A blinded observer recorded sensory and motor blocks on both sides, quality of analgesia, and volumes of local anesthetic used during the first 48 h of patient-controlled epidural analgesia. Readiness to surgery required 21 +/- 6 min in the control group and 17 +/- 7 min in the 45 degree-rotation group (P > 0.50). The maximum sensory level reached on the operative side was T10 (T10-7) in the control group and T9 (T10-6) in the 45 degree-rotation group (P > 0.50); whereas the maximum sensory level reached on the nonoperative side was T10 (T12-9) in the control group and L3 (L5-T12) in the 45 degree-rotation group (P = 0.0005). Complete motor blockade of the operative limb was achieved earlier in the 45 degree-rotation than in the control group, and motor block of the nonoperative side was more intense in patients in the control group. Two-segment regression of sensory level on the surgical side was similar in the two groups, but occurred earlier on the nonoperative side in the 45 degree-rotation group (94 +/- 70 min) than in the control group (178 +/- 40 min) (P = 0.0005). Postoperative analgesia was similar in the 2 groups, but the 45 degree-rotation group consumed less local anesthetic (242 +/- 35 mL) than the control group (297 +/- 60 mL) (P = 0.0005). We conclude that the rotation of the Tuohy introducer needle 45 degrees toward the operative side before threading the epidural catheter provides a preferential distribution of sensory and motor block toward the operative side, reducing the volume of local anesthetic solution required to maintain postoperative analgesia. Turning the Tuohy introducer needle 45 degrees toward the operative side before threading the epidural catheter is a simple maneuver that produces a preferential distribution of epidural anesthesia and analgesia toward the operative side, minimizing the volume of local anesthetic required to provide adequate pain relief after total hip arthroplasty.

Neuromuscular Diseases Associated with HIV-1 Infection

PubMed Central

Robinson-Papp, Jessica; Simpson, David M.

2010-01-01

Neuromuscular disorders are common in HIV, occurring at all stages of disease and affecting all parts of the peripheral nervous system. These disorders have diverse etiologies including HIV itself, immune suppression and dysregulation, co-morbid illnesses and infections, and side effects of medications. In this article, we review the following HIV-associated conditions: distal symmetric polyneuropathy, inflammatory demyelinating polyneuropathy, mononeuropathy, mononeuropathy multiplex, autonomic neuropathy, progressive polyradiculopathy due to cytomegalovirus, herpes zoster, myopathy and other rarer disorders. PMID:19771594

Photo-onycholysis from minocycline. Side effects of minocycline therapy

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

Kestel, J.L. Jr.

1981-07-01

Minocycline, prescribed for a patient with acne, produced a photosensitivity reaction (photo-onycholysis) involving the fingernails. The onset of this reaction coincided with an increase in sun exposure and cleared several months later, when the drug was discontinued. This type of reaction has been reported to occur in patients taking tetracycline or a member of the tetracycline group of antibiotics, of which minocycline is a member. This appears to be first report of photo-onycholysis due to minocycline.

Developing Gene Silencing for the Study and Treatment of Dystonia

DTIC Science & Technology

2017-12-01

1 AWARD NUMBER: W81XWH-14-1-0282 TITLE: Developing Gene Silencing for the Study and Treatment of Dystonia PRINCIPAL INVESTIGATOR: Pedro...30/2014-9/29/2017 4. TITLE AND SUBTITLE Developing Gene Silencing for the Study and Treatment of Dystonia 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...function. More importantly, we will check if no side effects or toxicity occurs. Successful completion of our studies will move us a step closer to

Telluric currents: A meeting of theory and observation

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

Boteler, D.H.; Seager, W.H.

Pipe-to-soil (P/S) potential variations resulting from telluric currents have been observed on pipelines in many locations. However, it has never teen clear which parts of a pipeline will experience the worst effects. Two studies were conducted to answer this question. Distributed-source transmission line (DSTL) theory was applied to the problem of modeling geomagnetic induction in pipelines. This theory predicted that the largest P/S potential variations would occur at the ends of the pipeline. The theory also predicted that large P/S potential variations, of opposite sign, should occur on either side of an insulating flange. Independently, an observation program was conductedmore » to determine the change in telluric current P/S potential variations and to design counteractive measures along a pipeline in northern Canada. Observations showed that the amplitude of P/S potential fluctuations had maxima at the northern and southern ends of the pipeline. A further set of recordings around an insulating flange showed large P/S potential variations, of opposite sign, on either side of the flange. Agreement between the observations and theoretical predictions was remarkable. While the observations confirmed the theory, the theory explains how P/S potential variations are produced by telluric currents and provides the basis for design of cathodic protection systems for pipelines that can counteract any adverse telluric effects.« less

Effect of chlorhexidine varnish on gingival growth in orthodontic patients: a randomized prospective split-mouth study.

PubMed

Pretti, Henrique; Barbosa, Gabriella Lopes de Rezende; Lages, Elizabeth Maria Bastos; Gala-García, Alfonso; Magalhães, Claudia Silami de; Moreira, Allyson Nogueira

2015-10-01

Fixed orthodontic appliances patients suffer limitations on the effective control of biofilm by mechanical methods, bringing the need of a coadjutant in the control of inflammation and oral health improvement. The aim of this prospective split-mouth blind study was to analyze the effect of a 40% chlorhexidine (CHX) varnish on gingival growth of patients with orthodontic fixed appliances. Healthy teenage patients with fixed orthodontic appliances and increased gingival volume were recruited (n = 30). Each individual was his own control, having in the maxilla one control side and one treatment side. An application of varnishes occurred on the vestibular area of the upper premolars and first molar crowns, on the control side (placebo varnish) and on the experimental side (EC40(r) Biodentic CHX varnish). The varnishes and sides were randomly chosen and its identification and group was kept by a third party observer and it was not revealed to the researchers and participants until the end of study. In order to establish a baseline registration, digital photographs were taken by a trained photographer before varnish application at baseline (T0), as well as 14 days (T14) and 56 days (T56) after the application. The gingival volume was calculated indirectly using the vestibular areas (mm2) of the upper second premolars' clinical crowns by RapidSketch(r) software, at all study times. The data were analyzed using ANOVA and the Turkey-Krammer test. It was observed, in the final sample of 30 individuals, that at T0, the control and treatment groups were similar. At T14 and T56, a progressive reduction of the clinical crown area was seen in the control group, and an increase in the average area was detected in the experimental group (p < 0,05). The use of 40% CHX varnish decreases the gingival overgrowth in patients undergoing orthodontic treatment. Further studies are necessary to set the action time and frequency of application.

Effect of chlorhexidine varnish on gingival growth in orthodontic patients: a randomized prospective split-mouth study

PubMed Central

Pretti, Henrique; Barbosa, Gabriella Lopes de Rezende; Lages, Elizabeth Maria Bastos; Gala-García, Alfonso; de Magalhães, Claudia Silami; Moreira, Allyson Nogueira

2015-01-01

Introduction: Fixed orthodontic appliances patients suffer limitations on the effective control of biofilm by mechanical methods, bringing the need of a coadjutant in the control of inflammation and oral health improvement. Objective: The aim of this prospective split-mouth blind study was to analyze the effect of a 40% chlorhexidine (CHX) varnish on gingival growth of patients with orthodontic fixed appliances. Methods: Healthy teenage patients with fixed orthodontic appliances and increased gingival volume were recruited (n = 30). Each individual was his own control, having in the maxilla one control side and one treatment side. An application of varnishes occurred on the vestibular area of the upper premolars and first molar crowns, on the control side (placebo varnish) and on the experimental side (EC40(r) Biodentic CHX varnish). The varnishes and sides were randomly chosen and its identification and group was kept by a third party observer and it was not revealed to the researchers and participants until the end of study. In order to establish a baseline registration, digital photographs were taken by a trained photographer before varnish application at baseline (T0), as well as 14 days (T14) and 56 days (T56) after the application. The gingival volume was calculated indirectly using the vestibular areas (mm2) of the upper second premolars' clinical crowns by RapidSketch(r) software, at all study times. The data were analyzed using ANOVA and the Turkey-Krammer test. Results: It was observed, in the final sample of 30 individuals, that at T0, the control and treatment groups were similar. At T14 and T56, a progressive reduction of the clinical crown area was seen in the control group, and an increase in the average area was detected in the experimental group (p < 0,05). Conclusions: The use of 40% CHX varnish decreases the gingival overgrowth in patients undergoing orthodontic treatment. Further studies are necessary to set the action time and frequency of application. PMID:26560823

Explanations for side effect aversion in preventive medical treatment decisions

PubMed Central

Waters, Erika A.; Weinstein, Neil D.; Colditz, Graham A.; Emmons, Karen

2008-01-01

Objective Many laypeople demonstrate excessive sensitivity to negative side effects of medical treatments, which may lead them to refuse beneficial therapies. This Internet-based experiment investigated three possible explanations for such “side effect aversion.” One was derived from mental accounting, one examined the mere presence of a side effect, and one focused on computational difficulties. Design Participants (N = 5,379) were presented with a hypothetical cancer preventive treatment situation that was or was not accompanied by one or two small side effects. The side effects were either beneficial or harmful. In all conditions the net absolute risk reduction associated with the treatment was 15%. Main Outcome Measures Participants indicated their willingness to accept treatment and their perceptions of the treatment’s effects on their overall cancer risk. Results Data were consistent only with the “mere presence” explanation of side effect aversion, the idea that side effects act as a strong negative cue that directly affects treatment appraisal. The number of negative side effects did not influence treatment willingness. Conclusion Side effect aversion is a challenge to informed decision making. Specific mechanisms that produce side effect aversion should be identified. PMID:19290712

The position 68(E11) side chain in myoglobin regulates ligand capture, bond formation with heme iron, and internal movement into the xenon cavities.

PubMed

Dantsker, David; Roche, Camille; Samuni, Uri; Blouin, George; Olson, John S; Friedman, Joel M

2005-11-18

After photodissociation, ligand rebinding to myoglobin exhibits complex kinetic patterns associated with multiple first-order geminate recombination processes occurring within the protein and a simpler bimolecular phase representing second-order ligand rebinding from the solvent. A smooth transition from cryogenic-like to solution phase properties can be obtained by using a combination of sol-gel encapsulation, addition of glycerol as a bathing medium, and temperature tuning (-15 --> 65 degrees C). This approach was applied to a series of double mutants, myoglobin CO (H64L/V68X, where X = Ala, Val, Leu, Asn, and Phe), which were designed to examine the contributions of the position 68(E11) side chain to the appearance and disappearance of internal rebinding phases in the absence of steric and polar interactions with the distal histidine. Based on the effects of viscosity, temperature, and the stereochemistry of the E11 side chain, the three major phases, B --> A, C --> A, and D --> A, can be assigned, respectively, to ligand rebinding from the following: (i) the distal heme pocket, (ii) the xenon cavities prior to large amplitude side chain conformational relaxation, and (iii) the xenon cavities after significant conformational relaxation of the position 68(E11) side chain. The relative amplitudes of the B --> A and C --> A phases depend markedly on the size and shape of the E11 side chain, which regulates sterically both ligand return to the heme iron atom and ligand migration to the xenon cavities. The internal xenon cavities provide a transient docking site that allows side chain relaxations and the entry of water into the vacated distal pocket, which in turn slows ligand recombination markedly.

Chronic neuropathic facial pain after intense pulsed light hair removal. Clinical features and pharmacological management

PubMed Central

Párraga-Manzol, Gabriela; Sánchez-Torres, Alba; Moreno-Arias, Gerardo

2015-01-01

Intense Pulsed Light (IPL) photodepilation is usually performed as a hair removal method. The treatment is recommended to be indicated by a physician, depending on each patient and on its characteristics. However, the use of laser devices by medical laypersons is frequent and it can suppose a risk of damage for the patients. Most side effects associated to IPL photodepilation are transient, minimal and disappear without sequelae. However, permanent side effects can occur. Some of the complications are laser related but many of them are caused by an operator error or mismanagement. In this work, we report a clinical case of a patient that developed a chronic neuropathic facial pain following IPL hair removal for unwanted hair in the upper lip. The specific diagnosis was painful post-traumatic trigeminal neuropathy, reference 13.1.2.3 according to the International Headache Society (IHS). Key words:Neuropathic facial pain, photodepilation, intense pulse light. PMID:26535105

Understanding the Role of Solvation Forces on the Preferential Attachment of Nanoparticles in Liquid

DOE PAGES

Welch, David A.; Woehl, Taylor J.; Park, Chiwoo; ...

2015-11-20

We discuss optimization of colloidal nanoparticle synthesis techniques, which requires an understanding of underlying particle growth mechanisms. Nonclassical growth mechanisms are particularly important as they affect nanoparticle size and shape distributions, which in turn influence functional properties. For example, preferential attachment of nanoparticles is known to lead to the formation of mesocrystals, although the formation mechanism is currently not well-understood. Here we employ in situ liquid cell scanning transmission electron microscopy and steered molecular dynamics (SMD) simulations to demonstrate that the experimentally observed preference for end-to-end attachment of silver nanorods is a result of weaker solvation forces occurring at rodmore » ends. In conclusion, SMD reveals that when the side of a nanorod approaches another rod, perturbation in the surface-bound water at the nanorod surface creates significant energy barriers to attachment. Additionally, rod morphology (i.e., facet shape) effects can explain the majority of the side attachment effects that are observed experimentally.« less

Understanding the Role of Solvation Forces on the Preferential Attachment of Nanoparticles in Liquid

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

Welch, David A.; Woehl, Taylor J.; Park, Chiwoo

We discuss optimization of colloidal nanoparticle synthesis techniques, which requires an understanding of underlying particle growth mechanisms. Nonclassical growth mechanisms are particularly important as they affect nanoparticle size and shape distributions, which in turn influence functional properties. For example, preferential attachment of nanoparticles is known to lead to the formation of mesocrystals, although the formation mechanism is currently not well-understood. Here we employ in situ liquid cell scanning transmission electron microscopy and steered molecular dynamics (SMD) simulations to demonstrate that the experimentally observed preference for end-to-end attachment of silver nanorods is a result of weaker solvation forces occurring at rodmore » ends. In conclusion, SMD reveals that when the side of a nanorod approaches another rod, perturbation in the surface-bound water at the nanorod surface creates significant energy barriers to attachment. Additionally, rod morphology (i.e., facet shape) effects can explain the majority of the side attachment effects that are observed experimentally.« less

Understanding the Role of Solvation Forces on the Preferential Attachment of Nanoparticles in Liquid

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

Welch, David A.; Woehl, Taylor J.; Park, Chiwoo

Optimization of colloidal nanoparticle synthesis techniques requires an understanding of underlying particle growth mechanisms. Non-classical growth mechanisms are particularly important as they affect nanoparticle size and shape distributions which in turn influence functional properties. For example, preferential attachment of nanoparticles is known to lead to the formation of mesocrystals, although the formation mechanism is currently not well understood. Here we employ in situ liquid cell scanning transmission electron microscopy (STEM) and steered molecular dynamics (SMD) simulations to demonstrate that the experimentally observed preference for end-to-end attachment of silver nanorods is a result of weaker solvation forces occurring at rod ends.more » SMD reveals that when the side of a nanorod approaches another rod, perturbation in the surface bound water at the nanorod surface creates significant energy barriers to attachment. Additionally, rod morphology (i.e. facet shape) effects can explain the majority of the side attachment effects that are observed experimentally.« less

Stress concentration in the vicinity of a hole defect under conditions of Hertzian contact

NASA Technical Reports Server (NTRS)

Yamamoto, T.; Eguchi, M.; Murayama, K.

1981-01-01

Two dimensional photoelastic stress analyses were conducted for epoxy resin models containing a hole defect under the conditions of Hertzian contact. Stress concentrations around the defect were determined as a function of several parameters. The effect of tangential traction on the stress concentration was also determined. Sharp stress concentrations occur in the vicinity of both the left and the right side of the hole. The stress concentration becomes more distinct the larger the hole diameter and the smaller distance between the hole and the contact surface. The stress concentration is greatest when the disk imposing a normal load is located at the contact surface directly over the hole. The magnitude and the location of stress concentration varies with the distance between the Hertzian contact area and the hole. The area involved in a process of rolling contact fatigue is confined to a shallow region at both sides of the hole. It was found that the effect of tangential traction is comparatively small on the stress concentration around the hole.

Using aberrant behaviors as reinforcers for autistic children.

PubMed Central

Charlop, M H; Kurtz, P F; Casey, F G

1990-01-01

In a series of experiments, we assessed the efficacy of using autistic children's aberrant behaviors as reinforcers to increase their correct task responding. In Experiment 1, reinforcer conditions of stereotypy, food, and varied (food or stereotypy) were compared. In Experiment 2, the conditions were delayed echolalia, food, and varied (food or delayed echolalia), and in Experiment 3, perseverative behavior was compared with stereotypy and food as potential reinforcers. A multielement design was used for all comparisons, and side-effect measures were recorded during and after teaching sessions as well as at home. Results indicated that, in general, task performance was highest when brief opportunities to engage in aberrant behaviors were provided as reinforcers. Edibles were associated with the lowest performance. Furthermore, no negative side effects (e.g., an increase in aberrant behaviors) occurred. The results are discussed in terms of suggesting a more pragmatic treatment approach by addressing the contingent use of autistic children's aberrant behaviors as reinforcers. PMID:2373653

Effect of driver's age and side of impact on crash severity along urban freeways: a mixed logit approach.

PubMed

Haleem, Kirolos; Gan, Albert

2013-09-01

This study identifies geometric, traffic, environmental, vehicle-related, and driver-related predictors of crash injury severity on urban freeways. The study takes advantage of the mixed logit model's ability to account for unobserved effects that are difficult to quantify and may affect the model estimation, such as the driver's reaction at the time of crash. Crashes of 5 years occurring on 89 urban freeway segments throughout the state of Florida in the United States were used. Examples of severity predictors explored include traffic volume, distance of the crash to the nearest ramp, and detailed driver's age, vehicle types, and sides of impact. To show how the parameter estimates could vary, a binary logit model was compared with the mixed logit model. It was found that the at-fault driver's age, traffic volume, distance of the crash to the nearest ramp, vehicle type, side of impact, and percentage of trucks significantly influence severity on urban freeways. Additionally, young at-fault drivers were associated with a significant severity risk increase relative to other age groups. It was also observed that some variables in the binary logit model yielded illogic estimates due to ignoring the random variation of the estimation. Since the at-fault driver's age and side of impact were significant random parameters in the mixed logit model, an in-depth investigation was performed. It was noticed that back, left, and right impacts had the highest risk among middle-aged drivers, followed by young drivers, very young drivers, and finally, old and very old drivers. To reduce side impacts due to lane changing, two primary strategies can be recommended. The first strategy is to conduct campaigns to convey the hazardous effect of changing lanes at higher speeds. The second is to devise in-vehicle side crash avoidance systems to alert drivers of a potential crash risk. The study provided a promising approach to screening the predictors before fitting the mixed logit model using the random forest technique. Furthermore, potential countermeasures were proposed to reduce the severity of impacts. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Muscle wasting and sarcopenia in heart failure and beyond: update 2017.

PubMed

Springer, Jochen; Springer, Joshua-I; Anker, Stefan D

2017-11-01

Sarcopenia (loss of muscle mass and muscle function) is a strong predictor of frailty, disability and mortality in older persons and may also occur in obese subjects. The prevalence of sarcopenia is increased in patients suffering from chronic heart failure. However, there are currently few therapy options. The main intervention is resistance exercise, either alone or in combination with nutritional support, which seems to enhance the beneficial effects of training. Also, testosterone has been shown to increased muscle power and function; however, a possible limitation is the side effects of testosterone. Other investigational drugs include selective androgen receptor modulators, growth hormone, IGF-1, compounds targeting myostatin signaling, which have their own set of side effects. There are abundant prospective targets for improving muscle function in the elderly with or without chronic heart failure, and the continuing development of new treatment strategies and compounds for sarcopenia and cardiac cachexia makes this field an exciting one. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Growth of Malignant Non-CNS Tumors Alters Brain Metabolome

PubMed Central

Kovalchuk, Anna; Nersisyan, Lilit; Mandal, Rupasri; Wishart, David; Mancini, Maria; Sidransky, David; Kolb, Bryan; Kovalchuk, Olga

2018-01-01

Cancer survivors experience numerous treatment side effects that negatively affect their quality of life. Cognitive side effects are especially insidious, as they affect memory, cognition, and learning. Neurocognitive deficits occur prior to cancer treatment, arising even before cancer diagnosis, and we refer to them as “tumor brain.” Metabolomics is a new area of research that focuses on metabolome profiles and provides important mechanistic insights into various human diseases, including cancer, neurodegenerative diseases, and aging. Many neurological diseases and conditions affect metabolic processes in the brain. However, the tumor brain metabolome has never been analyzed. In our study we used direct flow injection/mass spectrometry (DI-MS) analysis to establish the effects of the growth of lung cancer, pancreatic cancer, and sarcoma on the brain metabolome of TumorGraft™ mice. We found that the growth of malignant non-CNS tumors impacted metabolic processes in the brain, affecting protein biosynthesis, and amino acid and sphingolipid metabolism. The observed metabolic changes were similar to those reported for neurodegenerative diseases and brain aging, and may have potential mechanistic value for future analysis of the tumor brain phenomenon. PMID:29515623

Long-term follow-up of botulinum toxin therapy for focal hand dystonia: outcome at 10 years or more.

PubMed

Lungu, Codrin; Karp, Barbara I; Alter, Katharine; Zolbrod, Regina; Hallett, Mark

2011-03-01

Previous studies have explored the efficacy and safety of botulinum neurotoxin (BoNT) treatment for Focal hand dystonia (FHD), but none have followed a large number of patients for 10 years or more. Retrospective study, with benefit and weakness assessed on a 0 to 4 subjective scale. Demographic, clinical and treatment characteristics were analyzed using t tests and Pearson correlations. Twenty FHD patients had 10 years or longer treatment. Interinjection intervals were variable. Musicians were more likely to wait longer between injections and had less complex dystonia. There was a trend for larger benefit in women and with shorter intervals. The dose increased over time. Dystonia characteristics did not predict response or side-effects, but benefit magnitude predicted longer compliance. No serious side-effects or antibody-mediated resistance occurred. This is the longest reported period of BoNT treatment in the largest FHD cohort. BoNT therapy for FHD remains safe and effective after more than a decade of treatment. Copyright © 2011 Movement Disorder Society.

Discovery, clinical development, and therapeutic uses of bisphosphonates.

PubMed

Licata, Angelo A

2005-04-01

To review the literature concerning the history, development, and therapeutic uses of bisphosphonates. English-language articles were identified through a search of MEDLINE (through December 2004) using the key word bisphosphonate. Reference lists of pivotal studies, reviews, and full prescribing information for the approved agents were also examined. Selected studies included those that discussed the discovery and initial applications of bisphosphonates, as well as their historical development, pharmacokinetic and pharmacodynamic properties, and current therapeutic uses. Bisphosphonates structurally resemble pyrophosphates (naturally occurring polyphosphates) and have demonstrated similar physicochemical effects to pyrophosphates. In addition, bisphosphonates reduce bone turnover and resist hydrolysis when administered orally. The information gained from initial work with etidronate generated a considerable scientific effort to design new and more effective bisphosphonates. The PCP moiety in the general bisphosphonate structure is essential for binding to hydroxyapatite and allows for a number of chemical variations by changing the 2 lateral side chains (designated R(1) and R(2)). The R(1) side chain determines binding affinity to hydroxyapatite, and the R(2) side chain determines antiresorptive potency. Accordingly, each bisphosphonate has its own characteristic profile of activity. The bisphosphonates reduce bone turnover, increase bone mass, and decrease fracture risk and therefore have a significant place in the management of skeletal disorders including osteoporosis, Paget's disease, bone metastases, osteogenesis imperfecta, and heterotopic ossification.

Effect of Preheating on the Inertia Friction Welding of the Dissimilar Superalloys Mar-M247 and LSHR

NASA Astrophysics Data System (ADS)

Senkov, O. N.; Mahaffey, D. W.; Semiatin, S. L.

2016-12-01

Differences in the elevated temperature mechanical properties of cast Mar-M247 and forged LSHR make it difficult to produce sound joints of these alloys by inertia friction welding (IFW). While extensive plastic upset occurs on the LSHR side, only a small upset is typically developed on the Mar-M247 side. The limited plastic flow of Mar-M247 thus restricts the extent of "self-cleaning" and mechanical mixing of the mating surfaces, so that defects remain at the bond line after welding. In the present work, the effect of local preheating of Mar-M247 immediately prior to IFW on the welding behavior of Mar-M247/LSHR couples was determined. An increase in the preheat temperature enhanced the plastic flow of Mar-M247 during IFW, which resulted in extensive mechanical mixing with LSHR at the weld interface, the formation of extensive flash on both the Mar-M247 and LSHR sides, and a sound bond. Performed in parallel with the experimental work, finite-element-method (FEM) simulations showed that higher temperatures are achieved within the preheated sample during IFW relative to its non-preheated counterpart, and plastic flow is thus facilitated within it. Microstructure and post-weld mechanical properties of the welded samples were also established.

Subjective Report of Side Effects of Prescribed and Nonprescribed Psychostimulant Use in Young Adults.

PubMed

Smith, Tess E; Martel, Michelle M; DeSantis, Alan D

2017-03-21

Side effects of prescribed and nonprescribed psychostimulant use are understudied. The study examined side effects of prescribed and nonprescribed psychostimulant use in a college sample with attention to possible gender differences. 2716 undergraduates (1448 male) between the ages of 17 and 57 years (M = 19.43 years, SD = 1.7 years) completed an online survey that included questions about the subjective side effects of prescribed and nonprescribed psychostimulant use. Results suggested that prescribed users more frequently reported side effects, compared to nonprescribed users. For prescribed users, females more frequently reported appetite, somatic, and anxiety-related side effects compared to males. For nonprescribed users, while females reported more somatic and anxiety-related side effects, males more frequently reported loss of sex drive and sweating as side effects. Conclusions/Importance: These findings suggest prescribed users of psychostimulants more frequently report side effects with prominent gender differences in line with gender roles.

Sexual side effects associated with conventional and atypical antipsychotics.

PubMed

Compton, M T; Miller, A H

2001-01-01

The sexual side effects of psychotropic medications are becoming increasingly recognized in clinical psychiatry. The magnitude of the problem of sexual side effects associated with antipsychotic medications has yet to be fully elucidated, but a multitude of references in the literature demonstrate the importance of these side effects in both men and women. All currently used antipsychotic medications are associated with sexual side effects of various types. Although each antipsychotic medication may have a specific side effect profile determined by its various receptor affinities and by the degree to which it elevates serum prolactin, there is currently no evidence that specific side effects can be predicted. Sexual side effects can be categorized according to the phase of the sexual response cycle with which they interfere. Suggestions for clinical evaluation and treatment options are provided, including risk factor modification, dose reduction, switching agents, and addition of other agents. Sexual side effects associated with conventional and atypical antipsychotic medications represent an underestimated and understudied set of side effects that may diminish a patient's quality of life and lead to treatment noncompliance. Clinicians prescribing antipsychotic medications should be familiar with the classification, evaluation, and treatment of these side effects.

Aromatic fluorine compounds. VI. Displacement of aryl fluorine in diazonium salts

USGS Publications Warehouse

Finger, G.C.; Oesterling, R.E.

1956-01-01

Several chlorofluorobenzenes have been isolated from the Schiemann synthesis of fluorobenzenes. These have been shown to be the products of two side reactions occurring during thermal decomposition of the dry benzenediazonium fluoborate salt containing coprecipitated sodium chloride, an unavoidable contaminant in large preparations involving the use of hydrochloric acid and sodium fluoborate. The major side reaction and its chloro product were unexpected; a unique displacement of fluorine ortho to the diazonium group was observed. Replacement of the diazo group with chlorine was the predicted side reaction which proved to be minor. Conditions causing the side reactions and the isolation and identification of the products are described.

Gravitational effects on plant growth hormone concentration

NASA Astrophysics Data System (ADS)

Bandurski, Robert S.; Schulze, Aga

Numerous studies, particularly those of H. Dolk in the 1930's, established by means of bio-assay, that more growth hormone diffused from the lower, than from the upper side of a gravity-stimulated plant shoot. Now, using an isotope dilution assay, with 4,5,6,7 tetradeutero indole-3-acetic acid as internal standard, and selected ion monitoring-gas chromatography-mass spectrometry as the method of determination, we have confirmed Dolk's finding and established that the asymmetrically distributed hormone is, in fact, indole-3-acetic acid (IAA). This is the first physico-chemical demonstration that there is more free IAA on the lower sides of a geo-stimulated plant shoot. We have also shown that free IAA occurs primarily in the conductive vascular tissues of the shoot, whereas IAA esters predominate in the growing cortical cells. Now, using an especially sensitive gas chromatographic isotope dilution assay we have found that the hormone asymmetry also occurs in the non-vascular tissue. Currently, efforts are directed to developing isotope dilution assays, with picogram sensitivity, to determine how this asymmetry of IAA distribution is attained so as to better understand how the plant perceives the geo-stimulus.

Local and global gravitational aspects of domain wall space-times

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

Cvetic, M.; Griffies, S.; Soleng, H.H.

1993-09-15

Local and global gravitational effects induced by eternal vacuum domain walls are studied. We concentrate on thin walls between nonequal and nonpositive cosmological constants on each side of the wall. The assumption of homogeneity, isotropy, and geodesic completeness of the space-time intrinsic to the wall as described in the comoving coordinate system and the constraint that the same symmetries hold in hypersurfaces parallel to the wall yield a general [ital Ansatz] for the line element of space-time. We restrict the problem further by demanding that the wall's surface energy density, [sigma], is positive and by requiring that the infinitely thinmore » wall represents a thin-wall limit of kinklike scalar field configuration. These vacuum domain walls fall in three classes depending on the value of their [sigma]: (1) extreme walls with [sigma]=[sigma][sub ext] are planar, static walls corresponding to supersymmetric configurations, (2) nonextreme walls with [sigma]=[sigma][sub non][gt][sigma][sub ext] correspond to expanding bubbles with observers on either side of the wall being [ital inside] the bubble, and (3) ultraextreme walls with [sigma]=[sigma][sub ultra][lt][sigma][sub ext] represent the bubbles of false vacuum decay. On the sides with less negative cosmological constant, the extreme, nonextreme, and ultraextreme walls exhibit no, repulsive, and attractive effective gravitational forces,'' respectively. These gravitational forces'' are global effects not caused by local curvature. Since the nonextreme wall encloses observers on both sides, the supersymmetric system has the lowest gravitational mass accessible to outside observers. It is conjectured that similar positive mass protection occurs in all physical systems and that no finite negative mass object can exist inside the universe.« less

Speech and language adverse effects after thalamotomy and deep brain stimulation in patients with movement disorders: A meta-analysis.

PubMed

Alomar, Soha; King, Nicolas K K; Tam, Joseph; Bari, Ausaf A; Hamani, Clement; Lozano, Andres M

2017-01-01

The thalamus has been a surgical target for the treatment of various movement disorders. Commonly used therapeutic modalities include ablative and nonablative procedures. A major clinical side effect of thalamic surgery is the appearance of speech problems. This review summarizes the data on the development of speech problems after thalamic surgery. A systematic review and meta-analysis was performed using nine databases, including Medline, Web of Science, and Cochrane Library. We also checked for articles by searching citing and cited articles. We retrieved studies between 1960 and September 2014. Of a total of 2,320 patients, 19.8% (confidence interval: 14.8-25.9) had speech difficulty after thalamotomy. Speech difficulty occurred in 15% (confidence interval: 9.8-22.2) of those treated with a unilaterally and 40.6% (confidence interval: 29.5-52.8) of those treated bilaterally. Speech impairment was noticed 2- to 3-fold more commonly after left-sided procedures (40.7% vs. 15.2%). Of the 572 patients that underwent DBS, 19.4% (confidence interval: 13.1-27.8) experienced speech difficulty. Subgroup analysis revealed that this complication occurs in 10.2% (confidence interval: 7.4-13.9) of patients treated unilaterally and 34.6% (confidence interval: 21.6-50.4) treated bilaterally. After thalamotomy, the risk was higher in Parkinson's patients compared to patients with essential tremor: 19.8% versus 4.5% in the unilateral group and 42.5% versus 13.9% in the bilateral group. After DBS, this rate was higher in essential tremor patients. Both lesioning and stimulation thalamic surgery produce adverse effects on speech. Left-sided and bilateral procedures are approximately 3-fold more likely to cause speech difficulty. This effect was higher after thalamotomy compared to DBS. In the thalamotomy group, the risk was higher in Parkinson's patients, whereas in the DBS group it was higher in patients with essential tremor. Understanding the pathophysiology of speech disturbance after thalamic procedures is a priority. © 2017 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

Wettability, polarity, and water absorption of holm oak leaves: effect of leaf side and age.

PubMed

Fernández, Victoria; Sancho-Knapik, Domingo; Guzmán, Paula; Peguero-Pina, José Javier; Gil, Luis; Karabourniotis, George; Khayet, Mohamed; Fasseas, Costas; Heredia-Guerrero, José Alejandro; Heredia, Antonio; Gil-Pelegrín, Eustaquio

2014-09-01

Plant trichomes play important protective functions and may have a major influence on leaf surface wettability. With the aim of gaining insight into trichome structure, composition, and function in relation to water-plant surface interactions, we analyzed the adaxial and abaxial leaf surface of holm oak (Quercus ilex) as a model. By measuring the leaf water potential 24 h after the deposition of water drops onto abaxial and adaxial surfaces, evidence for water penetration through the upper leaf side was gained in young and mature leaves. The structure and chemical composition of the abaxial (always present) and adaxial (occurring only in young leaves) trichomes were analyzed by various microscopic and analytical procedures. The adaxial surfaces were wettable and had a high degree of water drop adhesion in contrast to the highly unwettable and water-repellent abaxial holm oak leaf sides. The surface free energy and solubility parameter decreased with leaf age, with higher values determined for the adaxial sides. All holm oak leaf trichomes were covered with a cuticle. The abaxial trichomes were composed of 8% soluble waxes, 49% cutin, and 43% polysaccharides. For the adaxial side, it is concluded that trichomes and the scars after trichome shedding contribute to water uptake, while the abaxial leaf side is highly hydrophobic due to its high degree of pubescence and different trichome structure, composition, and density. Results are interpreted in terms of water-plant surface interactions, plant surface physical chemistry, and plant ecophysiology. © 2014 American Society of Plant Biologists. All Rights Reserved.

How propeller suction is the dominant factor for ship accidents at shallow water conditions

NASA Astrophysics Data System (ADS)

Acar, Dursun; Alpar, Bedri; Ozeren, Sinan

2017-04-01

The laminar flow comes to the fore with the disappearance of the several other directions in the internal displacements in the water current. Due to the dominant speed direction during the straightforward motion of the ship, the underwater hull is associated with the continuous flow of laminar currents. The open marine environment acts as a compressible liquid medium because of the presence of many variables about water volume overflow boundaries where the ship is associated. Layers of water rising over the sea surface due to ship's body and the propeller's water push provides loss of liquid lifting force for the ship. These situations change the well-known sea-floor morphology and reliable depth limits, and lead to probable accidents. If the ship block coefficient for the front side is 0.7 or higher, the "squat" will be more on the bow, because the associated factor "displacement volume" causes to the low-pressure environment due to large and rapid turbulence. Thus, the bow sinks further, which faced with liquid's weaker lift force. The vessels Gerardus Mercator, Queen Elizabeth and Costa Concordia had accidents because of unified reasons of squat, fast water mass displacement by hull push and propeller suction interaction. In the case of water mass displacement from the bow side away, that accident occurred in 2005 by the vessel Gerardus Mercator with excessive longitudinal trim angularity in the shallow water. The vessel Costa Concordia (2012), voluminous water displaced from the rear left side was an important factor because of the sharp manoeuvre of that the captain made before the accident. Observations before the accident indicate that full-speed sharp turn provided listed position for the ship from left (port side) in the direction of travel before colliding and then strike a rock on the sloping side of the seabed. The reason why the ship drifted to the left depends mainly the water discharge occurred at the left side of the hull during left-hand rudder control. Additionally the second water drainage from the shallow ridge area by the propeller's left-directed suction created a shallower environment. Similar situation for example collision of two ships during their side by side forward motions; their positions will be approached and listed to each other more same as downslope movement because of the shared area's water level collapse occur more by two propeller's suction.

Reorientation Motion and Preferential Interactions of a Peptide in Denaturants and Osmolyte.

PubMed

Jas, Gouri S; Rentchler, Eric C; Słowicka, Agnieszka M; Hermansen, John R; Johnson, Carey K; Middaugh, C Russell; Kuczera, Krzysztof

2016-03-31

Fluorescence anisotropy decay measurements and all atom molecular dynamics simulations are used to characterize the orientational motion and preferential interaction of a peptide, N-acetyl-tryptophan-amide (NATA) containing two peptide bonds, in aqueous, urea, guanidinium chloride (GdmCl), and proline solution. Anisotropy decay measurements as a function of temperature and concentration showed moderate slowing of reorientations in urea and GdmCl and very strong slowing in proline solution, relative to water. These effects deviate significantly from simple proportionality of peptide tumbling time to solvent viscosity, leading to the investigation of microscopic preferential interaction behavior through molecular dynamics simulations. Examination of the interactions of denaturants and osmolyte with the peptide backbone uncovers the presence of strongest interaction with urea, intermediate with proline, and weakest with GdmCl. In contrast, the strongest preferential solvation of the peptide side chain is by the nonpolar part of the proline zwitterion, followed by urea, and GdmCl. Interestingly, the local density of urea around the side chain is higher, but the GdmCl distribution is more organized. Thus, the computed preferential solvation of the side chain by the denaturants and osmolyte can account for the trend in reorientation rates. Analysis of water structure and its dynamics uncovered underlying differences between urea, GdmCl, and proline. Urea exerted the smallest perturbation of water behavior. GdmCl had a larger effect on water, slowing kinetics and stabilizing interactions. Proline had the largest overall interactions, exhibiting a strong stabilizing effect on both water-water and water-peptide hydrogen bonds. The results for this elementary peptide system demonstrate significant differences in microscopic behavior of the examined solvent environments. For the commonly used denaturants, urea tends to form disorganized local aggregates around the peptide groups and has little influence on water, while GdmCl only forms specific interactions with the side chain and tends to destabilize water structure. The protective osmolyte proline has the strongest and most specific interactions with the tryptophan side chain, and also stabilizes both water-water and water-peptide hydrogen bonds. Our results strongly suggest protein or peptide denaturation triggered by urea occurs by direct interaction, whereas GdmCl interacts favorably with side chains and destabilizes peptide-water hydrogen bonds. The stabilization of biopolymers by an osmolyte such as proline is governed by favorable preferential interaction with the side chains and stabilization of water.

Using photodynamic therapy to estimate effectiveness of innovative combined diclofenac and tazaroten therapy of disseminated actinic keratosis.

PubMed

Osiecka, Beata J; Jurczyszyn, Kamil; Nockowski, Piotr; Lipinski, Artur; Sieja, Agnieszka; Ziółkowski, Piotr

2015-01-01

Early diagnosis and therapy of precancerous lesions and malignant tumors belong to the most challenging tasks in modern medicine. Photodynamic diagnosis can help diagnose both precancerous lesions and early carcinoma. Actinic keratosis (AK) is the most common precancerous lesion of the skin. The available data show a high effectiveness of diclofenac in treating multifocal AK. We report a case of a 52-year-old woman who complained of multiple disseminated AK lesions predominantly on the lower limbs and trunk with a significant exacerbation within the last 6 months. Due to the spreading of disease and a high number of AK foci, as well as technical problems with visiting the hospital (PDT Laboratory), photodynamic therapy was not applied. The patient was treated for 2 months with a combination of local administration of 3% diclofenac and 0.1% tazaroten and 3% diclofenac only as a half side (left-right) comparison. The effects of therapy were later clinically evaluated and verified by means of photodynamic diagnosis (PDD) directly after therapy and at a follow-up examination 3 months later. The evaluation of treatment was blinded. Treatment with diclofenac only on the right side of the body resulted in clearing of 55% of all treated lesions, which increased to 60% three months after finishing therapy. On the left side of the body, where combined therapy (diclofenac 2 times daily on uneven dates and diclofenac once a day + tazaroten once a day on even dates) was used, 77.5% pathologic lesions disappeared, but this did not increase at follow up. The treatment of multifocal, disseminated AK is a difficult task and also burdensome for the patient due to side effects like scarring or burning and itching which occur during most therapies. Combined therapy with diclofenac and tazaroten supported by PDD may improve the effects of routine treatment of AK.

Case report: polyuria related to dexmedetomidine.

PubMed

Pratt, Alexandra; Aboudara, Matthew; Lung, Linn

2013-07-01

Dexmedetomidine has become a popular sedative in the intensive care unit for patients undergoing mechanical ventilation because of its highly selective α-2 agonism, which exerts a combination of anesthetic, analgesic, and anxiolytic effects. Bradycardia and hypotension have been reported as the most common side effects of its use in large studies. Dexmedetomidine has been reported to induce polyuria by suppressing vasopressin secretion and increasing permeability of the collecting ducts in a dose-dependent fashion. We report a case of dexmedetomidine-related polyuria that occurred with a high-dose continuous infusion and subsequently resolved with discontinuation of the drug. (Anesth Analg 2013;117:150-2).

Lipo-PGE1, a new lipid-encapsulated preparation of prostaglandin E1: placebo-and prostaglandin E1-controlled multicenter trials in patients with diabetic neuropathy and leg ulcers.

PubMed

Toyota, T; Hirata, Y; Ikeda, Y; Matsuoka, K; Sakuma, A; Mizushima, Y

1993-11-01

Several clinical trials have shown that prostaglandin E1 (PGE1) is effective in treating peripheral occlusive vascular disease, but not definitely for diabetic neuropathy. We developed a new preparation of PGE1 incorporated in lipid microspheres (lipo-PGE1) that was designed to accumulate at vascular lesions. The effect of lipo-PGE1 (10 micrograms/day) was compared with placebo and the normal dose of a free PGE1 preparation (PGE1-CD, 40 micrograms/day) in two studies (double-blind and well-controlled) which enrolled 364 diabetic patients with neuropathy and/or leg ulcers. The drugs were given intravenously (bolus or drip infusion) for 4 weeks. Clinical improvement was noted in 61.6% of the lipo-PGE1 group and 30.0% of the placebo group in Trial 1 (p < 0.01), while the figures were 58.3% in the lipo-PGE1 group and 37.1% in the PGE1-CD group in Trial 2 (p < 0.01). Leg ulcers became smaller in the lipo-PGE1 groups in both trials (p < 0.01). In Trial 2, motor conduction velocity improved in the lipo-PGE1 group (p = 0.016). Side effects occurred in few patients receiving lipo-PGE1 or placebo, but more patients developed local side effects in the PGE1-CD group (p < 0.01). Thus, bolus intravenous injection of lipo-PGE1 improved diabetic neuropathy and leg ulcers with minimal side effects.

Dissimilar Arc Welding of Advanced High-Strength Car-Body Steel Sheets

NASA Astrophysics Data System (ADS)

Russo Spena, P.; D'Aiuto, F.; Matteis, P.; Scavino, G.

2014-11-01

A widespread usage of new advanced TWIP steel grades for the fabrication of car-body parts is conditional on the employment of appropriate welding methods, especially if dissimilar welding must be performed with other automotive steel grades. Therefore, the microstructural features and the mechanical response of dissimilar butt weld seams of TWIP and 22MnB5 steel sheets after metal-active-gas arc welding are examined. The microstructural and mechanical characterization of the welded joints was carried out by optical metallography, microhardness and tensile testing, and fractographic examination. The heat-affected zone on the TWIP side was fully austenitic and the only detectable effect was grain coarsening, while on the 22MnB5 side it exhibited newly formed martensite and tempered martensite. The welded tensile specimens exhibited a much larger deformation on the TWIP steel side than on the 22MnB5. The fracture generally occurred at the interface between the fusion zone and the heat-affected zones, with the fractures surfaces being predominantly ductile. The ultimate tensile strength of the butt joints was about 25% lower than that of the TWIP steel.

Potentially risky postural behaviors during worksite keyboard use

PubMed Central

Baker, Nancy A.; Redfern, Mark

2016-01-01

Objective This study describes the frequency and distribution of potentially risky postural behaviors of keyboard users. Method Forty-three subjects’ keyboard postural behaviors were rated with the Keyboard – Personal Computer Style instrument (K-PeCS) while they worked at their own workstations. The frequency and distribution of keyboard postural behaviors, and the associations and differences between the right and left sides were assessed. Results Generally, each static body posture had a single criterion that occurred most frequently, (e.g. elbow flexion posture 80 – 120 degrees), while dynamic postures of the wrists and hands were distributed throughout their criteria. Right and left side postural behaviors were significantly associated for shoulder flexion, elbow flexion, hand displacement, wrist extension, forearm rotation, isolated 5th digit, MCP hyperextension, and wrist support use, and significantly different for hand displacement, isolated thumb, number of digits used, and MCP hyperextension. Conclusion Potentially problematic keyboard postural behaviors are common among keyboard users. Our results suggest that occupational therapists must systematically assess body, arm, wrist, and hand postures on both the right and left sides to be able to develop the most effective intervention strategies. PMID:19708467

Conflict between aftereffects of retinal sweep and looming motion.

PubMed

Bridgeman, B; Nardello, C

1994-01-01

Observers looked monocularly into a tunnel, with gratings on the left and right sides drifting toward the head. An exposure period was followed by a test with fixed gratings. With fixation points, left and right retinal fields could be stimulated selectively. When exposure and test were on the same retinal fields, but fixation was on opposite sides of the tunnel during exposure and test periods, aftereffects of retinal sweep and of perceived looming were in opposite directions. The two effects tended to cancel, yielding no perceived aftereffect. When they did occur, aftereffects in the retinal and the looming directions were equally likely. Cancellation was significantly more likely in the experimental conditions than in the control, when fixation always remained on the same side. When areas of retinal stimulation in the exposure and test periods did not overlap, cancellation was less frequent and aftereffects of looming were more frequent. Results were not significantly different for left and right visual fields, indicating that cortical vs. subcortical OKN pathways do not influence the illusion. Vection resulted for 16 of 20 observers under one or another of our conditions.

Reduced Performance of Prey Targeting in Pit Vipers with Contralaterally Occluded Infrared and Visual Senses

PubMed Central

Chen, Qin; Deng, Huanhuan; Brauth, Steven E.; Ding, Li; Tang, Yezhong

2012-01-01

Both visual and infrared (IR) senses are utilized in prey targeting by pit vipers. Visual and IR inputs project to the contralateral optic tectum where they activate both multimodal and bimodal neurons. A series of ocular and pit organ occlusion experiments using the short-tailed pit viper (Gloydius brevicaudus) were conducted to investigate the role of visual and IR information during prey targeting. Compared with unoccluded controls, snakes with either both eyes or pit organs occluded performed more poorly in hunting prey although such subjects still captured prey on 75% of trials. Subjects with one eye and one pit occluded on the same side of the face performed as well as those with bilateral occlusion although these subjects showed a significant targeting angle bias toward the unoccluded side. Performance was significantly poorer when only a single eye or pit was available. Interestingly, when one eye and one pit organ were occluded on opposite sides of the face, performance was poorest, the snakes striking prey on no more than half the trials. These results indicate that, visual and infrared information are both effective in prey targeting in this species, although interference between the two modalities occurs if visual and IR information is restricted to opposite sides of the brain. PMID:22606229

Making scents: improvement of olfactory profile after botulinum toxin-A treatment in healthy individuals.

PubMed

Heckmann, Marc; Kütt, Sandra; Dittmar, Sabine; Hamm, Henning

2007-01-01

The axilla is particularly associated with body odor and putative pheromone production in humans. Although botulinum toxin type A (BT-A) is injected increasingly into the axillary skin to stop excessive sweating, its potential to control body odor is largely unexplored. The objective was to measure the impact of BT-A on human axillary odor in an objective and reproducible fashion. This study was a randomized, double-blind, placebo-controlled trial with 51 healthy volunteers receiving 50 U of BOTOX (Allergan, Inc.) in one axilla and placebo in the other. Odor quality was assessed by treated subjects (questionnaire) as well as by independent raters who were exposed to blinded T-shirt samples. No major side effects occurred, and no subject withdrew from the study for medical reasons. Samples from the BT-A-treated side smelled less intense (p<.001) and better (p<.001) according to self-assessments. Likewise, independent raters found the BT-A-treated samples to smell less intense and better (p<.001). They preferred "to work together with the respective person" and found the odor "more erotic" (p<.001). Side-by-side comparison of odor samples (T-shirt sniff test) by independent raters showed that axillary odor in healthy individuals is significantly more appealing after BT-A injection.

Anatomy and prevalence of atlas vertebrae bridges in a Kenyan population: An osteological study.

PubMed

Karau, Paul Bundi; Ogengo, Julius A; Hassanali, Jameela; Odula, Paul

2010-09-01

Atlas bridges are bony outgrowths over the third segment of the vertebral artery. They may exist as incipient, incomplete, or complete bridges, converting the groove into a deep sulcus, incomplete, or complete foramen respectively. These bridges and their associated foramina display bilateral and sex differences in their prevalence and type. Occurrence of these bridges may predispose to vertebrobasilar insufficiency and Barre-Lieou syndrome. The coexistence of lateral and posterior bridges as well as side predilection is not clear in either sex. Their relative occurrence may also point to some evolutionary patterns. We studied the prevalence, side predilection, coexistence, and anatomical features of atlas bridges using 102 dry atlases (49 males and 53 females) obtained from the osteology department of the National Museums of Kenya. Complete posterior bridges occurred in 14.7% and 13.7% on the right and left sides, respectively. A lateral bridge was found in 3.9% of cases on the right side only. There was positive correlation in the coexistence of the bridges. A retrotransverse foramen was found in 13% of cases. This study has found that posterior and lateral atlas bridges occur in association especially on the right side. Complete bridges were more prevalent in females and were more often present on the right side. This pattern seems to mirror the sexual predilection of vertebral artery compression syndromes. Gender roles may have an influence on the occurrence of these bridges and therefore the syndromes as well.

Male Contraception

PubMed Central

Amory, John K.

2016-01-01

NARRATIVE ABSTRACT Although female contraceptives are very effective at preventing unintended pregnancy, some women cannot use them due to health conditions or side effects, leaving some couples without effective contraceptive options. In addition, many men wish to take active responsibility for family planning. Thus, there is a great need for male contraceptives to prevent unintended pregnancy, of which 80–90 million occur annually. At present, effective male contraceptive options are condoms and vasectomy, which are not ideal for all men. Therefore, efforts are under way to develop novel male contraceptives. This paper will briefly review the advantages and disadvantages of condoms and vasectomies, and then discuss the research directed towards the development of novel methods of male contraception. PMID:27678037

Anthropogenic desertification by high-albedo pollution Observations and modeling

NASA Technical Reports Server (NTRS)

Otterman, J.; Rosenberg, N. W.; Rosenberg, E.

1974-01-01

ERTS-1 MSS albedo data of Western Negev, Sinai and the Gaza strip are presented. A sharp contrast in albedo exists across the Negev-Sinai and Negev-Gaza strip borders. Anthropogenic desertification has occurred on the Arab side due to overgrazing and Bedouin agriculture, whereas natural vegetation grows much more abundantly on the Israeli side.

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

Ochs, I. E.; Bertelli, N.; Fisch, N. J.

Although lower hybrid waves are effective at driving currents in present-day tokamaks, they are expected to interact strongly with high-energy particles in extrapolating to reactors. In the presence of a radial alpha particle birth gradient, this interaction can take the form of wave amplification rather than damping. While it is known that this amplification more easily occurs when launching from the tokamak high-field side, the extent of this amplification has not been made quantitative. Here, by tracing rays launched from the high- field-side of a tokamak, the required radial gradients to achieve amplification are calculated for a temperature and densitymore » regime consistent with a hot-ion-mode fusion reactor. As a result, these simulations, while valid only in the linear regime of wave amplification, nonetheless illustrate the possibilities for wave amplification using high-field launch of the lower hybrid wave.« less

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

Ochs, I. E.; Bertelli, N.; Fisch, N. J.

Although lower hybrid waves are effective at driving currents in present-day tokamaks, they are expected to interact strongly with high-energy particles in extrapolating to reactors. In the presence of a radial alpha particle birth gradient, this interaction can take the form of wave amplification rather than damping. While it is known that this amplification more easily occurs when launching from the tokamak high-field side, the extent of this amplification has not been made quantitative. Here, by tracing rays launched from the high-field-side of a tokamak, the required radial gradients to achieve amplification are calculated for a temperature and density regimemore » consistent with a hot-ion-mode fusion reactor. These simulations, while valid only in the linear regime of wave amplification, nonetheless illustrate the possibilities for wave amplification using high-field launch of the lower hybrid wave.« less

The effect of H2O and CO2 on planetary mantles

NASA Technical Reports Server (NTRS)

Wyllie, P. J.

1978-01-01

The peridotite-H2O-CO2 system is discussed, and it is shown that even traces of H2O and CO2, in minerals or vapor, lower mantle solidus temperatures through hundreds of degrees in comparison with the volatile-free solidus. The solidus for peridotite-H2O-CO2 is a divariant surface traversed by univariant lines that locate the intersections of subsolidus divariant surfaces for carbonation or hydration reactions occurring in the presence of H2O-CO2 mixtures. Vapor phase compositions are normally buffered to these lines, and near the buffered curve for the solidus of partly carbonated peridotite there is a temperature maximum on the peridotite-vapor solidus. Characteristics on the CO2 side of the maximum and on the H2O side of the maximum are described.

Gastrointestinal Side Effects of Antiarrhythmic Medications: A Review of Current Literature.

PubMed

Amjad, Waseem; Qureshi, Waqas; Farooq, Ali; Sohail, Umair; Khatoon, Salma; Pervaiz, Sarah; Narra, Pratyusha; Hasan, Syeda M; Ali, Farman; Ullah, Aman; Guttmann, Steven

2017-09-03

Antiarrhythmic drugs are commonly prescribed cardiac drugs. Due to their receptor mimicry with several of the gastrointestinal tract receptors, they can frequently lead to gastrointestinal side effects. These side effects are the most common reasons for discontinuation of these drugs by the patients. Knowledge of these side effects is important for clinicians that manage antiarrhythmic drugs. This review focuses on the gastrointestinal side effects of these drugs and provides a detailed up-to-date literature review of the side effects of these drugs. The review provides case reports reported in the literature as well as possible mechanisms that lead to gastrointestinal side effects.

Memory for Medication Side Effects in Younger and Older Adults: The Role of Subjective and Objective Importance

PubMed Central

Friedman, Michael C.; McGillivray, Shannon; Murayama, Kou; Castel, Alan D.

2014-01-01

Older adults often experience memory impairments, but can sometimes use selective processing and schematic support to remember important information. The current experiments investigate to what degree younger and healthy older adults remember medication side effects that were subjectively or objectively important to remember. Participants studied a list of common side effects, and rated how negative these effects were if they were to experience them, and were then given a free recall test. In Experiment 1, the severity of the side effects ranged from mild (e.g., itching) to severe (e.g., stroke), and in Experiment 2, certain side effects were indicated as critical to remember (i.e., “contact your doctor if you experience this”). There were no age differences in terms of free recall of the side effects, and older adults remembered more severe side effects relative to mild effects. However, older adults were less likely to recognize critical side effects on a later recognition test, relative to younger adults. The findings suggest that older adults can selectively remember medication side effects, but have difficulty identifying familiar but potentially critical side effects, and this has implications for monitoring medication use in older age. PMID:25331278

“So far it’s been choosing which side effects I want or I can deal with”: A grounded theory of HIV treatment side effects among people living with HIV

PubMed Central

Holmes, Dave

2016-01-01

Despite the availability of new antiretroviral drugs and the simplification of treatment options, side effects continue to affect people living with HIV. In this paper, we present the findings of a grounded theory study designed to gain a critical understanding of the experience of side effects. Three main categories emerged from the data: the side effects, the experience, and the connections. The first category suggests that we need to change how we think about side effects in order to take into account the context in which they are experienced as well as the types and nature of side effects. The second category puts forward the idea that the experience of side effects is composed of three interrelated processes: becoming with, living with, and dealing with. Finally, the third category points to new connections that are formed with people, things and systems in the presence of side effects. PMID:27867446

Relation between therapeutic response and side effects induced by methylphenidate as observed by parents and teachers of children with ADHD.

PubMed

Lee, James; Grizenko, Natalie; Bhat, Venkataramana; Sengupta, Sarojini; Polotskaia, Anna; Joober, Ridha

2011-04-21

The desired (therapeutic) and undesired (side) effects of methylphenidate might have underlying correlations. The aim of this study was to explore the strength and the possible sources of these correlations. One hundred and fifty-seven children with ADHD (6-12 years) were administered placebo and methylphenidate (0.5 mg/kg in a divided b.i.d. dose), each for a one-week period, in a double-blind, crossover trial. Therapeutic response was assessed using the Conners' Global Index for parents (CGI-Parents) and teachers (CGI-Teachers), while side effects were assessed using the Barkley Side Effects Rating Scale (SERS). The side effect profile as assessed by the SERS was similar to that of previous studies with insomnia, decreased appetite, and headaches showing significant treatment effects (p < 0.005). These "somatic/physical" side effects did not correlate with CGI-Parents or CGI-Teachers. However, the side effects of "irritability", "proneness to crying", and "anxiousness" showed significant relationships with CGI-Parents. These "mood/anxiety" side effects showed no significant correlations with the CGI-Teachers. The greater "mood/anxiety" side effects on methylphenidate and placebo, the less the parents observe improvement of their children while treated with methylphenidate. This suggests that the correlations between "mood/anxiety" side effects and poor response to treatment may be driven by observer effects rather than biological commonalities between therapeutic and side effects of methylphenidate.

Cutaneous Adverse Effects of Neurologic Medications.

PubMed

Bahrani, Eman; Nunneley, Chloe E; Hsu, Sylvia; Kass, Joseph S

2016-03-01

Life-threatening and benign drug reactions occur frequently in the skin, affecting 8 % of the general population and 2-3 % of all hospitalized patients, emphasizing the need for physicians to effectively recognize and manage patients with drug-induced eruptions. Neurologic medications represent a vast array of drug classes with cutaneous side effects. Approximately 7 % of the United States (US) adult population is affected by adult-onset neurological disorders, reflecting a large number of patients on neurologic drug therapies. This review elucidates the cutaneous reactions associated with medications approved by the US Food and Drug Administration (FDA) to treat the following neurologic pathologies: Alzheimer disease, amyotrophic lateral sclerosis, epilepsy, Huntington disease, migraine, multiple sclerosis, Parkinson disease, and pseudobulbar affect. A search of the literature was performed using the specific FDA-approved drug or drug classes in combination with the terms 'dermatologic,' 'cutaneous,' 'skin,' or 'rash.' Both PubMed and the Cochrane Database of Systematic Reviews were utilized, with side effects ranging from those cited in randomized controlled trials to case reports. It behooves neurologists, dermatologists, and primary care physicians to be aware of the recorded cutaneous adverse reactions and their severity for proper management and potential need to withdraw the offending medication.

Drug abuse in athletes

PubMed Central

Reardon, Claudia L; Creado, Shane

2014-01-01

Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the history of doping in athletes, the effects of different classes of substances used for doping, side effects of doping, the role of anti-doping organizations, and treatment of affected athletes. Doping goes back to ancient times, prior to the development of organized sports. Performance-enhancing drugs have continued to evolve, with “advances” in doping strategies driven by improved drug testing detection methods and advances in scientific research that can lead to the discovery and use of substances that may later be banned. Many sports organizations have come to ban the use of performance-enhancing drugs and have very strict consequences for people caught using them. There is variable evidence for the performance-enhancing effects and side effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions. PMID:25187752

Priapism caused by 'Tribulus terrestris'.

PubMed

Campanelli, M; De Thomasis, R; Tenaglia, R L

2016-01-01

A 36-year-old Caucasian man was diagnosed with a 72-h-lasting priapism that occurred after the assumption of a Herbal supplement based on Tribulus terrestris, which is becoming increasingly popular for the treatment of sexual dysfunction. The patient underwent a cavernoglandular shunt (Ebbehoj shunt) in order to obtain complete detumescence, from which derived negative post-episode outcomes on sexual function. All patients consuming non-FDA-approved alternative supplements such as Tribulus terrestris should be warned about the possible serious side effects.

Encephalopathy due to tubercular otitis media.

PubMed

Gurjar, Mohan; Aggarwal, Sushil K; Saigal, Saurabh; Singh, Ratender K

2012-04-01

Middle ear infection due to Mycobacterium tuberculosis has been reduced from 3-5% to 0.05-0.9% in the last century due to advent of effective anti-tuberculosis therapy. On the other side, this decrease in frequency of tuberculous otitis media along with indistinguishable signs and symptoms of frequently occurring non-tuberculous otitis media makes clinicians vulnerable to delayed or misdiagnosis of the disease. A case of tubercular otitis media with atypical clinical manifestations in the form of encephalopathy is presented.

Stoichiometric and Catalytic Scavengers as Protection Against Nerve Agent Toxicity: A Mini Review

DTIC Science & Technology

2007-01-01

signs of nerve agent toxicity following exposure . Assessments of motor activity , coordination, and acquisition of spatial memory were performed for 2...serious side occur before endogenous AChE is affected (approxi- effects if administered in the absence of cholinesterase mately 2 min after exposure to an...after guinea pigs of cholinesterase in the blood and the level of protec- were administered 60mg/kg of HuBuChE (-󈧎-fold tion against OP poisoning

Double-Blind, Randomized Study of Safety and Efficacy of OnabotulinumtoxinA (OnaBoNT-A) versus Oral Oxybutynin in SCI Patients with NDO (11-09-10-04)

DTIC Science & Technology

2014-10-01

procedures in the clinic. The doctor wll decide if you will be given a local anesthesia to lessen the pain before beginning the injection procedure...injection and, while usually temporary, they may last several months. Pain , tenderness, or bruising around the injection site may also occur. Local weakness...indigestion; nausea; runny nose; stomach pain or upset; trouble sleeping; weakness Severe Side Effects: Severe allergic reactions (rash; hives

Co-occurring Conditions Toolkit: Mild Traumatic Brain Injury and Psychological Health

DTIC Science & Technology

2009-01-01

in OD yy Contraindi- cated with MAOIs within past 14 days of therapy yy Bupropion, Haloperidol and SSRIs may increase the TCA’s level which... Haloperidol (Haldol) yy Initial PTSD dose = 0.5mg TID or 1mg BID yy Max PTSD = 5mg QID yy Used in PTSD but therapeu- tic doses not established...yy The Opioid side effect of delirium may be treated with Haloperi- dol if phar- macologic treatment is deemed necessary yy Haloperidol may

[The implantation of bipolar coagulation to remove endometriosis foci].

PubMed

Sobkiewicz, S; Palatyński, A; Salata, I

2001-05-01

The paper compares the results of bipolar coagulation bey means of ERBE ICC 300 diatermy coagulator and WISAP endocoagulator. The results of both types of coagulation were assessed with reference to the changes occurring on peritoneum ligamenti sacro-uterini, Douglas pouch and ovary. The best results of endometriosis foci coagulation were obtained with bipolar ball at 20-30 W; no side effects or feelings of malaise were observed in patients just after the operation or over a longer period of convalescence.

Benign mass in tonsil- cavernous hemangioma.

PubMed

Joseph, Sumitha; Prakash, M; Mohammed, Hafida K; Govar, Aberna

2013-10-01

Cavernous hemangioma is also called as 'ANGIOMA CAVERNOSUM' or 'CAVERNOMA' as benign lesion of blood vessels. They are similar to strawberry hemangioma but deeply situated. Although most often associated with skin it is also sometimes found in mucous membrane, brain and the viscera. The diagnosis of hemangiomas is mainly based on clinical evaluation . Isolated hemangiomas in the tonsillar tissue is a rare occurance. In this we report had a case of adult tonsillar hemangioma of left side associated with recurrent tonsillitis . He was effectively managed surgically without any complications.

Oxytetracycline in the treatment of ocular rosacea: a double-blind trial.

PubMed Central

Bartholomew, R S; Reid, B J; Cheesbrough, M J; Macdonald, M; Galloway, N R

1982-01-01

Thirty-five patients with ocular rosacea were admitted to a trial of systemic oxytetracycline, 250 mg b.d. for 6 weeks. Oxytetracycline produced a significantly higher number of remissions than the placebo, 11/35. With repeated or continuous treatment 19/35 patients achieved a sustained remission for 8 months. There were no side effects. The nonspecific signs of ocular rosacea responded well to the treatment, but no permanent change in the conjunctival or corneal vascularisation occurred. PMID:6211188

The Major Magnetic Storm of March 13-14, 1989 and Associated Ionosphere Effects

DTIC Science & Technology

1993-06-30

latitude. top-side ionospheric disturbance occurred on March 13 and 14. The mag- nitudes of the particle energy flux (ergs cm-’) (I erg -10’ J) and...Joule heating were not unusually large for a storm, but the area of the energy depesition, and thus the total energy deposition, was extremely large...all as more energy is transferred from the solar wind to the magnetosphere, but the cross polar-cap potential during this storm shows no evidence of

[Apoplexy, diverticulum or Alzheimer disease? Deglutition disorders in seniors must always be evaluated!].

PubMed

Koester, M; Nekahm-Heis, D; Zorowka, P

2003-01-23

Problems with swallowing (dysphagia) occur in association with numerous illnesses. In many cases, however, they are either not recognized or considered not to require clarification, since other symptoms are of greater importance. In elderly, often multimorbid patients, neurodegenerative diseases, such as apoplexy, are the most common causes of dysphagia, but medications with central nervous side effects may also impair swallowing. The difficulty may be localized either in the oropharyngeal region or in the esophagus. There is considerable danger that such complications as aspiration pneumonia and malnutrition may occur and thus increase morbidity and mortality. In addition, the quality of life of the patient may also be diminished. The family doctor has the important task of initiating a differentiated diagnosis based on careful history-taking and a clinical examination that should include an inspection of the oral cavity and the nerves supplying the brain. Early treatment, for example, involving a logopedist, can be effective.

At-home laser treatment of oral neuronal disorders: Case reports

PubMed Central

Rocca, Jean-Paul; Oppici, Aldo; Cella, Luigi; Fornaini, Carlo

2017-01-01

The neuronal disorders occurring in the oral district are mainly anaesthesia, paraesthesia, hypoesthesia and hyperaesthesia and they may occur frequently after surgical procedures. Medical treatment depends on degree of severity of the nerve injury but, in every case, it must be immediately carried out to reduce immune inflammatory reaction. The aim of this report is to investigate the effectiveness in the recovery of the peripheral nerve lesions of a new laser device recently proposed by the commerce that, due to its reduced size and to be a class I laser according the ANSI classification, may be used at home by the patient himself. Three different cases were treated with this “at-home approach”: complete resolution of symptomatology was obtained after laser treatment with a good compliance for the patient and without reporting any side effect. Key words:Laser, biomodulation, low level laser therapy, oral neuronal disorders, at-home treatment, paresthesia. PMID:28469830

The use of lisuride in the treatment of multiple system atrophy with autonomic failure (Shy-Drager syndrome).

PubMed Central

Lees, A J; Bannister, R

1981-01-01

In a controlled trial lisuride, an ergolene derivative with dopamine receptor agonist properties was given maximum tolerated doses (2.4 mg/day) to seven patients with multiple system atrophy with autonomic failure (Shy-Drager syndrome). Improvement in Parkinsonian features occurred in only one patient and another patient who had been deriving marked benefit from levodopa treatment before the study began failed to respond to large doses of lisuride. Psychiatric side effects (including nightmares, isolated visual hallucinations and toxic confusional states) were the dose-limiting factor in six patients. A modest reduction in orthostatic hypotension occurred in two patients, one of whom had experienced an aggravation of this disturbance on levodopa and bromocriptine. Destruction of post-synaptic dopamine receptors and damage to central noradrenergic systems may offer an explanation for the lack of therapeutic effect of lisuride. PMID:7241162

Side Effects of HIV Medicines: HIV and Lactic Acidosis

MedlinePlus

... Drugs Clinical Trials Apps skip to content Side Effects of HIV Medicines Home Understanding HIV/AIDS Fact ... and Immunizations What is a Drug Interaction? Side Effects of HIV Medicines HIV Medicines and Side Effects ...

Progress in analgesia for labor: focus on neuraxial blocks

PubMed Central

Ranasinghe, J Sudharma; Birnbach, David J

2010-01-01

Neuraxial analgesia is widely accepted as the most effective and the least depressant method of providing pain relief in labor. Over the last several decades neuraxial labor analgesia techniques and medications have progressed to the point now where they provide high quality pain relief with minimal side effects to both the mother and the fetus while maximizing the maternal autonomy possible for the parturient receiving neuraxial analgesia. The introduction of the combined spinal epidural technique for labor has allowed for the rapid onset of analgesia with minimal motor blockade, therefore allowing the comfortable parturient to ambulate. Patient-controlled epidural analgesia techniques have evolved to allow for more flexible analgesia that is tailored to the individual needs of the parturient and effective throughout the different phases of labor. Computer integrated systems have been studied to provide seamless analgesia from induction of neuraxial block to delivery. New adjuvant drugs that improve the effectiveness of neuraxial labor analgesia while decreasing the side effects that may occur due to high dose of a single drug are likely to be added to future labor analgesia practice. Bupivacaine still remains a popular choice of local anesthetic for labor analgesia. New local anesthetics with less cardiotoxicity have been introduced, but their cost effectiveness in the current labor analgesia practice has been questioned. PMID:21072273

Are Senna based laxatives safe when used as long term treatment for constipation in children?

PubMed

Vilanova-Sanchez, Alejandra; Gasior, Alessandra C; Toocheck, Nicole; Weaver, Laura; Wood, Richard J; Reck, Carlos A; Wagner, Andrea; Hoover, Erin; Gagnon, Renae; Jaggers, Jordon; Maloof, Tassiana; Nash, Onnalisa; Williams, Charae; Levitt, Marc A

2018-04-01

Senna is a stimulant laxative commonly used by pediatricians, pediatric gastroenterologists, and pediatric surgeons. Many clinicians avoid Senna for reasons such as tolerance or side effects but this has little scientific justification. We recently found several patients we were caring for developed perineal blistering during the course of Senna treatment. Because of this we chose to review the literature to identify side effects in children taking this medication as well as to analyze our Center's experience with Senna's secondary effects. We performed a literature review (MEDLINE, PUBMED) using the keywords of Senna, sen, sennosides and children, and pediatric and functional (idiopathic) constipation. We looked for articles with information regarding perineal blisters related to Senna as well as other secondary effects of Senna laxatives in children when used on a long-term basis. We also reviewed the charts of our patients who had previously taken Senna or are currently taking Senna, looking for adverse reactions. Eight articles in the literature reported perineal blisters after administration of Senna laxatives in 28 patients. Of those occurrences, 18 patients (64%) had accidental administration of Senna and 10 (36%) had Senna prescribed as a long term treatment. All of the blistering episodes were related to high dose, night-time accidents, or intense diarrhea with a long period of stool to skin contact. At our institution, from 2014 to 2017, we prescribed Senna and have recorded data to 640 patients. During the study period, 17 patients (2.2%) developed blisters during their treatment. Patients who developed blisters had higher doses 60mg/day; 60 [12-100] vs. 17.5 [1.7-150] (p<0.001). All of the blistering episodes were related to night-time accidents, with a long period of stool to skin contact. 83 (13%) patients presented minor side effects such as abdominal cramping, vomiting or diarrhea which resolved once the type of laxatives were changed or enemas were started. The doses of Senna was not significantly different in these patients 15mg/day [4.4-150] vs. 17.5mg/day [1.5-150]. There were no other long-term side effects from Senna found in the pediatric literature for long-term treatment besides abdominal cramping or diarrhea during the first weeks of administration. We found no evidence of tolerance to Senna in our review. There is a paucity of information in the literature regarding side effects of sennosides as a long-term therapy, and to our knowledge, this is the first review of Senna side effects in children. Senna induced dermatitis is rare, but may occur when patients need a higher dose. All of the cases described had a long period of exposure of the skin to stool. Besides the perineal rash with blisters, we could find no other described major side effect with Senna administration in the pediatric population or evidence of the frequently mentioned concern of the development of tolerance to Senna. Pediatric caregivers should advise families of the rare side effect of skin blistering and educate them to change the diaper frequently in children who are not toilet- trained to reduce stool to skin exposure. We can conclude from this review that Senna is a safe treatment option for constipation in children. IV. Copyright © 2018 Elsevier Inc. All rights reserved.

A meta-analysis of avascular necrosis in systemic lupus erythematosus: prevalence and risk factors.

PubMed

Nevskaya, Tatiana; Gamble, Maeve P; Pope, Janet E

2017-01-01

To determine the prevalence of and risk factors for avascular necrosis (AVN) in systemic lupus erythematosus (SLE). MEDLINE, CINAHL, Web of Science, EMBASE and Cochrane Library were searched from inception to July, 2015 and a random effects model was used to combine frequencies; study quality was assessed using STROBE. 2,041 citations identified 62 articles. Many results had high heterogeneity. The prevalence of symptomatic AVN was 9% (range 0.8%-33%) in SLE and 29% for asymptomatic AVN; femoral head was the most common location (8.0%). High-dose corticosteroids (CS) any CS use, maximum and cumulative dose, pulse therapy, and CS side-effects (hypertension, Cushings, but not diabetes mellitus or hyperlipidaemia) were associated with AVN, as was active SLE (cutaneous vasculitis, renal and neuropsychiatric manifestations, serositis, cytopenias) and Sjögren's, Raynaud's phenomenon, arthritis, cyclophosphamide (but not azathioprine mycophenolate mofetil, or methotrexate) and more damage (excluding musculoskeletal system). Antimalarial drugs were not protective. Rashes and oral ulcers were not associated with AVN. Mean daily dose of CS and duration of CS use had no impact on AVN occurence. Autoantibodies and other immunological markers did not predispose to AVN, except IgM anticardiolipin antibodies which doubled the risk. African Americans experienced more AVN (OR 1.8, p=0.04). AVN may occur in 1/3 of patients with SLE and 9% with symptoms. Features of active organ SLE (CNS, renal, cutaneous vasculitis, serositis, cytopenias) are associated with AVN as are CS, especially early in disease and at high doses. Those with early CS side-effects seem to have the highest risk of AVN.

A comparison of erythromycin and cefadroxil in the prevention of flare-ups from asymptomatic teeth with pulpal necrosis and associated periapical pathosis.

PubMed

Morse, D R; Furst, M L; Lefkowitz, R D; D'Angelo, D; Esposito, J V

1990-05-01

In a previous study by our group with patients having asymptomatic teeth with pulpal necrosis and an associated periapical radiolucent lesion (PN/PL), it was shown that prophylactic administration of penicillin V or erythromycin (high-dose, 1-day regimen) resulted in a low incidence of flare-up (mean = 2.2%) and a low incidence of swelling and pain not associated with flare-up. No hypersensitivity responses occurred, and gastrointestinal side effects were found primarily with the erythromycins. To ascertain whether a single-dose administration of a long-acting 1-gm tablet of the cephalosporin antibiotic cefadroxil would result in a similar outcome, the present study was undertaken with 200 patients having quiescent PN/PL. The patients were randomly given either cefadroxil or erythromycin (base or stearate). Evaluations of flare-up were done 1 day, 1 week, and 2 months after endodontic treatment. A 2.0% flare-up incidence was found, with no statistically significant differences for cefadroxil (1.0%), stearate (2.0%), or base (4.0%). No hypersensitivity responses occurred. Gastrointestinal side effects were found primarily with the erythromycins (19.0%). The results showed that a 1-gm, single-dose regimen of cefadroxil was as effective as erythromycin and penicillin in preventing flare-ups and serious sequelae. A comparative analysis of the data from our first study (no peritreatment antibiotics) and the pooled data from our last three investigations (including the current trial) showed that peritreatment antibiotic coverage significantly reduced flare-ups and serious sequelae after endodontic treatment of asymptomatic PN/PL (p less than 0.001).

Protein unfolding in detergents: effect of micelle structure, ionic strength, pH, and temperature.

PubMed Central

Otzen, Daniel E

2002-01-01

The 101-residue monomeric protein S6 unfolds in the anionic detergent sodium dodecyl sulfate (SDS) above the critical micelle concentration, with unfolding rates varying according to two different modes. Our group has proposed that spherical micelles lead to saturation kinetics in unfolding (mode 1), while cylindrical micelles prevalent at higher SDS concentrations induce a power-law dependent increase in the unfolding rate (mode 2). Here I investigate in more detail how micellar properties affect protein unfolding. High NaCl concentrations, which induce cylindrical micelles, favor mode 2. This is consistent with our model, though other effects such as electrostatic screening cannot be discounted. Furthermore, unfolding does not occur in mode 2 in the cationic detergent LTAB, which is unable to form cylindrical micelles. A strong retardation of unfolding occurs at higher LTAB concentrations, possibly due to the formation of dead-end protein-detergent complexes. A similar, albeit much weaker, effect is seen in SDS in the absence of salt. Chymotrypsin inhibitor 2 exhibits the same modes of unfolding in SDS as S6, indicating that this type of protein unfolding is not specific for S6. The unfolding process in mode 1 has an activation barrier similar in magnitude to that in water, while the activation barrier in mode 2 is strongly concentration-dependent. The strong pH-dependence of unfolding in SDS and LTAB suggests that the rate of unfolding in anionic detergent is modulated by repulsion between detergent headgroups and anionic side chains, while cationic side chains modulate unfolding rates in cationic detergents. PMID:12324439

Exploring the presentation of HPV information online: A semantic network analysis of websites.

PubMed

Ruiz, Jeanette B; Barnett, George A

2015-06-26

Negative vaccination-related information online leads some to opt out of recommended vaccinations. To determine how HPV vaccine information is presented online and what concepts co-occur. A semantic network analysis of the words in first-page Google search results was conducted using three negative, three neutral, and three positive search terms for 10 base concepts such as HPV vaccine, and HPV immunizations. In total, 223 of the 300 websites retrieved met inclusion requirements. Website information was analyzed using network statistics to determine what words most frequently appear, which words co-occur, and the sentiment of the words. High levels of word interconnectivity were found suggesting a rich set of semantic links and a very integrated set of concepts. Limited number of words held centrality indicating limited concept prominence. This dense network signifies concepts that are well connected. Negative words were most prevalent and were associated with describing the HPV vaccine's side-effects as well as the negative effects of HPV and cervical cancer. A smaller cluster focuses on reporting negative vaccine side-effects. Clustering shows the words women and girls closely located to the words sexually, virus, and infection. Information about the HPV vaccine online centered on a limited number of concepts. HPV vaccine benefits as well as the risks of HPV, including severity and susceptibility, were centrally presented. Word cluster results imply that HPV vaccine information for women and girls is discussed in more sexual terms than for men and boys. Copyright © 2015 Elsevier Ltd. All rights reserved.

Framing effects on expectations, decisions, and side effects experienced: the case of influenza immunization.

PubMed

O'Connor, A M; Pennie, R A; Dales, R E

1996-11-01

To examine the effects of using positive or negative frames to describe influenza vaccine benefits and side effects on patients' expectations, decisions, decisional conflict, and reported side effects. 292 previously unimmunized patients with chronic respiratory or cardiac disease were randomly assigned to receive benefit/risk information that was framed: (1) positively as the percentage who remain free of influenza and have no vaccine side effects, or (2) negatively as the percentage who acquire influenza and have vaccine side effects. Questionnaires elicited expectations, decisions, and decisional conflict. Vaccines were telephoned 3 days later for a self-report of local and systemic side effects and work absenteeism. Both groups had similar immunization rates and decisional conflict scores. The positive frame group had lower and more realistic expectations of vaccine side effects, fewer systemic side effects, and less work absenteeism (p < 0.05). In contrast to previous studies of health care workers, framing did not influence patients' decisions, possibly due to the patients' awareness of their higher risk of influenza complications and greater desire to follow recommendations. The common practice of using negative frames when describing probabilities of side effects may need to be reexamined, considering its deleterious influence on self-reported side effects and work absenteeism.

Chemosensitization as a Means to Augment Commercial Antifungal Agents

PubMed Central

Campbell, Bruce C.; Chan, Kathleen L.; Kim, Jong H.

2012-01-01

Antimycotic chemosensitization and its mode of action are of growing interest. Currently, use of antifungal agents in agriculture and medicine has a number of obstacles. Foremost of these is development of resistance or cross-resistance to one or more antifungal agents. The generally high expense and negative impact, or side effects, associated with antifungal agents are two further issues of concern. Collectively, these problems are exacerbated by efforts to control resistant strains, which can evolve into a treadmill of higher dosages for longer periods. This cycle in turn, inflates cost of treatment, dramatically. A further problem is stagnation in development of new and effective antifungal agents, especially for treatment of human mycoses. Efforts to overcome some of these issues have involved using combinations of available antimycotics (e.g., combination therapy for invasive mycoses). However, this approach has had inconsistent success and is often associated with a marked increase in negative side effects. Chemosensitization by natural compounds to increase effectiveness of commercial antimycotics is a somewhat new approach to dealing with the aforementioned problems. The potential for safe natural products to improve antifungal activity has been observed for over three decades. Chemosensitizing agents possess antifungal activity, but at insufficient levels to serve as antimycotics, alone. Their main function is to disrupt fungal stress response, destabilize the structural integrity of cellular and vacuolar membranes or stimulate production of reactive oxygen species, augmenting oxidative stress and apoptosis. Use of safe chemosensitizing agents has potential benefit to both agriculture and medicine. When co-applied with a commercial antifungal agent, an additive or synergistic interaction may occur, augmenting antifungal efficacy. This augmentation, in turn, lowers effective dosages, costs, negative side effects and, in some cases, countermands resistance. PMID:22393330

The SNARC Effect in Number Memorization and Retrieval. What is the Impact of Congruency, Magnitude and the Exact Position of Numbers in Short-Term Memory Processing?

PubMed Central

Gut, Małgorzata; Staniszewski, Rafał

2016-01-01

Mental representations of numbers are spatially organized along a Mental Number Line (MNL). One widely proven manifestation of this relationship is the Spatial Numerical Association of Response Codes (SNARC) effect. It refers to the phenomenon of faster responses to numbers when there is congruency between the reaction side and the number position on the MNL . Although long-term memory is considered to house the MNL, short-term memory (STM) load may also modulate responses to numbers and the SN ARCRC effect. Our question, however, was not how STM content modulates the SNARC effect observed in responses to digits, but rather how the MNLNL representation affects the number retrieval from ST M. Each trial began with four digits presented horizontally in a spatial sequence (prime stimuli), which were then replaced by one of the priming digits as a single target. The task required participants to recall the exact location of the target. The SN ARCRC effect occurred only in the retrieval of left-sided digits, most likely because of the generally better processing of right-sided ones, as well as in reaction to digits presented more laterally. Moreover, memory processing was more efficient with low-magnitude numbers, which may suggest that they trigger attention shifting. We conclude that the MNL affects not only the responses to numbers obtained in typical SNARC-induction tasks, such as number detection, parity judgment or magnitude comparison, but also memorization and retrieval of them. Importantly, this effect seems to be dependent on the exact position of a digit in STM. PMID:28154615

The SNARC Effect in Number Memorization and Retrieval. What is the Impact of Congruency, Magnitude and the Exact Position of Numbers in Short-Term Memory Processing?

PubMed

Gut, Małgorzata; Staniszewski, Rafał

2016-01-01

Mental representations of numbers are spatially organized along a Mental Number Line (MNL). One widely proven manifestation of this relationship is the Spatial Numerical Association of Response Codes (SNARC) effect. It refers to the phenomenon of faster responses to numbers when there is congruency between the reaction side and the number position on the MNL . Although long-term memory is considered to house the MNL, short-term memory (STM) load may also modulate responses to numbers and the SN ARCRC effect. Our question, however, was not how STM content modulates the SNARC effect observed in responses to digits, but rather how the MNLNL representation affects the number retrieval from ST M. Each trial began with four digits presented horizontally in a spatial sequence (prime stimuli), which were then replaced by one of the priming digits as a single target. The task required participants to recall the exact location of the target. The SN ARCRC effect occurred only in the retrieval of left-sided digits, most likely because of the generally better processing of right-sided ones, as well as in reaction to digits presented more laterally. Moreover, memory processing was more efficient with low-magnitude numbers, which may suggest that they trigger attention shifting. We conclude that the MNL affects not only the responses to numbers obtained in typical SNARC-induction tasks, such as number detection, parity judgment or magnitude comparison, but also memorization and retrieval of them. Importantly, this effect seems to be dependent on the exact position of a digit in STM.

Dual-gate operation and carrier transport in SiGe p–n junction nanowires

DOE PAGES

Delker, Collin James; Yoo, Jink Young; Bussmann, Ezra; ...

2017-10-23

Here, we investigate carrier transport in silicon–germanium nanowires with an axial p–n junction doping profile by fabricating these wires into transistors that feature separate top gates over each doping segment. By independently biasing each gate, carrier concentrations in the n- and p-side of the wire can be modulated. For these devices, which were fabricated with nickel source–drain electrical contacts, holes are the dominant charge carrier, with more favorable hole injection occurring on the p-side contact. Channel current exhibits greater sensitivity to the n-side gate, and in the reverse biased source–drain configuration, current is limited by the nickel/n-side Schottky contact.

Dual-gate operation and carrier transport in SiGe p-n junction nanowires

NASA Astrophysics Data System (ADS)

Delker, C. J.; Yoo, J. Y.; Bussmann, E.; Swartzentruber, B. S.; Harris, C. T.

2017-11-01

We investigate carrier transport in silicon-germanium nanowires with an axial p-n junction doping profile by fabricating these wires into transistors that feature separate top gates over each doping segment. By independently biasing each gate, carrier concentrations in the n- and p-side of the wire can be modulated. For these devices, which were fabricated with nickel source-drain electrical contacts, holes are the dominant charge carrier, with more favorable hole injection occurring on the p-side contact. Channel current exhibits greater sensitivity to the n-side gate, and in the reverse biased source-drain configuration, current is limited by the nickel/n-side Schottky contact.

Dual-gate operation and carrier transport in SiGe p–n junction nanowires

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

Delker, Collin James; Yoo, Jink Young; Bussmann, Ezra

Here, we investigate carrier transport in silicon–germanium nanowires with an axial p–n junction doping profile by fabricating these wires into transistors that feature separate top gates over each doping segment. By independently biasing each gate, carrier concentrations in the n- and p-side of the wire can be modulated. For these devices, which were fabricated with nickel source–drain electrical contacts, holes are the dominant charge carrier, with more favorable hole injection occurring on the p-side contact. Channel current exhibits greater sensitivity to the n-side gate, and in the reverse biased source–drain configuration, current is limited by the nickel/n-side Schottky contact.

Outcomes of mandated treatment for women with histories of abuse and co-occurring disorders.

PubMed

Clark, Colleen; Young, M Scott

2009-12-01

Although there is much momentum for behavioral health policies supporting mandated treatment, there is little evidence supporting its safety and effectiveness for individuals with complex issues. The authors used a national study of women with co-occurring psychiatric, substance use disorders and histories of trauma to compare mandated and voluntary treatment by examining psychiatric, substance use, and trauma-related outcomes following treatment. This quasi-experimental study included 2,726 women, with measures completed at baseline, 6-month, and 12-month follow-up. Two-way analyses of covariance examined the main and interactive effects of coercive status (mandated vs. voluntary) and condition (integrated treatment vs. services as usual) on psychiatric distress, trauma-related symptoms, and substance use outcomes. Women did better with integrated treatment and with mandated treatment regardless of treatment condition for psychiatric, trauma, and substance use outcomes at both follow-ups. Further research clarifying unintended side effects and change mechanisms of mandated treatment is needed to inform policy decisions.

Hypoxia and hypoxia inducible factor-1α are required for normal endometrial repair during menstruation.

PubMed

Maybin, Jacqueline A; Murray, Alison A; Saunders, Philippa T K; Hirani, Nikhil; Carmeliet, Peter; Critchley, Hilary O D

2018-01-23

Heavy menstrual bleeding (HMB) is common and debilitating, and often requires surgery due to hormonal side effects from medical therapies. Here we show that transient, physiological hypoxia occurs in the menstrual endometrium to stabilise hypoxia inducible factor 1 (HIF-1) and drive repair of the denuded surface. We report that women with HMB have decreased endometrial HIF-1α during menstruation and prolonged menstrual bleeding. In a mouse model of simulated menses, physiological endometrial hypoxia occurs during bleeding. Maintenance of mice under hyperoxia during menses decreases HIF-1α induction and delays endometrial repair. The same effects are observed upon genetic or pharmacological reduction of endometrial HIF-1α. Conversely, artificial induction of hypoxia by pharmacological stabilisation of HIF-1α rescues the delayed endometrial repair in hypoxia-deficient mice. These data reveal a role for HIF-1 in the endometrium and suggest its pharmacological stabilisation during menses offers an effective, non-hormonal treatment for women with HMB.

Side Effects of Leukotriene Receptor Antagonists in Asthmatic Children.

PubMed

Erdem, Semiha Bahceci; Nacaroglu, Hikmet Tekin; Unsal Karkiner, Canan Sule; Gunay, Ilker; Can, Demet

2015-10-01

Leukotriene receptor antagonists (LTRAs) are drugs which have been widely used more than ten years. As the use of LTRAs increases, our knowledge with respect to their side effects increases as well. The objective of our study was to evaluat the observed side effects of LTRAs used in patients with astma. 1024 patients treated only with LTRAs owing to asthma or early wheezing were included in the study for a five-year period. The observed side effects of LTRAs in these patients were retrospectively investigated. The side effects were divided into two parts as psychiatric and non-psychiatric. Among the 1024 cases included in the study, 67.5% of the patients out of 41 with side effects were male, 32.5% were female and the average age was 6.5 years. The rate of patients with asthma was 63.41% and 36.58% of the patients had early wheezing. It was determined that sex, age and diagnosis (early wheezing or asthma) of the patients were ineffective in the emergence of side effects. The average period for the emergence of side effects was the first month. It was observed that hyperactivity was the most frequently observed psychiatric side effect and that abdominal pain was the non-psychiatric side effect. The side effects of LTRAs were common in children. Therefore, patients must be informed at the beginning of the treatment and they must be evaluated at certain intervals.

Asymmetry in Object Substitution Masking Occurs Relative to the Direction of Spatial Attention Shift

ERIC Educational Resources Information Center

Hirose, Nobuyuki; Osaka, Naoyuki

2010-01-01

A sparse mask that persists beyond the duration of a target can reduce its visibility, a phenomenon called "object substitution masking". Y. Jiang and M. M. Chun (2001a) found an asymmetric pattern of substitution masking such that a mask on the peripheral side of the target caused stronger substitution masking than on the central side.…

Chapter 1. Westslope cutthroat trout

Treesearch

John D. McIntyre; Bruce E. Rieman

1995-01-01

The westslope cutthroat trout inhabits streams on both sides of the Continental Divide. On the east side of the divide, they are distributed mostly in Montana but also occur in some headwaters in Wyoming and southern Alberta (Behnke 1992). They are in the Missouri Basin downstream to about 60 km below Great Falls and in the headwaters of the Judith, Milk, and Marias...

Central ossifying fibroma, periapical cemento-osseous dysplasia and complex odon-toma occurring in the same jaw

PubMed Central

Hosseini, Farzaneh Agha; Moslemi, Elham

2011-01-01

Central ossifying fibroma is a rare, benign fibro-osseous lesion that arises from the periodontal ligament. Periapical cemento-osseous dysplasia is another variant of fibro-osseous lesion which occurs in the anterior region of the mandible of females. Odontoma is a benign odontogenic tumor that contains enamel, dentine cement and pulp tissue. A 46-year-old woman was referred to the Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, with two non-painful swellings on both sides of the mandible, which had been slowly growing over a period of one year. Our differential diagnosis was florid cemento-osseous dysplasia, focal cemento-osseous dysplasia for the right side, complex odontoma for the left side and periapical cement-osseous dysplasia for the anterior side. The historical feature revealed ossifying fibroma, complex odontoma and periapical cemento-osseous dysplasia. The occurrence of these three lesions in the same jaw has been rarely reported in the literature. The relationship between the occurrence of these three lesions is not obvious it could be coincidental. It seems that more case reports are needed to establish the relationship between them. PMID:24765298

Central ossifying fibroma, periapical cemento-osseous dysplasia and complex odon-toma occurring in the same jaw.

PubMed

Hosseini, Farzaneh Agha; Moslemi, Elham

2011-05-16

Central ossifying fibroma is a rare, benign fibro-osseous lesion that arises from the periodontal ligament. Periapical cemento-osseous dysplasia is another variant of fibro-osseous lesion which occurs in the anterior region of the mandible of females. Odontoma is a benign odontogenic tumor that contains enamel, dentine cement and pulp tissue. A 46-year-old woman was referred to the Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, with two non-painful swellings on both sides of the mandible, which had been slowly growing over a period of one year. Our differential diagnosis was florid cemento-osseous dysplasia, focal cemento-osseous dysplasia for the right side, complex odontoma for the left side and periapical cement-osseous dysplasia for the anterior side. The historical feature revealed ossifying fibroma, complex odontoma and periapical cemento-osseous dysplasia. The occurrence of these three lesions in the same jaw has been rarely reported in the literature. The relationship between the occurrence of these three lesions is not obvious it could be coincidental. It seems that more case reports are needed to establish the relationship between them.

Juvenile catamenial pneumothorax: institutional report and review.

PubMed

Inoue, Takashi; Chida, Masayuki; Inaba, Hirohisa; Tamura, Motohiko; Kobayashi, Satoru; Sado, Tetsu

2015-06-13

Catamenial pneumothorax (CP) is a type of spontaneous pneumothorax due to thoracic endometriosis occurring in reproductive women, and usually involves the right side of the thorax showing diaphragm lesions. For the present study, we defined juvenile CP (JCP) as patients with CP who were 19 years old and younger. Institutional findings and a systematic literature review are presented. We retrospectively enrolled all patients with CP treated at our institutions from January 2002 to June 2013. In addition, we conducted a search of medical literature published using the PubMed and Japanese Ichushi databases with "catamenial pneumothorax" as the search term. Thirteen female patients with CP, 1 on the left side, were treated at our institutions. The patient with left-side CP was classified as JCP, while that was also identified in 29 of 451 CPs reported in our literature review. Pneumothorax occurred more frequently on the left side in JCP as compared to usual CP (p<0.01). There was a significantly lower ratio of JCP cases with diaphragm lesions as compared to usual CP (p<0.01). Significant laterality was not seen in JCP patients and fewer had diaphragm lesions as compared to usual CP. JCP may be a new entity of CP.

Effects of microrolling parameters on the microstructure and deformation behavior of pure copper

NASA Astrophysics Data System (ADS)

Jing, Yi; Zhang, Hong-mei; Wu, Hao; Li, Lian-jie; Jia, Hong-bin; Jiang, Zheng-yi

2018-01-01

Microrolling experiments and uniaxial tensile tests of pure copper under different annealing conditions were carried out in this paper. The effects of grain size and reduction on non-uniform deformation, edge cracking, and microstructure were studied. The experimental results showed that the side deformation became more non-uniform, resulting in substantial edge bulge, and the uneven spread increased with increasing grain size and reduction level. When the reduction level reached 80% and the grain size was 65 μm, slight edge cracks occurred. When the grain size was 200 μm, the edge cracks became wider and deeper. No edge cracks occurred when the grain size was 200 μm and the reduction level was less than 60%; edge cracks occurred when the reduction level was increased to 80%. As the reduction level increased, the grains were gradually elongated and appeared as a sheet-like structure along the rolling direction; a fine lamellar structure was obtained when the grain size was 20 μm and the reduction level was less than 60%.

A Comparison of Sexual Side Effects of Antidepressants With and Without Naltrexone.

PubMed

Thapa, Mona; Petrakis, Ismene; Ralevski, Elizabeth

2017-01-01

The aim of the study was to compare the rate of sexual side effects of the selective serotonin reuptake inhibitor paroxetine versus the tricyclic antidepressant desipramine and to examine the effect of co-prescription of naltrexone on sexual side effects among participants in a randomized clinical trial. This was a secondary analysis (N = 88) of veterans who participated in a 12-week trial. All veterans were randomized into one of four treatment groups: (a) desipramine/naltrexone, (b) desipramine/placebo, (c) paroxetine/naltrexone, and (d) paroxetine/placebo. The main outcome measure was the frequency of sexual side effects consisting of "decreased sex drive" and/or "impotence" reported by veterans at each weekly visit. Approximately 61% of the veterans reported sexual side effects at least once during the trial, and 26.4% reported sexual side effects throughout the study. There were no significant differences in the frequency of sexual side effects among the four treatment groups. The results were similar when the comparison was made between the two antidepressant groups. There were no significant differences in the reporting of sexual side effects between those receiving desipramine and paroxetine. Also, the comparison between naltrexone and placebo did not alter the results. This is the first study to compare frequency of sexual side effect reporting between paroxetine and desipramine. We found no statistically significant differences in sexual side effect reporting between the two antidepressants. Also, the addition of naltrexone did not show any beneficial effect on the sexual side effect profile.

Morel-Lavallée Lesions of the Knee: MRI Findings Compared With Cadaveric Study Findings.

PubMed

Vassalou, Evangelia E; Zibis, Aristeidis H; Raoulis, Vasileios A; Tsifountoudis, Ioannis P; Karantanas, Apostolos H

2018-05-01

The purpose of this study is to describe the MRI findings and treatment decisions and outcome for Morel-Lavallée lesions (MLLs) of the knee and to investigate whether evidence exists to support an increased frequency of such lesions on the medial or lateral side by performing a cadaveric experiment. In a 4-year period, 24 MRI studies of 24 consecutive patients (16 male patients and eight female patients) with knee MLLs were retrospectively reviewed. Patient demographic characteristics, treatment decisions and outcome, and associated injuries were recorded. The location of the MLL was categorized as medial, lateral, or global. Lesions were categorized according to an established MRI classification. During the cadaveric experiment, the compartmental pressures of the medial or lateral aspect of the knee were monitored in 20 cadaveric knees. The chi-square test, t test, and Pearson correlation were used for statistical analysis. MLLs were located medially in 16 patients, laterally in two patients, and globally in six patients. The medial location was significantly more common than a lateral or global location (p < 0.05). MLLs were classified as type I in 14 patients, type II in eight patients, and type III in two patients. MRI type was correlated with the chronicity of injury (r 2 = 0.614; p = 0.0014). Fractures were the most common associated injuries, occurring in seven of 24 patients. In 17 patients, all of whom had conservatively treated type I or type II lesions, complete resolution of the MLL occurred. The maximum compartmental pressures were significantly higher on the lateral side than on the medial side (p < 0.0001). Knee MLLs have a predilection for the medial side, which may be attributed to the lower resistance in this location, and they have variable patterns on MRI, which correlate with chronicity. Conservative treatment of type I and II lesions seems effective.

How does the side-effect information in patient information leaflets influence peoples' side-effect expectations? A cross-sectional national survey of 18- to 65-year-olds in England.

PubMed

Webster, Rebecca K; Weinman, John; Rubin, G James

2017-12-01

To establish how the terms recommended by the European Commission to describe side-effect risk in patient information leaflets (PILs) influences expectations of side-effects and to identify factors associated with these side-effect expectations. A cross-sectional online survey was carried out by a market research company. Data were collected in England between 18th March and 1st April 2016. A total of 1003 adults aged between 18 and 65. Self-reported expectation that the described side-effects would affect participants if they took the medicine, measured on a likelihood scale from 1 (very unlikely) to 5 (very likely). Participants formed high expectations of side-effects for "very common" and "common" side-effects, with 51.9% and 45.0% of participants rating these as "very likely" or "likely" to happen to them, respectively. This fell to 8.1% for "uncommon," 5.8% for "rare" and 4.1% for "very rare." For each descriptor, higher expectations of side-effects were more associated with women or being from an ethnic minority, or having less education, a household illness, high perceived sensitivity to medicines or negative beliefs about medicines. The current use of verbal descriptors to communicate side-effect risk in PILs leads to high side-effect expectations. These expectations could contribute to nocebo-induced medication side-effects experienced by patients. Additional work is required to identify ways to improve the way risk information is conveyed in PILs. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Tacrolimus treatment of atopic eczema/dermatitis syndrome.

PubMed

Thestrup-Pedersen, Kristian

2003-10-01

Atopic dermatitis is today the most common chronic disease of children in Europe, the US and Japan. The 'golden standard' of therapy is topical glucocorticosteroids and emollients. The steroids have been on the market for four decades, are efficacious, but only advised for short-term treatment due to their risks of side effects. More than 16,000 persons suffering from atopic dermatitis have been enrolled in clinical studies of tacrolimus. One third of patients with moderate to severe atopic dermatitis experience over 90% improvement in their disease over a 12-week treatment period and up to 70% of patients have over 50% improvement. A 1-year treatment leads to more than 90% improvement in 75% of patients. The most pronounced side effect is a burning sensation occurring in up to 60% of patients. Atopic dermatitis is a chronic skin disease leading to a demand for long-term treatment control. Such treatment options have not previously been available--except for emollients which are not efficacious for controlling skin inflammation. Tacrolimus and pimecrolimus are new treatment options, free from the potential side effects of topical steroids, which are known for their efficacy in short-term treatment. The new treatment modalities prevent the eczema from relapsing and at the same time they control active eczema. The future will see a shift towards the long-term use of tacrolimus which is able to control the skin inflammation and, hopefully, shorten the course of the eczema.

[Unwanted Side Effects in Children and Youth Psychotherapy - Introduction and Recommendations].

PubMed

Bieda, Angela; Pflug, Verena; Scholten, Saskia; Lippert, Michael Wilhelm; Ladwig, Inga; Nestoriuc, Yvonne; Schneider, Silvia

2018-05-30

Psychotherapy in children and adolescents is effective, but unwanted effects can occur. Until now, psychotherapy research has neglected this important topic, although children and youths are in need of special protection. Unwanted effects caused by therapy are not systematically investigated and a corresponding conceptualization is missing. The aim of this article is to investigate whether the current classifications of unwanted effects of psychotherapy in adults are applicable to children and adolescents and to identify distinctive features. Furthermore, the adaptation of the Inventory for the Assessment of Negative Effects of Psychotherapy for children and adolescents (Children-INEP) is presented. Finally, steps for the information and prevention of unwanted, and negative effects of psychotherapy in children and adolescents are pointed out. © Georg Thieme Verlag KG Stuttgart · New York.

Effects of dendritic cell-activated and cytokine-induced killer cell therapy on 22 children with acute myeloid leukemia after chemotherapy.

PubMed

Bai, Yan; Zheng, Jin-e; Wang, Nan; Cai, He-hua; Zhai, Li-na; Wu, Yao-hui; Wang, Fang; Jin, Run-ming; Zhou, Dong-feng

2015-10-01

The efficiency of dendritic cell-activated and cytokine-induced killer cell (DC-CIK) therapy on children with acute myeloid leukemia (AML) after chemotherapy was investigated. Mononuclear cells were collected from children achieving complete remission after chemotherapy, cultured in vitro and transfused back into the same patient. Interleukin-2 (IL-2) was injected subcutaneously every other day 10 times at the dose of 1 × 10(6) units. Peripheral blood lymphocyte subsets and minimal residual disease (MRD) were detected by flow cytometry. Function of bone marrow was monitored by methods of morphology, immunology, cytogenetics and molecular biology. The side effects were also observed during the treatment. The average follow-up period for all the 22 patients was 71 months and relapse occurred in two AML patients (9.1%). The percentage of CD3(+)/CD8(+) cells in peripheral blood of 15 patients at the 3rd month after DC-CIK treatment (36.73% ± 12.51%) was dramatically higher than that before treatment (29.20% ± 8.34%, P < 0.05). The MRD rate was >0.1% in 5 patients before the treatment, and became lower than 0.1% 3 months after the treatment. During the transfusion of DC-CIK, side effects including fever, chills and hives appeared in 7 out of 22 (31.82%) cases but disappeared quickly after symptomatic treatments. There were no changes in electrocardiography and liver-renal functions after the treatment. MRD in children with AML can be eliminated by DC-CIK therapy which is safe and has fewer side effects.

The ten-year single-center experience with 6-mercaptopurine in the treatment of inflammatory bowel disease.

PubMed

Glazier, Kenneth D; Palance, Adam L; Griffel, Louis H; Das, Kiron M

2005-01-01

To report the 10-year experience of a single center in treating patients with refractory inflammatory bowel disease (IBD) with relatively lower dose of 6-mercaptopurine (6-MP). The charts of 285 patients with IBD (Crohn's disease 160 and ulcerative colitis 125) receiving 6-MP were reviewed. Clinical response, subsequent breakthrough while taking 6-MP, and relapse rates when 6-MP was discontinued and side effects were assessed. Ninety-three percent of the patients were taking 50 to 75 mg/day of 6-MP. Complete remission was achieved in 62%, partial remission in 14.5%, and failure to achieve remission in 23.5% of the patients. Of complete responders, 27.5% had breakthrough while continuing 6-MP. Nine percent of those that achieved a complete remission experienced a relapse after 6-MP was discontinued. Side effects included leukopenia (11.2%), abnormal liver function tests (3.8%), various infections, including pneumonia (3.1%), pancreatitis (2.5%), nausea (2.1%), headache (2.8%), fever (1.4%), hair loss (1%), and rash (0.7%). Two cancers occurred while taking 6-MP: melanoma on the finger and a fatal colonic lymphoma. Four patients continued 6-MP throughout pregnancies and had normal outcomes. In our experience 6-MP is relatively safe and appears to be as effective at a lower dosage (0.84 mg/kg per day) compared with the recommended higher dosage (1-1.5 mg/kg per day), when leukopenia was more frequent. Serious side effects, although rare, need to be monitored.

Side-Effects of Glyphosate to the Parasitoid Telenomus remus Nixon (Hymenoptera: Platygastridae).

PubMed

Stecca, C S; Bueno, A F; Pasini, A; Silva, D M; Andrade, K; Filho, D M Z

2016-04-01

The aim of this study was to compare the side-effects of glyphosate to the parasitoid Telenomus remus Nixon (Hymenoptera: Platygastridae) when parasitoids were exposed to this chemical at the pupal (inside host eggs) and adult stages. Bioassays were conducted under laboratory conditions according to the International Organization for Biological Control (IOBC) standard methods for testing side-effects of pesticides to egg parasitoids. Different glyphosate-based pesticides (Roundup Original®, Roundup Ready®, Roundup Transorb®, Roundup WG®, and Zapp Qi®) were tested at the same acid equivalent concentration. Treatments were classified following the IOBC toxicity categories as (1) harmless, (2) slightly harmful, (3) moderately harmful, and (4) harmful. When tested against T. remus adults, Roundup Original®, Roundup Ready®, Roundup Transorb®, and Roundup WG® reduced parasitism 2 days after parasitoid emergence, being classified as slightly harmful. Differently, when tested against T. remus pupae, all tested glyphosate-based products did not differ in their lethal effect and therefore did not reduce T. remus adult emergence or parasitism capacity, being classified as harmless. However, differences on sublethal toxicity were found. Parasitism of individuals emerging from parasitized eggs sprayed at the pupal stage of T. remus with Zapp Qi® was lower compared to control, but parasitism was still higher than 66%, and therefore, Zapp Qi® was still classified as harmless. In conclusion, all tested glyphosate-based products can be used in agriculture without negative impact to T. remus as none was classified as harmful or moderately harmful to this parasitoid when exposure occurred at the pupal or adult stages.

Early pregnancy termination with intravaginally administered sodium chloride solution-moistened misoprostol tablets: historical comparison with mifepristone and oral misoprostol.

PubMed

Jain, J K; Meckstroth, K R; Mishell, D R

1999-12-01

The purpose of this study was to compare the abortifacient effect of intravaginally administered moistened misoprostol tablets with that of the combination regimen of mifepristone and oral misoprostol. One hundred women at

Treatment of good-prognosis polyarteritis nodosa and Churg-Strauss syndrome: comparison of steroids and oral or pulse cyclophosphamide in 25 patients. French Cooperative Study Group for Vasculitides.

PubMed

Gayraud, M; Guillevin, L; Cohen, P; Lhote, F; Cacoub, P; Deblois, P; Godeau, B; Ruel, M; Vidal, E; Piontud, M; Ducroix, J P; Lassoued, S; Christoforov, B; Babinet, P

1997-12-01

Twenty-five patients with good-prognosis polyarteritis nodosa or Churg-Strauss syndrome entered a prospective, randomized, multicentre study comparing two treatments: either oral corticosteroids and oral cyclophosphamide (CY; 2 mg/kg/day) for 1 yr (group A), or oral corticosteroids and monthly i.v. CY pulses (0.6 g/m2) (group B) for 1 yr. The objective was to determine the optimal CY regimen. Judgement criteria were the efficacy of the treatment in controlling the disease and the development of side-effects. Among the 25 patients who could be analysed, complete recovery was achieved with the experimental treatment in 9/12 patients in group A and 10/13 patients in group B. Two patients in each group relapsed after the end of therapy and were well controlled by corticosteroids or other drugs. One failure occurred in each group. The mean follow-up was 60.8 +/- 14.5 months after the beginning of the treatment. Side-effects associated with the administration of CY and steroids were noted 27 times in group A vs 14 times in group B (not significant). The oldest patient in these series (group B) died of pneumonia. No superiority in terms of efficacy could be established between the two regimens; however, the number of patients included was too small to conclude definitively. Toxic side-effects were significantly more frequent in women (P < 0.02). The high number of adverse effects leads us to recommend pulse over oral CY and an overall lowering of the doses of immunosuppression.

Side Effects to Antidepressant Treatment in Patients With Depression and Comorbid Panic Disorder.

PubMed

Shankman, Stewart A; Gorka, Stephanie M; Katz, Andrea C; Klein, Daniel N; Markowitz, John C; Arnow, Bruce A; Manber, Rachel; Rothbaum, Barbara O; Thase, Michael E; Schatzberg, Alan F; Keller, Martin B; Trivedi, Madhukar H; Kocsis, James H

2017-04-01

Side effects to antidepressant medication can affect the efficacy of treatment, but few predictors foretell who experiences side effects and which side effects they experience. This secondary data analysis examined whether depressed patients with comorbid panic disorder were more likely to experience side effects than those without panic disorder. The study also examined whether greater burden of side effects predicted a poorer treatment course for patients with panic disorder than those without panic disorder. To examine the specificity of these effects, analyses also examined 2 other anxiety disorders-social phobia and generalized anxiety disorder (GAD). Between 2002 and 2006, a large sample (N = 808) of chronically depressed individuals (assessed using the Structured Clinical Interview for DSM-IV-TR Axis I Disorders [SCID-IV]) received antidepressants according to a predetermined algorithm for 12 weeks. Every 2 weeks, depressive symptoms (per the Hamilton Depression Rating Scale) and side effects (specific side effects as well as several indicators of side effect burden) were assessed. Lifetime diagnosis of panic disorder (assessed using the SCID-IV) at baseline was associated with higher likelihood of gastrointestinal (OR = 1.6 [95% CI, 1.0-2.6]), cardiac (OR = 1.8 [95% CI, 1.1-3.1]), neurologic (OR = 2.6 [95% CI, 1.6-4.2]), and genitourinary side effects (OR = 3.0 [95% CI, 1.7-5.3]) during treatment. Increases in side effect frequency, intensity, and impairment over time were more strongly associated with increases in depressive symptoms for patients with panic disorder compared to those without panic disorder. Neither social phobia nor GAD was associated with these effects. Potentially due to heighte​ned interoceptive awareness of changes in their body, chronically depressed individuals with panic disorder may be at greater risk than those without panic disorder for antidepressant side effects and to experience a worsening of depressive symptoms as a result of these side effects over time. ClinicalTrials.gov identifier: NCT00057551​. © Copyright 2017 Physicians Postgraduate Press, Inc.

Medications and Side Effects

MedlinePlus

... to fully work. You might feel some side effects of your medication before your feel the benefits – ... as sleepiness, anxiety or headache) is a side effect or a symptom of your illness. Many side ...

Cancer Treatment for Women: Possible Sexual Side Effects

MedlinePlus

... the clitoris. These play a major part in sexual arousal in women. Removing the vulva and the clitoris ... www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-women-with-cancer.html. ...

"There is a chain of connections": using syndemics theory to understand HIV treatment side effects.

PubMed

Gagnon, Marilou

2018-03-12

Side effects are central to the experience of living longer with HIV but rarely have they been studied alone. Unlike other aspects of that experience, like quality of life, treatment adherence, chronicity, episodic disability, aging, health, and viral load suppression, side effects have not benefited from the same level of empirical and theoretical engagement from qualitative researchers. In this paper, we draw on syndemics theory and 50 qualitative interviews to better understand the experience of HIV treatment side effects. Two main categories were identified in the data: side effects as a product and side effects as a risk factor. The first category suggests that side effects are not just the product of taking antiretroviral drugs. They are also the product of particular conditions and tend to cluster with other health problems. The second category puts forward the idea that side effects can act as a syndemic risk factor by exposing PLWH to a greater risk of developing health problems and creating conditions in which psychosocial issues are more likely to emerge. The paper concludes by calling for more research on the complex nature of side effects and for the development of comprehensive approaches for the assessment and management of side effects.

Inundation of a barrier island (Chandeleur Islands, Louisiana, USA) during a hurricane: Observed water-level gradients and modeled seaward sand transport

NASA Astrophysics Data System (ADS)

Sherwood, Christopher R.; Long, Joseph W.; Dickhudt, Patrick J.; Dalyander, P. Soupy; Thompson, David M.; Plant, Nathaniel G.

2014-07-01

Large geomorphic changes to barrier islands may occur during inundation, when storm surge exceeds island elevation. Inundation occurs episodically and under energetic conditions that make quantitative observations difficult. We measured water levels on both sides of a barrier island in the northern Chandeleur Islands during inundation by Hurricane Isaac. Wind patterns caused the water levels to slope from the bay side to the ocean side for much of the storm. Modeled geomorphic changes during the storm were very sensitive to the cross-island slopes imposed by water-level boundary conditions. Simulations with equal or landward sloping water levels produced the characteristic barrier island storm response of overwash deposits or displaced berms with smoother final topography. Simulations using the observed seaward sloping water levels produced cross-barrier channels and deposits of sand on the ocean side, consistent with poststorm observations. This sensitivity indicates that accurate water-level boundary conditions must be applied on both sides of a barrier to correctly represent the geomorphic response to inundation events. More broadly, the consequence of seaward transport is that it alters the relationship between storm intensity and volume of landward transport. Sand transported to the ocean side may move downdrift, or aid poststorm recovery by moving onto the beach face or closing recent breaches, but it does not contribute to island transgression or appear as an overwash deposit in the back-barrier stratigraphic record. The high vulnerability of the Chandeleur Islands allowed us to observe processes that are infrequent but may be important at other barrier islands.

Microbial biodegradation of aromatic alkanoic naphthenic acids is affected by the degree of alkyl side chain branching

PubMed Central

Johnson, Richard J; Smith, Ben E; Sutton, Paul A; McGenity, Terry J; Rowland, Steven J; Whitby, Corinne

2011-01-01

Naphthenic acids (NAs) occur naturally in oil sands and enter the environment through natural and anthropogenic processes. NAs comprise toxic carboxylic acids that are difficult to degrade. Information on NA biodegradation mechanisms is limited, and there are no studies on alkyl branched aromatic alkanoic acid biodegradation, despite their contribution to NA toxicity and recalcitrance. Increased alkyl side chain branching has been proposed to explain NA recalcitrance. Using soil enrichments, we examined the biodegradation of four aromatic alkanoic acid isomers that differed in alkyl side chain branching: (4′-n-butylphenyl)-4-butanoic acid (n-BPBA, least branched); (4′-iso-butylphenyl)-4-butanoic acid (iso-BPBA); (4′-sec-butylphenyl)-4-butanoic acid (sec-BPBA) and (4′-tert-butylphenyl)-4-butanoic acid (tert-BPBA, most branched). n-BPBA was completely metabolized within 49 days. Mass spectral analysis confirmed that the more branched isomers iso-, sec- and tert-BPBA were transformed to their butylphenylethanoic acid (BPEA) counterparts at 14 days. The BPEA metabolites were generally less toxic than BPBAs as determined by Microtox assay. n-BPEA was further transformed to a diacid, showing that carboxylation of the alkyl side chain occurred. In each case, biodegradation of the carboxyl side chain proceeded through beta-oxidation, which depended on the degree of alkyl side chain branching, and a BPBA degradation pathway is proposed. Comparison of 16S rRNA gene sequences at days 0 and 49 showed an increase and high abundance at day 49 of Pseudomonas (sec-BPBA), Burkholderia (n-, iso-, tert-BPBA) and Sphingomonas (n-, sec-BPBA). PMID:20962873

Side effect burden of antipsychotic drugs in real life - Impact of gender and polypharmacy.

PubMed

Iversen, Trude Seselie Jahr; Steen, Nils Eiel; Dieset, Ingrid; Hope, Sigrun; Mørch, Ragni; Gardsjord, Erlend Strand; Jørgensen, Kjetil Nordbø; Melle, Ingrid; Andreassen, Ole A; Molden, Espen; Jönsson, Erik G

2018-03-02

Antipsychotic-associated side effects are well known and represent a significant treatment challenge. Still, few large studies have investigated the overall side effect burden of antipsychotics in real-life settings. To describe the occurrence of side effects and perceived burden of antipsychotics in a large naturalistic sample, taking polypharmacy and patient characteristics into account. Patients (n=1087) with psychotic disorders were assessed for side effects using the Udvalg for Kliniske Undersøgelser (UKU) side effect rating scale in addition to assessment of clinical and pharmacological data. Statistical analyses were performed controlling for possible confounding factors. Use of antipsychotics showed significant associations to neurologic and sexual symptoms, sedation and weight gain, and >75% of antipsychotics-users reported side effects. More side effects were observed in patients using several antipsychotics (p=0.002), with increasing total dose (p=0.021) and with antipsychotics in combinations with other psychotropic drugs. Patients and investigators evaluated the side effect burden differently, particularly related to severity, gender and antipsychotics dose. Twice as many females described side effect burden as severe (p=0.004). Patients with psychotic disorders have a high occurrence of symptoms associated with use of antipsychotics, and polypharmacy and female gender are seemingly risk factors for reporting a severe side effect burden. Due to the cross-sectional design evaluation of causality is tentative, and these findings should be further investigated in prospective studies. Copyright © 2017 Elsevier Inc. All rights reserved.

The Glasgow antipsychotic side-effects scale for clozapine in inpatients and outpatients with schizophrenia or schizoaffective disorder.

PubMed

Ignjatović Ristić, Dragana; Cohen, Dan; Obradović, Andrea; Nikić-Đuričić, Katarina; Drašković, Marija; Hinić, Darko

2018-02-01

The inconsistency in clinician and patient ratings of clozapine-induced side effects underscore the need to supplement clinician-based estimates of side effects with patient-reported ones. The main aims of the study are validation of the Glasgow antipsychotic side-effects scale for clozapine (GASS-C) in Serbian inpatients/outpatients with schizophrenia or schizo-affective disorder and recommendations for its future use, based on common and rare clozapine-associated side-effects. The GASS-C was administered to 95 outpatients/inpatients diagnosed with schizophrenia, schizoaffective, or chronic psychotic disorder. The scale showed good overall reliability, with an internal consistency coefficient of α = 0.84, an average retest coefficient of rho = 0.76, and a Spearman-Brown coefficient of validity of 0.81. Side effects were absent or mild in 64.2% of the patients, moderate in 31.6%, severe in 4.2%; 14% of the subjects considered their symptoms distressing. The most commonly reported side-effects were drowsiness, thirst, frequent urination, and dry mouth. Women reported more side effects than men, and patients not in a relationship reported significantly fewer side effects than patients in a relationship. Results indicate a weak positive correlation (rho = 0.231; p = .025) between severity of side effects and clozapine dose. The GASS-C showed good psychometric characteristics in clinical population of patients on clozapine. In future studies, clozapine serum concentrations should be measured when using the GASS-C to monitor side effects.

Learning to experience side effects after antidepressant intake - Results from a randomized, controlled, double-blind study.

PubMed

Rheker, Julia; Winkler, Alexander; Doering, Bettina K; Rief, Winfried

2017-02-01

Side effects play a key role in patients' failure to take antidepressants. There is evidence that verbal suggestions and informed consent elicit expectations that can in turn trigger the occurrence of side effects. Prior experience or learning mechanisms are also assumed to contribute to the development of side effects, although their role has not been thoroughly investigated. In this study, we examined whether an antidepressant's side effects can be learned via Pavlovian conditioning. Participants (n = 39) were randomly allocated to one of two groups and were exposed to a classical conditioning procedure. During acquisition, 19 participants received amitriptyline and 20 participants received a placebo pill. Pills were taken for four nights together with a novel-tasting drink. After a washout phase, both groups received a placebo pill together with the novel-tasting drink (evocation). Side effects were assessed via the Generic Assessment of Side Effects Scale prior to acquisition (baseline), after acquisition, and after evocation. A score of antidepressant-specific side effects was calculated. Participants taking amitriptyline reported significantly more antidepressant-specific side effects after acquisition compared to both baseline and the placebo group. After evocation, participants who underwent the conditioning procedure with amitriptyline reported significantly more antidepressant-specific side effects than those who never received amitriptyline, even though both groups received a placebo. Our results indicate that antidepressant side effects can be learned using a conditioning paradigm and evoked via a placebo pill when applied with the same contextual factors as the verum.

Tricuspid Regurgitation Associated With Ischemic Mitral Regurgitation: Characterization, Evolution After Mitral Surgery, and Value of Tricuspid Repair.

PubMed

Navia, José L; Elgharably, Haytham; Javadikasgari, Hoda; Ibrahim, Ahmed; Koprivanac, Marijan; Lowry, Ashley M; Blackstone, Eugene H; Klein, Allan L; Gillinov, A Marc; Roselli, Eric E; Svensson, Lars G

2017-08-01

Tricuspid regurgitation (TR) often accompanies ischemic mitral regurgitation and is generally assumed to be a secondary consequence of altered hemodynamics of the left-sided regurgitation. We hypothesized that it may also be a direct consequence of right-sided ischemic disease. Therefore, our objectives were to (1) characterize the nature of this TR and (2) describe its time course after mitral valve surgery for ischemic mitral regurgitation, with or without concomitant tricuspid valve repair. From 2001 to 2011, 568 patients with ischemic mitral regurgitation underwent mitral valve surgery. They had varying degrees of TR and altered right-side heart morphology and function; 131 had concomitant tricuspid valve repair. Postoperatively, 1,395 echocardiograms were available to assess residual and recurrent TR. Greater severity of preoperative TR was accompanied by larger tricuspid valve diameter, greater leaflet tethering, worse right ventricular function, and higher right ventricular pressure (all p [trend] ≤ 0.002). Without tricuspid valve repair, 31% of patients with no preoperative TR had moderate or greater TR by 5 years, as did 62% with moderate TR. With tricuspid valve repair, 25% with moderate preoperative TR remained in that grade at 5 years, but 11% had severe TR. Tricuspid regurgitation accompanying ischemic mitral regurgitation is associated with right-side heart remodeling and dysfunction often mirroring that occurring in the left side of the heart-ischemic TR. Tricuspid valve repair is effective initially, but as with mitral valve repair, TR progressively returns. Therefore, when the severity of TR and right-sided remodeling reaches the point of irreversibility, it may be an indication to eliminate the TR by replacing the tricuspid valve. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The association of HIV/AIDS treatment side effects with health status, work productivity, and resource use.

PubMed

daCosta DiBonaventura, Marco; Gupta, Shaloo; Cho, Michelle; Mrus, Joseph

2012-01-01

Due to stable incidence and improved survival rates, there are an increasing number of patients living with HIV/AIDS in the USA. Although highly effective, current antiretroviral therapies are associated with a variety of side effects. The role side effects play on health outcomes has not been fully examined. The current study assessed the association of medication side effects with (1) self-assessed health status; (2) work productivity and activity impairment; and (3) healthcare resource utilization. Data were from a cross-sectional patient-reported survey fielded in the USA using a dual methodology of Internet and paper questionnaires. A total of 953 patients living with HIV/AIDS who were currently taking a medication for their condition were included in the analyses. The most frequent side effects reported by patients were fatigue (70.72%), diarrhea (62.96%), insomnia (58.97%), dizziness (52.78%), neuropathy (52.68%), joint pain (52.36%), nausea (51.63%), and abdominal pain (50.37%). The presence of each side effect was associated with reduced self-assessed health status, increased productivity loss, increased activity impairment, and increased healthcare resource use. Controlling for CD4 cell counts in regression modeling did little to diminish the impact of side effects. Although not all side effects were associated with all outcomes, every side effect was associated with worse health status, some measure of increased work productivity loss, and/or some measure of increased healthcare resource use. Patients are living longer with HIV and, therefore, spending a greater length of time on treatment. The results of the current study suggest that many of these patients are experiencing a wide array of side effects from these therapies. These side effects have demonstrated a profound association with self-assessed health, work productivity, and healthcare resource use. Improved management of these side effects or development of treatments with a better side effect profile may have a substantial humanistic and economic benefit.

Prevention of retinal detachment in Stickler syndrome: the Cambridge prophylactic cryotherapy protocol.

PubMed

Fincham, Gregory S; Pasea, Laura; Carroll, Christopher; McNinch, Annie M; Poulson, Arabella V; Richards, Allan J; Scott, John D; Snead, Martin P

2014-08-01

The Stickler syndromes are the most common causes of inherited and childhood retinal detachment; however, no consensus exists regarding the effectiveness of prophylactic intervention. We evaluate the long-term safety and efficacy of the Cambridge prophylactic cryotherapy protocol, a standardized retinal prophylactic treatment developed to prevent retinal detachment arising from giant retinal tears in type 1 Stickler syndrome. Retrospective comparative case series. Four hundred eighty seven patients with type 1 Stickler syndrome. Time to retinal detachment was compared between patients who received bilateral prophylaxis and untreated controls, with and without individual patient matching. Patients receiving unilateral prophylaxis (after fellow eye retinal detachment) were similarly compared with an appropriate control subgroup. Individual patient matching ensured equal age and follow-up between groups and that an appropriate control (who had not suffered a retinal detachment before the age at which their individually matched treatment patient underwent prophylactic treatment) was selected. Matching was blinded to outcome events. Individual patient matching protocols purposely weighted bias against the effectiveness of treatment. All treatment side effects are reported. Time to retinal detachment and side effects occurring after prophylactic treatment. The bilateral control group (n = 194) had a 7.4-fold increased risk of retinal detachment compared to the bilateral prophylaxis group (n = 229) (hazard ratio [HR], 7.40; 95% confidence interval [CI], 4.53-12.08; P<0.001); the matched bilateral control group (n = 165) had a 5.0-fold increased risk compared to the matched bilateral prophylaxis group (n = 165) (HR, 4.97; 95% CI, 2.82-8.78; P<0.001). The unilateral control group (n = 104) had a 10.3-fold increased risk of retinal detachment compared to the unilateral prophylaxis group (n = 64) (HR, 10.29; 95% CI, 4.96-21.36; P<0.001); the matched unilateral control group (n = 39) had a 8.4-fold increased risk compared to the matched unilateral prophylaxis group (n = 39) (HR, 8.36; 95% CI, 3.24-21.57; P<0.001). No significant long-term side effects occurred. In the largest global cohort of type 1 Stickler syndrome patients published, all analyses indicate that the Cambridge prophylactic cryotherapy protocol is safe and markedly reduces the risk of retinal detachment. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Side Effects of Long-Term Continuous Intra-arterial Nimodipine Infusion in Patients with Severe Refractory Cerebral Vasospasm after Subarachnoid Hemorrhage.

PubMed

Kieninger, Martin; Flessa, Julia; Lindenberg, Nicole; Bele, Sylvia; Redel, Andreas; Schneiker, André; Schuierer, Gerhard; Wendl, Christina; Graf, Bernhard; Silbereisen, Vera

2018-02-01

Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects. All patients treated with CIAN therapy for at least 5 days between May 2011 and December 2015 were included. We retrospectively extracted data from the patient data management system regarding the period between 2 days before the beginning and 5 days after the termination of CIAN therapy to analyze the course of ventilation parameters and pulmonary gas exchange, hemodynamic support, renal and liver function, integrity of the gastrointestinal tract, and the occurrence of infectious complications. In addition, we recorded the mean daily values of intracranial pressure (ICP) and intracerebral problems associated with CIAN therapy. Data from 28 patients meeting inclusion criteria were analyzed. The mean duration of long-term CIAN therapy was 10.5 ± 4.5 days. Seventeen patients (60.7%) reached a good outcome level (Glasgow Outcome Scale [GOS] 4-5) 6 months after SAH. An impairment of the pulmonary gas exchange occurred only at the very beginning of CIAN therapy. The required vasopressor support with norepinephrine was significantly higher on all days during and the first day after CIAN therapy compared to the situation before starting CIAN therapy. Two patients required short-time resuscitation due to cardiac arrest during CIAN therapy. Acute kidney injury was observed in four patients, and one of them required renal replacement therapy with sustained low-efficiency daily dialysis. During CIAN therapy, 23 patients (82.1%) needed the escalation of a previous antiinfective therapy or the onset of antibiotics which was in line with a significant increase of C-reactive protein and white blood cell count. Obstipation was observed in 22 patients (78.6%). Ten patients (35.7%) even showed insufficient defecation on at least seven consecutive days. Compared to the situation before, ICP was significantly higher during the whole period of CIAN therapy. Long-term CIAN therapy is associated with diverse side effects. The leading problems are an impairment of the hemodynamic situation and cardiac problems, an increase in infectious complications, a worsening of the motility of the gastrointestinal tract, and rising ICP values. Teams on neurointensive care units must be aware of these side effects to avoid that the beneficial effects of CIAN therapy on CV reported elsewhere are foiled by the problems this technique can be associated with.

Decreasing the Burden of Side Effects Through Positive Message Framing: an Experimental Proof-of-Concept Study.

PubMed

Wilhelm, Marcel; Rief, Winfried; Doering, Bettina K

2018-05-21

Informing patients about treatment side effects increases the occurrence and intensity of side effects. Since the obligatory informed consent procedure in drug treatments requires transparency and nocebo research suggests that the informed consent of a drug leads to an increased occurrence of the mentioned side effects, the aim of this proof of concept study was to determine the effect of two different framings of informed consent on the occurrence, intensity, and perceived threat of side effects. Healthy male participants (n = 80) were randomized to one of two framing groups. The positive framing group was informed that the common side effect dizziness was a sign that the drug had started to work, while the neutral framing group was told that dizziness is an unpleasant but well-known side effect. Side effects were measured after the administration of metoprolol, an antihypertensive agent. Post hoc moderator analyses investigated the effect of pre-existing negative beliefs about the general harm of medication on the framing manipulation. Metoprolol-specific drug-attributed side effects were rated significantly less threatening in the positive framing group. The between-group effect size (Cohen's d) was small (d = 0.38, p = 0.049). Exploratory post hoc moderator analyses suggest that participants who believed that medication is a source of harmful effects benefited from positive framing, compared to neutral framing of drug-attributed side effects. Positive framing was partially effective in decreasing specific side effect measures, particularly among participants with a tendency to believe that medicine is harmful. Informed consent procedures should therefore be personalized, focusing on patients with negative treatment beliefs.

Alpha channeling with high-field launch of lower hybrid waves

DOE PAGES

Ochs, I. E.; Bertelli, N.; Fisch, N. J.

2015-11-04

Although lower hybrid waves are effective at driving currents in present-day tokamaks, they are expected to interact strongly with high-energy particles in extrapolating to reactors. In the presence of a radial alpha particle birth gradient, this interaction can take the form of wave amplification rather than damping. While it is known that this amplification more easily occurs when launching from the tokamak high-field side, the extent of this amplification has not been made quantitative. Here, by tracing rays launched from the high- field-side of a tokamak, the required radial gradients to achieve amplification are calculated for a temperature and densitymore » regime consistent with a hot-ion-mode fusion reactor. As a result, these simulations, while valid only in the linear regime of wave amplification, nonetheless illustrate the possibilities for wave amplification using high-field launch of the lower hybrid wave.« less

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

Mironov, Alexey Yu.; Silevitch, Daniel M.; Proslier, Thomas

Three decades after the prediction of charge-vortex duality in the critical vicinity of the two-dimensional superconductor-insulator transition (SIT), one of the fundamental implications of this duality-the charge Berezinskii-Kosterlitz-Thouless (BKT) transition that should occur on the insulating side of the SIT-has remained unobserved. The dual picture of the process points to the existence of a superinsulating state endowed with zero conductance at finite temperature. Here, we report the observation of the charge BKT transition on the insulating side of the SIT in 10 nm thick NbTiN films, identified by the BKT critical behavior of the temperature and magnetic field dependent resistance,more » and map out the magnetic-field dependence of the critical temperature of the charge BKT transition. Finally, we ascertain the effects of the finite electrostatic screening length and its divergence at the magnetic field-tuned approach to the superconductor-insulator transition.« less

Earthquakes at North Atlantic passive margins

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

Gregersen, S.; Basham, P.W.

1989-01-01

The main focus of this volume is the earthquakes that occur at and near the continental margins on both sides of the North Atlantic. The book, which contains the proceedings of the NATO workshop on Causes and Effects of Earthquakes at Passive Margins and in Areas of Postglacial Rebound on Both Sides of the North Atlantic, draws together the fields of geophysics, geology and geodesy to address the stress and strain in the Earth's crust. The resulting earthquakes produced on ancient geological fault zones and the associated seismic hazards these pose to man are also addressed. Postglacial rebound in Northmore » America and Fennoscandia is a minor source of earthquakes today, during the interglacial period, but evidence is presented to suggest that the ice sheets suppressed earthquake strain while they were in place, and released this strain as a pulse of significant earthquakes after the ice melted about 9000 years ago.« less

Combined use of alcohol and energy drinks: Dose relationship with self-reported physiological stimulation and sedation side effects.

PubMed

Droste, Nicolas; Peacock, Amy; Bruno, Raimondo; Pennay, Amy; Zinkiewicz, Lucy; Lubman, Dan I; Miller, Peter

2017-08-01

Negative physiological stimulation and sedation side effects are experienced by a significant proportion of consumers who consume alcohol mixed with energy drinks (AmED). Few studies have compared the frequency of side effects between sessions of AmED and sessions of alcohol only within-subject, and none have explored a dose relationship. Explore the occurrence of self-reported physiological stimulant and sedative side effects between sessions of AmED and alcohol only, and at varying ED dosage levels within AmED sessions. A convenience sample of 2953 residents of New South Wales, Australia completed an online survey. N=731 AmED users reported daily caffeine intake, typical alcohol and AmED consumption, and past 12-month experience of physiological stimulation and sedation side effects during AmED and alcohol only sessions. Within-subject analyses compared occurrence of side effects between session types. Hierarchical binary logistic regression analyses explored the association of ED dose during AmED sessions with the experience of physiological side effects. There were greater odds of most stimulant side effects, and lower odds of sedation side effects, during AmED sessions compared to alcohol only sessions. Compared to one ED, consumption of three or more EDs was significantly associated with the majority of both stimulant and alcohol intoxication side effects after controlling for demographics and consumption covariates. AmED is associated with perceived changes in physiological stimulant and sedation side effects of alcohol. Experience of side effects is positively associated with ED dosage. Future research should account for varying ED dosage, and reflect real world consumption levels. Copyright © 2017 Elsevier Ltd. All rights reserved.

Heme Oxygenase-1 Induction and Organic Nitrate Therapy: Beneficial Effects on Endothelial Dysfunction, Nitrate Tolerance, and Vascular Oxidative Stress

PubMed Central

Daiber, Andreas; Oelze, Matthias; Wenzel, Philip; Bollmann, Franziska; Pautz, Andrea; Kleinert, Hartmut

2012-01-01

Organic nitrates are a group of very effective anti-ischemic drugs. They are used for the treatment of patients with stable angina, acute myocardial infarction, and chronic congestive heart failure. A major therapeutic limitation inherent to organic nitrates is the development of tolerance, which occurs during chronic treatment with these agents, and this phenomenon is largely based on induction of oxidative stress with subsequent endothelial dysfunction. We therefore speculated that induction of heme oxygenase-1 (HO-1) could be an efficient strategy to overcome nitrate tolerance and the associated side effects. Indeed, we found that hemin cotreatment prevented the development of nitrate tolerance and vascular oxidative stress in response to chronic nitroglycerin therapy. Vice versa, pentaerithrityl tetranitrate (PETN), a nitrate that was previously reported to be devoid of adverse side effects, displayed tolerance and oxidative stress when the HO-1 pathway was blocked pharmacologically or genetically by using HO-1+/– mice. Recently, we identified activation of Nrf2 and HuR as a principle mechanism of HO-1 induction by PETN. With the present paper, we present and discuss our recent and previous findings on the role of HO-1 for the prevention of nitroglycerin-induced nitrate tolerance and for the beneficial effects of PETN therapy. PMID:22506100

Bimatoprost in the treatment of eyelash hypotrichosis

PubMed Central

Law, Simon K

2010-01-01

Eyelashes hypotrichosis is a condition indicated by an inadequate amount of eyelashes. Hypertrichosis of eyelashes, characterized by excessive eyelash growth, is a regular phenomenon associated with ophthalmic prostaglandin and prostamide analogs. Recently, the US Food and Drug Administration approved Latisse® (bimatoprost 0.03% solution), identical to the ophthalmic solution for glaucoma treatment, for increasing eyelash length, thickness and darkness in patients with hypotrichosis of the eyelashes. When prostaglandin and prostamide analogs interact with the prostanoid receptors in the hair follicle, this most likely stimulates the resting follicles (telogen phase) to growing follicles (anagen phase). Prostaglandin and prostamide analogs may also prolong the anagen phase of eyelashes, leading to an increase of eyelash length. Although bimatoprost is effective in promoting increased growth of healthy eyelashes and adnexal hairs, its effectiveness in patients with eyelash alopecia areata is debatable and its protective effect is not yet studied in patients with eyelash loss secondary to radiation or chemotherapy. Bimatoprost is generally safe when applied to the base of the eyelashes at the lid margin with minimum side effects. However, other ocular or systemic side effects associated with ophthalmic prostaglandin and prostamide analogs may occur when instilled on the surface of the eye, and patients must be informed and monitored. PMID:20463804

Long-term recovery of muscle strength after denervation in the fibular division of the sciatic nerve.

PubMed

Stefancic, Martin; Vidmar, Gaj; Blagus, Rok

2016-10-01

The probability and degree of muscle recovery after lesions of long peripheral nerves have not been assessed quantitatively. Twelve adults with closed injuries of the fibular division of the sciatic nerve with complete denervation of associated muscles were followed-up for 2-10 years. The onset of reinnervation was detected electromyographically. Calf circumference and maximum voluntary isometric contraction (MVIC) of foot dorsiflexion were measured on both sides during 2-4 visits. Reinnervation occurred in 11 patients after an average of 13 months. MVIC on the affected side was 2%-27% of that on the unaffected side (average 11%) and remained stable for the following 2-3 years. Correlations and mixed-model regressions confirmed that the degree of recovery was negatively associated with duration of denervation. Reinnervation occurs in about 90% of patients within about 1 year. About 10% of baseline dorsiflexion strength is permanently recovered, which is functionally relevant. Muscle Nerve, 2016 Muscle Nerve 54: -, 2016 Muscle Nerve 54: 702-708, 2016. © 2016 Wiley Periodicals, Inc.

Male contraception.

PubMed

Amory, John K

2016-11-01

Although female contraceptives are very effective at preventing unintended pregnancy, some women can not use them because of health conditions or side-effects, leaving some couples without effective contraceptive options. In addition, many men wish to take active responsibility for family planning. Thus, there is a great need for male contraceptives to prevent unintended pregnancies, of which 80-90 million occur annually. At present, effective male contraceptive options are condoms and vasectomy, which are not ideal for all men. Therefore, efforts are under way to develop novel male contraceptives. This paper briefly reviews the advantages and disadvantages of condoms and vasectomies and then discusses the research directed toward development of novel methods of male contraception. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Effects of the catastrophic flood of December 1966, north rim area, eastern Grand Canyon, Arizona

USGS Publications Warehouse

Cooley, Maurice E.; Aldridge, B.N.; Euler, Robert C.

1977-01-01

Precipitation from the unusual storm of December 1966 was concentrated on highlands in northern Arizona, southwestern Utah , southern Nevada, and south-central California and caused widely scattered major floods in the four States. In Arizona the largest amount of precipitation was in the north rim area of eastern Grand Canyon, where about 14 inches was measured. The largest flows occurred along Bright Angel Creek and the MilK Creek-Dragon Creek part of the Crystal Creek drainage basin. The maximum effects of the flood were along Milk Creek-Dragon Creek, where a mudflow caused extensive channel modification. Floods that occurred in the Bright Angel and Crystal Creek basins have a recurrence interval of only once in several centuries. The streamflow that resulted from the storm on the Kaibab Plateau caused considerable local scouring and deepening of channels, including some renewed arroyo cutting. The most catastrophic effects of the 1966 floods were caused by two mudflows that extended from the edge of the Kaibab Plateau along Dragon Creek in the Crystal Creek basin and Lava Creek in the Chuar Creek basin to the Colorado River. More than 10 other large mudflows occurred in Nankoweap, Kwagunt, Crystal, and Shinumo Creek basins. About 80 large debris slides left conspicuous scars in the amphitheaters at the heads of the side gorges, and at least 10 small slides occurred on the Kaibab Plateau. (Woodard-USGS)

Treatment factors affecting longitudinal quality of life in new onset pediatric epilepsy.

PubMed

Modi, Avani C; Ingerski, Lisa M; Rausch, Joseph R; Glauser, Tracy A

2011-05-01

Recognizing the importance of patient-reported outcomes, this longitudinal, prospective study examined: Changes in health-related quality of life (HRQOL) over seven months following antiepileptic drug (AED) initiation and the relationship of seizures, AED side-effects, and AED type to HRQOL. Parents of 124 children with newly diagnosed epilepsy completed measures of HRQOL and side-effects at each clinic visit. Treatment information was also collected. HRQOL remained stable over time; however, seizures and AED side-effects significantly affected multiple HRQOL domains. Higher seizure activity was associated with decreased Physical HRQOL. Side-effects were negatively associated with all HRQOL domains. Children taking carbamazepine who experienced higher side-effects early in therapy demonstrated declining emotional functioning compared to children experiencing no/some side-effects. AED side-effects, AED type, and seizure frequency were associated with longitudinal HRQOL in children with newly-diagnosed epilepsy. Routine assessment of AED side-effects and HRQOL may be useful for clinical decision making.

[Accelerated partial breast irradiation with image-guided intensity-modulated radiotherapy following breast-conserving surgery - preliminary results of a phase II clinical study].

PubMed

Mészáros, Norbert; Major, Tibor; Stelczer, Gábor; Zaka, Zoltán; Mózsa, Emõke; Fodor, János; Polgár, Csaba

2015-06-01

The purpose of the study was to implement accelerated partial breast irradiation (APBI) by means of image-guided intensity-modulated radiotherapy (IG-IMRT) following breast-conserving surgery (BCS) for low-risk early invasive breast cancer. Between July 2011 and March 2014, 60 patients with low-risk early invasive (St I-II) breast cancer who underwent BCS were enrolled in our phase II prospective study. Postoperative APBI was given by means of step and shoot IG-IMRT using 4 to 5 fields to a total dose of 36.9 Gy (9×4.1 Gy) using a twice-a-day fractionation. Before each fraction, series of CT images were taken from the region of the target volume using a kV CT on-rail mounted in the treatment room. An image fusion software was used for automatic image registration of the planning and verification CT images. Patient set-up errors were detected in three directions (LAT, LONG, VERT), and inaccuracies were adjusted by automatic movements of the treatment table. Breast cancer related events, acute and late toxicities, and cosmetic results were registered and analysed. At a median follow-up of 24 months (range 12-44) neither locoregional nor distant failure was observed. Grade 1 (G1), G2 erythema, G1 oedema, and G1 and G2 pain occurred in 21 (35%), 2 (3.3%), 23 (38.3%), 6 (10%) and 2 (3.3%) patients, respectively. No G3-4 acute side effects were detected. Among late radiation side effects G1 pigmentation, G1 fibrosis, and G1 fat necrosis occurred in 5 (8.3%), 7 (11.7%), and 2 (3.3%) patients, respectively. No ≥G2 late toxicity was detected. Excellent and good cosmetic outcome was detected in 45 (75%) and 15 (25%) patients. IG-IMRT is a reproducible and feasible technique for the delivery of APBI following conservative surgery for the treatment of low-risk, early-stage invasive breast carcinoma. Preliminary results are promising, early radiation side effects are minimal, and cosmetic results are excellent.

Comparing Balance and Inverse Methods on Learning Conceptual and Procedural Knowledge in Equation Solving: A Cognitive Load Perspective

ERIC Educational Resources Information Center

Ngu, Bing Hiong; Phan, Huy Phuong

2016-01-01

We examined the use of balance and inverse methods in equation solving. The main difference between the balance and inverse methods lies in the operational line (e.g. +2 on both sides vs -2 becomes +2). Differential element interactivity favours the inverse method because the interaction between elements occurs on both sides of the equation for…

Traits and Resource Use of Co-Occurring Introduced and Native Trees in a Tropical Novel Forest

Treesearch

Jéssica Fonseca da Silva; Ernesto Medina; Ariel Lugo

2017-01-01

Novel forests are naturally regenerating forests that have established on degraded lands and have a species composition strongly influenced by introduced species. We studied ecophysiological traits of an introduced species (Castilla elastica Sessé) and several native species growing side by side in novel forests dominated by C. elastica ...

A vertical perspective of Santa Ana winds in a canyon

Treesearch

Bill C. Ryan

1969-01-01

The cross-section analyses of the 3 days of weak Santa Ana conditions reveal how rapid changes in windspeed and direction may occur under these conditions. The analyses indicate the significant dip of the wind field down the lee side of the range even under relatively light wind conditions, and show how opposing wind systems interact on the lee side to allow rapidly...

Effect of Endobronchial Coils vs Usual Care on Exercise Tolerance in Patients With Severe Emphysema: The RENEW Randomized Clinical Trial.

PubMed

Sciurba, Frank C; Criner, Gerard J; Strange, Charlie; Shah, Pallav L; Michaud, Gaetane; Connolly, Timothy A; Deslée, Gaëtan; Tillis, William P; Delage, Antoine; Marquette, Charles-Hugo; Krishna, Ganesh; Kalhan, Ravi; Ferguson, J Scott; Jantz, Michael; Maldonado, Fabien; McKenna, Robert; Majid, Adnan; Rai, Navdeep; Gay, Steven; Dransfield, Mark T; Angel, Luis; Maxfield, Roger; Herth, Felix J F; Wahidi, Momen M; Mehta, Atul; Slebos, Dirk-Jan

Preliminary clinical trials have demonstrated that endobronchial coils compress emphysematous lung tissue and may improve lung function, exercise tolerance, and symptoms in patients with emphysema and severe lung hyperinflation. To determine the effectiveness and safety of endobronchial coil treatment. Randomized clinical trial conducted among 315 patients with emphysema and severe air trapping recruited from 21 North American and 5 European sites from December 2012 through November 2015. Participants were randomly assigned to continue usual care alone (guideline based, including pulmonary rehabilitation and bronchodilators; n = 157) vs usual care plus bilateral coil treatment (n = 158) involving 2 sequential procedures 4 months apart in which 10 to 14 coils were bronchoscopically placed in a single lobe of each lung. The primary effectiveness outcome was difference in absolute change in 6-minute-walk distance between baseline and 12 months (minimal clinically important difference [MCID], 25 m). Secondary end points included the difference between groups in 6-minute walk distance responder rate, absolute change in quality of life using the St George's Respiratory Questionnaire (MCID, 4) and change in forced expiratory volume in the first second (FEV1; MCID, 10%). The primary safety analysis compared the proportion of participants experiencing at least 1 of 7 prespecified major complications. Among 315 participants (mean age, 64 years; 52% women), 90% completed the 12-month follow-up. Median change in 6-minute walk distance at 12 months was 10.3 m with coil treatment vs -7.6 m with usual care, with a between-group difference of 14.6 m (Hodges-Lehmann 97.5% CI, 0.4 m to ∞; 1-sided P = .02). Improvement of at least 25 m occurred in 40.0% of patients in the coil group vs 26.9% with usual care (odds ratio, 1.8 [97.5% CI, 1.1 to ∞]; unadjusted between-group difference, 11.8% [97.5% CI, 1.0% to ∞]; 1-sided P = .01). The between-group difference in median change in FEV1 was 7.0% (97.5% CI, 3.4% to ∞; 1-sided P < .001), and the between-group St George's Respiratory Questionnaire score improved -8.9 points (97.5% CI, -∞ to -6.3 points; 1-sided P < .001), each favoring the coil group. Major complications (including pneumonia requiring hospitalization and other potentially life-threatening or fatal events) occurred in 34.8% of coil participants vs 19.1% of usual care (P = .002). Other serious adverse events including pneumonia (20% coil vs 4.5% usual care) and pneumothorax (9.7% vs 0.6%, respectively) occurred more frequently in the coil group. Among patients with emphysema and severe hyperinflation treated for 12 months, the use of endobronchial coils compared with usual care resulted in an improvement in median exercise tolerance that was modest and of uncertain clinical importance, with a higher likelihood of major complications. Further follow-up is needed to assess long-term effects on health outcomes. clinicaltrials.gov Identifier: NCT01608490.

Efficacy of tylosin tablets for the treatment of pyoderma due to Staphylococcus intermedius infection in dogs.

PubMed Central

Scott, D W; Miller, W H; Cayatte, S M; Bagladi, M S

1994-01-01

Tylosin tablets (20 mg/kg, q12h) were administered orally to 21 dogs with superficial or deep staphylococcal pyodermas. Response to therapy was excellent in 90.5% of the dogs, and in vitro susceptibility testing correlated perfectly with therapeutic response. Duration of therapy varied from 17 to 91 days, with an average of 33 days. Relapses occurred in 28.6% of the dogs within a three-month period. No side effects were reported. Under the conditions of the study, tylosin was an effective and safe antibiotic for the treatment of staphylococcal pyoderma in dogs. PMID:7994702

Novel Antipsychotics in the Treatment of Behavioral Disturbances and Psychoses Associated With Neurodegenerative Disorders

PubMed Central

Masand, Prakash S.

2000-01-01

Behavioral disturbances and psychosis are common features of neurodegenerative disorders and may be drug induced, intrinsic to the underlying pathology, or both. These disturbances, including psychotic and mood symptoms, apathy, aggression and other behavioral symptoms, and superimposed delirium, cause a great amount of disability to the patient and stress on the caregiver. Conventional neuroleptics have been shown to be effective in the treatment of these symptoms, but unacceptable side effects may occur. However, the novel antipsychotics, with their lower risk of inducing extrapyramidal symptoms, have shown promise in the treatment of behavioral disturbances and psychosis associated with neurodegenerative disorders. PMID:15014653

[Treatment side effects and compliance in patients with depression].

PubMed

Petrova, N N; Kucher, E O

2012-01-01

The impact of treatment side-effects on the compliance was studied in 85 depressive patients with different mental disorders - recurrent depressive disorder, postschizophrenic depression and organic affective disorder. The comparison of objective and subjective evaluations of compliance and a comparative analysis of the level of compliance, with its dependence on the treatment specifics, in different diseases were done. A significant role of efficacy and treatment side-effects was identified. The levels of "mental" and "autonomous" side-effects were highest in the treatment of depression: patients with postschizophrenic depression had the highest risk in respect of maintenance treatment; patients with recurrent depressive disorder and organic (affective) disorder were more tolerant to the treatment side-effects and their treatment, including the maintenance therapy, was rather effective. The compliance of all patients with depression was negatively correlated with the severity of side-effects of pharmacotherapy. The greatest side-effects and the lowest level of compliance were observed in the complex treatment with antidepressants and atypical neuroleptics. The effect of side-effects on the compliance was dependent on their severity and subjective tolerability and, to a lesser extent, on the amount of drugs.

Alpha1-adrenergic blockers: current usage considerations.

PubMed

Sica, Domenic A

2005-12-01

Alpha1-adrenergic-blocking drugs are effective in reducing blood pressure and do so in a fashion comparable to most other antihypertensive drug classes. These compounds are most effective in patients in the upright position, reducing systolic and diastolic pressures by 8%-10%. Alpha1-adrenergic-blocking drugs incrementally reduce blood pressure when combined with most drug classes and are the only antihypertensive drug class to improve plasma lipid profiles. Alpha1-adrenergic-blocking drugs are also accepted as important elements of the treatment plan for symptomatic benign prostatic hypertrophy. Dose escalation of an alpha1-adrenergic-blocking drug can trigger renal Na+ retention, and the ensuing volume expansion can attenuate its blood pressure-lowering effect. Orthostatic hypotension can occur with these compounds, particularly when a patient is volume-contracted. Dizziness, headache, and drowsiness are common side effects with alpha1-adrenergic blockers. A modest decline in the use of doxazosin and other alpha1-adrenergic-blocking drugs has occurred coincident to the early termination of the doxazosin treatment arm in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial.

Exploring the associations between drug side-effects and therapeutic indications.

PubMed

Wang, Fei; Zhang, Ping; Cao, Nan; Hu, Jianying; Sorrentino, Robert

2014-10-01

Drug therapeutic indications and side-effects are both measurable patient phenotype changes in response to the treatment. Inferring potential drug therapeutic indications and identifying clinically interesting drug side-effects are both important and challenging tasks. Previous studies have utilized either chemical structures or protein targets to predict indications and side-effects. In this study, we compared drug therapeutic indication prediction using various information including chemical structures, protein targets and side-effects. We also compared drug side-effect prediction with various information sources including chemical structures, protein targets and therapeutic indication. Prediction performance based on 10-fold cross-validation demonstrates that drug side-effects and therapeutic indications are the most predictive information source for each other. In addition, we extracted 6706 statistically significant indication-side-effect associations from all known drug-disease and drug-side-effect relationships. We further developed a novel user interface that allows the user to interactively explore these associations in the form of a dynamic bipartitie graph. Many relationship pairs provide explicit repositioning hypotheses (e.g., drugs causing postural hypotension are potential candidates for hypertension) and clear adverse-reaction watch lists (e.g., drugs for heart failure possibly cause impotence). All data sets and highly correlated disease-side-effect relationships are available at http://astro.temple.edu/∼tua87106/druganalysis.html. Copyright © 2014 Elsevier Inc. All rights reserved.

Hydronephrosis in Acute Uncomplicated Appendicitis.

PubMed

Schok, T; Austen, S; Lewicz, R B C B; Zande, F H R van der; Peters, N A L R; Janzing, H M J

2015-01-01

Right-sided hydronephrosis as a sign of appendicitis occurs rarely in the literature. To our knowledge, this is the first published account of the occurrence of right-sided hydronephrosis as a result of uncomplicated appendicitis. We describe a 15 year old patient referred to the emergency department with suspected appendicitis. Additional ultrasound examination showed a right-sided hydronephrosis. This finding was discussed with the urologist who noted the hydronephrosis as a chance finding. Because of persistent clinical suspicion of appendicitis, a diagnostic laparoscopy was performed. A retrocaecal appendicitis with secondary hydronephrosis was found. Right-sided hydronephrosis may be a sign of acute uncomplicated (retrocaecal) appendicitis. It is important to keep sight of these findings, especially in view of the emphasis on imaging techniques in the current Dutch guideline on appendicitis.

Jupiter Night and Day

NASA Technical Reports Server (NTRS)

2001-01-01

Day and night side narrow angle images taken on January 1, 2001 illustrating storms visible on the day side which are the sources of visible lightning when viewed on the night side. The images have been enhanced in contrast. Note the two day-side occurrences of high clouds, in the upper and lower parts of the image, are coincident with lightning storms seen on the darkside. The storms occur at 34.5 degrees and 23.5 degrees North latitude, within one degree of the latitudes at which similar lightning features were detected by the Galileo spacecraft. The images were taken at different times. The storms' longitudinal separation changes from one image to the next because the winds carrying them blow at different speeds at the two latitudes.

Stitch in the side: causes, workup, and solutions.

PubMed

Eichner, E Randy

2006-12-01

Side stitch is an acute, localized, sharp, transient pain that occurs during exercise, most often in runners or swimmers, but also in those participating in team sports, and less often in cyclists. The pain is vexing and performance-limiting, but fleeting and benign. Three theories compete to explain it: diaphragmatic ischemia, stress on peritoneal ligaments, and irritation of the parietal peritoneum. The differential diagnosis seems broad, but the classic side stitch is so unique in its features and setting that a reasonable working diagnosis can be made from a careful history and physical examination. Practical tips, although anecdotal, offer lasting solutions.

Successful Conservative Treatment of a Kommerell Aneurysm Associated With Right-Sided Aortic Arch.

PubMed

Lococo, Filippo; Tusini, Nicola; Brandi, Loris; Leuzzi, Giovanni; Galeone, Carla; Paci, Massimiliano; Rapicetta, Cristian

2016-08-01

Right-side aortic arch is a rare congenital aortic anomaly occurring in 0.05% to 0.1% of the general population. Approximately, half of these cases may be associated with an aberrant left subclavian artery and occasionally with aneurysmatic change at its origin known as Kommerell diverticulum or aneurysm (KA). Herein we report a challenging case of a right-side aortic arch associated with KA incidentally observed in a 73-year-old male with metastatic lung cancer. After careful multidisciplinary discussion, a conservative strategy of care was successfully adopted. © The Author(s) 2016.

Asymmetrical development of root endodermis and exodermis in reaction to abiotic stresses

PubMed Central

Líška, Denis; Martinka, Michal; Kohanová, Jana; Lux, Alexander

2016-01-01

Background and Aims In the present study, we show that development of endodermis and exodermis is sensitively regulated by water accessibility. As cadmium (Cd) is known to induce xeromorphic effects in plants, maize roots were exposed also to Cd to understand the developmental process of suberin lamella deposition in response to a local Cd source. Methods In a first experiment, maize roots were cultivated in vitro and unilaterally exposed to water-containing medium from one side and to air from the other. In a second experiment, the roots were placed between two agar medium layers with a strip of Cd-containing medium attached locally and unilaterally to the root surface. Key Results The development of suberin lamella (the second stage of exodermal and endodermal development) started asymmetrically, preferentially closer to the root tip on the side exposed to the air. In the root contact with Cd in a spatially limited area exposed to one side of the root, suberin lamella was preferentially developed in the contact region and additionally along the whole length of the root basipetally from the contact area. However, the development was unilateral and asymmetrical, facing the treated side. The same pattern occurred irrespective of the distance of Cd application from the root apex. Conclusions These developmental characteristics indicate a sensitive response of root endodermis and exodermis in the protection of vascular tissues against abiotic stresses. PMID:27112163

Parental Expectation of Side Effects Following Vaccination Is Self-fulfilling: A Prospective Cohort Study.

PubMed

Smith, Louise E; Weinman, John; Amlôt, Richard; Yiend, Jenny; Rubin, G James

2018-06-02

One of the major factors contributing to parental refusal of vaccinations is the perception that vaccines cause side effects. Although symptoms are commonly reported following vaccinations, their causes are not always straightforward. Although some may be directly attributable to the vaccine itself, others may reflect pre-existing or coincidental symptoms that are misattributed to the vaccine. To investigate psychological factors associated with parental report of side effects following vaccination with the child influenza vaccine, and parental intention to re-vaccinate one's child the following year. A prospective cohort study was run in primary care practices in London in the 2016-2017 influenza season (ClinicalTrials.gov number NCT02909855). Two hundred seventy parents from 14 practices completed a questionnaire before their child's vaccination. Follow-up questionnaires were completed 3 days after vaccination and one month after vaccination. Parental report of side effects and vaccination intention for the subsequent year were measured. Parental report of side effects was strongly associated with pre-vaccination expectation of side effects. Suggestions received from the media, National Health Service (NHS) vaccination leaflet, and health care workers, as well as uncertainty-related beliefs, perceived sensitivity of the child to medicines, pessimism, and anxiety were also associated with reporting side effects. Side effect report was associated with lower vaccination intention for the following influenza season. Side effect perception following vaccination is influenced by psychological factors, in particular expectations. Perceiving side effects reduces future vaccination intention. Future public health communications should aim to decrease unrealistic expectations of side effects to increase vaccine uptake.

Pharmacogenomic and clinical data link non-pharmacokinetic metabolic dysregulation to drug side effect pathogenesis

PubMed Central

Zielinski, Daniel C.; Filipp, Fabian V.; Bordbar, Aarash; Jensen, Kasper; Smith, Jeffrey W.; Herrgard, Markus J.; Mo, Monica L.; Palsson, Bernhard O.

2015-01-01

Drug side effects cause a significant clinical and economic burden. However, mechanisms of drug action underlying side effect pathogenesis remain largely unknown. Here, we integrate pharmacogenomic and clinical data with a human metabolic network and find that non-pharmacokinetic metabolic pathways dysregulated by drugs are linked to the development of side effects. We show such dysregulated metabolic pathways contain genes with sequence variants affecting side effect incidence, play established roles in pathophysiology, have significantly altered activity in corresponding diseases, are susceptible to metabolic inhibitors and are effective targets for therapeutic nutrient supplementation. Our results indicate that metabolic dysregulation represents a common mechanism underlying side effect pathogenesis that is distinct from the role of metabolism in drug clearance. We suggest that elucidating the relationships between the cellular response to drugs, genetic variation of patients and cell metabolism may help managing side effects by personalizing drug prescriptions and nutritional intervention strategies. PMID:26055627

Use of mechanical devices for distal hemoperfusion during balloon catheter coronary angioplasty.

PubMed

Heibig, J; Angelini, P; Leachman, D R; Beall, M M; Beall, A C

1988-01-01

Previous attempts to protect the dependent myocardium during balloon catheter coronary angioplasty in animals and humans have had generally unsatisfactory results. This paper summarizes the authors' experience in investigating commercially available mechanical pumps for distal coronary hemoperfusion during balloon angioplasty. Both roller and piston pumps can attain adequate distal perfusion without significant side effects in the majority of patients. Our goal was to suppress angina for at least 5 min to prolong balloon inflation in awake patients. Minor T-wave changes without concomitant angina pectoris can be expected when the distal coronary bed is perfused with hypothermic blood. Side branch occlusion by the inflated balloon prevents effective protection of the corresponding part of the dependent myocardium during distal hemoperfusion, which may result in persistent angina and ST-T changes uncorrected by increasing the hemoperfusion rate. Distal coronary diffuse spasm, rare and transient, was the only immediate complication of this procedure. It is suggested that intense local wall stimulation could occur with a higher flow rate (jet effect). Improved balloon catheter pressure/flow characteristics and on-line continuous mechanical pumps should soon make distal coronary hemoperfusion through balloon catheters an accepted clinical technique.

Decrease in cytotoxicity of copper-based intrauterine devices (IUD) pretreated with 6-mercaptopurine and pterin as biocompatible corrosion inhibitors.

PubMed

Alvarez, Florencia; Grillo, Claudiaa; Schilardi, Patricial; Rubert, Aldo; Benítez, Guillermo; Lorente, Carolina; de Mele, Mónica Fernández Lorenzo

2013-01-23

The copper intrauterine device (IUD) based its contraceptive action on the release of cupric ions from a copper wire. Immediately after the insertion, a burst release of copper ions occurs, which may be associated to a variety of side effects. 6-Mercaptopurine (6-MP) and pterin (PT) have been proposed as corrosion inhibitors to reduce this harmful release. Pretreatments with 1 × 10(-4) M 6-MP and 1 × 10(-4) M PT solutions with 1h and 3h immersion times were tested. Conventional electrochemical techniques, EDX and XPS analysis, and cytotoxicity assays with HeLa cell line were employed to investigate the corrosion behavior and biocompatibility of copper with and without treatments. Results showed that copper samples treated with PT and 6-MP solutions for 3 and 1 h, respectively, are more biocompatible than those without treatment. Besides, the treatment reduces the burst release effect of copper in simulated uterine solutions during the first week after the insertion. It was concluded that PT and 6-MP treatments are promising strategies able to reduce the side effects related to the "burst release" of copper-based IUD without altering the contraceptive action.

A Mobile Multimedia Reminiscence Therapy Application to Reduce Behavioral and Psychological Symptoms in Persons with Alzheimer's.

PubMed

Imtiaz, Danish; Khan, Arshia; Seelye, Adriana

2018-01-01

The goal of this project is to develop a novel and innovative mobile solution to address behavioral and psychological symptoms of dementia (BPSD) that occur in individuals with Alzheimer's. BPSD can include agitation, restlessness, aggression, apathy, obsessive-compulsive and repetitive behaviors, hallucinations, delusions, paranoia, and wandering. Alzheimer's currently affects 5.4 million adults in the United States and that number is projected to increase to 14 million by 2050. Almost 90% of all affected with AD experience BPSD, resulting in increased healthcare costs, heavier burden on caregivers, poor patient outcomes, early nursing home placement, long-term hospitalizations, and misuse of medications. Pharmacological support may have undesirable side effects such as sedation. Nonpharmacological interventions are alternative solutions that have shown to be effective without undesirable side effects. Music therapy has been found to lower BPSD symptoms significantly. Our study is based on combination of the reminiscence and the music therapies where past memorable events are recalled using prompts such as photos, videos, and music. We are proposing a mobile multimedia solution, a technical version of the combined reminiscence, and music therapies to prevent the occurrence of BPSD, especially for the rural population who have reduced access to dementia care services.

Treatment of painful diabetic peripheral neuropathy.

PubMed

Rosenberg, Casandra J; Watson, James C

2015-02-01

Painful diabetic peripheral neuropathy impairs quality of life and can be difficult to treat. To discuss current treatment recommendations for painful diabetic peripheral neuropathy. Literature review. Systematic review of the literature discussing treatment of painful diabetic peripheral neuropathy. Existing treatment guidelines were studied and compared. Painful diabetic peripheral neuropathy occurs in about one in six people with diabetes. This condition impairs quality of life and increases healthcare costs. Treatment recommendations exist, but individual patient therapy can require a trial-and-error approach. Many treatment options have adjuvant benefits or side effects which should be considered prior to initiating therapy. Often, a combination of treatment modalities with various mechanisms of action is required for adequate pain control. Adequate medication titration and a reasonable trial period should be allowed. The treatment of painful diabetic peripheral neuropathy can be challenging, but effective management can improve patient's quality of life. Painful diabetic peripheral neuropathy impairs quality of life and can be difficult to treat. Many treatment options have adjuvant benefits or side effects which should be considered prior to initiating therapy. Often, a combination of treatment modalities with various mechanisms of action is required for adequate pain control. © The International Society for Prosthetics and Orthotics 2014.

Cryolipolysis for Targeted Fat Reduction and Improved Appearance of the Enlarged Male Breast.

PubMed

Munavalli, Girish S; Panchaprateep, Ratchathorn

2015-09-01

Pseudogynecomastia refers to benign male breast enlargement due to excess subareolar fat. Standard treatment is surgical excision under general anesthesia, liposuction, or a combination of both. The safety and efficacy of cryolipolysis was investigated for nonsurgical treatment of pseudogynecomastia. Enrollment consisted of 21 males with pseudogynecomastia. Subjects received a first treatment consisting of a 60-minute cryolipolysis cycle, followed by a two-minute massage, and a second 60-minute cycle with 50% treatment area overlap. At 60 days of follow-up, subjects received a second 60-minute treatment. Safety was evaluated by monitoring side effects and adverse events. Efficacy was assessed by ultrasound, clinical photographs, and subject surveys. Surveys revealed that 95% of subjects reported improved visual appearance and 89% reported reduced embarrassment associated with pseudogynecomastia. Ultrasound showed mean fat layer reduction of 1.6 ± 1.2 mm. Blinded reviewers correctly identified 82% of baseline photographs. Side effects included mild discomfort during treatment and transient paresthesia and tenderness. One case of paradoxical hyperplasia (PH) occurred but likelihood of PH in the male breast is not believed to be greater than in any other treatment area. This study demonstrated feasibility of cryolipolysis for safe, effective, and well-tolerated nonsurgical treatment of pseudogynecomastia.

Study on the measures of tunnels side-crossing bridge based on sheltering effects of isolation piles

NASA Astrophysics Data System (ADS)

Tang, Jian; Liu, Jun yan; Liu, Yan

2017-08-01

Based on the transit line 3, we studied the effect of the bridge piles crossed closely from the side by the shield tunnel. Using the three-dimensional finite element numerical analysis software Midas GTS/NX, we analyzed the effect of shield tunnel on pile deformation, statistics are obtained that under the condition of pile, subgrade reinforcement and ground changes. The calculation results show that in the condition of reinforcement, the new tunnel shield crossing through the pile caused longitudinal disturbance of the tunnel surrounding strata along the tunnel, where the soil over the area is within a certain range of pile and settlement deformation of surface subsidence occurs, changing the surface roughly to the shape of “V”. The maximum value appears above the shield tunnel and the value is high. In combination with engineering geology, hydrogeology and environment factors, this paper adopted isolation pile reinforcement to the pile, and the simulated results show that, pile settlement was significantly reduced under the condition of pile reinforcement. The calculation results show the rationality of the reinforcement scheme to a certain extent, which provides a theoretical basis for the similar tunnel.

The natural history of acute hepatitis C: clinical presentation, laboratory findings, and treatment outcomes

PubMed Central

Loomba, R.; Rivera, M. M.; McBurney, R.; Park, Y.; Haynes-Williams, V.; Rehermann, B.; Alter, H. J.; Herrine, S. K.; Liang, T. J.; Hoofnagle, J. H.; Heller, T.

2017-01-01

Summary Background Acute hepatitis C has variable modes of presentation and frequently results in chronic infection. Its optimal management has yet to be defined. Aims To establish natural history and complications of treatment of acute hepatitis C. Methods Data from all patients presenting with acute hepatitis C to the National Institutes of Health between 1994 and 2007 were reviewed. Results Twenty-five patients were identified. Symptoms were reported by 80% and jaundice by 40%. Aminotransferase levels and HCV RNA levels fluctuated greatly; 18% of patients were intermittently negative for HCV RNA. Five patients recovered spontaneously whereas 20 developed chronicity or received interferon-based therapy during the acute phase. Among 15 patients treated during the acute phase with peginterferon with or without ribavirin for 24 weeks, all became HCV RNA negative within 4 to 8 weeks, and all except two (HIV-positive) achieved a sustained virological response. Side effects (particularly psychiatric) were common and limited treatment in 30%. Conclusion Thus, among 25 patients with acute HCV infection, fluctuating illness was common and spontaneous recovery occurred in only 20%. Antiviral treatment with a 24-week course of peginterferon and ribavirin was highly effective but marked by frequent and severe side effects. PMID:21198704

Organic nitrates: update on mechanisms underlying vasodilation, tolerance and endothelial dysfunction.

PubMed

Münzel, Thomas; Steven, Sebastian; Daiber, Andreas

2014-12-01

Given acutely, organic nitrates, such as nitroglycerin (GTN), isosorbide mono- and dinitrates (ISMN, ISDN), and pentaerythrityl tetranitrate (PETN), have potent vasodilator and anti-ischemic effects in patients with acute coronary syndromes, acute and chronic congestive heart failure and arterial hypertension. During long-term treatment, however, side effects such as nitrate tolerance and endothelial dysfunction occur, and therapeutic efficacy of these drugs rapidly vanishes. Recent experimental and clinical studies have revealed that organic nitrates per se are not just nitric oxide (NO) donors, but rather a quite heterogeneous group of drugs considerably differing for mechanisms underlying vasodilation and the development of endothelial dysfunction and tolerance. Based on this, we propose that the term nitrate tolerance should be avoided and more specifically the terms of GTN, ISMN and ISDN tolerance should be used. The present review summarizes preclinical and clinical data concerning organic nitrates. Here we also emphasize the consequences of chronic nitrate therapy on the supersensitivity of the vasculature to vasoconstriction and on the increased autocrine expression of endothelin. We believe that these so far rather neglected and underestimated side effects of chronic therapy with at least GTN and ISMN are clinically important. Copyright © 2014 Elsevier Inc. All rights reserved.

Effect of tetracycline and UV radiation on melanization and antioxidant status of melanocytes.

PubMed

Rok, Jakub; Buszman, Ewa; Delijewski, Marcin; Otręba, Michał; Beberok, Artur; Wrześniok, Dorota

2015-07-01

Tetracycline is a semisynthetic antibiotic and is used in several types of infections against both gram-positive and gram-negative bacteria. This therapy is often associated with phototoxic reactions that occur after exposure to UV radiation and lead to photo-onycholysis, pseudoporphyria, solar urticaria and the fixed drug eruption in the skin. The phototoxic reactions may be related to the melanin content which, on one side may bind drugs - leading to their accumulation, and on the other side, they have photoprotective and antioxidant properties. In this study the effect of tetracycline and UVA irradiation on cell viability, biosynthesis of melanin and antioxidant defense system in cultured normal human epidermal melanocytes (HEMn-DP) was analyzed. The viability of the cells treated with tetracycline and exposed to UVA radiation decreased in a drug concentration-dependent manner. At the same time, the induction of the melanization process was observed. The significant alterations in antioxidant defense system, on the basis of changes in SOD, CAT and GPx activities, were stated. The obtained results may give explanation for the phototoxic effects of tetracycline therapy observed in skin cells exposed to UVA radiation. Copyright © 2015 Elsevier B.V. All rights reserved.

Patient positioning and ventilator-associated pneumonia.

PubMed

Hess, Dean R

2005-07-01

Rotational beds, prone position, and semi-recumbent position have been proposed as procedures to prevent ventilator-associated pneumonia (VAP). Rotational therapy uses a special bed designed to turn continuously, or nearly continuously, the patient from side to side; specific designs include kinetic therapy and continuous lateral rotation therapy. A meta-analysis of studies evaluating the effect of rotational bed therapy shows a decrease in the risk of pneumonia but no effect on mortality. Two studies reported a lower risk of VAP in patients placed in a prone position, with no effect on mortality. Studies using radiolabeled enteral feeding solutions in mechanically ventilated patients have reported that aspiration of gastric contents occurs to a greater degree when patients are in the supine position, compared with the semirecumbent position. One study reported a lower rate of VAP in patients randomized to semi-recumbent compared to supine position. Although each of the techniques discussed in this paper has been shown to reduce the risk of VAP, none has been shown to affect mortality. The available evidence suggests that semi-recumbent position should be used routinely, rotational therapy should be considered in selected patients, and prone position should not be used as a technique to reduce the risk of VAP.

A Review of Treatment Options for Co-Occurring Methamphetamine Use Disorders and Depression

PubMed Central

Hellem, Tracy L.; Lundberg, Kelly J.; Renshaw, Perry F.

2017-01-01

Co-occurring methamphetamine use and depression interferes with treatment outcomes. Female methamphetamine users are known to have higher rates of depression than male methamphetamine users, although this is also true for the general population. There are limited treatment options for the management of depression among methamphetamine users. In this integrative review, we summarize data on treatment strategies for co-occurring depression and methamphetamine use disorders. English-language articles were identified from PsychINFO, CINAHL, PubMed, and Medline as well as from reference lists of key articles. Search terms included “methamphetamine,” “depression,” and “treatment.” Research articles describing psychological (n =3), pharmacological (n = 6), nutritional supplement (n =1), and psychological combined with pharmacological (n = 3) approaches for the treatment of methamphetamine use or withdrawal and/or depression are included in this review. Psychological and combination of psychological with pharmacological approaches have not been shown to be effective in treating these co-occurring conditions. Antidepressants have been determined to be ineffective and/or to introduce side effects. Gender differences with response to treatment were examined in only one of the published studies. There is a large gap in knowledge regarding treatment of co-occurring methamphetamine use disorders and depression. Considering that female methamphetamine users experience higher rates of depression than men, a focus on gender-specific treatment approaches is warranted. PMID:25761159

Radiation Therapy Side Effects

Cancer.gov

Radiation therapy has side effects because it not only kills or slows the growth of cancer cells, it can also affect nearby healthy cells. Many people who get radiation therapy experience fatigue. Other side effects depend on the part of the body that is being treated. Learn more about possible side effects.

Influence of opioid-related side effects on disability, mood, and opioid misuse risk among patients with chronic pain in primary care.

PubMed

Jamison, Robert N; Dorado, Kathleen; Mei, Anna; Edwards, Robert R; Martel, Marc O

2017-03-01

There is increasing concern among primary care practitioners about the use of opioids for chronic pain, including their adverse effects, but little attention has been given to how reports of side effects from prescription medication can contribute to outcomes among patients with chronic pain. The aim of this study was to investigate the impact of frequently reported side effects on mood, disability, and opioid misuse in patients with chronic pain prescribed opioids within primary care. Two hundred (N = 200) patients with chronic pain taking opioids for pain were recruited into the study. All patients completed baseline measures and a monthly side effects checklist once a month for 6 months. Patients were divided evenly based on a median split of the number of endorsed side effects over 6 months. The subjects repeated the baseline measures at the end of the study period. Over time, reports of medication side effects tended to decrease, but differences in frequency of reported side effects from baseline to follow-up (6-month time) were not significant, and the order of the frequency of the reported side effects remained similar. Patients who reported significant medication-related adverse effects reported significantly greater activity interference, negative affect, and catastrophizing compared with those with fewer side effects ( P < 0.01). In addition, those patients with pain who reported more side effects showed significantly higher scores on opioid misuse risk ( P < 0.001). This study demonstrates the important role of monitoring medication-related side effects among patients with chronic pain who are prescribed opioid medication for pain within primary care.

Influence of opioid-related side effects on disability, mood, and opioid misuse risk among patients with chronic pain in primary care

PubMed Central

Jamison, Robert N.; Dorado, Kathleen; Mei, Anna; Edwards, Robert R.; Martel, Marc O.

2017-01-01

Abstract Background: There is increasing concern among primary care practitioners about the use of opioids for chronic pain, including their adverse effects, but little attention has been given to how reports of side effects from prescription medication can contribute to outcomes among patients with chronic pain. The aim of this study was to investigate the impact of frequently reported side effects on mood, disability, and opioid misuse in patients with chronic pain prescribed opioids within primary care. Methods: Two hundred (N = 200) patients with chronic pain taking opioids for pain were recruited into the study. All patients completed baseline measures and a monthly side effects checklist once a month for 6 months. Patients were divided evenly based on a median split of the number of endorsed side effects over 6 months. The subjects repeated the baseline measures at the end of the study period. Results: Over time, reports of medication side effects tended to decrease, but differences in frequency of reported side effects from baseline to follow-up (6-month time) were not significant, and the order of the frequency of the reported side effects remained similar. Patients who reported significant medication-related adverse effects reported significantly greater activity interference, negative affect, and catastrophizing compared with those with fewer side effects (P < 0.01). In addition, those patients with pain who reported more side effects showed significantly higher scores on opioid misuse risk (P < 0.001). Discussion: This study demonstrates the important role of monitoring medication-related side effects among patients with chronic pain who are prescribed opioid medication for pain within primary care. PMID:29392205

Underlying Rheumatic Disease: An Important Determinant of Outcome in Tricuspid Valve Repair.

PubMed

Munasur, Mandhir; Naidoo, Datshana

2016-03-01

Tricuspid regurgitation (TR) accompanying severe left-sided valve disease occurs on a functional basis, secondary to pulmonary hypertension and tricuspid annular dilatation. In the context of endemic left-sided rheumatic heart disease, non-recognition of organic disease of the tricuspid valve may adversely influence surgical decision-making, resulting in suboptimal outcomes. A retrospective analysis of the perioperative and follow up data of 30 patients who underwent tricuspid valve surgery with concomitant left-sided valve replacement was undertaken. Preoperative evaluation by two-dimensional transthoracic echocardiography was routinely employed. Outcomes were analyzed by evaluation of the perioperative and two-year follow up clinical and echocardiographic data. All subjects had severe TR. Mixed tricuspid valve disease occurred in 11 subjects (36.7%). Tricuspid valve repair was performed in 28 patients. A significant improvement (p <0.05) in the following parameters occurred at six weeks postoperatively: NYHA functional class, tricuspid annular diameter, systolic pulmonary artery pressure, severity of TR and tricuspid transvalvular gradient. Severe residual postoperative TR occurred in 26.7% of patients, but there were no identifiable predictors for this phenomenon. Severe residual postoperative TR was not associated with major adverse cardiovascular events. Preoperative (p = 0.013) and postoperative (p<0.002) pulmonary hypertension were associated with the development of major adverse cardiovascular events. The technique of tricuspid valve repair was not associated with the occurrence of major adverse cardiovascular events, nor with the development of severe residual postoperative TR. A satisfactory outcome was observed in only 40% of the study population. The coexistence of mixed tricuspid valve disease in rheumatic heart disease patients undergoing left-sided valve surgery is an important determinant of outcome in tricuspid valve repair. The persistence of severe TR contributes to poor long-term outcomes, and its incidence may be lowered by the adoption of appropriate perioperative imaging techniques to delineate valve morphology.

ω-Turn: a novel β-turn mimic in globular proteins stabilized by main-chain to side-chain C−H···O interaction.

PubMed

Dhar, Jesmita; Chakrabarti, Pinak; Saini, Harpreet; Raghava, Gajendra Pal Singh; Kishore, Raghuvansh

2015-02-01

Mimicry of structural motifs is a common feature in proteins. The 10-membered hydrogen-bonded ring involving the main-chain C − O in a β-turn can be formed using a side-chain carbonyl group leading to Asx-turn. We show that the N − H component of hydrogen bond can be replaced by a C(γ) -H group in the side chain, culminating in a nonconventional C − H···O interaction. Because of its shape this β-turn mimic is designated as ω-turn, which is found to occur ∼ three times per 100 residues. Three residues (i to i + 2) constitute the turn with the C − H···O interaction occurring between the terminal residues, constraining the torsion angles ϕi + 1, ψi + 1, ϕi + 2 and χ'1(i + 2) (using the interacting C(γ) atom). Based on these angles there are two types of ω-turns, each of which can be further divided into two groups. C(β) -branched side-chains, and Met and Gln have high propensities to occur at i + 2; for the last two residues the carbonyl oxygen may participate in an additional interaction involving the S and amino group, respectively. With Cys occupying the i + 1 position, such turns are found in the metal-binding sites. N-linked glycosylation occurs at the consensus pattern Asn-Xaa-Ser/Thr; with Thr at i + 2, the sequence can adopt the secondary structure of a ω-turn, which may be the recognition site for protein modification. Location between two β-strands is the most common occurrence in protein tertiary structure, and being generally exposed ω-turn may constitute the antigenic determinant site. It is a stable scaffold and may be used in protein engineering and peptide design. © 2014 Wiley Periodicals, Inc.

Side effects of low-dose pyridostigmine bromide are not related to cholinesterase inhibition.

PubMed

Cook, M R; Gerkovich, M M; Sastre, A; Graham, C

2001-12-01

Pretreatment with pyridostigmine bromide (PB) has become part of standard military procedures for protection against the effects of possible chemical warfare attack. The purpose of the work reported here was to quantify the type, intensity and frequency of side effects of low-dose PB, and to examine factors that predict the intensity and frequency of side effects. A double-blind, cross-over, placebo (PL)-controlled design was used. Of the 67 subjects, 33 received 30 mg PB every 8 h for 13 doses, and 34 received 60 mg on the same schedule. Order of PB and PL administration was counterbalanced. Overall, side effects were mild, even at the 60-mg dose level. More side effects were reported when volunteers were taking PB than when they were taking placebo. Women reported more symptoms than men. Neither cholinesterase inhibition nor plasma levels of PB predicted side effect scores during the PB week; the best predictor of side effect scores during the PB week was side effect scores during the PL week. PB is well tolerated by healthy young people, even when twice the recommended military dose is administered.

Analysis of Dynamic Avalanche Phenomenon in SOI Lateral High-speed Diode during Reverse Recovery and Development of a Novel Device Structure for Suppressing Dynamic Avalanche

NASA Astrophysics Data System (ADS)

Tokura, Norihito; Yamamoto, Takao; Kato, Hisato; Nakagawa, Akio

We have studied the dynamic avalanche phenomenon in an SOI lateral diode during reverse recovery by using a mixed-mode device simulation. In the study, it has been found that local impact ionization occurs near an anode-side field oxide edge, where a high-density hole current flows and a high electric field appears simultaneously. We propose that a p-type anode extension region (AER) along a trench side wall effectively sweeps out stored carriers beneath an anode p-diffusion layer during reverse recovery, resulting in reduction of the electric field and remarkable suppression of the dynamic avalanche. The AER reduces the total recovery charge and does not cause any increase in the total stored charge under a forward bias operation. This effect is verified experimentally by the fabricated device with AER. Thus, the developed SOI lateral diode is promising as a high-speed and highly rugged free-wheeling diode, which can be integrated into next-generation SOI microinverters.

Lichenoid dermatitis in three patients with metastatic melanoma treated with anti-PD-1 therapy.

PubMed

Joseph, Richard W; Cappel, Mark; Goedjen, Brent; Gordon, Matthew; Kirsch, Brandon; Gilstrap, Cheryl; Bagaria, Sanjay; Jambusaria-Pahlajani, Anokhi

2015-01-01

Therapies that activate the immune system through blocking the binding of programmed death ligand 1 (PD-L1) present on tumors and PD-1 (programmed death 1) present on activated immune cells are revolutionizing the care for patients with cancer. These therapies work by inhibiting negative regulators of the immune system, thereby decreasing a tumor's ability to evade the immune system. The side effects of anti-PD-1/PD-L1 therapies are generally mild and as expected are related to autoimmune reactions. Two of the most common side effects of anti-PD-1/PD-L1 therapies are rash and pruritus occurring in approximately 20% of patients. Although the rash is generally recognized to be immune mediated, the exact mechanisms of the rash remain unclear. Herein, we report three cases of lichenoid dermatitis in three patients treated with MK-3475 (anti-PD-1) that were characterized with marked T-cell infiltrates with few PD-1-positive cells. The rashes in all three patients were relatively mild, allowing treatment to continue despite the rashes. ©2014 American Association for Cancer Research.

Severe hypophosphataemia after intravenous iron administration.

PubMed

Blazevic, A; Hunze, J; Boots, J M M

2014-01-01

Currently, in many centres, intravenous administration of iron is becoming increasingly popular because of higher efficacy and decreased side effects, mainly gastrointestinal, compared with oral iron therapy. Studies of intravenous ferric carboxymaltose administration in the postpartum setting and in patients with non-dialysis-dependent chronic kidney disease revealed a decrease in serum phosphate levels that was generally asymptomatic and transient. Here, we report four cases of severe and symptomatic hypophosphataemia after intravenous iron administration. All patients received this as therapy for iron deficiency anaemia due to heavy menstrual bleeding. In most cases, a pre-existent disorder in the phosphate homeostasis existed, such as a secondary (cases 3 and 4) or tertiary hyperparathyroidism (case 1). However, in the second case there were no risk factors for a dysregulation of the phosphate homeostasis. Based on these findings, we conclude that severe and symptomatic hypophosphatemia can occur as a side effect of intravenous iron administration and can persist for months after administration. Especially patients with low phosphate levels prior to therapy due to concomitant disorders in phosphate homeostasis (e.g. hyperparathyroidism, vitamin D deficiency) are at risk.

A phase I trial of a new antiemetic drug--clebopride malate--in cisplatin-treated patients.

PubMed

Bleiberg, H; Piccart, M; Lips, S; Panzer, J M; N'Koua Mbon, J B

1992-02-01

Clebopride, a new benzamide derivative, has, in common with the other members of this group, antidopaminergic activity. In animals, its therapeutic ratio is superior to that of metoclopramide at doses free of side effects associated with hyperprolactinemia and extrapyramidal symptoms. The present study was designed to define the maximum tolerated dose (MTD) in patients with advanced histologically-proven cancer, treated with cisplatin at a dose of greater than 50 mg/m2. Most of them were pretreated and refractory to standard antiemetics. Clebopride was started at a dosage of 0.10 mg/kg in a group of 6 patients and escalated by 0.2 mg at each dose level. A total of 30 patients were included. Side effects include somnolence, diarrhea and extrapyramidal-like symptoms. The latter occurred at almost all dose levels in 14% of the cycles and limited continuation of the study. Activity in this group of patients was encouraging but, considering the rate of extrapyramidal symptoms, further dose escalation is not indicated and activity at lower, nontoxic levels should be investigated.

In silico modification of Zn2+ binding group of suberoylanilide hydroxamic acid (SAHA) by organoselenium compounds as Homo sapiens class II HDAC inhibitor of cervical cancer

NASA Astrophysics Data System (ADS)

Sumo Friend Tambunan, Usman; Bakri, Ridla; Aditya Parikesit, Arli; Ariyani, Titin; Dyah Puspitasari, Ratih; Kerami, Djati

2016-02-01

Cervical cancer is the most common cancer in women, and ranks seventh of all cancers worldwide, with 529000 cases in 2008 and more than 85% cases occur in developing countries. One way to treat this cancer is through the inhibition of HDAC enzymes which play a strategic role in the regulation of gene expression. Suberoyl Anilide Hydroxamic Acid (SAHA) or Vorinostat is a drug which commercially available to treat the cancer, but still has some side effects. This research present in silico SAHA modification in Zinc Binding Group (ZBG) by organoselenium compound to get ligands which less side effect. From molecular docking simulation, and interaction analysis, there are five best ligands, namely CC27, HA27, HB28, IB25, and KA7. These five ligands have better binding affinity than the standards, and also have interaction with Zn2+ cofactor of inhibited HDAC enzymes. This research is expected to produce more potent HDAC inhibitor as novel drug for cervical cancer treatment.

Direct-to-consumer advertisements for prescription drugs: what are Americans being sold?

PubMed

Woloshin, S; Schwartz, L M; Tremmel, J; Welch, H G

2001-10-06

Pharmaceutical companies spent US$1.8 billion on direct-to-consumer advertisements for prescription drugs in 1999. Our aim was to establish what messages are being communicated to the public by these advertisements. We investigated the content of advertisements, which appeared in ten magazines in the USA. We examined seven issues of each of these published between July, 1998, and July, 1999. 67 advertisements appeared a total of 211 times during our study. Of these, 133 (63%) were for drugs to ameliorate symptoms, 54 (26%) to treat disease, and 23 (11%) to prevent illness. In the 67 unique advertisements, promotional techniques used included emotional appeals (45, 67%) and encouragement of consumers to consider medical causes for their experiences (26, 39%). More advertisements described the benefit of medication with vague, qualitative terms (58, 87%), than with data (9, 13%). However, half the advertisements used data to describe side-effects, typically with lists of side-effects that generally occurred infrequently. None mentioned cost. Provision of complete information about the benefit of prescription drugs in advertisements would serve the interests of physicians and the public.

Pomegranate for Prevention and Treatment of Cancer: An Update.

PubMed

Sharma, Pooja; McClees, Sarah F; Afaq, Farrukh

2017-01-24

Cancer is the second leading cause of death in the United States, and those who survive cancer may experience lasting difficulties, including treatment side effects, as well as physical, cognitive, and psychosocial struggles. Naturally-occurring agents from dietary fruits and vegetables have received considerable attention for the prevention and treatment of cancers. These natural agents are safe and cost efficient in contrast to expensive chemotherapeutic agents, which may induce significant side effects. The pomegranate ( Punica granatum L.) fruit has been used for the prevention and treatment of a multitude of diseases and ailments for centuries in ancient cultures. Pomegranate exhibits strong antioxidant activity and is a rich source of anthocyanins, ellagitannins, and hydrolysable tannins. Studies have shown that the pomegranate fruit as well as its juice, extract, and oil exert anti-inflammatory, anti-proliferative, and anti-tumorigenic properties by modulating multiple signaling pathways, which suggest its use as a promising chemopreventive/chemotherapeutic agent. This review summarizes preclinical and clinical studies highlighting the role of pomegranate in prevention and treatment of skin, breast, prostate, lung, and colon cancers.

Pomegranate for Prevention and Treatment of Cancer: An Update

PubMed Central

Sharma, Pooja; McClees, Sarah F.; Afaq, Farrukh

2017-01-01

Cancer is the second leading cause of death in the United States, and those who survive cancer may experience lasting difficulties, including treatment side effects, as well as physical, cognitive, and psychosocial struggles. Naturally-occurring agents from dietary fruits and vegetables have received considerable attention for the prevention and treatment of cancers. These natural agents are safe and cost efficient in contrast to expensive chemotherapeutic agents, which may induce significant side effects. The pomegranate (Punica granatum L.) fruit has been used for the prevention and treatment of a multitude of diseases and ailments for centuries in ancient cultures. Pomegranate exhibits strong antioxidant activity and is a rich source of anthocyanins, ellagitannins, and hydrolysable tannins. Studies have shown that the pomegranate fruit as well as its juice, extract, and oil exert anti-inflammatory, anti-proliferative, and anti-tumorigenic properties by modulating multiple signaling pathways, which suggest its use as a promising chemopreventive/chemotherapeutic agent. This review summarizes preclinical and clinical studies highlighting the role of pomegranate in prevention and treatment of skin, breast, prostate, lung, and colon cancers. PMID:28125044

Skin Effect Simulation for Area 11 Dense Plasma Focus Hot Plate

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

Meehan, B. Timothy

Two arc flashover events occurred at the DPF Area 11 facility. These flashover events happened in the same location on the bank current delivery plates. The damage from one of these events can be seen on the left-hand side of Figure 1. Since the flashovers occurred in the same area of the bank, and the reliability of the bank is important for future DPF experiments, a failure analysis effort was initiated. Part of this failure analysis effort was an effort to understand the physical reasons behind why the flashover happened, and why it happened in the same place twice. Thismore » paper summarizes an effort to simulate the current flow in the bank in order to understand the reasons for the flashover.« less

Factors affecting patient's perception of anticancer treatments side-effects: an observational study.

PubMed

Russo, Stefania; Cinausero, Marika; Gerratana, Lorenzo; Bozza, Claudia; Iacono, Donatella; Driol, Pamela; Deroma, Laura; Sottile, Roberta; Fasola, Gianpiero; Puglisi, Fabio

2014-02-01

Analysis of relative importance of side effects of anticancer therapy is extremely useful in the process of clinical decision making. There is evidence that patients' perception of the side effects of anticancer treatments changes over time. Aim of this study was to evaluate the cancer patients' perceptions of physical and non-physical side effects of contemporary anticancer therapy. Four hundred and sixty-four patients entered the study (153 men and 311 women). Participants were asked to rank their side effects in order of distress by using two sets of cards naming physical and non-physical effects, respectively. Influencing factors, including treatment and patient characteristics, were also analysed. Patients ranked the non-physical side effect 'Affects my family or partner' first. 'Constantly tired' and 'Loss of hair' were ranked second and third, respectively. Significant differences from previous studies on this topic emerged. In particular, 'Vomiting', a predominant concern in previous studies, almost disappeared, whereas 'Nausea' and 'Loss of hair' remained important side effects in the patients' perception. Interestingly, marital status was predominant in driving patients' perception, being associated with several side effects ('Constantly tired', 'Loss of appetite', 'Affects my work/Home duties', 'Affects my social activities', 'Infertility'). Other significant factors influencing patient's perception of side effects included age, disease characteristics and ongoing anticancer therapy. This study provided information on current status of patients' perceptions of side effects of anticancer treatment. These results could be used in pre-treatment patient education and counselling.

Effects of Double-Leakage Tip Clearance Flow on the Performance of a Compressor Stage with a Large Rotor Tip Gap

NASA Technical Reports Server (NTRS)

Hah, Chunill

2016-01-01

Effects of a large rotor tip gap on the performance of a one and half stage axial compressor are investigated in detail with a numerical simulation based on LES and available PIV data. The current paper studies the main flow physics, including why and how the loss generation is increased with the large rotor tip gap. The present study reveals that when the tip gap becomes large, tip clearance fluid goes over the tip clearance core vortex and enters into the next blade's tip gap, which is called double-leakage tip clearance flow. As the tip clearance flow enters into the adjacent blade's tip gap, a vortex rope with a lower pressure core is generated. This vortex rope breaks up the tip clearance core vortex of the adjacent blade, resulting in a large additional mixing. This double-leakage tip clearance flow occurs at all operating conditions, from design flow to near stall condition, with the large tip gap for the current compressor stage. The double-leakage tip clearance flow, its interaction with the tip clearance core vortex of the adjacent blade, and the resulting large mixing loss are the main flow mechanism of the large rotor tip gap in the compressor. When the tip clearance is smaller, flow near the end wall follows more closely with the main passage flow and this double-leakage tip clearance flow does not happen near the design flow condition for the current compressor stage. When the compressor with a large tip gap operates at near stall operation, a strong vortex rope is generated near the leading edge due to the double-leakage flow. Part of this vortex separates from the path of the tip clearance core vortex and travels from the suction side of the blade toward the pressure side of the blade. This vortex is generated periodically at near stall operation with a large tip gap. As the vortex travels from the suction side to the pressure side of the blade, a large fluctuation of local pressure forces blade vibration. Nonsynchronous blade vibration occurs due to this vortex as the frequency of this vortex generation is not the same as the rotor. The present investigation confirms that this vortex is a part of separated tip clearance vortex, which is caused by the double-leakage tip clearance flow.

Electromigration Failure Mechanism in Sn-Cu Solder Alloys with OSP Cu Surface Finish

NASA Astrophysics Data System (ADS)

Chu, Ming-Hui; Liang, S. W.; Chen, Chih; Huang, Annie T.

2012-09-01

Organic solderable preservative (OSP) has been adopted as the Cu substrate surface finish in flip-chip solder joints for many years. In this study, the electromigration behavior of lead-free Sn-Cu solder alloys with thin-film under bump metallization and OSP surface finish was investigated. The results showed that severe damage occurred on the substrate side (cathode side), whereas the damage on the chip side (cathode side) was not severe. The damage on the substrate side included void formation, copper dissolution, and formation of intermetallic compounds (IMCs). The OSP Cu interface on the substrate side became the weakest point in the solder joint even when thin-film metallization was used on the chip side. Three-dimensional simulations were employed to investigate the current density distribution in the area between the OSP Cu surface finish and the solder. The results indicated that the current density was higher along the periphery of the bonding area between the solder and the Cu pad, consistent with the area of IMC and void formation in our experimental results.

Does combined strength training and local vibration improve isometric maximum force? A pilot study.

PubMed

Goebel, Ruben; Haddad, Monoem; Kleinöder, Heinz; Yue, Zengyuan; Heinen, Thomas; Mester, Joachim

2017-01-01

The aim of the study was to determine whether a combination of strength training (ST) and local vibration (LV) improved the isometric maximum force of arm flexor muscles. ST was applied to the left arm of the subjects; LV was applied to the right arm of the same subjects. The main aim was to examine the effect of LV during a dumbbell biceps curl (Scott Curl) on isometric maximum force of the opposite muscle among the same subjects. It is hypothesized, that the intervention with LV produces a greater gain in isometric force of the arm flexors than ST. Twenty-seven collegiate students participated in the study. The training load was 70% of the individual 1 RM. Four sets with 12 repetitions were performed three times per week during four weeks. The right arm of all subjects represented the vibration trained body side (VS) and the left arm served as the traditional trained body side (TTS). A significant increase of isometric maximum force in both body sides (Arms) occurred. VS, however, significantly increased isometric maximum force about 43% in contrast to 22% of the TTS. The combined intervention of ST and LC improves isometric maximum force of arm flexor muscles. III.

Quantifying the variability in stiffness and damping of an automotive vehicle's trim-structure mounts

NASA Astrophysics Data System (ADS)

Abolfathi, Ali; O'Boy, Dan J.; Walsh, Stephen J.; Dowsett, Amy; Fisher, Stephen A.

2016-09-01

Small plastic clips are used in large numbers in automotive vehicles to connect interior trims to vehicle structures. The variability in their properties can contribute to the overall variability in noise and vibration response of the vehicle. The variability arises due to their material and manufacturing tolerances and more importantly due to the boundary condition. To measure their stiffness and damping, a simple experimental rig is used where a mass is supported by the clip which is modelled as a single degree of freedom system. The rig is designed in a way that it simulates the boundary condition as those of the real vehicle. The variability in clip and also due to the boundary condition at the structure side is first examined which is 7% for stiffness and 8% for damping. To simulate the connection of the trim side, a mount is built using a 3D printer. Rattling occurs in the response of the clips with loose connections, however by preloading the mount the effective stiffness increases and the rattling is eliminated. The variability due to the boundary condition at the trim side was as large as 40% for stiffness and 52% for damping.

Low-level laser therapy (LLLT) does not reduce subcutaneous adipose tissue by local adipocyte injury but rather by modulation of systemic lipid metabolism.

PubMed

Jankowski, Marek; Gawrych, Mariusz; Adamska, Urszula; Ciescinski, Jakub; Serafin, Zbigniew; Czajkowski, Rafal

2017-02-01

Low-level laser (light) therapy (LLLT) has been applied recently to body contouring. However the mechanism of LLLT-induced reduction of subcutaneous adipose tissue thickness has not been elucidated and proposed hypotheses are highly controversial. Non-obese volunteers were subject to 650nm LLLT therapy. Each patient received 6 treatments 2-3 days apart to one side of the abdomen. The contralateral side was left untreated and served as control. Subjects' abdominal adipose tissue thickness was measured by ultrasound imaging at baseline and 2 weeks post-treatment. Our study is to the best of our knowledge, the largest split-abdomen study employing subcutaneous abdominal fat imaging. We could not show a statistically significant reduction of abdominal subcutaneous adipose tissue by LLLT therapy. Paradoxically when the measurements of the loss of fat thickness on treated side was corrected for change in thickness on non treated side, we have observed that in 8 out of 17 patients LLLT increased adipose tissue thickness. In two patients severe side effect occurred as a result of treatment: one patient developed ulceration within appendectomy scar, the other over the posterior superior iliac spine. The paradoxical net increase in subcutaneous fat thickness observed in some of our patients is a rationale against liquefactive and transitory pore models of LLLT-induced adipose tissue reduction. LLLT devices with laser diode panels applied directly on the skin are not as safe as devices with treatment panels separated from the patient's skin.

Microstructural variation through weld thickness and mechanical properties of peened friction stir welded 6061 aluminum alloy joints

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

Abdulstaar, Mustafa A., E-mail: mustafa.abdulstaar

The current study examined the effect of microstructure variation on the development of mechanical properties in friction stir welded joints of 6061-T6 aluminum alloy, which were subsequently processed by shot peening (SP). Following to FSW, fatigue specimens were extracted perpendicularly to the welding direction. Surface Skimming to 0.5 mm from crown and root sides of the joint was made and SP was later applied on the two sides using ceramic shots of two different Almen intensities of 0.18 mmA and 0.24 mmA. Microstructural examination by electron back scattered diffraction (EBSD) indicated variation in the grain refinement of the weld zone,more » with coarsest grains (5 μm) at the crown side and finest grains (2 μm) at the root side. Reduction of microhardness to 60 HV occurred in the weld zone for samples in FSW condition. Application of SP promoted significant strain hardening at the crown side, with Almen intensities of 0.24 mmA providing maximum increase in microhardness to 120 HV. On the contrary, only a maximum microhardness of 75 HV was obtained at the root side. The difference in strain hardening capability at the two sides was strongly dependent on grain size. The two Almen intensities produced similar distribution of compressive residual stresses in the subsurface regions that led to enhance the fatigue strength to the level of base metal for N ≥ 10{sup 5} cycles. Yet, the increase in fatigue strength was more pronounced with increasing Almen intensity to 0.24 mmA, demonstrating further enhancement by strain hardening. - Highlights: • Grain refinement was observed after friction stir welding of AA 6061-T6. • Reduction in microhardness and fatigue strength were obtained after welding. • Variation in grain refinement led to different hardening behavior after peening. • Shot peening induced beneficial compressive residual stresses. • Shot peening and surface skimming markedly improved the fatigue performance.« less

Medication Side Effects among People with Epilepsy Taking Phenobarbital in Zambia

PubMed Central

Elafros, Melissa A.; Bui, Esther; Birbeck, Gretchen L.

2014-01-01

Phenobarbital remains one of the most widely used antiepileptic drugs worldwide, yet there are limited data regarding side effects associated with its use in routine clinical care settings in low-income countries. Available data suggests that phenobarbital is as effective as other first-line drugs for treating tonic-clonic seizures, but side effect reports differ widely between high and low-income settings. A better understanding of phenobarbital side effect profile and severity in low-income settings is warranted given its role in efforts to decrease the epilepsy treatment gap. We used the Liverpool Adverse Events Profile (LEAP) to assess side effects in consecutive patients with epilepsy on phenobarbital seeking care in rural Zambia. Data regarding age, gender, medication dose, and medication adherence were also collected. T-tests and Spearman’s correlation coefficient were used to assess predictors of LEAP score and medication adherence. Thirty-five patients receiving a mean dose of 2.1 mg/kg/day (SD: 2.78 mg/kg/day) of phenobarbital were assessed. All participants reported at least one side effect in the previous four weeks with a median of 6 symptoms (IQR: 4–8) and a mean side effects score of 28/76 (SD: 5.38). Over half reported sleepiness and dizziness. Memory problems and depression were also common (both 46%). Total LAEP score was not associated with age (p=0.88), gender (p=0.17), or phenobarbital dose (p=0.13). Medication adherence was not associated with side effects total score (p=0.56). Rural Zambian adults taking phenobarbital at doses recommended by the WHO report a significant number of side effects. The most common side effects reported were similar to those reported in high-income countries. The significant burden of phenobarbital-associated side effects in this African cohort is in contrast to data from non-randomized clinical trials in China that reported phenobarbital to be well-tolerated with few side effects. Additional investigations regarding phenobarbital side effects in routine care in low income settings is warranted. PMID:25219354

Medication side effects among people with epilepsy taking phenobarbital in Zambia.

PubMed

Elafros, Melissa A; Bui, Esther; Birbeck, Gretchen L

2014-11-01

Phenobarbital remains one of the most widely used antiepileptic drugs worldwide, yet there are limited data regarding side effects associated with its use in routine clinical care settings in low-income countries. Available data suggests that phenobarbital is as effective as other first-line drugs for treating tonic-clonic seizures, but side effect reports differ widely between high and low-income settings. A better understanding of phenobarbital side effect profile and severity in low-income settings is warranted given its role in efforts to decrease the epilepsy treatment gap. We used the Liverpool adverse events profile (LEAP) to assess side effects in consecutive patients with epilepsy on phenobarbital seeking care in rural Zambia. Data regarding age, gender, medication dose, and medication adherence were also collected. T-tests and Spearman's correlation coefficient were used to assess predictors of LEAP score and medication adherence. Thirty-five patients receiving a mean dose of 2.1mg/kg/day (SD: 2.78 mg/kg/day) of phenobarbital were assessed. All participants reported at least one side effect in the previous four weeks with a median of 6 symptoms (IQR: 4-8) and a mean side effects score of 28/76 (SD: 5.38). Over half reported sleepiness and dizziness. Memory problems and depression were also common (both 46%). Total LAEP score was not associated with age (p=0.88), gender (p=0.17), or phenobarbital dose (p=0.13). Medication adherence was not associated with side effects total score (p=0.56). Rural Zambian adults taking phenobarbital at doses recommended by the World Health Organization report a significant number of side effects. The most common side effects reported were similar to those reported in high-income countries. The significant burden of phenobarbital-associated side effects in this African cohort is in contrast to data from non-randomized clinical trials in China that reported phenobarbital to be well-tolerated with few side effects. Additional investigations regarding phenobarbital side effects during routine care in low income settings is warranted. Copyright © 2014 Elsevier B.V. All rights reserved.

Enhancement of Electrokinetically-Driven Flow Mixing in Microchannel with Added Side Channels

NASA Astrophysics Data System (ADS)

Yang, Ruey-Jen; Wu, Chien-Hsien; Tseng, Tzu-I; Huang, Sung-Bin; Lee, Gwo-Bin

2005-10-01

Electroosmotic flow (EOF) in microchannels is restricted to low Reynolds number regimes. Since the inertial forces are extremely weak in such regimes, turbulent conditions do not readily develop. Therefore, species mixing occurs primarily via diffusion, with the result that extended mixing channels are generally required. The present study considers a T-shaped microchannel configuration with a mixing channel of width W=280 μm. Computational fluid dynamics simulations and experiments were performed to investigate the influence on the mixing efficiency of various geometrical parameters, including the side-channel width, the side-channel separation, and the number of side-channel pairs. The influence of different applied voltages is also considered. The numerical results reveal that the mixing efficiency can be enhanced to yield a fourfold improvement by incorporating two pairs of side channels into the mixing channel. It was also found that the mixing performance depends significantly upon the magnitudes of the applied voltages.

SIDECACHE: Information access, management and dissemination framework for web services.

PubMed

Doderer, Mark S; Burkhardt, Cory; Robbins, Kay A

2011-06-14

Many bioinformatics algorithms and data sets are deployed using web services so that the results can be explored via the Internet and easily integrated into other tools and services. These services often include data from other sites that is accessed either dynamically or through file downloads. Developers of these services face several problems because of the dynamic nature of the information from the upstream services. Many publicly available repositories of bioinformatics data frequently update their information. When such an update occurs, the developers of the downstream service may also need to update. For file downloads, this process is typically performed manually followed by web service restart. Requests for information obtained by dynamic access of upstream sources is sometimes subject to rate restrictions. SideCache provides a framework for deploying web services that integrate information extracted from other databases and from web sources that are periodically updated. This situation occurs frequently in biotechnology where new information is being continuously generated and the latest information is important. SideCache provides several types of services including proxy access and rate control, local caching, and automatic web service updating. We have used the SideCache framework to automate the deployment and updating of a number of bioinformatics web services and tools that extract information from remote primary sources such as NCBI, NCIBI, and Ensembl. The SideCache framework also has been used to share research results through the use of a SideCache derived web service.

Both sides retaliate in the Israeli–Palestinian conflict

PubMed Central

Haushofer, Johannes; Biletzki, Anat; Kanwisher, Nancy

2010-01-01

Ending violent international conflicts requires understanding the causal factors that perpetuate them. In the Israeli–Palestinian conflict, Israelis and Palestinians each tend to see themselves as victims, engaging in violence only in response to attacks initiated by a fundamentally and implacably violent foe bent on their destruction. Econometric techniques allow us to empirically test the degree to which violence on each side occurs in response to aggression by the other side. Prior studies using these methods have argued that Israel reacts strongly to attacks by Palestinians, whereas Palestinian violence is random (i.e., not predicted by prior Israeli attacks). Here we replicate prior findings that Israeli killings of Palestinians increase after Palestinian killings of Israelis, but crucially show further that when nonlethal forms of violence are considered, and when a larger dataset is used, Palestinian violence also reveals a pattern of retaliation: (i) the firing of Palestinian rockets increases sharply after Israelis kill Palestinians, and (ii) the probability (although not the number) of killings of Israelis by Palestinians increases after killings of Palestinians by Israel. These findings suggest that Israeli military actions against Palestinians lead to escalation rather than incapacitation. Further, they refute the view that Palestinians are uncontingently violent, showing instead that a significant proportion of Palestinian violence occurs in response to Israeli behavior. Well-established cognitive biases may lead participants on each side of the conflict to underappreciate the degree to which the other side's violence is retaliatory, and hence to systematically underestimate their own role in perpetuating the conflict. PMID:20921415

Reducing Aversion to Side Effects in Preventive Medical Treatment Decisions

ERIC Educational Resources Information Center

Waters, Erika A.; Weinstein, Neil D.; Colditz, Graham A.; Emmons, Karen M.

2007-01-01

Laypeople tend to be overly sensitive to side effects of treatments that prevent illness, possibly leading them to refuse beneficial therapies. This Internet-based study attempted to reduce such side effect aversion by adding graphic displays to the numerical risk probabilities. It also explored whether graphics reduce side effect aversion by…

Systematic identification of proteins that elicit drug side effects

PubMed Central

Kuhn, Michael; Al Banchaabouchi, Mumna; Campillos, Monica; Jensen, Lars Juhl; Gross, Cornelius; Gavin, Anne-Claude; Bork, Peer

2013-01-01

Side effect similarities of drugs have recently been employed to predict new drug targets, and networks of side effects and targets have been used to better understand the mechanism of action of drugs. Here, we report a large-scale analysis to systematically predict and characterize proteins that cause drug side effects. We integrated phenotypic data obtained during clinical trials with known drug–target relations to identify overrepresented protein–side effect combinations. Using independent data, we confirm that most of these overrepresentations point to proteins which, when perturbed, cause side effects. Of 1428 side effects studied, 732 were predicted to be predominantly caused by individual proteins, at least 137 of them backed by existing pharmacological or phenotypic data. We prove this concept in vivo by confirming our prediction that activation of the serotonin 7 receptor (HTR7) is responsible for hyperesthesia in mice, which, in turn, can be prevented by a drug that selectively inhibits HTR7. Taken together, we show that a large fraction of complex drug side effects are mediated by individual proteins and create a reference for such relations. PMID:23632385

Prediction of Central Nervous System Side Effects Through Drug Permeability to Blood-Brain Barrier and Recommendation Algorithm.

PubMed

Fan, Jun; Yang, Jing; Jiang, Zhenran

2018-04-01

Drug side effects are one of the public health concerns. Using powerful machine-learning methods to predict potential side effects before the drugs reach the clinical stages is of great importance to reduce time consumption and protect the security of patients. Recently, researchers have proved that the central nervous system (CNS) side effects of a drug are closely related to its permeability to the blood-brain barrier (BBB). Inspired by this, we proposed an extended neighborhood-based recommendation method to predict CNS side effects using drug permeability to the BBB and other known features of drug. To the best of our knowledge, this is the first attempt to predict CNS side effects considering drug permeability to the BBB. Computational experiments demonstrated that drug permeability to the BBB is an important factor in CNS side effects prediction. Moreover, we built an ensemble recommendation model and obtained higher AUC score (area under the receiver operating characteristic curve) and AUPR score (area under the precision-recall curve) on the data set of CNS side effects by integrating various features of drug.

Polyurethane-covered mammary implants: a 12-year experience.

PubMed

Gasperoni, C; Salgarello, M; Gargani, G

1992-10-01

Polyurethane-covered mammary implants are the implants of choice in aesthetic and reconstructive mammary surgery. These implants give very good results in regard to breast contour and consistency, and have a very low complication rate. We present our 12-year experience using polyurethane-covered prostheses. We place the implant mostly in the subglandular or subcutaneous site, and their capsular contracture rate is extremely low (3.3%). Based on our experience, we also review the other complications and side effects occurring with polyurethane prostheses and discuss them in detail.

Reinventing the PN Junction: Dimensionality Effects on Tunneling Switches

DTIC Science & Technology

2012-05-11

Figure 4.7. Finally we need to define the band tail density of states:    > < = −− Vp qVEE Vp p EEe EE ED OVp , ,1 )( /)( (4.3.10...Cn qVEE Cn n EEe EE ED OCn , ,1 )( /)( (4.3.11) Here EVp is the valence band edge on the p side and ECn is the conduction band...semiconductor will occur at the oxide semiconductor interface and is given by the boundary condition SSOXOX EE  εε = . This means that the maximum

The transition to a deterrence posture more reliant on strategic defenses

NASA Astrophysics Data System (ADS)

Chrzanowski, Paul L.

1988-12-01

Strategic nuclear deterrence is currently based on the overwhelming capability of the arsenals of the two superpowers. Massive damage would be inflicted upon the military forces and industrial capacity of both sides should nuclear war occur and escalation of conflict not be controlled. Nuclear deterrence has fostered a condition of peace in central Europe and an absence of direct conflict between the U.S. and the Soviet Union. However, some question whether deterrence will remain effective into the indefinite future, and should deterrence fail the consequences are grave.

Ocular changes with oxaliplatin.

PubMed

O'Dea, Denise; Handy, Catherine M; Wexler, Ann

2006-04-01

Ocular toxicity, although uncommon, can occur with many chemotherapeutic agents. Platinum compounds have been documented to produce a variety of ocular side effects, and reports have been made of ocular toxicity with oxaliplatin. This article reports on four patients who experienced ocular symptoms while receiving oxaliplatin. The symptoms included tunnel vision and visual loss with postural changes. One patient had objective findings that included papilledema. All of the changes were reversible. Oxaliplatin will continue to be used widely, so clinicians treating patients with it must be alert for unusual toxicities such as those described in this article.

An Ensemble Approach for Drug Side Effect Prediction

PubMed Central

Jahid, Md Jamiul; Ruan, Jianhua

2014-01-01

In silico prediction of drug side-effects in early stage of drug development is becoming more popular now days, which not only reduces the time for drug design but also reduces the drug development costs. In this article we propose an ensemble approach to predict drug side-effects of drug molecules based on their chemical structure. Our idea originates from the observation that similar drugs have similar side-effects. Based on this observation we design an ensemble approach that combine the results from different classification models where each model is generated by a different set of similar drugs. We applied our approach to 1385 side-effects in the SIDER database for 888 drugs. Results show that our approach outperformed previously published approaches and standard classifiers. Furthermore, we applied our method to a number of uncharacterized drug molecules in DrugBank database and predict their side-effect profiles for future usage. Results from various sources confirm that our method is able to predict the side-effects for uncharacterized drugs and more importantly able to predict rare side-effects which are often ignored by other approaches. The method described in this article can be useful to predict side-effects in drug design in an early stage to reduce experimental cost and time. PMID:25327524

Right sided weakness with right subdural hematoma: motor deafferentation of left hemisphere resulted in paralysis of the right side.

PubMed

Derakhshan, Iraj

2009-08-01

A right handed man with trauma to the head was admitted with headache and seizures. A severe right sided weakness was noted after a blunt trauma to the right side of his head. MRI of brain revealed a right-sided subdural hematoma and a normal left hemisphere and downstream motor pathways. Bimanual simultaneous drawing and manual reaction times indicated that the patient was right hemispheric in laterality of his major hemisphere. The right sided weakness in this patient was due to temporary transcallosal disconnection (diaschisis) of the minor hemisphere (left, in this case) from the excitatory signals arising from those structures of his major hemisphere devoted to movements occurring on nondominant side, transmitted via the corpus callosum to his left hemisphere. This case draws attention to disparity between neural and behavioral handedness (laterality of major hemisphere versus that of the preferred hand). Drawing longer lines by the left hand in simultaneous bimanual tasks and a slower simple reaction time to central visual stimuli by the ostensible dominant hand permitted lateralization of the major hemisphere to the right. Thus, the neurally nondominant side (right) lagged behind the dominant (left) by an interval equal to interhemispheric transfer time.

Effect of cationic side-chains on intracellular delivery and cytotoxicity of pH sensitive polymer-doxorubicin nanocarriers.

PubMed

Fang, Chen; Kievit, Forrest M; Cho, Yong-Chan; Mok, Hyejung; Press, Oliver W; Zhang, Miqin

2012-11-21

Fine-tuning the design of polymer-doxorubicin conjugates permits optimization of an efficient nanocarrier to greatly increase intracellular uptake and cytotoxicity. Here, we report synthesis of a family of self-assembled polymer-doxorubicin nanoparticles and an evaluation of the effects of various types of side-chains on intracellular uptake and cytotoxicity of the nanocarriers for lymphoma cells. Monomers with three different cationic side-chains (CA) and pK(a)'s, i.e., a guanidinium group (Ag), an imidazole group (Im), and a tertiary amine group (Dm), were comparatively investigated. The cationic monomer, poly(ethylene glycol) (PEG), and doxorubicin (Dox) were reacted with 1,4-(butanediol) diacrylate (BUDA) to prepare a poly(β-amino ester) (PBAE) polymer via Michael addition. All three polymer-Dox conjugates spontaneously formed nanoparticles (NP) through hydrophobic interactions between doxorubicin in aqueous solution, resulting in NP-Im/Dox, NP-Ag/Dox, and NP-Dm/Dox, with hydrodynamic sizes below 80 nm. Doxorubicin was linked to all 3 types of NPs with a hydrazone bond to assure selective release of doxorubicin only at acidic pH, as it occurs in the tumor microenvironment. Both NP-Im/Dox and NP-Ag/Dox exhibited much higher intracellular uptake by Ramos cells (Burkitt's lymphoma) than NP-Dm/Dox, suggesting that the type of side chain in the NPs determines the extent of intracellular uptake. As a result, NP-Im/Dox and NP-Ag/Dox showed cytotoxicity that was comparable to free Dox in vitro. Our findings suggest that the nature of surface cationic group on nanocarriers may profoundly influence their intracellular trafficking and resulting therapeutic efficacy. Thus, it is a crucial factor to be considered in the design of novel carriers for intracellular drug delivery.