Sample records for study year ii

  1. Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades II and III hemorrhoids: Results from a multicenter study

    PubMed Central

    Miyamoto, Hidenori; Hada, Takenori; Ishiyama, Gentaro; Ono, Yoshito; Watanabe, Hideo

    2016-01-01

    AIM: To show that aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy has a high success rate for Grade II and III hemorrhoids. METHODS: This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015. The objective of this study was to assess the efficacy of this treatment for Grades II and III hemorrhoids. Preoperative and postoperative symptoms, complications and success rate were all assessed retrospectively. Follow-up consisted of a simple questionnaire, physical examination and an anoscopy. Patients were followed-up at one day, one week, two weeks, one month, one year, two years, three years, four years and five years after the ALTA sclerotherapy. RESULTS: One hundred and sixty-nine patients were diagnosed with Grade II hemorrhoids and 435 patients were diagnosed with Grade III hemorrhoids. The one year, three year and five year cumulative success rates of ALTA sclerotherapy for Grades II and III hemorrhoids were 95.9% and 93.1%; 89.3% and 83.7%; and 89.3% and 78.2%, respectively. No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between Grades II and III hemorrhoids (P = 0.09). There were forty-seven post-operative complications (low grade fever; anal pain; urinary retention; rectal ulcer; and others). No serious or life-threatening complications occurred and all cases improved through conservative treatment. At univariate analysis there were no predictive factors of failure. CONCLUSION: ALTA sclerotherapy has had a high success rate for Grade II and III hemorrhoids during five years of post-operative treatment. However, additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease. PMID:27458504

  2. Sino-implant (II) - a levonorgestrel-releasing two-rod implant: systematic review of the randomized controlled trials

    PubMed Central

    Steiner, Markus J.; Lopez, Laureen M.; Grimes, David A.; Cheng, Linan; Shelton, Jim; Trussell, James; Farley, Timothy M.M.; Dorflinger, Laneta

    2013-01-01

    Background Sino-implant (II) is a subdermal contraceptive implant manufactured in China. This two-rod levonorgestrel-releasing implant has the same amount of active ingredient (150 mg levonorgestrel) and mechanism of action as the widely available contraceptive implant Jadelle. We examined randomized controlled trials of Sino-implant (II) for effectiveness and side effects. Study design We searched electronic databases for studies of Sino-implant (II), and then restricted our review to randomized controlled trials. The primary outcome of this review was pregnancy. Results Four randomized trials with a total of 15,943 women assigned to Sino-implant (II) had first-year probabilities of pregnancy ranging from 0.0% to 0.1%. Cumulative probabilities of pregnancy during the four years of the product's approved duration of use were 0.9% and 1.06% in the two trials that presented date for four-year use. Five-year cumulative probabilities of pregnancy ranged from 0.7% to 2.1%. In one trial, the cumulative probability of pregnancy more than doubled during the fifth year (from 0.9% to 2.1%), which may be why the implant is approved for four years of use in China. Five-year cumulative probabilities of discontinuation due to menstrual problems ranged from 12.5% to 15.5% for Sino-implant (II). Conclusions Sino-implant (II) is one of the most effective contraceptives available today. These available clinical data, combined with independent laboratory testing, and the knowledge that 7 million women have used this method since 1994, support the safety and effectiveness of Sino-implant (II). The lower cost of Sino-implant (II) compared with other subdermal implants could improve access to implants in resource-constrained settings. PMID:20159174

  3. Predictors of activity limitation in people with gout: a prospective study.

    PubMed

    Stewart, Sarah; Rome, Keith; Eason, Alastair; House, Meaghan E; Horne, Anne; Doyle, Anthony J; Knight, Julie; Taylor, William J; Dalbeth, Nicola

    2018-04-21

    The objective of the study was to determine clinical factors associated with activity limitation and predictors of a change in activity limitation after 1 year in people with gout. Two hundred ninety-five participants with gout (disease duration < 10 years) attended a baseline assessment which included medical and disease-specific history, pain visual analog score and plain radiographs scored for erosion and narrowing. Activity limitation was assessed using the Health Assessment Questionnaire-II (HAQ-II). After 1 year, participants were invited to complete a further HAQ-II; follow-up questionnaires were available for 182 participants. Fully saturated and stepwise regression analyses were used to determine associations between baseline characteristics and HAQ-II at baseline and 1 year, and to determine predictors of worsening HAQ-II in those with normal baseline scores. Median (range) baseline HAQ-II was 0.20 (0-2.50) and 0.20 (0-2.80) after 1 year of follow-up. Pain score was the strongest independent predictor of baseline HAQ-II, followed by radiographic narrowing score, type 2 diabetes, swollen joint count, BMI, age and urate (model R 2  = 0.51, P < 0.001). Baseline HAQ-II was the strongest predictor of change in HAQ-II at 1 year, followed by tender joint count (model R 2  = 0.19, P < 0.001). Of those with HAQ-II scores of 0 at baseline (n = 59, 32% of those with follow-up data), most did not progress (n = 52, 88%); however, baseline pain score, type 2 diabetes and flare frequency were significant predictors of worsening HAQ-II in this group (R 2  = 0.34, P < 0.001). People with gout experience a wide range of activity limitation, and levels of activity limitation are, on average, stable over a 1-year period. Baseline pain scores are strongly associated with activity limitation and predict development of activity limitation in those with normal HAQ-II scores at baseline.

  4. MHC class II expression in lung cancer.

    PubMed

    He, Yayi; Rozeboom, Leslie; Rivard, Christopher J; Ellison, Kim; Dziadziuszko, Rafal; Yu, Hui; Zhou, Caicun; Hirsch, Fred R

    2017-10-01

    Immunotherapy is an exciting development in lung cancer research. In this study we described major histocompatibility complex (MHC) Class II protein expression in lung cancer cell lines and patient tissues. We studied MHC Class II (DP, DQ, DR) (CR3/43, Abcam) protein expression in 55 non-small cell lung cancer (NSCLC) cell lines, 42 small cell lung cancer (SCLC) cell lines and 278 lung cancer patient tissues by immunohistochemistry (IHC). Seven (12.7%) NSCLC cell lines were positive for MHC Class II. No SCLC cell lines were found to be MHC Class II positive. We assessed 139 lung cancer samples available in the Hirsch Lab for MHC Class II. There was no positive MHC Class II staining on SCLC tumor cells. MHC Class II expression on TILs in SCLC was significantly lower than that on TILs in NSCLC (P<0.001). MHC Class II was also assessed in an additional 139 NSCLC tumor tissues from Medical University of Gdansk, Poland. Patients with positive staining of MHC Class II on TILs had longer regression-free survival (RFS) and overall survival (OS) than those whose TILs were MHC Class II negative (2.980 years, 95% CI 1.628-4.332 vs. 1.050 years, 95% CI 0.556-1.554, P=0.028) (3.230 years, 95% CI 2.617-3.843 vs. 1.390 years, 95% CI 0.629-2.151, P=0.014). MHC Class II was expressed both in NSCLC cell lines and tissues. However, MHC Class II was not detected in SCLC cell lines or tissue tumor cells. MHC Class II expression was lower on SCLC TILs than on NSCLC TILs. Loss of expression of MHC Class II on SCLC tumor cells and reduced expression on SCLC TILs may be a means of escaping anti-cancer immunity. Higher MHC Class II expression on TILs was correlated with better prognosis in patients with NSCLC. Copyright © 2017. Published by Elsevier B.V.

  5. Intimate Partner Violence and 5-Year Weight Change in Young Women: A Longitudinal Study

    PubMed Central

    Ayour, Noussaiba; Canney, Suzanne; Eisenberg, Marla E.; Neumark-Sztainer, Dianne

    2017-01-01

    Abstract Background: Intimate partner violence (IPV) and obesity are national public health problems that are potentially associated. We examined the association between IPV exposure and 5-year weight gain in young women. We also examined whether depressive mood conferred additional increases in weight gain. Materials and Methods: Analyses were conducted among women in Project EAT, a longitudinal cohort study of weight-related health, which has collected data at three 5-year survey waves: “EAT I” (mean age 15 years), “EAT II” (mean age 19 years), and “EAT III” (mean age 25 years). Height and body weight were self-reported at each survey wave. IPV victimization and depressive mood were assessed on the EAT II survey. The study comprised women with data on IPV and body mass index (BMI) (N = 619). Linear regression analyses examined (1) 5-year (EAT II to EAT III) BMI change as a function of IPV exposure and (2) 5-year BMI change as a function of depressive mood at EAT II in women with and without IPV exposure. Results: Almost 20% of the study sample reported IPV. Women exposed to both physical and sexual IPV at EAT II gained 1.1 kg/m2 (95% CI −0.2 to 2.4) more, over 5 years, than women unexposed to IPV, although this did not reach statistical significance. Among those with IPV exposure, depressive mood at EAT II was associated with an additional increase in BMI of 1.8 kg/m2 (95% CI 0.2–3.4) relative to no depressive mood. Conclusion: Survivors of IPV with depressive mood may have accelerated weight gain. Trauma-informed obesity prevention strategies may be warranted in this group. PMID:28075656

  6. Correlates of Depression in First-Year College Students

    ERIC Educational Resources Information Center

    Villatte, Aude; Marcotte, Diane; Potvin, Alexandra

    2017-01-01

    This study aimed to identify and rank the personal, family-related, social, and academic correlates of depressive symptoms in first-year college students. A questionnaire that included the Beck Depression Inventory-II (BDI-II) was administered to 389 first-year college students (mean age = 18.9; SD = 3.38; 59.4% female). Eight variables…

  7. Depressive Symptoms Correlate with Disability and Disease Course in Multiple Sclerosis Patients: An Italian Multi-Center Study Using the Beck Depression Inventory.

    PubMed

    Solaro, C; Trabucco, E; Signori, A; Martinelli, V; Radaelli, M; Centonze, D; Rossi, S; Grasso, M G; Clemenzi, A; Bonavita, S; D'Ambrosio, A; Patti, F; D'Amico, E; Cruccu, G; Truini, A

    2016-01-01

    Depression occurs in about 50% of patients with multiple sclerosis. The aims of this study was to investigate the prevalence of depressive symptoms in a multicenter MS population using the Beck Depression Inventory II (BDI II) and to identify possible correlations between the BDI II score and demographic and clinical variables. Data were collected in a multi-center, cross-sectional study over a period of six months in six MS centers in Italy using BDI II. 1,011 MS patients participated in the study. 676 subjects were female, with a mean age of 34 years (SD 10.8), mean EDSS of 3.3 (0-8.5) and mean disease duration of 10.3 years (range 1-50 years). 668 (%) subjects scored lower than 14 on the BDI II and 343 (33.9%) scored greater than 14 (14 cut-off score). For patients with BDI>14 multivariate analysis showed a significant difference between EDSS and disease course. BDI II scores for subjects with secondary progressive (SP) MS were significantly different from primary progressive (PP) patients (p < 0.001) but similar to relapsing-remitting (RR) patients. Considering subjects with moderate to severe depressive symptoms (BDI II score from 20-63), in relation to disease course, 11.7% (83/710) had RR MS, 40.7% (96/236) SP and 13.6% (6/44) PP. Using the BDI II, 30% of the current sample had depressive symptoms. BDI II score correlates with disability and disease course, particularly in subjects with SP MS. The BDI II scale can be a useful tool in clinical practice to screen depressive symptoms in people with MS.

  8. Paramagnetic resonance studies of bistrispyrazolylborate cobalt(II) and related derivatives

    NASA Astrophysics Data System (ADS)

    Myers, William K.

    Herein, a systematic frozen solution electron-nuclear double resonance (ENDOR) study of high-spin Co(II) complexes is reported to demonstrate the efficacy of methyl substitutions as a means of separating dipolar and contact coupling, and further, to increase the utility of high-spin Co(II) as a spectroscopic probe for the ubiquitous, but spectroscopically-silent Zn(II) metalloenzymes. High-spin (hs) Co(II) has been subject of paramagnetic resonance studies for over 50 years and has been used as a spectroscopic probe for Zn metalloenzymes for over 35 years. However, as will be seen, the inherent complexity of the electronic properties of the cobaltous ion remains to be exploited to offer a wealth of information on Zn(II) enzymatic environments. Specifically, ENDOR measurements on bistrispyrazolylborate cobalt(II) confirm the utility of the novel method of methyl substitution to differentiate dipolar and Fermi contact couplings. An extensive set of electron paramagnetic resonance (EPR) simulations were performed. Software was developed to implement an ENDOR control interface. Finally, proton relaxation measurements were made in the range of 12-42 MHz, which were accounted for with the large g-value anisotropy of the Co(II) compounds. Taken as a whole, these studies point to the rich complexity of the electronic structure of high-spin cobalt(II) and, when sufficiently well-characterized, the great utility it has as a surrogate of biological Zn(II).

  9. Antimicrobial Exposure Assessment Task Force II (AEATF II) Volume 5: Governing Document for a Multi-Year Antimicrobial Chemical Exposure Monitoring Program (interim draft document)

    EPA Pesticide Factsheets

    Describes the overall scope of the AEATF II program, demonstrates the need for additional human exposure monitoring data and explains the proposed methodology for the exposure monitoring studies proposed for conduct by the AEATF II.

  10. Association of maternal anti-HLA class II antibodies with protection from allergy in offspring.

    PubMed

    Jones, M; Jeal, H; Harris, J M; Smith, J D; Rose, M L; Taylor, A N; Cullinan, P

    2013-09-01

    Recent studies have suggested that the birth order effect in allergy may be established during the prenatal period and that the protective effect may originate in the mother. HLA class II disparity between mother and foetus has been associated with significantly increased Th1 production. In this study, we investigated whether production of HLA antibodies 4 years after pregnancy with index child is associated with allergic outcomes in offspring at 8 years. Anti-HLA class I and II antibodies were measured in maternal serum (n = 284) and levels correlated to numbers of pregnancies and birth order, and allergic outcomes in offspring at 8 years of age. Maternal anti-HLA class I and II antibodies were significantly higher when birth order, and the number of pregnancies were larger. Anti-HLA class II, but not class I antibodies were associated with significantly less atopy and seasonal rhinitis in the offspring at age 8 years. Mothers with nonatopic (but not atopic) offspring had a significant increase in anti-HLA class I and II antibodies with birth order. This study suggests that the 'birth order' effect in children may be due to parity-related changes in the maternal immune response to foetal antigens. We have observed for the first time an association between maternal anti-HLA class II antibodies and protection from allergy in the offspring. Further work is required to determine immunologically how HLA disparity between mother and father can protect against allergy. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Chesapeake Bay Low Freshwater Inflow Study. Phase II. MAP FOLIO. Biota Assessment.

    DTIC Science & Technology

    1982-05-01

    conditions. These were: 1) Base Average -- average freshwater inflow conditions. by increased water consumption projected for the year 2020. 3) Base Drought...RESOLUTION TEST CHART NATIONAL BUREAU OF STANDARDS. 1963- A TAI m - ii J May 1982 Chesapeake Bay Low Freshwater Inflow Study Phase II Biota Assessment Map...A PERIOD ZOVERED change was found to CIESAPEAKE BAY LOW FRESHWATER INFLOW STUDY FINAL BIOTA ASSESSMENT PHASE II: FINAL REPORT MAP FOLIO s PERFORMING

  12. Chemoradiation in elderly esophageal cancer patients: rationale and design of a phase I/II multicenter study (OSAGE).

    PubMed

    Servagi-Vernat, Stéphanie; Créhange, Gilles; Bonnetain, Franck; Mertens, Cécile; Brain, Etienne; Bosset, Jean François

    2017-07-13

    The management of elderly patients with cancer is a therapeutic challenge and a public health problem. Definitive chemoradiotherapy (CRT) is an accepted standard treatment for patients with locally advanced esophageal cancer who cannot undergo surgery. However, there are few reports regarding tolerance to CRT in elderly patients. We previously reported results for CRT in patients aged ≥75 years. Following this first phase II trial, we propose to conduct a phase I/II study to evaluate the combination of carboplatin and paclitaxel, with concurrent RT in unresectable esophageal cancer patients aged 75 years or older. This prospective multicenter phase I/II study will include esophageal cancer in patients aged 75 years or older. Study procedures will consist to determinate the tolerated dose of chemotherapy (Carboplatin, paclitaxel) and of radiotherapy (41.4-45 and 50.4 Gy) in the phase I. Efficacy will be assessed using a co-primary endpoint encompassing health related quality of life and the progression-free survival in the phase II with the dose recommended of CRT in the phase I. This geriatric evaluation was defined by the French geriatric oncology group (GERICO). This trial has been designed to assess the tolerated dose of CRT in selected patient aged 75 years or older. Clinicaltrials.gov ID: NCT02735057 . Registered on 18 March 2016.

  13. Motor testing at 1 year improves the prediction of motor and mental outcome at 2 years after perinatal hypoxic-ischaemic encephalopathy.

    PubMed

    van Schie, Petra E M; Becher, Jules G; Dallmeijer, Annet J; Barkhof, Frederik; Van Weissenbruch, Mirjam M; Vermeulen, R Jeroen

    2010-01-01

    To investigate the predictive value of motor testing at 1 year for motor and mental outcome at 2 years after perinatal hypoxic-ischaemic encephalopathy (HIE) in term neonates. Motor and mental outcome at 2 years was assessed with the Bayley Scales of Infant Development, 2nd edition (BSID-II) in 32 surviving children (20 males, 12 females; mean gestational age 40.2 wk, SD 1.4; mean birthweight 3217g, SD 435) participating in a prospective cohort study of HIE. The predictive value of three motor tests (Alberta Infant Motor Scale [AIMS], BSID-II, and the Neurological Optimality Score [NOS]) at 1 year was analysed, in addition to predictions based on neonatal Sarnat staging and magnetic resonance imaging (MRI). Poor motor test results were defined as an AIMS z-score of <-2, a psychomotor developmental index of the BSID-II of <70, or a NOS of <26. Poor motor and poor mental outcome at 2 years was defined as a psychomotor developmental index or mental developmental index of the BSID-II of <70. Twelve children, all with Sarnat grade II, had a poor motor outcome and 12 children, of whom one had Sarnat grade I, had a poor mental outcome at 2 years. Nine children had cerebral palsy, of whom five had quadriplegia, three had dyskinesia, and one had hemiplegia. Poor motor tests at 1 year increased the probability of a poor motor outcome from 71% (range 92 to 100%), and a poor mental outcome from 59% (range 77 to 100%) in children with Sarnat grade II and abnormal MRI, assessed with the AIMS and BSID-II or NOS respectively. Additional motor testing at 1 year improves the prediction of motor and mental outcome at 2 years in children with Sarnat grade II and abnormal MRI.

  14. A Statistical Comparison of First Time Praxis II Pass Rates between Homegrown 4 Year Students and Transfer Students of a Medium Size Suburban University: A Six Year Study

    ERIC Educational Resources Information Center

    Holmes, Jason Edward, Jr.

    2011-01-01

    In order to meet the federal mandate specified by the No Child Left Behind Act to demonstrate content competency for teaching certification, students must pass a written examination. Missouri and 37 other states chose the Praxis II to satisfy requirements. Presently, schools of education advertise the passing rate of the Praxis II as 100%, since…

  15. Antimicrobial Exposure Assessment Task Force II (AEATF II) Volume 5: Governing Document for a Multi-Year Antimicrobial Chemical Exposure Monitoring Program (interim draft document with changes)

    EPA Pesticide Factsheets

    This document describes the overall scope of the AEATF II program, demonstrates the need for additional human exposure monitoring data and explains the proposed methodology for the exposure monitoring studies proposed for conduct by the AEATF II.

  16. A multicenter comparative study on the efficacy, safety, and acceptability of the contraceptive subdermal implants Norplant and Norplant-II.

    PubMed

    del Carmen Cravioto, M; Alvarado, G; Canto-de-Cetina, T; Bassol, S; Oropeza, G; Santos-Yung, R; Valencia, J; Palma, Y; Fuziwara, J L; Navarrete, T; Garza-Flores, J; Pérez-Palacios, G

    1997-06-01

    In order to assess efficacy, safety, and acceptability of the contraceptive subdermal implants Norplant and Norplant-II in Mexican women, a comparative phase III clinical trial was undertaken in eight clinics across the country. The study involved 1052 women who were followed-up trimonthly for three years. Cumulative pregnancy rates were 0.29% and 0.34% for Norplant and Norplant-II implants, respectively. Similar overall cumulative discontinuation rates were observed at three years: 50.38% for Norplant capsules, and 50.44% for Norplant-II rods. The main method-related reason for termination was endometrial bleeding irregularity which led to discontinuation rates of 11.94% and 11.62% for Norplant and Norplant-II contraceptive systems, respectively. In 15,279 woman-months of experience accumulated with Norplant implants and 14,092 with Norplant-II implants, there were few adverse events reported. No difference was found between the two groups in either difficulty for implants placement and removal or women's discomfort, even though the time required for insertion and removal of Norplant capsules was longer than for Norplant-II rods. It is concluded that during the first three years of use, both implants systems are equally effective, safe, and acceptable.

  17. Outcome for stage II and III rectal and colon cancer equally good after treatment improvement over three decades.

    PubMed

    Fischer, Joern; Joern, Fischer; Hellmich, Gunter; Gunter, Hellmich; Jackisch, Thomas; Thomas, Jackisch; Puffer, Erik; Erik, Puffer; Zimmer, Jörg; Jörg, Zimmer; Bleyl, Dorothea; Dorothea, Bleyl; Kittner, Thomas; Thomas, Kittner; Witzigmann, Helmut; Helmut, Witzigmann; Stelzner, Sigmar; Sigmar, Stelzner

    2015-06-01

    This study aimed to investigate the outcome for stage II and III rectal cancer patients compared to stage II and III colonic cancer patients with regard to 5-year cause-specific survival (CSS), overall survival, and local and combined recurrence rates over time. This prospective cohort study identified 3,355 consecutive patients with adenocarcinoma of the colon or rectum and treated in our colorectal unit between 1981 and 2011, for investigation. The study was restricted to International Union Against Cancer (UICC) stages II and III. Postoperative mortality and histological incomplete resection were excluded, which left 995 patients with colonic cancer and 726 patients with rectal cancer for further analysis. Five-year CSS rates improved for colonic cancer from 65.0% for patients treated between 1981 and 1986 to 88.1% for patients treated between 2007 and 2011. For rectal cancer patients, the respective 5-year CSS rates improved from 53.4% in the first observation period to 89.8% in the second one. The local recurrence rate for rectal cancer dropped from 34.2% in the years 1981-1986 to 2.1% in the years 2007-2011. In the last decade of observation, prognosis for rectal cancer was equal to that for colon cancer (CSS 88.6 vs. 86.7%, p = 0.409). Survival of patients with colon and rectal cancer has continued to improve over the last three decades. After major changes in treatment strategy including introduction of total mesorectal excision and neoadjuvant (radio)chemotherapy, prognosis for stage II and III rectal cancer is at least as good as for stage II and III colonic cancer.

  18. World War II never ended in my house: interviews of 12 Office of Strategic Services veterans of wartime espionage on the 50th anniversary of WW II.

    PubMed

    Cavin, Susan

    2006-07-01

    The author conducted sociological interviews of 12 OSS spies (7 male, 5 female) who were operatives in France during World War II (WW II). The Office of Strategic Services (OSS) existed from 1941 to 1945 and was later renamed the CIA in 1947. This paper includes family studies of six close relatives of OSS vets and observation of 400 OSS veterans at the 50th anniversary of WW II. Three of the 12 OSS veterans who had been tortured by the Gestapo still suffered from PTSD-startle symptoms after 50 years; those three also suffered massive strokes in later life. The majority of OSS vets, regardless of gender, exhibited "war excitement" when talking about the war 50 years later. Most saw the war as the highpoint of their lives. War excitement needs more careful study within PTSD circles.

  19. Selective attention: psi performance in children with learning disabilities.

    PubMed

    Garcia, Vera Lúcia; Pereira, Liliane Desgualdo; Fukuda, Yotaka

    2007-01-01

    Selective attention is essential for learning how to write and read. The objective of this study was to examine the process of selective auditory attention in children with learning disabilities. Group I included forty subjects aged between 9 years and six months and 10 years and eleven months, who had a low risk of altered hearing, language and learning development. Group II included 20 subjects aged between 9 years and five months and 11 years and ten months, who presented learning disabilities. A prospective study was done using the Pediatric Speech Intelligibility Test (PSI). Right ear PSI with an ipsilateral competing message at speech/noise ratios of 0 and -10 was sufficient to differentiate Group I and Group II. Special attention should be given to the performance of Group II on the first tested ear, which may substantiate important signs of improvements in performance and rehabilitation. The PSI - MCI of the right ear at speech/noise ratios of 0 and -10 was appropriate to differentiate Groups I and II. There was an association with the group that presented learning disabilities: this group showed problems in selective attention.

  20. HLA antibodies and soluble CD30 are associated with poor renal graft outcome: updated results of a single-center cross-sectional study.

    PubMed

    Langan, Leanne L; D'Orsogna, Lloyd; Park, Lawrence P; Hughes, Tiffany L; Irish, Ashley; Luxton, Grant; Witt, Campbell S; Christiansen, Frank T

    2006-01-01

    In a previous study, we have shown that HLA class II antibodies and a high soluble CD30 (sCD30) measured at least 1 year post-transplant predict subsequent graft failure. We have now updated the results of this same cohort of 208 patients 15 months later. HLA-specific antibodies (class I and class II) were detected by ELISA LAT-M and Luminex LabScreen assays. Data on graft outcome was collected with a median follow-up of 4.7 years. By Kaplan-Meier analysis, class II antibody was again associated with a poorer outcome, with an estimated 6-year graft survival of 67% and 71% when detected by ELISA and Luminex, respectively, compared with 92% for those without class II antibody (p < or = 0.0001). A soluble CD30 level of > or = 100 U/ml was also associated with a poorer estimated 6-year graft survival (p = 0.02). HLA antibodies and high sCD30 (> or = 100 U/ml) had an additive effect such that those with both high sCD30 and class II antibodies had a hazard ratio for subsequent graft failure of 18.1 (p = 0.0008) and 8.6 (p = 0.007) when detected by ELISA and Luminex, respectively. These data show that detection of HLA class II antibodies and serum sCD30 measured at least 1 year post-transplant continues to predict a subsequent outcome up to 6 years after the initial measurement; they also show that such measures provide important information that may allow for modification of ongoing therapy.

  1. Survival effect of first- and second-line treatments for patients with primary glioblastoma: a cohort study from a prospective registry, 1997–2010

    PubMed Central

    Nava, Francesca; Tramacere, Irene; Fittipaldo, Andrea; Bruzzone, Maria Grazia; DiMeco, Francesco; Fariselli, Laura; Finocchiaro, Gaetano; Pollo, Bianca; Salmaggi, Andrea; Silvani, Antonio; Farinotti, Mariangela; Filippini, Graziella

    2014-01-01

    Background Prospective follow-up studies of large cohorts of patients with glioblastoma (GBM) are needed to assess the effectiveness of conventional treatments in clinical practice. We report GBM survival data from the Brain Cancer Register of the Fondazione Istituto Neurologico Carlo Besta (INCB) in Milan, Italy, which collected longitudinal data for all consecutive patients with GBM from 1997 to 2010. Methods Survival data were obtained from 764 patients (aged>16 years) with histologically confirmed primary GBM who were diagnosed and treated over a 7-year period (2004–2010) with follow-up to April 2012 (cohort II). Equivalent data from 490 GBM patients diagnosed and treated over the preceding 7 years (1997–2003) with follow-up to April 2005 (cohort I) were available for comparison. Progression-free survival (PFS) was available from 361 and 219 patients actively followed up at INCB in cohorts II and I, respectively. Results Survival probabilities were 54% at 1 year, 21% at 2 years, and 11% at 3 years, respectively, in cohort II compared with 47%, 11%, and 5%, respectively, in cohort I. PFS was 22% and 12% at 1 year in cohorts II and I. Better survival and PFS in cohort II was significantly associated with introduction of the Stupp protocol into clinical practice, with adjusted hazard ratios (HRs) of 0.78 for survival and 0.73 for PFS, or a 22% relative decrease in the risk of death and a 27% relative decrease in the risk of recurrence. After recurrence, reoperation was performed in one-fifth of cohort I and in one-third of cohort II but was not effective (HR, 1.05 in cohort I and 1.02 in cohort II). Second-line chemotherapy, mainly consisting of nitrosourea-based chemotherapy, temozolomide, mitoxantrone, fotemustine, and bevacizumab, improved survival in both cohorts (HR, 0.57 in cohort I and 0.74 in cohort II). Radiosurgery was also effective (HR, 0.52 in cohort II). Conclusions We found a significant increase in overall survival, PFS, and survival after recurrence after 2004, likely due to improvements in surgical techniques, introduction of the Stupp protocol as a first-line treatment, and new standard protocols for second-line chemotherapy and radiosurgery after tumor recurrence. In both cohorts, reoperation after tumor recurrence did not improve survival. PMID:24463354

  2. Survival effect of first- and second-line treatments for patients with primary glioblastoma: a cohort study from a prospective registry, 1997-2010.

    PubMed

    Nava, Francesca; Tramacere, Irene; Fittipaldo, Andrea; Bruzzone, Maria Grazia; Dimeco, Francesco; Fariselli, Laura; Finocchiaro, Gaetano; Pollo, Bianca; Salmaggi, Andrea; Silvani, Antonio; Farinotti, Mariangela; Filippini, Graziella

    2014-05-01

    Prospective follow-up studies of large cohorts of patients with glioblastoma (GBM) are needed to assess the effectiveness of conventional treatments in clinical practice. We report GBM survival data from the Brain Cancer Register of the Fondazione Istituto Neurologico Carlo Besta (INCB) in Milan, Italy, which collected longitudinal data for all consecutive patients with GBM from 1997 to 2010. Survival data were obtained from 764 patients (aged>16 years) with histologically confirmed primary GBM who were diagnosed and treated over a 7-year period (2004-2010) with follow-up to April 2012 (cohort II). Equivalent data from 490 GBM patients diagnosed and treated over the preceding 7 years (1997-2003) with follow-up to April 2005 (cohort I) were available for comparison. Progression-free survival (PFS) was available from 361 and 219 patients actively followed up at INCB in cohorts II and I, respectively. Survival probabilities were 54% at 1 year, 21% at 2 years, and 11% at 3 years, respectively, in cohort II compared with 47%, 11%, and 5%, respectively, in cohort I. PFS was 22% and 12% at 1 year in cohorts II and I. Better survival and PFS in cohort II was significantly associated with introduction of the Stupp protocol into clinical practice, with adjusted hazard ratios (HRs) of 0.78 for survival and 0.73 for PFS, or a 22% relative decrease in the risk of death and a 27% relative decrease in the risk of recurrence. After recurrence, reoperation was performed in one-fifth of cohort I and in one-third of cohort II but was not effective (HR, 1.05 in cohort I and 1.02 in cohort II). Second-line chemotherapy, mainly consisting of nitrosourea-based chemotherapy, temozolomide, mitoxantrone, fotemustine, and bevacizumab, improved survival in both cohorts (HR, 0.57 in cohort I and 0.74 in cohort II). Radiosurgery was also effective (HR, 0.52 in cohort II). We found a significant increase in overall survival, PFS, and survival after recurrence after 2004, likely due to improvements in surgical techniques, introduction of the Stupp protocol as a first-line treatment, and new standard protocols for second-line chemotherapy and radiosurgery after tumor recurrence. In both cohorts, reoperation after tumor recurrence did not improve survival.

  3. A Research Project to Determine the Student Acceptability and Learning Effectiveness of Microform Collections in Community Junior Colleges: Phase II. Final Report.

    ERIC Educational Resources Information Center

    Gaddy, Dale

    Five pilot studies were conducted at four two-year colleges in the Washington, D.C. area during the 1970-71 academic year to identify relevant variables for subsequent in-depth examination in this USOE-funded research project which is designed to determine student acceptance and learning effectiveness of microform. Known as Phase II, the year's…

  4. Retinal Prosthesis System for Advanced Retinitis Pigmentosa: A Health Technology Assessment Update

    PubMed Central

    Lee, Christine; Tu, Hong Anh; Wells, David; Holubowich, Corinne

    2017-01-01

    Background Retinitis pigmentosa is a group of inherited disorders characterized by the degeneration of the photoreceptors in the retina, resulting in progressive vision loss. The Argus II system is designed to restore partial functional vision in patients with profound vision loss from advanced retinitis pigmentosa. At present, it is the only treatment option approved by Health Canada for this patient population. In June 2016, Health Quality Ontario published a health technology assessment of the Argus II retinal prosthesis system for patients with advanced retinitis pigmentosa. Based on that assessment, the Ontario Health Technology Advisory Committee recommended against publicly funding the Argus II system for this population. It also recommended that Health Quality Ontario re-evaluate the evidence in 1 year. The objective of this report was to examine new evidence published since the 2016 health technology assessment. Methods We completed a health technology assessment, which included an evaluation of clinical benefits and harms, value for money, and patient preferences related to the Argus II system. We performed a systematic literature search for studies published since the 2016 Argus II health technology assessment. We developed a Markov decision-analytic model to assess the cost-effectiveness of the Argus II system compared with standard care, and we calculated incremental cost-effectiveness ratios over a 20-year time horizon. We also conducted a five-year budget impact analysis. Finally, we interviewed people with retinitis pigmentosa about their lived experience with vision loss, and with the Argus II system. Results Four publications from one multicentre international study were included in the clinical review. Patients showed significant improvements in visual function and functional outcomes with the Argus II system, and these outcomes were sustained up to a 5-year follow-up (moderate quality of evidence). The safety profile was generally acceptable. In the base case economic analysis, the Argus II system was cost-effective compared with standard care if the willingness to pay was more than $97,429 per quality-adjusted life-year. We estimated that funding the Argus II system would cost the province $0.71 to $0.78 million per year over 5 years, assuming 4 implants per year. People with lived experience spoke about the challenges of retinitis pigmentosa, including the gradual but persistent progression of the disease; its impact on their quality of life and their families; and the accessibility challenges they faced. Those who used the Argus II system spoke about its positive impact on their quality of life. Conclusions Based on evidence of moderate quality, the Argus II retinal prosthesis system improved visual function, real-life functional outcomes, and quality of life in patients with advanced retinitis pigmentosa. The Argus II system is expensive, but the cost to publicly fund it would be low, because of the small number of eligible patients. The Argus II system can only enable perception of light/dark and shapes/objects, but these advancements represent important gains for people with retinitis pigmentosa in terms of mobility and quality of life. PMID:29201260

  5. Effect of cell phone exposure on physiologic and hematologic parameters of male medical students of Bijapur (Karnataka) with reference to serum lipid profile.

    PubMed

    Parkar, Matin A; Ahmed, Rishad; Abdullah, Bilal Bin; Patil, B S; Das, Kusal K

    2010-01-01

    The public awareness about cell phone safety increased greatly in the last few years as various reports of potential adverse health effects on humans exposed to radiations emitted from cellular phones were published. The aim of the study was to assess the effect of long term cell phone exposure on physiological and hematological parameters along with its impact on serum lipid profiles and a single call effect on heart rate, blood pressure and SpO2(%) of healthy male medical students. The students were divided into two groups, group I (n=22, age 20.63 +/- 1.17 yrs) comprising first year medical students who were never exposed to cell phones at the time of this study and group II (n=35, age 22.00 +/- 1.56 yrs) consists of final year (fourth year) male medical students who were using cell phone for more than four years before this study. The results showed no significant differences the groups in basal heart rate, systolic blood pressure, SpO2(%), or various hematologic parameters. Acute exposure (single call of cell phone with 900 MHz for 1 minute) in both groups showed a significant increase in peak heart rate in group II as compared with group I and a significant decrease in peak SpO2 (%) in group I as compared with group II. Serum total cholesterol, VLDL-cholesterol, and triglycerides concentration were significantly higher in group II (long term cell phone exposed) than in group I, suggesting a mild alteration of lipid profile among group II subjects.

  6. Dental health of 6-year-old children in Alpes Maritimes, France.

    PubMed

    Joseph, C; Velley, A M; Pierre, A; Bourgeois, D; Muller-Bolla, M

    2011-10-01

    To describe the dental health status of 6-year-old children using the ICDAS-II advanced method and to evaluate the association between the known caries risk factors with the cavitated caries lesion (WHO basic method) or with both non-cavitated and cavitated caries lesion caries (ICDAS II). In this cross-sectional study, a questionnaire was used to evaluate oral health and dietary habits of children. A clinical examination and a Cario analysis test (Pierre Fabre Oral care) were performed. Logistic regression analyses were used to assess the association between caries and daily tooth-brushing, dietary habits, visible plaque and salivary factors. There were 341 children (52% female and 6.25+/-0.46 years of age) in this study. Using the ICDAS-II advanced method, 39% of the children were caries-free. This proportion was larger (67.2%) using the WHO method. In multivariate models, visible dental plaque and Streptococcus mutans count were associated with caries experience registered as ICDAS-II codes 1-6 or codes 3-6. The absence of daily tooth-brushing with fluoridated toothpaste was associated only with caries experience ICDAS-II codes 3-6. The use of WHO or ICDAS-II method changed the proportion of caries-free children but not the clinical caries risk factors associated with caries experience.

  7. Diagnosis, quality of life, and treatment of patients with Hunter syndrome in the French healthcare system: a retrospective observational study.

    PubMed

    Guffon, Nathalie; Heron, Bénédicte; Chabrol, Brigitte; Feillet, François; Montauban, Vincent; Valayannopoulos, Vassili

    2015-04-12

    Mucopolysaccharidosis II (MPS II) is associated with a broad spectrum of chronic and progressive, life-limiting symptoms. Idursulfase is approved for MPS II enzyme replacement therapy (ERT) in over 50 countries. This retrospective study evaluated the MPS II burden, organization of clinical care, and effects of idursulfase treatment on the disease in France. MPS II patients who had received idursulfase ERT in the French healthcare system were enrolled. In addition to clinician and patient questionnaires, the Clinical Global Impression-Improvement (CGI-I); Patient Global Impression-Improvement (PGI-I); KIDSCREEN-27, and EuroQoL-5D for adult patients scales were used to assess quality of life (QoL) and efficacy. Fifty-two patients were enrolled from 5 sites in France. The majority of patients (69.2%) presented a severe MPS II phenotype with progressive neurocognitive impairment. Major impacts on QoL were apparent, with at least 1 member of the family having to reorganize working hours (45.5%) or to stop working (22.7%). KIDSCREEN-27 and EuroQoL-5D scale scores were well below those for referent (control) populations. Most families (70.0%) experienced a diagnostic delay of at least 3 years after the initial observation of symptoms. The MPS II diagnosis was often delivered without adequate sensitivity, psychological support, or comprehensive information about the disease. The study population had received a mean of 3.8 ± 1.3 years ERT. Forty-four percent of patients with the attenuated phenotype (without progressive neurocognitive impairment) showed symptom improvement during both the first year (Period 1) and from the end of the first year of treatment to "the present" (Period 2), as measured by CGI-I/PGI-I. 30.3% and 9.1% of severe patients experienced symptom improvement during Periods 1 and 2, respectively, while 63.6% and 51.5% displayed no change. The most common adverse reactions reported were skin rash and other infusion-associated reactions. MPS II adversely affects multiple domains of QoL for patients and families, requiring multiple healthcare services and social aid programs. The majority of patients with either phenotype experienced either improvement or stability in their symptoms during the first year of ERT, but this was clearly less so for patients with the severe phenotype after the first year of treatment.

  8. Correlates of mothers' persistent depressive symptoms: a national study.

    PubMed

    Pascoe, John M; Stolfi, Adrienne; Ormond, Mary B

    2006-01-01

    The purpose of this study was to examine the prevalence, persistence, and correlates of mothers' depressive symptoms over a 5-year period in a nationally representative sample of the United States population. Data from 2235 mothers in the National Survey of Families and Households, Wave I, 1987-1988, and Wave II, 1992-1994, were analyzed. Outcome measures were scores on the Center for Epidemiological Studies Depression Scale (CES-D, 12-item version) and a validated three-item depression screen. One fifth of study mothers had positive CES-D scores and almost half (48%) had negative CES-D scores in both waves. Wave I risk factors for persistent "positive" CES-D scores were maternal age less than 30 years (24%), African-American (33%), never married (26%) or divorced (32%), education less than high school (35%), and indigent (32%). Adjusted odds ratios (AOR) and 95% confidence intervals for persistent "positive" versus persistent "negative" CES-D scores were: age less than 30 years (Wave I), AOR = 1.64, (1.22-2.21); unmarried (Wave II), AOR = 2.60, (1.89-3.56); education less than high school (Wave II), AOR = 2.18, (1.41-3.38); and indigent (Wave II), AOR = 2.09 (1.36-3.21). About one fifth of the study sample reported high depressive symptoms twice over a 5-year period. Depression in women, especially mothers, is an urgent public health problem.

  9. Biology--Chemistry--Physics, Students' Guide, A Three-Year Sequence, Parts I and II.

    ERIC Educational Resources Information Center

    Scott, Arthur; And Others

    Parts I and II of the students' guide to the three-year integrated biology, chemistry, and physics course being prepared by the Portland Project Committee are contained in this guide. A committee reviewed and selected material developed by the national course improvement groups--Physical Science Study Committee, Chemical Bond Approach, Chemical…

  10. Serum cholesterol concentrations among Navajo Indians.

    PubMed Central

    Sugarman, J R; Gilbert, T J; Percy, C A; Peter, D G

    1992-01-01

    Navajo Indians have been reported by earlier investigators to have low concentrations of serum lipids and a low prevalence of hyperlipidemia, as well as low rates of ischemic heart disease. However, no data on serum lipid concentrations among Navajos have been reported for more than two decades. The authors conducted a study to determine the distribution of concentrations of serum total cholesterol (TC), high density lipoprotein cholesterol, low density lipoprotein cholesterol, and triglyceride among persons 25-74 years old living in a representative community on the Navajo Indian reservation. Data are reported for 255 subjects, 105 men and 150 women, ages 25-74 years. The authors compared these data to those for the general population as determined by the second National Health and Nutrition Examination Survey (NHANES II). TC concentrations among Navajo men were similar to those from NHANES II. TC concentrations among younger Navajo women were similar to those for women younger than 55 years from NHANES II, but were significantly lower among older Navajo women. While 27.6 percent of men ages 25-74 years studied in NHANES II had TC concentrations greater than 240 milligrams per deciliter, 33.8 percent of Navajo men had similarly elevated TC. However, the prevalence of serum TC concentrations greater than 240 milligrams per deciliter among Navajo women (17.5 percent) was about half that among women studied in NHANES II (32.9 percent). A similar pattern was found for low density lipoprotein cholesterol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1738814

  11. Treatment and posttreatment effects induced by the Forsus appliance: A controlled clinical study.

    PubMed

    Cacciatore, Giorgio; Ghislanzoni, Luis Tomas Huanca; Alvetro, Lisa; Giuntini, Veronica; Franchi, Lorenzo

    2014-11-01

    To evaluate treatment and posttreatment dentoskeletal effects induced by the Forsus device (FRD) in growing patients with Class II malocclusion in a retrospective controlled clinical study. Thirty-six Class II patients (mean [SD] age 12.3 [1.2] years) were treated consecutively with the FRD protocol and compared with a sample of 20 subjects with untreated Class II malocclusion (mean [SD] age 12.2 [0.9] years). Lateral cephalograms were taken at the beginning of treatment, at the end of comprehensive treatment (after 2.3 ± 0.4 years), and at a postretention period (after 2.3 ± 1.1 years from the end of comprehensive treatment). Statistical comparisons were carried out with the unpaired t-test and Benjamini-Hochberg correction (P < .05). After comprehensive treatment, the FRD sample showed a significant restriction of the sagittal maxillary growth together with a significant correction in overjet, overbite, and molar relationship. During the overall observation interval, the FRD group exhibited no significant sagittal or vertical skeletal changes, while significant improvements were recorded in overjet (-3.8 mm), overbite (-1.5 mm), and molar relationship (+3.7 mm). The FRD protocol was effective in correcting Class II malocclusion mainly at the dentoalveolar level when evaluated 2 years after the end of comprehensive treatment.

  12. Two-year clinical evaluation of IPS Empress II ceramic onlays/inlays.

    PubMed

    Tagtekin, D A; Ozyöney, G; Yanikoglu, F

    2009-01-01

    The stronger the ceramic material, the longer the restoration stays in the mouth. The current study evaluated the two-year clinical performance of a strong ceramic system, IPS Empress II, with increased strength on onlay/inlay restorations of molars. Teeth from 35 patients, including three premolars and 32 molars, were prepared for 28 onlay and seven inlay restorations with IPS Empress II ceramics. The restorations were cemented with a highly viscous, dual-curing luting composite cement (Bifix) and evaluated by two examiners using USPHS criteria at baseline (one week following insertion), six months, one year and two years. The baseline scores and recalls were assessed by Wilcoxon signed rank test. Statistically significant marginal discoloration at the Bravo level was found at the 12- and 24-month recalls (p=0.046). One debonding was statistically insignificant. No changes were observed with respect to anamnesis, such as any symptom from the TMJ or masticatory muscles. No restorations were replaced due to hypersensitivity or were missing at the two-year evaluation. Any wear on the restoration, antagonist tooth or any changes of proximal contacts were not observed. IPS Empress II Ceramics were found to be appropriate as onlay/inlay restorations for clinical use under the conditions of the current study.

  13. The Effect of Long-Term Training Program on Balance in Children with Cerebral Palsy: Results of a Pilot Study for Individually Based Functional Exercises

    ERIC Educational Resources Information Center

    Uzun, Selda

    2013-01-01

    This study examines the effects of long-term training program on balance and center of pressure (COP) for four male children (13 years of age) with cerebral palsy (CP). These children were classified into one hemiplegic (level II), one diplegic (level II) and two quadriplegic children (levels III and II) using the Gross Motor Function…

  14. Reliability and validity of the test of gross motor development-II in Korean preschool children: applying AHP.

    PubMed

    Kim, Chung-Il; Han, Dong-Wook; Park, Il-Hyeok

    2014-04-01

    The Test of Gross Motor Development-II (TGMD-II) is a frequently used assessment tool for measuring motor ability. The purpose of this study is to investigate the reliability and validity of TGMD-II's weighting scores (by comparing pre-weighted TGMD-II scores with post ones) as well as examine applicability of the TGMD-II on Korean preschool children. A total of 121 Korean children (three kindergartens) participated in this study. There were 65 preschoolers who were 5-years-old (37 boys and 28 girls) and 56 preschoolers who were 6-years-old (34 boys and 22 girls). For internal consistency, reliability, and construct validity, only one researcher evaluated all of the children using the TGMD-II in the following areas: running; galloping; sliding; hopping; leaping; horizontal jumping; overhand throwing; underhand rolling; striking a stationary ball; stationary dribbling; kicking; and catching. For concurrent validity, the evaluator measured physical fitness (strength, flexibility, power, agility, endurance, and balance). The key findings were as follows: first, the reliability coefficient and the validity coefficient between pre-weighted and post-weighted TGMD-II scores were quite similar. Second, the research showed adequate reliability and validity of the TGMD-II for Korean preschool children. The TGMD-II is a proper instrument to test Korean children's motor development. Yet, applying relative weighting on the TGMD-II should be a point of consideration. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Follow-up studies of world war II and Korean conflict prisoners. III. Mortality to January 1, 1976.

    PubMed

    Keehn, R J

    1980-02-01

    Mortality through 1975 in US Army veterans released from prisoner-of-war camps following World War II (Europe, Pacific) and the Korean conflict and in several non-prisoner groups is compared using death rates and standard mortality ratios. The World War II Pacific and Korean conflict experience reveal increased risk of dying among former prisoners which, though diminishing with time, persist for 9 and 13 years, respectively. Mortality from tuberculosis and from trauma contributes to the increase among Pacific ex-prisoners, while for Korea the increase is limited to trauma. An excess of deaths due to cirrhosis of the liver in all three former prisoner groups appeared from about the 10th follow-up year. While the reported mortality experience for World War II spans 30 calendar years and for Korea 22 years, no evidence of increased aging among former prisoners of war is seen in mortality from the chronic and degenerative diseases.

  16. The year 2012 in the European Heart Journal-Cardiovascular Imaging. Part II.

    PubMed

    Plein, Sven; Knuuti, Juhani; Edvardsen, Thor; Saraste, Antti; Piérard, Luc A; Maurer, Gerald; Lancellotti, Patrizio

    2013-07-01

    The part II of the best of the European Heart Journal - Cardiovascular Imaging in 2012 specifically focuses on studies of valvular heart diseases, heart failure, cardiomyopathies, and congenital heart diseases.

  17. Improvement in Renal Hemodynamics following Combined Angiotensin II Infusion and AT1R Blockade in Aged Female Sheep following Fetal Unilateral Nephrectomy

    PubMed Central

    Singh, Reetu R.; Lankadeva, Yugeesh R.

    2013-01-01

    Renin-angiotensin system (RAS) is a powerful modulator of renal hemodynamic and fluid homeostasis. Up-regulation in components of intra-renal RAS occurs with ageing. Recently we reported that 2 year old uninephrectomised (uni-x) female sheep have low renin hypertension and reduced renal function. By 5 years of age, these uni-x sheep had augmented decrease in renal blood flow (RBF) compared to sham. We hypothesised that this decrease in RBF in 5 year old uni-x sheep was due to an up-regulation in components of the intra-renal RAS. In this study, renal responses to angiotensin II (AngII) infusion and AngII type 1 receptor (AT1R) blockade were examined in the same 5 year old sheep. We also administered AngII in the presence of losartan to increase AngII bioavailability to the AT2R in order to understand AT2R contribution to renal function in this model. Uni-x animals had significantly lower renal cortical content of renin, AngII (∼40%) and Ang 1–7 (∼60%) and reduced cortical expression of AT1R gene than sham animals. In response to both AngII infusion and AT1R blockade via losartan, renal hemodynamic responses and tubular sodium excretion were significantly attenuated in uni-x animals compared to sham. However, AngII infusion in the presence of losartan caused ∼33% increase in RBF in uni-x sheep compared to ∼14% in sham (P<0.05). This was associated with a significant decrease in renal vascular resistance in the uni-x animals (22% vs 15%, P<0.05) without any changes in systemic blood pressure. The present study shows that majority of the intra-renal RAS components are suppressed in this model of low renin hypertension. However, increasing the availability of AngII to AT2R by AT1R blockade improved renal blood flow in uni-x sheep. This suggests that manipulation of the AT2R maybe a potential therapeutic target for treatment of renal dysfunction associated with a congenital nephron deficit. PMID:23840884

  18. A Two-Year Randomized Trial of Interventions to Decrease Stress Hormone Vasopressin Production in Patients with Meniere's Disease-A Pilot Study.

    PubMed

    Kitahara, Tadashi; Okamoto, Hidehiko; Fukushima, Munehisa; Sakagami, Masaharu; Ito, Taeko; Yamashita, Akinori; Ota, Ichiro; Yamanaka, Toshiaki

    2016-01-01

    Meniere's disease, a common inner ear condition, has an incidence of 15-50 per 100,000. Because mental/physical stress and subsequent increase in the stress hormone vasopressin supposedly trigger Meniere's disease, we set a pilot study to seek new therapeutic interventions, namely management of vasopressin secretion, to treat this disease. We enrolled 297 definite Meniere's patients from 2010 to 2012 in a randomized-controlled and open-label trial, assigning Group-I (control) traditional oral medication, Group-II abundant water intake, Group-III tympanic ventilation tubes and Group-IV sleeping in darkness. Two hundred sixty-three patients completed the planned 2-year-follow-up, which included assessment of vertigo, hearing, plasma vasopressin concentrations and changes in stress/psychological factors. At 2 years, vertigo was completely controlled in 54.3% of patients in Group-I, 81.4% in Group-II, 84.1% in Group-III, and 80.0% in Group-IV (statistically I < II = III = IV). Hearing was improved in 7.1% of patients in Group-I, 35.7% in Group-II, 34.9% in Group-III, and 31.7% in Group-IV (statistically I < II = III = IV). Plasma vasopressin concentrations decreased more in Groups-II, -III, and -IV than in Groups-I (statistically I < II = III = IV), although patients' stress/psychological factors had not changed. Physicians have focused on stress management for Meniere's disease. However, avoidance of stress is unrealistic for patients who live in demanding social environments. Our findings in this pilot study suggest that interventions to decrease vasopressin secretion by abundant water intake, tympanic ventilation tubes and sleeping in darkness is feasible in treating Meniere's disease, even though these therapies did not alter reported mental/physical stress levels. ClinicalTrials.gov NCT01099046.

  19. Institutional Self-Analysis and Long-Range Planning in a Small Liberal Arts College. Part II-- Study Procedure.

    ERIC Educational Resources Information Center

    Frame, Stanley M.

    In the Spring of 1969, Bethany Nazarene College started an intensive self evaluation effort, called the Ten-Year Advance Study. Part I of the report, the Study Design, was published in October 1969. This study, Part II, relates the study activities, the methodology, and sources consulted. The effort involved over 120 administrators, faculty,…

  20. Five-year safety and performance results from the Argus II Retinal Prosthesis System clinical trial

    PubMed Central

    da Cruz, Lyndon; Dorn, Jessy D.; Humayun, Mark S.; Dagnelie, Gislin; Handa, James; Barale, Pierre-Olivier; Sahel, José-Alain; Stanga, Paulo E.; Hafezi, Farhad; Safran, Avinoam B.; Salzmann, Joel; Santos, Arturo; Birch, David; Spencer, Rand; Cideciyan, Artur V.; de Juan, Eugene; Duncan, Jacque L.; Eliott, Dean; Fawzi, Amani; Olmos de Koo, Lisa C.; Ho, Allen C.; Brown, Gary; Haller, Julia; Regillo, Carl; Del Priore, Lucian V.; Arditi, Aries; Greenberg, Robert J.

    2016-01-01

    Purpose The Argus® II Retinal Prosthesis System (Second Sight Medical Products, Inc., Sylmar, CA) was developed to restore some vision to patients blind from retinitis pigmentosa (RP) or outer retinal degeneration. A clinical trial was initiated in 2006 to study the long-term safety and efficacy of the Argus II System in patients with bare or no light perception due to end-stage RP. Design The study is a prospective, multicenter, single-arm, clinical trial. Within-patient controls included the non-implanted fellow eye and patients' native residual vision compared to their vision when using the System. Subjects There were 30 subjects in 10 centers in the U.S. and Europe. Methods The worse-seeing eye of blind patients was implanted with the Argus II System. Patients wore glasses mounted with a small camera and a video processor that converted images into stimulation patterns sent to the electrode array on the retina. Main Outcome Measures The primary outcome measures were safety (the number, seriousness, and relatedness of adverse events) and visual function, as measured by three computer-based, objective tests. Secondary measures included functional vision performance on objectively-scored real-world tasks. Results Twenty-four out of 30 patients remained implanted with functioning Argus II Systems at 5 years post-implant. Only one additional serious adverse event was experienced since the 3-year time point. Patients performed significantly better with the System ON than OFF on all visual function tests and functional vision tasks. Conclusions The five-year results of the Argus II trial support the long-term safety profile and benefit of the Argus II System for patients blind from RP. The Argus II is the first and only retinal implant to have market approval in the European Economic Area, the United States, and Canada. PMID:27453256

  1. The Youth-Nominated Support Team-Version II for Suicidal Adolescents: A Randomized Controlled Intervention Trial

    ERIC Educational Resources Information Center

    King, Cheryl A.; Klaus, Nicole; Kramer, Anne; Venkataraman, Sanjeev; Quinlan, Paul; Gillespie, Brenda

    2009-01-01

    The purpose of this study was to examine the efficacy of the Youth-Nominated Support Team-Version II (YST-II) for suicidal adolescents, an intervention based on social support and health behavior models, which was designed to supplement standard treatments. Psychiatrically hospitalized and suicidal adolescents, 13-17 years of age, were randomly…

  2. Attainment and Stability of Sustained Symptomatic Remission and Recovery among Borderline Patients and Axis II Comparison Subjects: A 16-year Prospective Follow-up Study

    PubMed Central

    Zanarini, Mary C.; Frankenburg, Frances R.; Reich, D. Bradford; Fitzmaurice, Garrett

    2012-01-01

    Objective The first purpose of this study was to determine time-to-attainment of symptomatic remissions and recoveries of 2, 4, 6, and 8 years duration for those with borderline personality disorder and comparison subjects with other personality disorders; the second was to determine the stability of these outcomes. Method 290 inpatients meeting both Revised Diagnostic Interview for Borderlines and DSM-III-R criteria for borderline personality disorder and 72 axis II comparison subjects were assessed during their index admission using a series of semistructured interviews. The same instruments were readministered at eight contiguous two-year time periods. Results Borderline patients were significantly slower to achieve remission or recovery (which involved good social and vocational functioning as well as symptomatic remission) than axis II comparison subjects. However, those in both study groups ultimately achieved about the same high rates of remission (borderline patients: 78–99%; axis II comparison subjects: 97–99%) but not recovery (40–60% vs. 75–85%) by the time of the 16-year follow-up. In contrast, symptomatic recurrence (10–36% vs. 4–7%) and loss of recovery (20–44% vs. 9–28%) occurred more rapidly and at substantially higher rates among borderline patients than axis II comparison subjects. Conclusions Taken together, the results of this study suggest that sustained symptomatic remission is substantially more common than sustained recovery from borderline personality disorder. They also suggest that sustained remissions and recoveries are substantially more difficult for borderline patients to attain and maintain than those with other forms of personality disorder. PMID:22737693

  3. The minimum follow-up required for radial head arthroplasty: a meta-analysis.

    PubMed

    Laumonerie, P; Reina, N; Kerezoudis, P; Declaux, S; Tibbo, M E; Bonnevialle, N; Mansat, P

    2017-12-01

    The primary aim of this study was to define the standard minimum follow-up required to produce a reliable estimate of the rate of re-operation after radial head arthroplasty (RHA). The secondary objective was to define the leading reasons for re-operation. Four electronic databases, between January 2000 and March 2017 were searched. Articles reporting reasons for re-operation (Group I) and results (Group II) after RHA were included. In Group I, a meta-analysis was performed to obtain the standard minimum follow-up, the mean time to re-operation and the reason for failure. In Group II, the minimum follow-up for each study was compared with the standard minimum follow-up. A total of 40 studies were analysed: three were Group I and included 80 implants and 37 were Group II and included 1192 implants. In Group I, the mean time to re-operation was 1.37 years (0 to 11.25), the standard minimum follow-up was 3.25 years; painful loosening was the main indication for re-operation. In Group II, 33 Group II articles (89.2%) reported a minimum follow-up of < 3.25 years. The literature does not provide a reliable estimate of the rate of re-operation after RHA. The reproducibility of results would be improved by using a minimum follow-up of three years combined with a consensus of the definition of the reasons for failure after RHA. Cite this article: Bone Joint J 2017;99-B:1561-70. ©2017 The British Editorial Society of Bone & Joint Surgery.

  4. The influence of implant design on periprosthetic bone remodelling of two types of uncemented HA-coated hip stems. A two-year follow-up study using DEXA.

    PubMed

    Van der Wal, B C H; Rahmy, A I A; Grimm, B; Blake, G M; Heyligers, I C; Tonino, A J

    2006-01-01

    Proximal bone resorption and an increased fracture rate in the ABG-I stem has been shown. For these reasons the ABG-I stem design was changed to the ABG-II. In this study periprosthetic bone loss around the ABG-I vs ABG-II is compared to verify if the design changes resulted in improved proximal bone preservation. 51 patients were randomised to either the ABG-I or ABG-II hip prosthesis. Periprosthetic BMD change at various time points was measured using DEXA. Between the two groups (age, gender, weight etc.) no statistical difference was encountered. Compared to the baseline at two years the ABG-II preserved bone better proximally (e.g. zone 7: ABG-II: -3.7%, ABG-I: -11.9%, p=0.05) than the ABG-I. Distally, the trend was opposite and less bone loss was measured for the ABG-I than the ABG-II in zones 3, 4 and 5 (n.s.). this study confirms the philosophy behind the design changes from the ABG-I to ABG-II stem where increased elasticity, more proximal HA-coating, a shorter and distally polished stem, were meant to reduce proximal bone resorption. In future this may lead to fewer periprosthetic fractures and to less complicated revision surgery.

  5. Changeover Trial of Azilsartan and Olmesartan Comparing Effects on the Renin-Angiotensin-Aldosterone System in Patients with Essential Hypertension after Cardiac Surgery (CHAOS Study)

    PubMed Central

    Osaka, Shunji; Yaoita, Hiroko; Arimoto, Munehito; Hata, Hiroaki; Shiono, Motomi; Sakino, Hisakuni

    2016-01-01

    Background: Angiotensin II receptor blockers (ARBs) have been widely used to treat hypertension and large-scale clinical studies have shown various benefits. In this study, we compared olmesartan with azilsartan, the newest ARB. Methods: The subjects were outpatients who were clinically stable after cardiac surgery. Sixty patients were randomized to receive either azilsartan or olmesartan for 1 year and were switched to the other drug for the following 1 year. The primary endpoints were the levels of plasma renin activity, angiotensin II, and aldosterone. Results: Home blood pressure exceeded 140/90 mmHg and additional antihypertensive medication was administered to 12 patients (20 episodes) in the azilsartan group versus 4 patients (4 episodes) in the olmesartan group, with the number being significantly higher in the azilsartan group. After 1 year of treatment, both angiotensin II and aldosterone levels were significantly lower in the olmesartan group than the azilsartan group. Left ventricular mass index was also significantly lower in the olmesartan group than the azilsartan group. Conclusion: This study showed that olmesartan reduces angiotensin II and aldosterone levels more effectively than azilsartan. Accordingly, it may be effective in patients with increased renin-angiotensin-aldosterone system activity after cardiac surgery or patients with severe cardiac hypertrophy. PMID:27086671

  6. Changeover Trial of Azilsartan and Olmesartan Comparing Effects on the Renin-Angiotensin-Aldosterone System in Patients with Essential Hypertension after Cardiac Surgery (CHAOS Study).

    PubMed

    Sezai, Akira; Osaka, Shunji; Yaoita, Hiroko; Arimoto, Munehito; Hata, Hiroaki; Shiono, Motomi; Sakino, Hisakuni

    2016-06-20

    Angiotensin II receptor blockers (ARBs) have been widely used to treat hypertension and large-scale clinical studies have shown various benefits. In this study, we compared olmesartan with azilsartan, the newest ARB. The subjects were outpatients who were clinically stable after cardiac surgery. Sixty patients were randomized to receive either azilsartan or olmesartan for 1 year and were switched to the other drug for the following 1 year. The primary endpoints were the levels of plasma renin activity, angiotensin II, and aldosterone. Home blood pressure exceeded 140/90 mmHg and additional antihypertensive medication was administered to 12 patients (20 episodes) in the azilsartan group versus 4 patients (4 episodes) in the olmesartan group, with the number being significantly higher in the azilsartan group. After 1 year of treatment, both angiotensin II and aldosterone levels were significantly lower in the olmesartan group than the azilsartan group. Left ventricular mass index was also significantly lower in the olmesartan group than the azilsartan group. This study showed that olmesartan reduces angiotensin II and aldosterone levels more effectively than azilsartan. Accordingly, it may be effective in patients with increased renin-angiotensin-aldosterone system activity after cardiac surgery or patients with severe cardiac hypertrophy.

  7. The NHLBI Retrovirus Epidemiology Donor Studies (REDS and REDS-II): Twenty years of research to advance blood product safety and availability

    PubMed Central

    Kleinman, Steven; King, Melissa R; Busch, Michael P; Murphy, Edward L; Glynn, Simone A.

    2012-01-01

    The Retrovirus Epidemiology Donor Study (REDS), conducted from 1989–2001, and the Retrovirus Epidemiology Donor Study-II (REDS-II), conducted from 2004–2012, were National Heart Lung and Blood Institute (NHLBI) funded multicenter programs focused on improving blood safety and availability in the United States. REDS-II also included international study sites in Brazil and China. The three major research domains of REDS/REDS-II have been infectious disease risk evaluation, blood donation availability, and blood donor characterization. Both programs have made significant contributions to transfusion medicine research methodology by the use of mathematical modeling, large-scale donor surveys, innovative methods of repository sample storage, and establishing an infrastructure that responded to potential emerging blood safety threats such as XMRV. Blood safety studies have included protocols evaluating epidemiologic and/or laboratory aspects of HIV, HTLV I/II, HCV, HBV, WNV, CMV, HHV-8, B19V, malaria, CJD, influenza, and T. cruzi infections. Other analyses have characterized: blood donor demographics, motivations to donate, factors influencing donor return, behavioral risk factors, donors’ perception of the blood donation screening process, and aspects of donor deferral. In REDS-II, two large-scale blood donor protocols examined iron deficiency in donors and the prevalence of leukocyte antibodies. This review describes the major study results from over 150 peer-reviewed articles published by these two REDS programs. In 2011, a new seven year program, the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III), was launched. REDS-III expands beyond donor-based research to include studies of blood transfusion recipients in the hospital setting, and adds a third country, South Africa, to the international program. PMID:22633182

  8. VizieR Online Data Catalog: SNe type II from CSP-I, SDSS-II, and SNLS (de Jaeger+, 2017)

    NASA Astrophysics Data System (ADS)

    de Jaeger, T.; Gonzalez-Gaitan, S.; Hamuy, M.; Galbany, L.; Anderson, J. P.; Phillips, M. M.; Stritzinger, M. D.; Carlberg, R. G.; Sullivan, M.; Gutierrez, C. P.; Hook, I. M.; Howell, D. A.; Hsiao, E. Y.; Kuncarayakti, H.; Ruhlmann-Kleider, V.; Folatelli, G.; Pritchet, C.; Basa, S.

    2017-10-01

    The CSP-I (Carnegie Supernova Project-I) had guaranteed access to ~300 nights per year between 2004 and 2009 on the Swope 1m and du Pont 2.5m telescopes at the Las Campanas Observatory (LCO). This observation time allowed the CSP-I to obtain optical-band light curves for 67 SNe II. From the CSP-I sample, we remove six outliers. The SDSS-II SN Survey operated for three years, from 2005 September to 2007 November. Using the 2.5m telescope at the Apache Point Observatory in New Mexico. This survey observed about 80 spectroscopically confirmed core-collapse SNe but the main driver of this project was the study of SNe Ia, involving the acquisition of only one or two spectra per SNe II. The total SDSS-II SN sample is composed of 16 spectroscopically confirmed SNe II. The SNLS (Supernova Legacy Survey) was designed to discover SNe and to obtain photometric follow-up using the MegaCam imager on the 3.6m Canada-France-Hawaii Telescope. The observation strategy consisted of obtaining images of the same field every four nights over five years (between 2003 and 2008); thus, in total more than 470 nights were allocated to this project. The total SNLS sample is composed of 28 SNeII. See section 2 for further explanations on the data sample. (1 data file).

  9. CORRELATIONS BETWEEN INTELLIGENCE, HEAD CIRCUMFERENCE AND HEIGHT: EVIDENCE FROM TWO SAMPLES IN SAUDI ARABIA.

    PubMed

    Bakhiet, Salaheldin Farah Attallah; Essa, Yossry Ahmed Sayed; Dwieb, Amira Mahmood Mohsen; Elsayed, Abdelkader Mohamed Abdelkader; Sulman, Afra Sulman Mohammed; Cheng, Helen; Lynn, Richard

    2017-03-01

    This study was based on two independent studies which in total consisted of 1812 school pupils aged 6-12 years in Saudi Arabia. Study I consisted of 1591 school pupils (609 boys and 982 girls) attending state schools, and Study II consisted of 211 boys with learning disabilities. Intelligence (measured using the Standard Progressive Matrices Plus for Study I and the Standard Progressive Matrices for Study II), head size and height were measured for the two samples. The results showed that intelligence was statistically significantly correlated with head circumference (r=0.350, p<0.001 for Study I and r=0.168, p<0.05 for Study II) and height (r=0.271, p<0.001 for Study I and r=0.178, p<0.05 for Study II).

  10. Impact of current video game playing on robotic simulation skills among medical students.

    PubMed

    Öge, Tufan; Borahay, Mostafa A; Achjian, Tamar; Kılıç, Sami Gökhan

    2015-01-01

    To evaluate the impact of current and prior video game playing on initial robotic simulation skill acquisition. This cross-sectional descriptive study (Canadian Task Force Classification II-1) was conducted at a medical university training center. The study subjects were medical students who currently played video games (Group I) and those who had not played video games in the last 2 years (Group II). The robotic skills of both groups were assessed using simulation. Twenty-two students enrolled in this study; however, only 21 completed it. The median age of the participants was 23 (22-24) years and 24 (23-26) years in Groups I and II, respectively. Among the participants, 15 (71.4%) were male and 6 (28.5%) were female, and 90.4% of the students started playing video games in primary school. When the 2 groups were compared according to the completion time of each exercise, Group I finished more quickly than Group II in the Peg Board-1 exercise (p>0.05), whereas Group II had better results in 3 exercises including Pick and Place, Ring and Rail, and Thread the Rings-1. However, none of the differences were found to be statistically significant (p>.05), and according to the overall scores based on the time to complete exercises, economy of motion, instrument collision, use of excessive instrument force, instruments out of view, and master workspace range, the scores were not statistically different between Groups I and II (p>.05). According to the basic robotic simulation exercise results, there was no difference between medical students who used to play video games and those who still played video games. Studies evaluating baseline visuospatial skills with larger sample sizes are needed.

  11. Impact of current video game playing on robotic simulation skills among medical students

    PubMed Central

    Öge, Tufan; Borahay, Mostafa A.; Achjian, Tamar; Kılıç, Sami Gökhan

    2015-01-01

    Objective To evaluate the impact of current and prior video game playing on initial robotic simulation skill acquisition. Material and Methods This cross-sectional descriptive study (Canadian Task Force Classification II-1) was conducted at a medical university training center. The study subjects were medical students who currently played video games (Group I) and those who had not played video games in the last 2 years (Group II). The robotic skills of both groups were assessed using simulation. Results Twenty-two students enrolled in this study; however, only 21 completed it. The median age of the participants was 23 (22–24) years and 24 (23–26) years in Groups I and II, respectively. Among the participants, 15 (71.4%) were male and 6 (28.5%) were female, and 90.4% of the students started playing video games in primary school. When the 2 groups were compared according to the completion time of each exercise, Group I finished more quickly than Group II in the Peg Board-1 exercise (p>0.05), whereas Group II had better results in 3 exercises including Pick and Place, Ring and Rail, and Thread the Rings-1. However, none of the differences were found to be statistically significant (p>.05), and according to the overall scores based on the time to complete exercises, economy of motion, instrument collision, use of excessive instrument force, instruments out of view, and master workspace range, the scores were not statistically different between Groups I and II (p>.05). Conclusion According to the basic robotic simulation exercise results, there was no difference between medical students who used to play video games and those who still played video games. Studies evaluating baseline visuospatial skills with larger sample sizes are needed. PMID:25788841

  12. Incidence and predictors of suicide attempts in bipolar I and II disorders: A 5-year follow-up study.

    PubMed

    Pallaskorpi, Sanna; Suominen, Kirsi; Ketokivi, Mikko; Valtonen, Hanna; Arvilommi, Petri; Mantere, Outi; Leppämäki, Sami; Isometsä, Erkki

    2017-02-01

    Few long-term studies on bipolar disorder (BD) have investigated the incidence and risk factors of suicide attempts (SAs) specifically related to illness phases. We examined the incidence of SAs during different phases of BD in a long-term prospective cohort of bipolar I (BD-I) and bipolar II (BD-II) patients, and risk factors specifically for SAs during major depressive episodes (MDEs). In the Jorvi Bipolar Study (JoBS), 191 BD-I and BD-II patients were followed using life-chart methodology. Prospective information on SAs of 177 patients (92.7%) during different illness phases was available up to 5 years. The incidence of SAs and their predictors were investigated using logistic and Poisson regression models. Analyses of risk factors for SAs occurring during MDEs were conducted using two-level random-intercept logistic regression models. During the 5 years of follow-up, 90 SAs per 718 patient-years occurred. The incidence was highest, over 120-fold higher than in euthymia, during mixed states (765/1000 person-years; 95% confidence interval [CI] 461-1269 person-years), and also very high in MDEs, almost 60-fold higher than in euthymia (354/1000 person-years; 95% CI 277-451 person-years). For risk of SAs during MDEs, the duration of MDEs, severity of depression, and cluster C personality disorders were significant predictors. We confirmed in this long-term study that the highest incidences of SAs occur in mixed and major depressive illness phases. The variations in incidence rates between euthymia and illness phases were remarkably large, suggesting that the question "when" rather than "who" may be more relevant for suicide risk in BD. However, risk during MDEs is likely also influenced by personality factors. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. A noninterventional study evaluating the effectiveness of rotigotine and levodopa combination therapy in younger versus older patients with Parkinson's disease.

    PubMed

    Woitalla, Dirk; Dunac, Antoine; Safavi, Ali; Ceravolo, Maria-Gabriella; Gomez Esteban, Juan Carlos; Pavese, Nicola; Asgharnejad, Mahnaz; Joeres, Lars; Schuller, Jan-Christof; Chaudhuri, K Ray

    2018-06-19

    PD0013 was a 6-month noninterventional study in clinical practice comparing effectiveness/tolerability of rotigotine+levodopa in younger (<70 years) vs. older (≥70 years) Parkinson's disease (PD) patients. Patients previously received levodopa for ≥6 months as monotherapy/in combination with another dopamine-agonist (DA). Primary variable: Unified PD Rating Scale (UPDRS) Part-II change from baseline to end-of-observation-period (EOP). 91 younger/99 older patients started rotigotine; 68 younger/62 older patients completed the study. Most switched from levodopa+another DA. Addition of rotigotine as first DA was more common in older patients (20.2% vs.15.4%). Mean ± SD rotigotine-exposure: 6.1 ± 3.4 mg/24h younger vs. 4.9 ± 2.4 mg/24h older. Eleven patients changed levodopa dose. At EOP, improvement in mean UPDRS-II was greater in younger patients (p = 0.0289). UPDRS-II responder-rate (≥20% decrease in UPDRS-II score) was higher in younger patients (42.3% vs. 25.9%). Improvement across age groups was similar on PD Sleep Scale-2 and Clinical Global Impressions-Improvement Scale. Adverse drug reactions (ADRs), and discontinuations because of ADRs, were more common among older patients. There were no new safety signals. Despite low rotigotine doses, when added to levodopa/switched from levodopa+another DA, rotigotine led to greater improvement in UPDRS-II in younger patients (<70 years). Individual patient data revealed clinically meaningful improvements in UPDRS-II in both groups.

  14. Evaluation of the Walking Index for Spinal Cord Injury II (WISCI-II) in children with Spinal Cord Injury (SCI).

    PubMed

    Calhoun Thielen, C; Sadowsky, C; Vogel, L C; Taylor, H; Davidson, L; Bultman, J; Gaughan, J; Mulcahey, M J

    2017-05-01

    Mixed methods were used in this study. The appropriateness of the levels of the Walking Index for Spinal Cord Injury II (WISCI-II) for application in children was critically reviewed by physical therapists using the Modified Delphi Technique, and the inter- and intra-rater reliability of the WISCI-II in children was evaluated. To examine the construct validity, and to establish reliability of the WISCI-II related to its use in children with spinal cord injury (SCI). United States of America. Using a Modified Delphi Technique, physical therapists critically reviewed the WISCI-II levels for pediatric utilization. Concurrently, ambulatory children under age 18 years with SCI were evaluated using the WISCI-II on two occasions by the same therapist to establish intra-rater reliability. One trial was photographed and de-identified. Each photograph was reviewed by four different physical therapists who gave WISCI-II scores to establish inter-rater reliability. Summary and descriptive statistics were used to calculate the frequency of yes/no responses for each WISCI-II level question and to determine the percent agreement for each question. Inter- and intra-rater reliability was calculated using interclass correlation coefficients (ICCs) with 95% confidence intervals (CI). Construct validity was confirmed after one Delphi round during which at least 80% agreement was established by 51 physical therapists on the appropriateness of the WISCI-II levels for children. Fifty-two children with SCI aged 2-17 years completed repeated WISCI-II assessments and 40 de-identified photographs were scored by four physical therapists. Intra- and inter-rater reliability was high (ICC=0.997, CI=0.995-0.998 and ICC=0.97, CI=0.95-0.98, respectively). This study demonstrates support for the use of the WISCI-II in ambulatory children with SCI. This study was funded by the Craig H Neilsen Foundation, Spinal Cord Injury Research on the Translation Spectrum, Senior Research Award #282592 (Mulcahey, PI).

  15. Two-year antibody persistence in children vaccinated at 12-15 months with a measles-mumps-rubella virus vaccine without human serum albumin.

    PubMed

    Berry, Andrea A; Abu-Elyazeed, Remon; Diaz-Perez, Clemente; Mufson, Maurice A; Harrison, Christopher J; Leonardi, Michael; Twiggs, Jerry D; Peltier, Christopher; Grogg, Stanley; Carbayo, Antonio; Shapiro, Steven; Povey, Michael; Baccarini, Carmen; Innis, Bruce L; Henry, Ouzama

    2017-07-03

    One combined measles-mumps-rubella (MMR) vaccine without Human Serum Albumin (HSA) is currently licensed in the USA (M-M-R II; Merck, USA) and another has been developed (Priorix™ [MMR-RIT, GSK, Belgium]). In this follow-up study, children from USA or Puerto Rico, who had received one dose of M-M-R II or MMR-RIT at 12-15 months of age in the primary study (NCT00861744), were followed-up for 2 y post-vaccination. Anti-measles and anti-rubella antibodies were measured using Enzyme-Linked Immunosorbent Assay (ELISA), and anti-mumps antibodies using ELISA and plaque reduction neutralization (PRN) assays. Serious adverse events (SAEs) were recorded during the entire follow-up. The according-to-protocol (ATP) persistence cohort included 752 children (M-M-R II = 186, MMR-RIT = 566), who received primary vaccination at a mean age of 12.3 ( ± 0.67) months. 104 children were revaccinated with MMR-containing vaccines; therefore, serology results for timepoints after revaccination were excluded from the analysis. Seropositivity for measles (Year 1≥ 98.3%; Year 2≥ 99.4%) and rubella (Year 1≥ 98.9%; Year 2 = 100%) remained as high at Year 2 as at Day 42. Similarly, seropositivity for mumps determined by ELISA (Year 1≥ 90.1%; Year 2≥ 94.1%) and PRN assays (Year 1≥ 87.5%; Year 2≥ 91.7%) persisted. Thirty-three SAEs were recorded in 23 children; 2 SAEs (inguinal adenitis and idiopathic thrombocytopenic purpura) and one SAE (febrile convulsion) were considered as potentially related to MMR-RIT and M-M-R II, respectively. This study showed that antibodies against measles, mumps and rubella persisted for up to 2 y post-vaccination with either MMR vaccine in children aged 12-15 months, and that both vaccines were well-tolerated during the follow-up period.

  16. In vivo release of levonorgestrel from Sino-implant (II) — an innovative comparison of explant data.

    PubMed

    Callahan, Rebecca L; Taylor, Douglas; Jenkins, David W; Owen, Derek H; Cheng, Linan; Cancel, Aida M; Dorflinger, Laneta J; Steiner, Markus J

    2015-10-01

    Measuring the amount of progestin remaining in contraceptive implants used for different lengths of time provides useful information on in vivo release kinetics including change over time. We compared estimated in vivo levonorgestrel (LNG) release rates derived from Sino-implant (II) explants with similar data from removed Jadelle. We measured LNG remaining in 44 sets of Sino-implant (II) used for up to 7 years and removed in four Chinese clinics. Results were compared with published data for Jadelle explants used for up to 36 months. We estimated and compared monthly and daily LNG release rates for the two products using prediction models for drug release. We also estimated the dissolution profile similarity factor, f2, for LNG release. Both Sino-implant (II) and Jadelle release approximately 30% of total LNG load after 3 years. Results of fitting the data to a biologically plausible modified Higuchi prediction model indicate comparable release through 3 years. An estimated similarity factor of 80.6 (90% confidence interval: 70.8-85.7) indicates similarity in the dissolution profiles of the two implants. LNG release in vivo measured through explant analysis suggest that Sino-implant (II) and Jadelle may perform similarly through 3 years of use and could remain highly effective beyond this time point. These results align with published data for Jadelle and Sino-implant (II) showing high effectiveness for 5 years. Ongoing clinical studies comparing the products over 5 years present an opportunity to verify this supportive measure of clinical effectiveness. This innovative approach provides evidence that Sino-implant (II) may perform clinically similarly to Jadelle over 3 years and remain a highly effective contraceptive beyond this time point. Data from explant analyses show promise for investigating the equivalence of elusion profiles of contraceptive implants. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Long-term outcomes and social independence level after arterial switch operation.

    PubMed

    Yamazaki, Akira; Yamamoto, Noboru; Sakamoto, Takahiko; Ishihara, Kazuaki; Iwata, Yusuke; Matsumura, Goki; Kurosawa, Hiromi

    2008-02-01

    Various issues regarding the long-term survivors of arterial switch operation (ASO) have been clarified according to the improvement of surgical mortality. We reviewed the long-term results and social independence level after ASO. Two hundred and four (204) patients who had undergone ASO more than 15 years ago were studied retrospectively. ASO was performed as a primary operation (group I, n=99) or as a secondary operation (group II, n=105). Lecompte procedure was performed in 197 patients, modified Aubert procedure in 5, and original Jatene procedure in 2. There were 11 late deaths. Kaplan-Meier survival rate (not including operative deaths) was 94.9% at 10 years and 94.9% at 15 years in group I, and 96.9% at 10 years and 94.4% at 15 years in group II. Forty-eight reoperations were performed (aortic valve replacement in 6, aortic valvoplasty in 2, Konno procedure in 1, double valve replacement in 1, right ventricular outflow tract reconstruction in 35). The reoperation-free rate including late death was 82.2% at 10 years and 75.7% at 15 years in group I, and 88.2% at 10 years and 78.1% at 15 years in group II. One hundred and seventy-eight patients were classified as NYHA class I and 7 patients as class II. All the patients except those with mental disorder (1) or neurodevelopmental impairment (3) were attending school or working. There was no significant difference in left ventricular function between group I and II, both showing values within the normal range. The long-term (>15 years) outcome of ASO survivors was satisfactory. Most patients showed excellent cardiac function and were socially independent.

  18. Orbital atherectomy for treating de novo, severely calcified coronary lesions: 3-year results of the pivotal ORBIT II trial.

    PubMed

    Lee, Michael; Généreux, Philippe; Shlofmitz, Richard; Phillipson, Daniel; Anose, Bynthia M; Martinsen, Brad J; Himmelstein, Stevan I; Chambers, Jeff W

    2017-06-01

    The presence of heavy coronary artery calcification increases the complexity of percutaneous coronary intervention (PCI) and increases the incidence of major adverse cardiac events (MACE): death, myocardial infarction (MI), target vessel revascularization (TVR), and stent thrombosis. The ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial reported low rates of procedural, 30-day, 1-year, and 2-year ischemic complications after treatment of de novo, severely calcified lesions with the Diamondback 360° Coronary Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc.). ORBIT II was a single-arm trial that enrolled 443 patients at 49U.S. sites; in this study, de novo, severely calcified coronary lesions were treated with OAS prior to stenting. The primary safety endpoint was 30-day MACE: the composite of cardiac death, MI, and TVR (inclusive of target lesion revascularization (TLR)). The primary efficacy endpoint was procedural success: stent delivery with a residual stenosis of <50% without the occurrence of in-hospital MACE.The present analysis reports the final, 3-year follow-up results from ORBIT II. The majority of subjects (88.2%) underwent PCI with drug-eluting stents after orbital atherectomy. There were 360 (81.3%) subjects who completed the protocol-mandated 3-year visit.The overall cumulative rate of 3-year MACE was 23.5%, including cardiac death (6.7%), MI (11.2%), and TVR (10.2%). The 3-year target lesion revascularization rate was 7.8%. In the final 3-year analysis of the ORBIT II trial, orbital atherectomy of severely calcified coronary lesions followed by stenting resulted in a low rate of adverse ischemic events compared with historical controls.Orbital atherectomy represents a safe and effective revascularization strategy for patients with severely calcified coronary lesions. The ORBIT II trial enrolled 443 subjects to study orbital atherectomy followed by stenting for de novo severely calcified coronary lesions. The overall cumulative 3-year MACE rate was 23.5%, including cardiac death (6.7%), MI (11.2%), and TVR (10.2%); the 3-year target lesion revascularization rate was 7.8%. Orbital atherectomy of heavily calcified coronary lesions followed by stenting results in a low rate of adverse ischemic events compared with historical controls; it represents a reasonable revascularization strategy for patients with severely calcified coronary lesions. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. An investigation into the effect of type I and type II diabetes duration on employment and wages.

    PubMed

    Minor, Travis

    2013-12-01

    Using data from the National Longitudinal Survey of Youth 1979, the current study examines the effect of type I and type II diabetes on employment status and wages. The results suggest that both the probability of employment and wages are negatively related to the number of years since the initial diagnosis of diabetes. Moreover, the effect of diabetes duration on the probability of employment appears to be nonlinear, peaking around 16 years for females and 10 years for males. A similar negative effect on wages is found only in male diabetics. Finally, the results suggest that failure to distinguish between type I and type II diabetics may lead to some counterintuitive results. Published by Elsevier B.V.

  20. Pavement performance evaluation, phase II : data collection.

    DOT National Transportation Integrated Search

    2008-12-01

    Phase I and II of this study tested approximately 1500 rehabilitated pavements (asphalt and PCC) : throughout the State. These pavements ranged from 5 to 15 years old and were intended to develop a : snapshot of how various rehabilitations were perfo...

  1. The Higher Education Act, Title II-C Program: Strengthening Research Library Resources. A Ten-Year Profile and an Assessment of the Program's Effects upon the Nation's Scholarship.

    ERIC Educational Resources Information Center

    Streit, Samuel Allen

    The aim of this study is to trace how the Title II-C program has facilitated scholarly access to research materials across the United States. It is intended to give evidence of the importance of the Title II-C Program to libraries' efforts toward developing, preserving, and sharing their resources with the nation's scholars. The study consists of…

  2. Surgical outcomes of Majewski osteodysplastic primordial dwarfism Type II with intracranial vascular anomalies.

    PubMed

    Teo, Mario; Johnson, Jeremiah N; Bell-Stephens, Teresa E; Marks, Michael P; Do, Huy M; Dodd, Robert L; Bober, Michael B; Steinberg, Gary K

    2016-12-01

    OBJECTIVE Majewski osteodysplastic primordial dwarfism Type II (MOPD II) is a rare genetic disorder. Features of it include extremely small stature, severe microcephaly, and normal or near-normal intelligence. Previous studies have found that more than 50% of patients with MOPD II have intracranial vascular anomalies, but few successful surgical revascularization or aneurysm-clipping cases have been reported because of the diminutive arteries and narrow surgical corridors in these patients. Here, the authors report on a large series of patients with MOPD II who underwent surgery for an intracranial vascular anomaly. METHODS In conjunction with an approved prospective registry of patients with MOPD II, a prospectively collected institutional surgical database of children with MOPD II and intracranial vascular anomalies who underwent surgery was analyzed retrospectively to establish long-term outcomes. RESULTS Ten patients with MOPD II underwent surgery between 2005 and 2012; 5 patients had moyamoya disease (MMD), 2 had intracranial aneurysms, and 3 had both MMD and aneurysms. Patients presented with transient ischemic attack (TIA) (n = 2), ischemic stroke (n = 2), intraparenchymal hemorrhage from MMD (n = 1), and aneurysmal subarachnoid hemorrhage (n = 1), and 4 were diagnosed on screening. The mean age of the 8 patients with MMD, all of whom underwent extracranial-intracranial revascularization (14 indirect, 1 direct) was 9 years (range 1-17 years). The mean age of the 5 patients with aneurysms was 15.5 years (range 9-18 years). Two patients experienced postoperative complications (1 transient weakness after clipping, 1 femoral thrombosis that required surgical repair). During a mean follow-up of 5.9 years (range 3-10 years), 3 patients died (1 of subarachnoid hemorrhage, 1 of myocardial infarct, and 1 of respiratory failure), and 1 patient had continued TIAs. All of the surviving patients recovered to their neurological baseline. CONCLUSIONS Patients with MMD presented at a younger age than those in whom aneurysms were more prevalent. Microneurosurgery with either intracranial bypass or aneurysm clipping is extremely challenging but feasible at expert centers in patients with MOPD II, and good long-term outcomes are possible.

  3. Phenotypic expression of late-onset glycogen storage disease type II: identification of asymptomatic adults through family studies and review of reported families.

    PubMed

    Ausems, M G; ten Berg, K; Beemer, F A; Wokke, J H

    2000-10-01

    The intrafamilial variability of late-onset glycogen storage disease type II was studied in siblings of 18 patients and in reports in the literature. Siblings of seven of the 18 index cases opted for DNA testing or enzyme studies after being informed by the index case of the availability of testing, and after genetic counselling. Of the 12 siblings tested, five asymptomatic individuals were diagnosed (mean age, 32.8 years; range, 17-53). Intrafamilial variability in the age at onset (more than 10 years difference) or in the clinical symptoms was found in one of seven sibships tested in this study, and also in seven sibships reported in the literature. We advocate that testing should not be offered to healthy siblings of late-onset glycogen storage disease type II patients as a routine, because it is impossible to give a precise prognosis to an individual who is symptom-free, but has been identified with a glycogen storage disease type II genotype, nor is there any therapeutic intervention available.

  4. Age and Workers' Perceptions of Workplace Safety: A Comparative Study

    ERIC Educational Resources Information Center

    Gyekye, Seth Ayim; Salminen, Simo

    2009-01-01

    The study examined the relationship between age and I) safety perception; ii) job satisfaction; iii) compliance with safety management policies; and (iv) accident frequency. Participants were Ghanaian industrial workers (N = 320) categorized into 4 age groups: 19-29 years; 30-39 years; 40-50 years; and 51 years and above. Workplace safety…

  5. A high 18F-FDOPA uptake is associated with a slow growth rate in diffuse Grade II-III gliomas.

    PubMed

    Isal, Sibel; Gauchotte, Guillaume; Rech, Fabien; Blonski, Marie; Planel, Sophie; Chawki, Mohammad B; Karcher, Gilles; Marie, Pierre-Yves; Taillandier, Luc; Verger, Antoine

    2018-04-01

    In diffuse Grade II-III gliomas, a high 3,4-dihydroxy-6-( 18 F)-fluoro-L-phenylalanine ( 18 F-FDOPA) positron emission tomography (PET) uptake, with a standardized uptake value (SUV max )/contralateral brain tissue ratio greater than 1.8, was previously found to be consistently associated with the presence of an isocitrate dehydrogenase (IDH) mutation, whereas this mutation is typically associated with a better prognosis. This pilot study was aimed to ascertain the prognostic value of this high 18 F-FDOPA uptake in diffuse Grade II-III gliomas with regard to the velocity of diameter expansion (VDE), which represents an established landmark of better prognosis when below 4 mm per year. 20 patients (42 ± 10 years, 10 female) with newly-diagnosed diffuse Grade II-III gliomas (17 with IDH mutation) were retrospectively included. All had a 18 F-FDOPA PET, quantified with SUV max ratio, along with a serial MRI enabling VDE determination. SUV max ratio was above 1.8 in 5 patients (25%) all of whom had a VDE <4 mm/year (100%) and IDH mutation (100%). Moreover, a SUV max ratio above 1.8 was associated with higher rates of VDE <4 mm/year in the overall population (45 vs 0%, p = 0.04) and also in the subgroup of patients with IDH mutation (45 vs 0%, p = 0.10). This pilot study shows that in diffuse Grade II-III gliomas, a high 18 F-FDOPA uptake would be predictive of low tumour growth, with a different prognostic significance than IDH mutation. Advances in knowledge: 18 F-FDOPA PET in a single session imaging could have prognostic value in initial diagnosis of diffuse Grade II-III gliomas.

  6. Retinal Prosthesis System for Advanced Retinitis Pigmentosa: A Health Technology Assessment

    PubMed Central

    Lee, Christine; Tu, Hong Anh; Weir, Mark; Holubowich, Corinne

    2016-01-01

    Background Retinitis pigmentosa is a group of genetic disorders that involves the breakdown and loss of photoreceptors in the retina, resulting in progressive retinal degeneration and eventual blindness. The Argus II Retinal Prosthesis System is the only currently available surgical implantable device approved by Health Canada. It has been shown to improve visual function in patients with severe visual loss from advanced retinitis pigmentosa. The objective of this analysis was to examine the clinical effectiveness, cost-effectiveness, budget impact, and safety of the Argus II system in improving visual function, as well as exploring patient experiences with the system. Methods We performed a systematic search of the literature for studies examining the effects of the Argus II retinal prosthesis system in patients with advanced retinitis pigmentosa, and appraised the evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria, focusing on visual function, functional outcomes, quality of life, and adverse events. We developed a Markov decision-analytic model to assess the cost-effectiveness of the Argus II system compared with standard care over a 10-year time horizon. We also conducted a 5-year budget impact analysis. We used a qualitative design and an interview methodology to examine patients’ lived experience, and we used a modified grounded theory methodology to analyze information from interviews. Transcripts were coded, and themes were compared against one another. Results One multicentre international study and one single-centre study were included in the clinical review. In both studies, patients showed improved visual function with the Argus II system. However, the sight-threatening surgical complication rate was substantial. In the base-case analysis, the Argus II system was cost-effective compared with standard care only if willingness-to-pay was more than $207,616 per quality-adjusted life-year. The 5-year budget impact of funding the Argus II system ranged from $800,404 to $837,596. Retinitis pigmentosa significantly affects people's ability to navigate physical and virtual environments. Argus II was described as enabling the fundamental elements of sight. As such, it had a positive impact on quality of life for people with retinitis pigmentosa. Conclusions Based on evidence of moderate quality, patients with advanced retinitis pigmentosa who were implanted with the Argus II retinal prosthesis system showed significant improvement in visual function, real-life functional outcomes, and quality of life, but there were complications associated with the surgery that could be managed through standard ophthalmologic treatments. The costs for the technology are high. PMID:27468325

  7. Retinal Prosthesis System for Advanced Retinitis Pigmentosa: A Health Technology Assessment.

    PubMed

    2016-01-01

    Retinitis pigmentosa is a group of genetic disorders that involves the breakdown and loss of photoreceptors in the retina, resulting in progressive retinal degeneration and eventual blindness. The Argus II Retinal Prosthesis System is the only currently available surgical implantable device approved by Health Canada. It has been shown to improve visual function in patients with severe visual loss from advanced retinitis pigmentosa. The objective of this analysis was to examine the clinical effectiveness, cost-effectiveness, budget impact, and safety of the Argus II system in improving visual function, as well as exploring patient experiences with the system. We performed a systematic search of the literature for studies examining the effects of the Argus II retinal prosthesis system in patients with advanced retinitis pigmentosa, and appraised the evidence according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria, focusing on visual function, functional outcomes, quality of life, and adverse events. We developed a Markov decision-analytic model to assess the cost-effectiveness of the Argus II system compared with standard care over a 10-year time horizon. We also conducted a 5-year budget impact analysis. We used a qualitative design and an interview methodology to examine patients' lived experience, and we used a modified grounded theory methodology to analyze information from interviews. Transcripts were coded, and themes were compared against one another. One multicentre international study and one single-centre study were included in the clinical review. In both studies, patients showed improved visual function with the Argus II system. However, the sight-threatening surgical complication rate was substantial. In the base-case analysis, the Argus II system was cost-effective compared with standard care only if willingness-to-pay was more than $207,616 per quality-adjusted life-year. The 5-year budget impact of funding the Argus II system ranged from $800,404 to $837,596. Retinitis pigmentosa significantly affects people's ability to navigate physical and virtual environments. Argus II was described as enabling the fundamental elements of sight. As such, it had a positive impact on quality of life for people with retinitis pigmentosa. Based on evidence of moderate quality, patients with advanced retinitis pigmentosa who were implanted with the Argus II retinal prosthesis system showed significant improvement in visual function, real-life functional outcomes, and quality of life, but there were complications associated with the surgery that could be managed through standard ophthalmologic treatments. The costs for the technology are high.

  8. Fixed-functional appliance treatment combined with growth hormone therapy.

    PubMed

    Jung, Min-Ho

    2017-09-01

    The purpose of this study was to illustrate the effects of growth hormone (GH) therapy and fixed functional appliance treatment in a 13-year-old Class II malocclusion patient without GH deficiency. GH has been shown to effectively increase endochondral growth and induce a more prognathic skeletal pattern. Although a major concern in Class II retrognathic patients is chin deficiency, long-term studies have shown that the mandibular growth enhancement effects of functional appliances are clinically insignificant. This case report demonstrates that the mandible grew significantly during fixed functional appliance treatment combined with GH therapy, with stable results during 2 years 11 months of retention. More studies are needed to evaluate GH therapy as a supplement in Class II treatment. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  9. One-year course and predictors of outcome of adolescent depression: a case-control study in Finland.

    PubMed

    Karlsson, Linnea; Kiviruusu, Olli; Miettunen, Jouko; Heilä, Hannele; Holi, Matti; Ruuttu, Titta; Tuisku, Virpi; Pelkonen, Mirjami; Marttunen, Mauri

    2008-05-01

    Clinical studies on the outcome of adolescent depression beyond treatment trials are scarce. To investigate the impact of characteristics of the depressive episode and current comorbidity on the 1-year outcome of depression. A sample of 174 consecutive adolescent psychiatric outpatients (aged 13 through 19 years) and 17 school-derived matched controls, all with unipolar depressive disorders at baseline, were reinterviewed for DSM-IV Axis I and Axis II disorders at 12 months. The study was conducted between January 1998 and May 2002. The outpatients had equal recovery rate and episode duration but shorter time to recurrence than the controls. Among the outpatients, Axis II comorbidity predicted shorter time to recurrence (p = .02). Longer time to recovery was predicted by earlier lifetime age at onset for depression (p = .02), poor psychosocial functioning (p = .003), depressive disorder diagnosis (p

  10. Cognitive Experiences Reported by Borderline Patients and Axis II Comparison Subjects: A 16-year Prospective Follow-up Study

    PubMed Central

    Zanarini, Mary C.; Frankenburg, Frances R.; Wedig, Michelle M.; Fitzmaurice, Garrett M.

    2013-01-01

    Objective This study assesses three main types of cognition: nonpsychotic thought (odd thinking, unusual perceptual experiences, and non-delusional paranoia), quasi-psychotic thought, and true-psychotic thought in borderline patients followed prospectively for 16 years. It also compares the rates of these disturbed cognitions to those reported by axis II comparison subjects. Method The cognitive experiences of 362 inpatients—290 borderline patients and 72 axis II comparison subjects—were assessed at study entry using the cognitive section of the Revised Diagnostic Interview for Borderlines. Their cognitive experiences were reassessed every two years using the same interview. Results Each of the five main types of thought studied was reported by a significantly higher percentage of borderline patients than axis II comparison subjects over time. Each of these types of thought, except true-psychotic thought, declined significantly over time for those in both groups. Eleven of the 17 more specific forms of thought studied were also reported by a significantly higher percentage of borderline patients over the years of follow-up: magical thinking, overvalued ideas, recurrent illusions, depersonalization, derealization, undue suspiciousness, ideas of reference, other paranoid ideation, quasi-psychotic delusions, quasi-psychotic hallucinations, and true-psychotic hallucinations. Fourteen specific forms of thought were found to decline significantly over time for those in both groups: all forms of thought mentioned above except true-psychotic hallucinations plus marked superstitiousness, sixth sense, telepathy, and clairvoyance. Conclusions Disturbed cognitions are common among borderline patients and distinguishing for the disorder. They also decline substantially over time but remain a problem, particularly those of a nonpsychotic nature. PMID:23558452

  11. Autoimmune severe hypertriglyceridemia induced by anti-apolipoprotein C-II antibody.

    PubMed

    Yamamoto, Hiroyasu; Tanaka, Minoru; Yoshiga, Satomi; Funahashi, Tohru; Shimomura, Iichiro; Kihara, Shinji

    2014-05-01

    Among type V hyperlipoproteinemias, only one-fourth of the patients have genetic defects in lipoprotein lipase (LPL) or in its associated molecules; the exact mechanism in other patients is usually unknown. The aim of the study was to report a case of severe hypertriglyceridemia induced by anti-apolipoprotein (apo) C-II autoantibody and to clarify its pathogenesis. A 29-year-old Japanese woman presented with severe persistent hypertriglyceridemia since the age of 20 years. The past history was negative for acute pancreatitis, eruptive xanthomas, or lipemia retinalis. LPL mass and activities were normal. Plasma apo C-II levels were extremely low, but no mutation was observed in APOC2. Apo C-II protein was detected in the serum by immunoprecipitation and Western blotting. Large amounts of IgG and IgM were incorporated with apo C-II protein coimmunoprecipitated by anti-apo C-II antibody. IgG, but not IgM, purified from the serum prevented interaction of apo C-II with lipid substrate and diminished LPL hydrolysis activity. We identified anti-apo C-II antibody in a myeloma-unrelated severe hypertriglyceridemic patient. In vitro analysis confirmed that the autoantibody disrupted the interaction between apo C-II and lipid substrate, suggesting the etiological role of anti-apo C-II antibody in severe hypertriglyceridemia in this patient.

  12. Cognition and Incident Coronary Heart Disease in Late Midlife: The Whitehall II Study

    ERIC Educational Resources Information Center

    Singh-Manoux, Archana; Sabia, Severine; Kivimaki, Mika; Shipley, Martin J.; Ferrie, Jane E.; Marmot, Michael G.

    2009-01-01

    The purpose of this study was to investigate whether cognitive function in midlife predicts incident coronary heart disease (CHD), followed up over 6 years. Data on 5292 (28% women, mean age 55) individuals free from CHD at baseline were drawn from the British Whitehall II study. We used Cox regression to model the association between cognition…

  13. Radiation tolerance of readout electronics for Belle II

    NASA Astrophysics Data System (ADS)

    Higuchi, T.; Nakao, M.; Nakano, E.

    2012-02-01

    We plan to start the Belle II experiment in 2015 and to continue data taking for more than ten years. Because some of the front-end electronics cards of Belle II are located inside the detector, radiation effects onto their components will be a severe problem. Using experimental exposure facilities of neutrons and γ rays, we study the radiation effects from these particles to the Virtex-5 FPGA, optical transceivers, and voltage regulators. The Virtex-5 FPGA is found to keep its operation after irradiation of more than 20-year-equivalent neutron flux of Belle II and 88-year-equivalent γ-ray dose. We observe single event upsets (SEUs) and multiple bit upsets (MBUs) in the Virtex-5 FPGA in the neutron irradiation. We also find almost doubled SEU counts in the Virtex-5 FPGA bombarded from its tail side than its head side. We extrapolate the observed SEU and MBU counts in the Virtex-5 FPGA to the entire readout system of the Belle II central drift chamber, and expect the SEU and MBU rates as one SEU per four minutes and one MBU per 11.5 hours, respectively. The optical transceivers are found to keep its operation after integration of 12-year-equivalent neutron flux, while they are killed by about 3-year-equivalent γ-ray dose, which should be solved in the future research. The voltage regulators are found to keep its operation for more than 10-year-equivalent γ-ray dose.

  14. Five-Year Safety and Performance Results from the Argus II Retinal Prosthesis System Clinical Trial.

    PubMed

    da Cruz, Lyndon; Dorn, Jessy D; Humayun, Mark S; Dagnelie, Gislin; Handa, James; Barale, Pierre-Olivier; Sahel, José-Alain; Stanga, Paulo E; Hafezi, Farhad; Safran, Avinoam B; Salzmann, Joel; Santos, Arturo; Birch, David; Spencer, Rand; Cideciyan, Artur V; de Juan, Eugene; Duncan, Jacque L; Eliott, Dean; Fawzi, Amani; Olmos de Koo, Lisa C; Ho, Allen C; Brown, Gary; Haller, Julia; Regillo, Carl; Del Priore, Lucian V; Arditi, Aries; Greenberg, Robert J

    2016-10-01

    The Argus II Retinal Prosthesis System (Second Sight Medical Products, Inc, Sylmar, CA) was developed to restore some vision to patients blind as a result of retinitis pigmentosa (RP) or outer retinal degeneration. A clinical trial was initiated in 2006 to study the long-term safety and efficacy of the Argus II System in patients with bare or no light perception resulting from end-stage RP. Prospective, multicenter, single-arm clinical trial. Within-patient controls included the nonimplanted fellow eye and patients' native residual vision compared with their vision with the Argus II. Thirty participants in 10 centers in the United States and Europe. The worse-seeing eye of blind patients was implanted with the Argus II. Patients wore glasses mounted with a small camera and a video processor that converted images into stimulation patterns sent to the electrode array on the retina. The primary outcome measures were safety (the number, seriousness, and relatedness of adverse events) and visual function, as measured by 3 computer-based, objective tests. Secondary measures included functional vision performance on objectively scored real-world tasks. Twenty-four of 30 patients remained implanted with functioning Argus II Systems at 5 years after implantation. Only 1 additional serious adverse event was experienced after the 3-year time point. Patients performed significantly better with the Argus II on than off on all visual function tests and functional vision tasks. The 5-year results of the Argus II trial support the long-term safety profile and benefit of the Argus II System for patients blind as a result of RP. The Argus II is the first and only retinal implant to have market approval in the European Economic Area, the United States, and Canada. Copyright © 2016 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  15. The year 2013 in the European Heart Journal--Cardiovascular Imaging: Part II.

    PubMed

    Plein, Sven; Edvardsen, Thor; Pierard, Luc A; Saraste, Antti; Knuuti, Juhani; Maurer, Gerald; Lancellotti, Patrizio

    2014-08-01

    The new multi-modality cardiovascular imaging journal, European Heart Journal - Cardiovascular Imaging, was created in 2012. Here we summarize the most important studies from the journal's second year in two articles. Part I of the review has summarized studies in myocardial function, myocardial ischaemia, and emerging techniques in cardiovascular imaging. Part II is focussed on valvular heart diseases, heart failure, cardiomyopathies, and congenital heart diseases. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  16. HLA-G and MHC Class II Protein Expression in Diffuse Large B-Cell Lymphoma.

    PubMed

    Jesionek-Kupnicka, Dorota; Bojo, Marcin; Prochorec-Sobieszek, Monika; Szumera-Ciećkiewicz, Anna; Jabłońska, Joanna; Kalinka-Warzocha, Ewa; Kordek, Radzisław; Młynarski, Wojciech; Robak, Tadeusz; Warzocha, Krzysztof; Lech-Maranda, Ewa

    2016-06-01

    The expression of human leukocyte antigen-G (HLA-G) and HLA class II protein was studied by immunohistochemical staining of lymph nodes from 148 patients with diffuse large B-cell lymphoma (DLBCL) and related to the clinical course of the disease. Negative HLA-G expression was associated with a lower probability of achieving a complete remission (p = 0.04). Patients with negative HLA-G expression tended towards a lower 3-year overall survival (OS) rate compared to those with positive expression of HLA-G (p = 0.08). When restricting the analysis to patients receiving chemotherapy with rituximab, the estimated 3-year OS rate of patients with positive HLA-G expression was 73.3 % compared with 47.5 % (p = 0.03) in those with negative expression. Patients with negative HLA class II expression presented a lower 3-year OS rate compared to subjects with positive expression (p = 0.04). The loss of HLA class II expression (p = 0.05) and belonging to the intermediate high/high IPI risk group (p = 0.001) independently increased the risk of death. HLA class II expression also retained its prognostic value in patients receiving rituximab; the 3-year OS rate was 65.3 % in patients with positive HLA class II expression versus 29.6 % (p = 0.04) in subjects that had loss of HLA class II expression. To our knowledge, for the first time, the expression of HLA-G protein in DLBCL and its association with the clinical course of the disease was demonstrated. Moreover, the link between losing HLA class II protein expression and poor survival of patients treated with immunochemotherapy was confirmed.

  17. The prevalence of diabetes mellitus (DM) type II among Iranian elderly population and its association with other age-related diseases, 2012.

    PubMed

    Taheri Tanjani, Parisa; Moradinazar, Mehdi; Esmail Mottlagh, Mohammad; Najafi, Farid

    2015-01-01

    DM type II is one of the most common chronic diseases. The objective of this study is to investigate the prevalence of DM and its association with other age-related diseases in Iran, 2012. In this cross-sectional study, people aged 60 years and over were selected using multistage sampling method. Mini-Nutritional Assessment (MNA), Activity of Daily Living (ADL), and Geriatric Depression Scale (GDS-15 items) questionnaires were used. History of common disorders was taken through self-report, medical records and the results of clinical examinations. A total of 1350 old people were studied. DM type II was found in 297 (22.0%) subjects and 371 (27.5%) of subjects were not aware of their DM status. Hypertension (55.6%), high serum cholesterol (51.8%), malnutrition (40.1%), Alzheimer's disease (16.9%), weight loss within past year (16.1%), weight gain within past year (11.7%), frailty (64.6%), insomnia (50.1%), and vision problems (62.6%) were significantly more common in diabetics. Those who were not aware of their status of DM either were between diabetics and non-diabetics or more similar to non-diabetics. Considering high prevalence of age-related diseases among Iranian elderly people, in particular women and those with DM type II, preventive measures are recommended so as to decrease and control DM type II and its consequent complications. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Validation Study of Maternal Recall on Breastfeeding Duration 6 Years After Childbirth.

    PubMed

    Amissah, Emma Ayorkor; Kancherla, Vijaya; Ko, Yi-An; Li, Ruowei

    2017-05-01

    Breastfeeding duration is an important indicator commonly measured in maternal and child health and nutrition research. Maternal short-term recall for both initiation and duration of breastfeeding has been shown to be valid; however, validity of long-term recall is not well understood. Research aim: This study aims to assess the validity of maternal recall of breastfeeding duration 6 years after childbirth and its association with sociodemographic factors. Among 635 mother-child pairs, breastfeeding duration data collected monthly throughout the 1st year after childbirth in the Infant Feeding Practices Study II (IFPS II) were compared to recall data obtained 6 years later during the Year 6 Follow-Up. The intraclass correlation coefficient (ICC) and Bland-Altman plots were examined to study the agreement between the two data sets. Sociodemographic factors associated with accurate recall to within 1 month of the IFPS II breastfeeding duration were assessed using multivariable logistic regression modeling. Maternal recall of breastfeeding duration was found to be valid 6 years after childbirth with a small median overall bias (1 week) toward overestimation. The overall concordance was high (ICC = 0.84), except for high school graduates (ICC = 0.63) and smokers (ICC = 0.61). Smokers (adjusted odds ratio = 0.52; 95% confidence interval [0.4, 0.8]) and multiparous women (adjusted odds ratio = 0.57; 95% confidence interval [0.4, 0.9]) were also less likely to give an accurate recall of their breastfeeding duration to within 1 month. Our study found that maternal recall of breastfeeding duration varies by sociodemographic factors but is accurate 6 years after childbirth.

  19. Mogamulizumab for relapsed adult T-cell leukemia-lymphoma: Updated follow-up analysis of phase I and II studies.

    PubMed

    Ishida, Takashi; Utsunomiya, Atae; Jo, Tatsuro; Yamamoto, Kazuhito; Kato, Koji; Yoshida, Shinichiro; Takemoto, Shigeki; Suzushima, Hitoshi; Kobayashi, Yukio; Imaizumi, Yoshitaka; Yoshimura, Kenichi; Kawamura, Kouichi; Takahashi, Takeshi; Tobinai, Kensei; Ueda, Ryuzo

    2017-10-01

    The present study sought to elucidate the prognosis of adult T-cell leukemia-lymphoma (ATL) patients receiving mogamulizumab, a defucosylated anti-CCR4 monoclonal antibody. Progression-free survival (PFS) and overall survival (OS) of ATL patients enrolled in two studies are herein updated, namely NCT00355472 (phase I study of mogamulizumab in relapsed patients with ATL and peripheral T-cell lymphoma) and NCT00920790 (phase II study for relapsed ATL). Of 13 patients with relapsed aggressive ATL in the phase I study, four (31%) survived >3 years. For 26 relapsed patients with aggressive ATL in the phase II study, median PFS was 5.2 months and 1-year PFS was 26%, whereas median OS was 14.4 months, and 3-year OS was 23%. For patients without a rash or who developed a grade 1 rash only, median PFS was 0.8 months, and 1-year PFS was zero, with a median OS of 6.0 months, and 3-year OS of 8%. In contrast, for patients who developed a rash ≥grade 2, median PFS was 11.7 months, and 1-year PFS was 50%, with a median OS of 25.6 months, and 3-year OS of 36%. Thus, we conclude that mogamulizumab monotherapy may improve PFS and OS in some patients with relapsed aggressive ATL, especially those who develop a skin rash as a moderate immune-related adverse event. Therefore, further investigation is warranted to validate the present observations and to clarify the mechanisms involved in the activity of mogamulizumab. © 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

  20. Effects of olmesartan on the renin-angiotensin-aldosterone system for patients with essential hypertension after cardiac surgery--investigation using a candesartan change-over study.

    PubMed

    Sezai, Akira; Soma, Masayoshi; Hata, Mitsumasa; Yoshitake, Isamu; Unosawa, Satoshi; Wakui, Shinji; Shiono, Motomi

    2011-01-01

    Various angiotensin II receptor blockers are widely used for the treatment of hypertension in recent years. The results of large-scale clinical studies have shown that they have various efficacies: not only hypotensive effects but also organ protective effects. In this study, the effects of a change-over from candesartan to olmesartan on renin-angiotensin-aldsterone system, cardiomegaly and peripheral circulation were studied. Participants enrolled in this trial were outpatients with essential hypertension after cardiac surgery who had received candesartan for more than one year. Fifty-six patients switched from candesartan to olmesartan. The primary endpoints were 1) renin activity, angiotensin II, aldosterone, and 2) left ventricular mass index (LVMI). It was clear that angiotensin II and aldosterone are decreased by the potent hypotensive effects of olmesartan in a change-over from candesartan to olmesartan. Since LVMI and BNP were decreased, inhibitory effects on myocardial hypertrophy were also confirmed. In the present study, left ventricular hypertrophy and on arterial compliance were inhibited by a decrease in angiotensin II and aldosterone due to the change-over to olmesartan. In the future, protective effects on organs will be clarified by long-term observations.

  1. Alemtuzumab CARE-MS II 5-year follow-up

    PubMed Central

    Cohen, Jeffrey A.; Fox, Edward J.; Giovannoni, Gavin; Hartung, Hans-Peter; Havrdova, Eva; Schippling, Sven; Selmaj, Krzysztof W.; Traboulsee, Anthony; Compston, D. Alastair S.; Margolin, David H.; Thangavelu, Karthinathan; Chirieac, Madalina C.; Jody, Darlene; Xenopoulos, Panos; Hogan, Richard J.; Panzara, Michael A.; Arnold, Douglas L.

    2017-01-01

    Objective: To evaluate 5-year efficacy and safety of alemtuzumab in patients with active relapsing-remitting multiple sclerosis and inadequate response to prior therapy. Methods: In the 2-year Comparison of Alemtuzumab and Rebif Efficacy in Multiple Sclerosis (CARE-MS) II study (NCT00548405), alemtuzumab-treated patients received 2 courses (baseline and 12 months later). Patients could enter an extension (NCT00930553), with as-needed alemtuzumab retreatment for relapse or MRI activity. Annualized relapse rate (ARR), 6-month confirmed disability worsening (CDW; ≥1-point Expanded Disability Status Scale [EDSS] score increase [≥1.5 if baseline EDSS = 0]), 6-month confirmed disability improvement (CDI; ≥1-point EDSS decrease [baseline score ≥2.0]), no evidence of disease activity (NEDA), brain volume loss (BVL), and adverse events (AEs) were assessed. Results: Most alemtuzumab-treated patients (92.9%) who completed CARE-MS II entered the extension; 59.8% received no alemtuzumab retreatment. ARR was low in each extension year (years 3–5: 0.22, 0.23, 0.18). Through 5 years, 75.1% of patients were free of 6-month CDW; 42.9% achieved 6-month CDI. In years 3, 4, and 5, proportions with NEDA were 52.9%, 54.2%, and 58.2%, respectively. Median yearly BVL remained low in the extension (years 1–5: −0.48%, −0.22%, −0.10%, −0.19%, −0.07%). AE exposure-adjusted incidence rates in the extension were lower than in the core study. Thyroid disorders peaked at year 3, declining thereafter. Conclusions: Alemtuzumab provides durable efficacy through 5 years in patients with an inadequate response to prior therapy in the absence of continuous treatment. Classification of evidence: This study provides Class III evidence that alemtuzumab provides efficacy and slowing of brain atrophy through 5 years. PMID:28835403

  2. Surface-enhanced Raman scattering and DFT investigation of 1,5-diphenylcarbazide and its metal complexes with Ca(II), Mn(II), Fe(III) and Cu(II)

    NASA Astrophysics Data System (ADS)

    Szabó, László; Herman, Krisztian; Mircescu, Nicoleta Elena; Tódor, István Szabolcs; Simon, Botond Lorand; Boitor, Radu Alex; Leopold, Nicolae; Chiş, Vasile

    2014-09-01

    In recent years, surface-enhanced Raman scattering (SERS) has become an increasingly viable method for the detection of metal ions, evidenced by the existing studies on metal complexes. In this study, 1,5-diphenylcarbazide (DPC) and its Ca(II), Mn(II), Fe(III) and Cu(II) complexes were investigated by FTIR/ATR, FT-Raman and surface-enhanced Raman spectroscopies. The hybrid B3LYP exchange-correlation functional was used for the molecular geometry optimizations, molecular electrostatic potential (MEP) distribution and vibrational frequencies calculations of the DPC molecule and its complexes. Based on experimental and theoretical data, we were able to accurately identify unique and representative features for each DPC-metal complex, features that enable the detection of said metal complexes in millimolar concentrations.

  3. Discontinuation of orthokeratology on eyeball elongation (DOEE).

    PubMed

    Cho, P; Cheung, S W

    2017-04-01

    To evaluate and compare changes in axial elongation, over a 14-month period, in subjects who discontinued and then resumed ortho-k lens wear with those who continued to wear their lenses or spectacles following a 2-year myopia control study. This single masked, prospective study recruited subjects who had just completed a 2-year myopia control study. Ortho-k subjects were classified as Group OKc, in which subjects continued ortho-k lens wear for the duration of the study; or Group OKd in which subjects discontinued lens wear for seven months and wore single-vision spectacles (Phase I) and then resumed ortho-k lens wear for another seven months (Phase II). Spectacle-wearing control subjects from the initial myopia control study continued wearing spectacles as control subjects. Axial lengths were measured at scheduled visits using the IOLMaster. Thirteen, 16, and 15 Control, OKc, and OKd subjects, aged 8-14 years, respectively completed the study. Significant increase in axial elongation was found in OKd subjects only in Phase I but not in Phase II. On resuming lens wear, in Phase II, the rate of axial elongation was no longer significantly different from those of the Control or OKc subjects. Stopping ortho-k lens wear at or before the age of 14 years led to a more rapid increase in axial length; comparable to those wearing spectacles during the initial 2-year myopia control study, but greater than the Control and OKc group in this study. Axial elongation slowed again with resumed lens wear after six months. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  4. Pain Relief in CRPS-II after Spinal Cord and Motor Cortex Simultaneous Dual Stimulation.

    PubMed

    Lopez, William Oc; Barbosa, Danilo C; Teixera, Manoel J; Paiz, Martin; Moura, Leonardo; Monaco, Bernardo A; Fonoff, Erich T

    2016-05-01

    We describe a case of a 30-year-old woman who suffered a traumatic injury of the right brachial plexus, developing severe complex regional pain syndrome type II (CRPS-II). After clinical treatment failure, spinal cord stimulation (SCS) was indicated with initial positive pain control. However, after 2 years her pain progressively returned to almost baseline intensity before SCS. Additional motor cortex electrode implant was then proposed as a rescue therapy and connected to the same pulse generator. This method allowed simultaneous stimulation of the motor cortex and SCS in cycling mode with independent stimulation parameters in each site. At 2 years follow-up, the patient reported sustained improvement in pain with dual stimulation, reduction of painful crises, and improvement in quality of life. The encouraging results in this case suggests that this can be an option as add-on therapy over SCS as a possible rescue therapy in the management of CRPS-II. However, comparative studies must be performed in order to determine the effectiveness of this therapy. Chronic neuropathic pain, Complex regional pain syndrome Type II, brachial plexus injury, motor cortex stimulation, spinal cord stimulation.

  5. Long-Term Neurodevelopmental Outcomes of Premature Infants in Singapore.

    PubMed

    Teo, Charmaine M; Poon, Woei Bing; Ho, Selina Ky

    2018-02-01

    Neonatal care advances have resulted in improved survival but have raised concerns of increase in neurodevelopmental impairment. This study looked at long-term neurodevelopmental outcomes at ages 5 and 8 years of very low birthweight infants born in the 2000s as compared to the 1990s. Neurodevelopmental assessment at 2 years old was compared to that at 5 and 8 years to determine if assessment at 2 years was predictive of later outcomes. A retrospective cohort study of consecutive infants with birthweight less than 1250 grams admitted to a tertiary centre in Singapore between January 1994 to December 1995 (Epoch I) and January 2004 to December 2005 (Epoch II) were included. Neurodevelopmental impairment was defined as having intelligence quotient (IQ) of less than 70, cerebral palsy, legal blindness, or hearing impairment requiring hearing aids. Mean gestational age was lower for Epoch II compared to Epoch I (28.1 ± 2.5 vs 29.4 ± 2.7 weeks, P = 0.004). Death or neurodevelopmental impairment rates did not differ (24.3% and 17.1% at 5 years old, P = 0.398; 29.1% and 25.0% at 8 years old, P = 0.709). There was improvement in visual impairment rate at 8 years in Epoch II (10.7% vs 34.0%, P = 0.024). Mean IQ was better in Epoch II (109 and 107 vs 97 and 99 at 5 [ P = 0.001] and 8 years [ P = 0.047], respectively). All infants with no neurodevelopmental impairment at 2 years remained without impairment later on. Over a decade, neurodevelopmental outcomes did not worsen despite lower mean gestational age. Long- term improvement in IQ scores and a reduction in visual impairment rates were seen. Our data suggests that children without neurodevelopmental impairment at 2 years are without impairment later on; therefore, they may need only developmental monitoring with targeted assessments instead of routine formal IQ assessments.

  6. Thymidine phosphorylase and hypoxia-inducible factor 1-α expression in clinical stage II/III rectal cancer: association with response to neoadjuvant chemoradiation therapy and prognosis.

    PubMed

    Lin, Shuhan; Lai, Hao; Qin, Yuzhou; Chen, Jiansi; Lin, Yuan

    2015-01-01

    The aim of this study was to determine whether pretreatment status of thymidine phosphorylase (TP), and hypoxia-inducible factor alpha (HIF-1α) could predict pathologic response to neoadjuvant chemoradiation therapy with oxaliplatin and capecitabine (XELOXART) and outcomes for clinical stage II/III rectal cancer patients. A total of 180 patients diagnosed with clinical stage II/III rectal cancer received XELOXART. The status of TP, and HIF-1α were determined in pretreatment biopsies by immunohistochemistry (IHC). Tumor response was assessed in resected regimens using the tumor regression grade system and TNM staging system. 5-year disease free survival (DFS) and 5-year overall survival (OS) were evaluated with the Kaplan-Meier method and were compared by the log-rank test. Over expression of TP and low expression of HIF-1α were associated with pathologic response to XELOXART and better outcomes (DFS and OS) in clinical stage II/III rectal cancer patients (P < 0.05). Our result suggested that pretreatment status of TP and HIF-1α were found to predict pathologic response and outcomes in clinical stage II/III rectal cancer received XELOXART. Additional well-designed, large sample, multicenter, prospective studies are needed to confirm the result of this study.

  7. Superior MRI outcomes with alemtuzumab compared with subcutaneous interferon β-1a in MS.

    PubMed

    Arnold, Douglas L; Fisher, Elizabeth; Brinar, Vesna V; Cohen, Jeffrey A; Coles, Alasdair J; Giovannoni, Gavin; Hartung, Hans-Peter; Havrdova, Eva; Selmaj, Krzysztof W; Stojanovic, Miroslav; Weiner, Howard L; Lake, Stephen L; Margolin, David H; Thomas, David R; Panzara, Michael A; Compston, D Alastair S

    2016-10-04

    To describe detailed MRI results from 2 head-to-head phase III trials, Comparison of Alemtuzumab and Rebif Efficacy in Multiple Sclerosis Study I (CARE-MS I; NCT00530348) and Study II (CARE-MS II; NCT00548405), of alemtuzumab vs subcutaneous interferon β-1a (SC IFN-β-1a) in patients with active relapsing-remitting multiple sclerosis (RRMS). The impact of alemtuzumab 12 mg vs SC IFN-β-1a 44 μg on MRI measures was evaluated in patients with RRMS who were treatment-naive (CARE-MS I) or who had an inadequate response, defined as at least one relapse, to prior therapy (CARE-MS II). Both treatments prevented T2-hyperintense lesion volume increases from baseline. Alemtuzumab was more effective than SC IFN-β-1a on most lesion-based endpoints in both studies (p < 0.05), including decreased risk of new/enlarging T2 lesions over 2 years and gadolinium-enhancing lesions at year 2. Reduced risk of new T1 lesions (p < 0.0001) and gadolinium-enhancing lesion conversion to T1-hypointense black holes (p = 0.0078) were observed with alemtuzumab vs SC IFN-β-1a in CARE-MS II. Alemtuzumab slowed brain volume loss over 2 years in CARE-MS I (p < 0.0001) and II (p = 0.012) vs SC IFN-β-1a. Alemtuzumab demonstrated greater efficacy than SC IFN-β-1a on MRI endpoints in active RRMS. The superiority of alemtuzumab was more prominent during the second year of both studies. These findings complement the superior clinical efficacy of alemtuzumab over SC IFN-β-1a in RRMS. NCT00530348 and NCT00548405. The results reported here provide Class I evidence that, for patients with active RRMS, alemtuzumab is superior to SC IFN-β-1a on multiple MRI endpoints. © 2016 American Academy of Neurology.

  8. Long-acting PEGylated recombinant human growth hormone (Jintrolong) for children with growth hormone deficiency: phase II and phase III multicenter, randomized studies.

    PubMed

    Luo, Xiaoping; Hou, Ling; Liang, Li; Dong, Guanping; Shen, Shuixian; Zhao, Zhuhui; Gong, Chun Xiu; Li, Yuchuan; Du, Min-Lian; Su, Zhe; Du, Hongwei; Yan, Chaoying

    2017-08-01

    We assessed the efficacy and safety of a weekly pegylated human growth hormone (PEG-rhGH) (Jintrolong) vs daily rhGH for children with growth hormone deficiency (GHD). Phase II and III, multicenter, open-label, randomized controlled trials. 108 and 343 children with treatment-naive GHD from 6 hospitals in China were enrolled in the phase II and III studies respectively. Patients in the phase II study were randomized 1:1:1 to weekly Jintrolong (0.1 mg/kg/week PEG-rhGH complex), weekly Jintrolong (0.2 mg/kg/week PEG-rhGH complex) or daily rhGH (0.25 mg/kg/week) for 25 weeks. Patients in the phase III study were randomized in a 2:1 ratio to weekly Jintrolong (0.2 mg/kg/week) or daily rhGH (0.25 mg/kg/week) for 25 weeks. The primary endpoint for both studies was height velocity (HV) increase at the end of treatment. Other growth-related parameters, safety and compliance were also monitored. The phase II study established the preliminary efficacy, safety and recommended dose of Jintrolong PEG-rhGH. In the phase III study, we demonstrated significantly greater HV increases in patients receiving Jintrolong treatment (from 2.26 ± 0.87 cm/year to 13.41 ± 3.72 cm/year) vs daily rhGH (from 2.25 ± 0.82 cm/year to 12.55 ± 2.99 cm/year) at the end of treatment ( P  < 0.05). Additionally, significantly greater improvement in the height standard deviation scores was associated with Jintrolong throughout the treatment ( P  < 0.05). Adverse event rates and treatment compliance were comparable between the two groups. Jintrolong PEG-rhGH at a dose of 0.2 mg/kg/week for 25 weeks is effective and safe for GHD treatment and is non-inferior to daily rhGH. © 2017 The authors.

  9. Long-acting PEGylated recombinant human growth hormone (Jintrolong) for children with growth hormone deficiency: phase II and phase III multicenter, randomized studies

    PubMed Central

    Hou, Ling; Liang, Li; Dong, Guanping; Shen, Shuixian; Zhao, Zhuhui; Gong, Chun Xiu; Li, Yuchuan; Du, Min-lian; Su, Zhe; Du, Hongwei; Yan, Chaoying

    2017-01-01

    Objective We assessed the efficacy and safety of a weekly pegylated human growth hormone (PEG-rhGH) (Jintrolong) vs daily rhGH for children with growth hormone deficiency (GHD). Design Phase II and III, multicenter, open-label, randomized controlled trials. Methods 108 and 343 children with treatment-naive GHD from 6 hospitals in China were enrolled in the phase II and III studies respectively. Patients in the phase II study were randomized 1:1:1 to weekly Jintrolong (0.1 mg/kg/week PEG-rhGH complex), weekly Jintrolong (0.2 mg/kg/week PEG-rhGH complex) or daily rhGH (0.25 mg/kg/week) for 25 weeks. Patients in the phase III study were randomized in a 2:1 ratio to weekly Jintrolong (0.2 mg/kg/week) or daily rhGH (0.25 mg/kg/week) for 25 weeks. The primary endpoint for both studies was height velocity (HV) increase at the end of treatment. Other growth-related parameters, safety and compliance were also monitored. Results The phase II study established the preliminary efficacy, safety and recommended dose of Jintrolong PEG-rhGH. In the phase III study, we demonstrated significantly greater HV increases in patients receiving Jintrolong treatment (from 2.26 ± 0.87 cm/year to 13.41 ± 3.72 cm/year) vs daily rhGH (from 2.25 ± 0.82 cm/year to 12.55 ± 2.99 cm/year) at the end of treatment (P < 0.05). Additionally, significantly greater improvement in the height standard deviation scores was associated with Jintrolong throughout the treatment (P < 0.05). Adverse event rates and treatment compliance were comparable between the two groups. Conclusion Jintrolong PEG-rhGH at a dose of 0.2 mg/kg/week for 25 weeks is effective and safe for GHD treatment and is non-inferior to daily rhGH. PMID:28566441

  10. Effect of occupational EMF exposure from radar at two different frequency bands on plasma melatonin and serotonin levels.

    PubMed

    Singh, Sarika; Mani, Kumar Vyonkesh; Kapoor, Neeru

    2015-05-01

    To delineate the effect of chronic electromagnetic field (EMF) exposure from radar on plasma melatonin and serotonin levels in occupationally exposed military personnel. A total of 166 male military personnel participated in the study out of which only 155 joined for blood draw. They were divided into three sets: Control group (n = 68), exposure group I (n = 40) exposed to 8-12 GHz and exposure group II (n = 58) working with radar at 12.5-18 GHz frequency. The three groups were further split into two groups according to their years of service (up to 10 years and > 10 years) in order to investigate the effect of years of exposure from radar. Melatonin and serotonin levels were estimated by enzyme immunoassay in fasting blood samples collected from 06:00-07:00 h. EMF measurements were recorded at different locations using Satimo EME Guard 'Personal Exposure Meter' and Narda 'Broad Band Field Meter'. The group I exposed population registered a minor though not significant decrease in plasma melatonin concentration while the other group II exposed population registered statistically significant decline in melatonin concentration when compared with controls. Highly significant increase in plasma serotonin levels was found in exposure group II when compared to control whereas marginal non-significant rise was also registered in exposure group I in comparison to control. Exposure in terms of length of service up to 10 years did not produce any significant effect in the indoleamine levels in both the exposure groups when they were compared with their respective control groups. Whereas, length of service greater than 10 years was observed to decrease and increase respectively the melatonin and serotonin concentration significantly in exposure group II but not in exposure group I. However, correlation test did not yield any significant association between years of service and melatonin or serotonin levels respectively in both the exposure sets I and II. No significant association was observed between melatonin and serotonin levels as well. The study showed the EMF ability to influence plasma melatonin and serotonin concentration in radar workers, significantly in 12.5-18 GHz range with service period greater than 10 years.

  11. A retrospective study of Class II mixed-dentition treatment.

    PubMed

    Oh, Heesoo; Baumrind, Sheldon; Korn, Edward L; Dugoni, Steven; Boero, Roger; Aubert, Maryse; Boyd, Robert

    2017-01-01

    To consider the effectiveness of early treatment using one mixed-dentition approach to the correction of moderate and severe Class II malocclusions. Three groups of Class II subjects were included in this retrospective study: an early treatment (EarlyTx) group that first presented at age 7 to 9.5 years (n = 54), a late treatment (LateTx) group whose first orthodontic visit occurred between ages 12 and 15 (n = 58), and an untreated Class II (UnTx) group to assess the pretreatment comparability of the two treated groups (n = 51). Thirteen conventional cephalometric measurements were reported for each group and Class II molar severity was measured on the study casts of the EarlyTx and LateTx groups. Successful Class II correction was observed in approximately three quarters of both the EarlyTx group and the LateTx group at the end of treatment. EarlyTx patients had fewer permanent teeth extracted than did the LateTx patients (5.6% vs 37.9%, P < .001) and spent less time in full-bonded appliance therapy in the permanent dentition than did LateTx patients (1.7 ± 0.8 vs 2.6 ± 0.7years, P < .001). When supervision time is included, the EarlyTx group had longer total treatment time and averaged more visits than did the LateTx group (53.1 ± 18. 8 vs 33.7 ± 8.3, P < .0001). Fifty-five percent of the LateTx extraction cases involved removal of the maxillary first premolars only and were finished in a Class II molar relationship. EarlyTx comprehensive mixed-dentition treatment was an effective modality for early correction of Class II malocclusions.

  12. Comparison of second molar eruption patterns in patients with skeletal Class II and skeletal Class I malocclusions.

    PubMed

    Brin, Ilana; Camasuvi, Semin; Dali, Nasser; Aizenbud, Dror

    2006-12-01

    The eruptive positions of the second molars in Class I and Class II malocclusions were studied. Pretreatment records of 221 patients with a mean age of 11.3 years were evaluated. About 19% of them had skeletal Class I, 31% had skeletal maxillary Class II, and 50% had skeletal mandibular Class II malocclusions. The mean values of the dental and chronologic ages of the subjects were similar. The eruptive positions in relation to a reference line, the developmental stages of the patients' second molars and dental ages were recorded from the panoramic roentgenograms. The distribution of the various developmental stages in each malocclusion group was similar, and no association between skeletal malocclusion and dental developmental stage of the second molars was encountered. The eruptive position of the maxillary second molars was more occlusal only in the oldest maxillary Class II group, above 12 years of age (P = .02). These results support, in part, previous reports suggesting that the maxillary second molars may erupt earlier in patients with skeletal maxillary Class II malocclusions.

  13. Multivitamin/multimineral supplements for cancer prevention: implications for primary care practice.

    PubMed

    Hardy, Mary L; Duvall, Karen

    2015-01-01

    There is a popular belief that multivitamin and mineral (MVM) supplements can help prevent cancer and other chronic diseases. Studies evaluating the effects of MVM supplements on cancer risk have largely been observational, with considerable methodologic limitations, and with conflicting results. We review evidence from the few available randomized, controlled trials that assessed the effects of supplements containing individual vitamins, a combination of a few select vitamins, or complete MVM supplements, with a focus on the recent Physicians' Health Study II (PHS II). PHS II is a landmark trial that followed generally healthy middle-aged and older men (mean age 64 years) who were randomized to daily MVM supplementation for a mean duration of 11 years. Men taking MVMs experienced a statistically significant 8% reduction in incidence of total cancer (hazard ratio [HR]: 0.92; 95% confidence interval [CI]: 0.86-0.998; p = 0.04). Men with a history of cancer derived an even greater benefit: cancer incidence was 27% lower with MVM supplementation versus placebo in this subgroup (HR: 0.73; 95% CI: 0.56-0.96; p = 0.02). Positive results of PHS II contrast with randomized studies of individual vitamins or small combinations of vitamins, which have largely shown a neutral effect, and in some cases, an adverse effect, on cancer risk. The results of PHS II may have a considerable public health impact, potentially translating to prevention of approximately 68 000 cancers per year if all men were to use similar supplements, and to an even greater benefit with regard to secondary prevention of cancer.

  14. Analysis of the Japanese subgroup in LEOPOLD II: a phase 2/3 study of BAY 81-8973, a new recombinant factor VIII product.

    PubMed

    Fujii, Teruhisa; Hanabusa, Hideji; Shima, Midori; Morinaga, Takeshi; Fukutake, Katsuyuki

    2017-03-01

    BAY 81-8973, a new full length recombinant FVIII product, has been developed for prophylaxis and on-demand therapy in patients with hemophilia A. LEOPOLD II was a phase 2/3 study comparing prophylaxis versus on-demand treatment with BAY 81-8973. The analysis herein evaluated the clinical profile in Japanese subjects enrolled in LEOPOLD II. The LEOPOLD II was an open-label randomized crossover study. Our analysis evaluated the efficacy using the annualized bleeding rate, safety, and pharmacokinetics in Japanese subjects with severe hemophilia A enrolled in LEOPOLD II. The median annualized bleeding rate was 59.9/year in the on-demand group and 1.9/year in the prophylaxis group for Japanese subjects. There were no study drug-related adverse events in the Japanese subjects. None of the subjects developed FVIII inhibitors. There were no apparent clinical differences in efficacy, safety, and pharmacokinetics between the Japanese and the non-Japanese subjects. Data for the Japanese subjects showed annualized bleeding rates to be remarkably lower in the prophylaxis group compared to the on-demand group and that BAY 81-8973 exhibited a good safety profile and tolerability. These results were similar for the non-Japanese subjects. The results support adoption of BAY 81-8973 for treatment of Japanese subjects with severe hemophilia A.

  15. [Microbiota of lower urine tract and genital organs of healthy men and in infertility].

    PubMed

    Naboka, Iu L; Kogan, M I; Gudima, I A; Ibishev, Kh S; Pasechnik, D G; Logvinov, A K; Ilmdarov, Sh B

    2015-01-01

    Study microflora of urine, ejaculate, urethra scrape in normal state and infertility. 2 groups of men were examined: I (28)--control, conditionally healthy men (20 - 25 years of age), II (26)--infertile patients (25 - 35 years of age). Middle portion of morning urine, ejaculate, urethra scrape were studied in group I, in II--ejaculate. Bacteriologic study of urine and ejaculate was carried out in an extended kit of nutrient media (HiMedia) for facultative- anaerobic (FAB) and non-clostridia anaerobic bacteria (NAB). Urethra scrape and ejaculate were studied by PCR in group I. In urethra scrape and ejaculate a wide spectrum of FAB and NAB was detected in group I. Corynebacterium spp. and coagulase-negative staphylococci (67.9% each) were the dominant cluster of FAB. Eubacterium spp.--in NAB. Bacteriologic study of ejaculate corresponded in PCR with similar results of dominating bacteria. Among FAB the same clusters dominated during bacteriologic study of ejaculate from group II patients, among NAB--Propionibacterium spp., Peptococcus spp. and Peptostreptococcus spp. Quantitative characteristics of ejaculate of group I and II differed insignificantly. The frequency of detection of certain genera of FAB and NAB was significantly higher in patients with infertility than in conditionally healthy men, however quantitative parameters of the isolated microorganisms practically did not differ between groups.

  16. Association Between National Board Dental Examination Part II Scores and Comprehensive Examinations at Harvard School of Dental Medicine.

    PubMed

    Lee, Min Kyeong; Allareddy, Veerasathpurush; Howell, T Howard; Karimbux, Nadeem Y

    2011-01-01

    Harvard School of Dental Medicine (HSDM) uses a hybrid problem-based approach to teaching in the predoctoral program. The objective structured clinical examination (OSCE) is a formative examination designed to assess the performance of students in the problem-based learning (PBL) curriculum. At HSDM three comprehensive examinations with OSCE components are administered during the third and fourth years of clinical training. The National Board Dental Examination (NBDE) Part II is taken in the final year of the predoctoral program. This study examines the association between the NBDE Part II and the comprehensive exams held at HSDM. Predoctoral students from the HSDM classes of 2005 and 2006 were included in this study. The outcome variable of interest was the scores obtained by students in the NBDE Part II, and the main independent variable of interest was the performance of students in the comprehensive exams (honors, pass, make-up exam to pass). The Mann-Whitney U-test was used to examine the association between the grades obtained in the each of the three comprehensive exams and the NBDE Part II scores. Multivariable linear regression analysis was also used to examine the association between the NBDE Part II scores and the comprehensive exam grades. The effect of potential confounding factors including age, sex, and race/ethnicity was adjusted. The results suggest that students who performed well in the comprehensive exams performed better on the NBDE Part II, even after adjusting for confounding factors. Future studies will examine the long-term impact of PBL on postdoctoral plans and career choices.

  17. Morphometric analysis of long-term dentoskeletal effects induced by treatment with Balters bionator.

    PubMed

    Bigliazzi, Renato; Franchi, Lorenzo; Bertoz, André Pinheiro de Magalhães; McNamara, James A; Faltin, Kurt; Bertoz, Francisco Antonio

    2015-09-01

    To evaluate the long-term effects of the standard (Class II) Balters bionator in growing patients with Class II malocclusion with mandibular retrusion by using morphometrics (thin-plate spline [TPS] analysis). Twenty-three Class II patients (8 male, 15 female) were treated consecutively with the Balters bionator (bionator group). The sample was evaluated at T0, start of treatment; T1, end of bionator therapy; and T2, long-term observation (including fixed appliances). Mean age at the start of treatment was 10 years 2 months (T0); at posttreatment, 12 years 3 months (T1); and at long-term follow-up, 18 years 2 months (T2). The control group consisted of 22 subjects (11 male, 11 female) with untreated Class II malocclusion. Lateral cephalograms were analyzed at the three time points for all groups. TPS analysis evaluated statistical differences (permutation tests) in the craniofacial shape and size between the bionator and control groups. TPS analysis showed that treatment with the bionator is able to produce favorable mandibular shape changes (forward and downward displacement) that contribute significantly to the correction of the Class II dentoskeletal imbalance. These results are maintained at a long-term observation after completion of growth. The control group showed no statistically significant differences in the correction of Class II malocclusion. This study suggests that bionator treatment of Class II malocclusion produces favorable results over the long term with a combination of skeletal and dentoalveolar shape changes.

  18. Rational Clinical Experiment: Assessing Prior Probability and Its Impact on the Success of Phase II Clinical Trials

    PubMed Central

    Halperin, Daniel M.; Lee, J. Jack; Dagohoy, Cecile Gonzales; Yao, James C.

    2015-01-01

    Purpose Despite a robust clinical trial enterprise and encouraging phase II results, the vast minority of oncologic drugs in development receive regulatory approval. In addition, clinicians occasionally make therapeutic decisions based on phase II data. Therefore, clinicians, investigators, and regulatory agencies require improved understanding of the implications of positive phase II studies. We hypothesized that prior probability of eventual drug approval was significantly different across GI cancers, with substantial ramifications for the predictive value of phase II studies. Methods We conducted a systematic search of phase II studies conducted between 1999 and 2004 and compared studies against US Food and Drug Administration and National Cancer Institute databases of approved indications for drugs tested in those studies. Results In all, 317 phase II trials were identified and followed for a median of 12.5 years. Following completion of phase III studies, eventual new drug application approval rates varied from 0% (zero of 45) in pancreatic adenocarcinoma to 34.8% (24 of 69) for colon adenocarcinoma. The proportion of drugs eventually approved was correlated with the disease under study (P < .001). The median type I error for all published trials was 0.05, and the median type II error was 0.1, with minimal variation. By using the observed median type I error for each disease, phase II studies have positive predictive values ranging from less than 1% to 90%, depending on primary site of the cancer. Conclusion Phase II trials in different GI malignancies have distinct prior probabilities of drug approval, yielding quantitatively and qualitatively different predictive values with similar statistical designs. Incorporation of prior probability into trial design may allow for more effective design and interpretation of phase II studies. PMID:26261263

  19. Angiotensin II receptor blocker-based therapy in Japanese elderly, high-risk, hypertensive patients.

    PubMed

    Ogawa, Hisao; Kim-Mitsuyama, Shokei; Matsui, Kunihiko; Jinnouchi, Tomio; Jinnouchi, Hideaki; Arakawa, Kikuo

    2012-10-01

    It is unknown whether high-dose angiotensin II receptor blocker therapy or angiotensin II receptor blocker + calcium channel blocker combination therapy is better in elderly hypertensive patients with high cardiovascular risk. The objective of the study was to compare the efficacy of these treatments in elderly, high-risk Japanese hypertensive patients. The OlmeSartan and Calcium Antagonists Randomized (OSCAR) study was a multicenter, prospective, randomized, open-label, blinded-end point study of 1164 hypertensive patients aged 65 to 84 years with type 2 diabetes or cardiovascular disease. Patients with uncontrolled hypertension during treatment with olmesartan 20 mg/d were randomly assigned to receive 40 mg/d olmesartan (high-dose angiotensin II receptor blocker) or a calcium channel blocker + 20 mg/d olmesartan (angiotensin II receptor blocker + calcium channel blocker). The primary end point was a composite of cardiovascular events and noncardiovascular death. During a 3-year follow-up, blood pressure was significantly lower in the angiotensin II receptor blocker + calcium channel blocker group than in the high-dose angiotensin II receptor blocker group. Mean blood pressure at 36 months was 135.0/74.3 mm Hg in the high-dose angiotensin II receptor blocker group and 132.6/72.6 mm Hg in the angiotensin II receptor blocker + calcium channel blocker group. More primary end points occurred in the high-dose angiotensin II receptor blocker group than in the angiotensin II receptor blocker + calcium channel blocker group (58 vs 48 events, hazard ratio [HR], 1.31, 95% confidence interval, 0.89-1.92; P=.17). In patients with cardiovascular disease at baseline, more primary events occurred in the high-dose angiotensin II receptor blocker group (HR, 1.63, P=.03); in contrast, fewer events were observed in the subgroup without cardiovascular disease (HR, 0.52, P=.14). This treatment-by-subgroup interaction was significant (P=.02). The angiotensin II receptor blocker and calcium channel blocker combination lowered blood pressure more than the high-dose angiotensin II receptor blocker and reduced the incidence of primary end points more than the high-dose angiotensin II receptor blocker in patients with cardiovascular disease. The addition of a second antihypertensive agent is more effective at lowering blood pressure than simply doubling the dose of an existing agent. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. Roux-en-Y or Billroth II Reconstruction After Radical Distal Gastrectomy for Gastric Cancer: A Multicenter Randomized Controlled Trial.

    PubMed

    So, Jimmy Bok-Yan; Rao, Jaideepraj; Wong, Andrew Siang-Yih; Chan, Yiong-Huak; Pang, Ning Qi; Tay, Amy Yuh Ling; Yung, Man Yee; Su, Zheng; Phua, Janelle Niam Sin; Shabbir, Asim; Ng, Enders Kwok Wai

    2018-02-01

    The aim of the study was to compare the clinical symptoms between Billroth II (B-II) and Roux-en-Y (R-Y) reconstruction after distal subtotal gastrectomy (DG) for gastric cancer. Surgery is the mainstay of curative treatment for gastric cancer. The technique for reconstruction after DG remains controversial. Both B-II and R-Y are popular methods. This is a prospective multicenter randomized controlled trial. From October 2008 to October 2014, 162 patients who underwent DG were randomly allocated to B-II (n = 81) and R-Y (n = 81) groups. The primary endpoint is Gastrointestinal (GI) Symptoms Score 1 year after surgery. We also compared the nutritional status, extent of gastritis on endoscopy, and quality of life after surgery between the 2 procedures at 1 year. Operative time was significantly shorter for B-II than for R-Y [mean difference 21.5 minutes, 95% confidence interval (95% CI) 3.8-39.3, P = 0.019]. The B-II and R-Y groups had a peri-operative morbidity of 28.4% and 33.8%, respectively (P = 0.500) and a 30-day mortality of 2.5% and 1.2%, respectively (P = 0.500). GI symptoms score did not differ between R-Y versus B-II reconstruction (mean difference -0.45, 95% CI -1.21 to 0.31, P = 0.232). R-Y resulted in a lower median endoscopic grade for gastritis versus B-II (mean difference -1.32, 95% CI -1.67 to -0.98, P < 0.001). We noted no difference in nutritional status (R-Y versus B-II mean difference -0.31, 95% CI -3.27 to 2.65, P = 0.837) and quality of life at 1 year between the 2 groups too. Although BII is associated with a higher incidence of heartburn symptom and higher median endoscopic grade for gastritis, BII and RY are similar in terms of overall GI symptom score and nutritional status at 1 year after distal gastrectomy.

  1. The 10-year course of adult aggression toward others in patients with borderline personality disorder and axis II comparison subjects.

    PubMed

    Zanarini, Mary C; Temes, Christina M; Ivey, Alexandra M; Cohn, Danielle M; Conkey, Lindsey C; Frankenburg, Frances R; Fitzmaurice, Garrett M

    2017-06-01

    This study had two aims. The first was to assess and compare various types of aggressive behavior toward others reported by borderline patients and axis II comparison subjects over time. The second was to determine the best baseline and time-varying predictors of aggressive behavior in these borderline patients. At baseline, a series of interviews and self-report measures were administered to 290 borderline patients and 72 axis II comparison subjects. Measures assessing aggression toward others, axis I and II disorders as well as adult adversity were re-administered every two years over the course of ten years. It was found that borderline patients reported significantly higher rates of verbal, emotional, and physical aggression toward others than comparison subjects but the rates of these forms of aggression toward others declined significantly for those in both study groups. Multivariate analyses indicated that the strongest predictors of adult aggression towards others were severity of adult adversity and a substance use disorder. Taken together, these results suggest that borderline patients commonly report aggression toward others but that this aggression declines significantly over time. These results also suggest that this aggression toward others is most strongly associated with adult experiences of adversity and concurrent substance abuse. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  2. Thirteen-year outcomes in the Anatomique Benoist Girard II hip prosthesis.

    PubMed

    Catanach, Michael J M; Sorial, Rami M; Eslick, Guy D

    2015-04-01

    The Stryker Anatomique Benoist Girard (ABG) hip implant system was a commonly used cementless prosthesis in the early 2000s, which fell from favour after several studies emerged implicating the prosthesis in high rates of revision. This retrospective, single-surgeon clinical study examines the fracture rate, revision rate and reasons for revision in 500 consecutive ABG II primary total conventional hip replacements. Follow-up was conducted by audit of patient notes, patient mailout survey, patient phone contact and audit of the Australian National Joint Replacement Registry (NJRR) database to find instances of fracture and revision. End points were periprosthetic fracture and revision for any reason. Follow-up was 1.2-13.8 years with a mean of 6.58 years. Of the 500 hips, 17 (3.4%) had undergone a revision. Of these, 13 were due to periprosthetic fracture. Four further fractures occurred that were not revised. Eight of these periprosthetic fractures occurred within 1 year post-operatively. There were four revisions for recurrent dislocations. Kaplan-Meier survival curve demonstrates a 93.7% survivorship at 6.58 years for revision for any reason. Multivariate analysis showed the only statistically significant factor for increased risk of revision was smaller stem size. Our results were consistent with the literature in that the ABG II system has good medium-term results but is prone to periprosthetic fractures, especially in the early post-operative period. When used as a primary total hip arthroplasty, the ABG II system has an 8-year revision rate of 5.6% compared with the 4.9% of all primary total hip arthroplasties. © 2014 Royal Australasian College of Surgeons.

  3. Coffee consumption, serum gamma-glutamyltransferase and risk of type II diabetes.

    PubMed

    Bidel, S; Silventoinen, K; Hu, G; Lee, D-H; Kaprio, J; Tuomilehto, J

    2008-02-01

    To study the joint association of coffee consumption and serum gamma-glutamyltransferase (GGT) levels on the risk of developing type II diabetes. A total of 21,826 Finnish men and women who were 35-74 years of age and without any history of diabetes at baseline (years 1982, 1987, 1992 and 1997) were included in the present analyses. They were prospectively followed up for onset of type II diabetes (n=862 cases), death or until the end of the year 2002. Coffee consumption, serum GGT and other study parameters were determined at baseline using standardized measurements. Analyses were stratified by the serum GGT level classified into two classes using the 75th sex-specific percentiles as the cut point. Coffee consumption was significantly and inversely associated with incident diabetes among both men and women. Serum GGT modified the association between coffee consumption and incident diabetes. Subjects in the high category of coffee consumption with the GGT level > or = 75th percentile showed a significant inverse association for women, and for both sexes combined. The association was not significant in subjects with the GGT level < or = 75th percentile. There was a significant interaction effect of GGT and coffee consumption on risk of type II diabetes in data of women (P=0.05) and in both sexes combined (P=0.02). Habitual coffee consumption is associated with lower incidence of type II diabetes particularly in those with higher baseline serum GGT levels.

  4. Multiple Intelligences and ESL Teaching and Learning: An Investigation in KG II Classrooms in One Private School in Beirut, Lebanon

    ERIC Educational Resources Information Center

    Ghamrawi, Norma

    2014-01-01

    This study examined teachers' use of the Multiple Intelligences Theory on vocabulary acquisition by preschoolers during English as a second language (ESL) classes in a K-12 school in Lebanon. Eighty kindergartners (KG II, aged 5 years) and eight teachers constituted the sample. The study used mixed methods, including observations of videotaped…

  5. Treatment of Japanese-American Internment During World War II in U.S. History Textbooks

    ERIC Educational Resources Information Center

    Ogawa, Masato

    2004-01-01

    The purpose of this study is to analyze the treatment of Japanese-American internment during World War II in high school United States history textbooks. Four reasons highlight the selection of this topic for study. First, this historical event was selected because a little over a year ago was the 60th anniversary of President Franklin D.…

  6. Clinical results of Hi-tech Knee II total knee arthroplasty in patients with rheumatoid athritis: 5- to 12-year follow-up.

    PubMed

    Yamanaka, Hajime; Goto, Ken-ichiro; Suzuki, Munetaka

    2012-02-22

    Total knee arthroplasty (TKA) is a common form of treatment to relieve pain and improve function in cases of rheumatoid arthritis (RA). Good clinical outcomes have been reported with a variety of TKA prostheses. The cementless Hi-Tech Knee II cruciate-retaining (CR)-type prosthesis, which has 6 fins at the anterior of the femoral component, posterior cruciate ligament (PCL) retention, flat-on-flat surface component geometry, all-polyethylene patella, strong initial fixation by the center screw of the tibial base plate, 10 layers of titanium alloy fiber mesh, and direct compression molded ultra high molecular weight polyethylene (UHMWPE), is appropriate for TKA in the Japanese knee.The present study was performed to evaluate the clinical results of primary TKA in RA using the cementless Hi-Tech Knee II CR-type prosthesis. We performed 32 consecutive primary TKAs using cementless Hi-Tech Knee II CR-type prosthesis in 31 RA patients. The average follow-up period was 8 years 3 months. Clinical evaluations were performed according to the American Knee Society (KS) system, knee score, function score, radiographic evaluation, and complications. The mean postoperative maximum flexion angle was 115.6°, and the KS knee score and function score improved to 88 and 70 after surgery, respectively. Complications, such as infection, occurred in 1 patient and revision surgery was performed. There were no cases of loosening in this cohort, and prosthesis survival rate was 96.9% at 12 years postoperatively. These results suggest that TKA using the cementless Hi-Tech Knee II CR-type prosthesis is a very effective form of treatment in RA patients at 5 to 12 years postoperatively. Further long-term follow-up studies are required to determine the ultimate utility of this type of prosthesis.

  7. Matrix metalloproteinases in pathogenesis of hemorrhoidal disease.

    PubMed

    Kisli, Erol; Kemik, Ahu; Sümer, Aziz; Kemik, Özgür

    2013-11-01

    The aim of this study is to investigate the accuracy of serum matrix metalloproteinase (MMP) levels in an effort to find a reliable factor that may play an important role in pathogenesis of hemorrhoidal disease. Twenty control subjects and 21 Grade I, 19 Grade II, 20 Grade III, and 21 Grade IV patients with internal hemorrhoid were included in this prospective study. The mean ages of control subjects were 47.65 ± 6.71 standard deviation (SD) years (range, 37 to 60 years). The mean age of internal Grade I, Grade II, Grade III, and Grade IV patients with internal hemorrhoid were 48.85 ± 6.44, 47.20 ± 6.75, 44.90 ± 6.13, and 42.95 ± 3.49 SD years (ranges, 38 to 58, 38 to 60, 34 to 55, and 38 to 50 years), respectively. Ten milliliters of blood was taken from all subjects. Enzyme-linked immunosorbent assay (ELISA) for MMP-1, -2, -7, and -9 levels were performed using an ELISA kit (R&D Systems) following the manufacturer's instructions. There was an important difference between Grade I and Grade II groups in the serum levels of MMP-9 (P < 0.01). Patients with Grade III hemorrhoidal disease had significantly higher serum levels of all MMP than patients with Grade I and Grade II hemorrhoidal disease (P < 0.001). Also, patients with Grade 4 hemorrhoidal disease had higher serum levels of MMP-7 and -9 according to Grade I, II, and III groups (P < 0.01, 0.001). High serum levels of MMP are present in patients with hemorrhoids, suggesting the possible mechanism in the pathogenesis of hemorrhoids.

  8. Randomized clinical trial of two resin-modified glass ionomer materials: 1-year results.

    PubMed

    Perdigão, J; Dutra-Corrêa, M; Saraceni, S H C; Ciaramicoli, M T; Kiyan, V H

    2012-01-01

    With institutional review board approval, 33 patients who needed restoration of noncarious cervical lesions (NCCL) were enrolled in this study. A total of 92 NCCL were selected and randomly assigned to three groups: (1) Ambar (FGM), a two-step etch-and-rinse adhesive (control), combined with the nanofilled composite resin Filtek Supreme Plus (FSP; 3M ESPE); (2) Fuji II LC (GC America), a traditional resin-modified glass ionomer (RMGIC) restorative material; (3) Ketac Nano (3M ESPE), a nanofilled RMGIC restorative material. Restorations were evaluated at six months and one year using modified United States Public Health Service parameters. At six months after initial placement, 84 restorations (a 91.3% recall rate) were evaluated. At one year, 78 restorations (a 84.8% recall rate) were available for evaluation. The six month and one year overall retention rates were 93.1% and 92.6%, respectively, for Ambar/FSP; 100% and 100%, respectively, for Fuji II LC; and 100% and 100%, respectively, for Ketac Nano with no statistical difference between any pair of groups at each recall. Sensitivity to air decreased for all three adhesive materials from the preoperative to the postoperative stage, but the difference was not statistically significant. For Ambar/FSP, there were no statistical differences for any of the parameters from baseline to six months and from baseline to one year. For Fuji II LC, surface texture worsened significantly from baseline to six months and from baseline to one year. For Ketac Nano, enamel marginal staining increased significantly from baseline to one year and from six months to one year. Marginal adaptation was statistically worse at one year compared with baseline only for Ketac Nano. When parameters were compared for materials at each recall, Ketac Nano resulted in significantly worse color match than any of the other two materials at any evaluation period. At one year, Ketac Nano resulted in significantly worse marginal adaptation than the other two materials and worse marginal staining than Fuji II LC. Surface texture was statistically worse for Fuji II LC compared with the other two materials at all evaluation periods. The one-year retention rate was statistically similar for the three adhesive materials. Nevertheless, enamel marginal deficiencies and color mismatch were more prevalent for Ketac Nano. Surface texture of Fuji II LC restorations deteriorated quickly.

  9. Barriers to participation in a phase II cardiac rehabilitation programme.

    PubMed

    Mak, Y M W; Chan, W K; Yue, C S S

    2005-12-01

    To identify barriers to participation in a phase II cardiac rehabilitation programme and measures that may enhance participation. Prospective study. Regional hospital, Hong Kong. Cardiac patients recruited for a phase I cardiac rehabilitation programme from July 2002 to January 2003. Reasons for not participating in a phase II cardiac rehabilitation programme. Of the 193 patients recruited for a phase I cardiac rehabilitation programme, 152 (79%) patients, with a mean age of 70.3 years (standard deviation, 11.9 years), did not proceed to phase II programme. Eleven (7%) deaths occurred before commencement of phase II and 74 (49%) patients were considered physically unfit. Reasons for the latter included fractures, pain, or degenerative changes in the lower limbs (24%), and co-morbidities such as cerebrovascular accident (19%), chronic renal failure (11%), congestive heart failure (9%), and unstable angina (8%). Phase II rehabilitation was postponed until after completion of scheduled cardiac interventions in 13% of patients. Failure of physicians to arrange the pre-phase II exercise stress test as per protocol was reported in 7% of patients. Other reasons were reported: work or time conflicts (16%), non-compliance with cardiac treatment (5%), financial constraints (4%), self-exercise (3%), fear after exercise stress testing (3%), and patients returning to their original cardiologists for treatment (3%). A significant (79%) proportion of patients did not proceed to a phase II cardiac rehabilitation programme for a variety of reasons. These included physical unfitness, work or time conflicts, and need to attend scheduled cardiac interventions. Further studies are required to determine how to overcome obstacles to cardiac rehabilitation.

  10. Treatment of Major Depressive Disorder with Iyengar Yoga and Coherent Breathing: A Randomized Controlled Dosing Study

    PubMed Central

    Gerbarg, Patricia L.; Whitfield, Theodore H.; Owen, Liz; Johnston, Jennifer; Silveri, Marisa M.; Gensler, Marysia; Faulkner, Carol L.; Mann, Cathy; Wixted, Mary; Hernon, Anne Marie; Nyer, Maren B.; Brown, E. Richard P.; Jensen, John E.

    2017-01-01

    Abstract Objectives: The aims of this study were to assess the effects of an intervention of Iyengar yoga and coherent breathing at five breaths per minute on depressive symptoms and to determine optimal intervention yoga dosing for future studies in individuals with major depressive disorder (MDD). Methods: Subjects were randomized to the high-dose group (HDG) or low-dose group (LDG) for a 12-week intervention of three or two intervention classes per week, respectively. Eligible subjects were 18–64 years old with MDD, had baseline Beck Depression Inventory-II (BDI-II) scores ≥14, and were either on no antidepressant medications or on a stable dose of antidepressants for ≥3 months. The intervention included 90-min classes plus homework. Outcome measures were BDI-II scores and intervention compliance. Results: Fifteen HDG (Mage = 38.4 ± 15.1 years) and 15 LDG (Mage = 34.7 ± 10.4 years) subjects completed the intervention. BDI-II scores at screening and compliance did not differ between groups (p = 0.26). BDI-II scores declined significantly from screening (24.6 ± 1.7) to week 12 (6.0 ± 3.8) for the HDG (–18.6 ± 6.6; p < 0.001), and from screening (27.7 ± 2.1) to week 12 (10.1 ± 7.9) in the LDG (–17.7 ± 9.3; p < 0.001). There were no significant differences between groups, based on response (i.e., >50% decrease in BDI-II scores; p = 0.65) for the HDG (13/15 subjects) and LDG (11/15 subjects) or remission (i.e., number of subjects with BDI-II scores <14; p = 1.00) for the HDG (14/15 subjects) and LDG (13/15 subjects) after the 12-week intervention, although a greater number of subjects in the HDG had 12-week BDI-II scores ≤10 (p = 0.04). Conclusion: During this 12-week intervention of yoga plus coherent breathing, depressive symptoms declined significantly in patients with MDD in both the HDG and LDG. Both groups showed comparable compliance and clinical improvements, with more subjects in the HDG exhibiting BDI-II scores ≤10 at week 12. PMID:28296480

  11. Gliomatosis cerebri type II: two case reports

    PubMed Central

    D’Urso, Pietro Ivo; Marsigliante, Santo; Storelli, Carlo; Distante, Alessandro; Sanguedolce, Francesca; Cimmino, Antonia; Luzi, Giuseppe; Gianfreda, Cosimo Damiano; Montinaro, Antonio; Ciappetta, Pasqualino

    2009-01-01

    Introduction Two types of gliomatosis cerebri exist: Type I and Type II. We report the results of a histological and genetic study of two cases of gliomatosis cerebri Type II, correlating these results with therapy and prognosis. Case presentation Two patients, a 52-year-old man (Patient 1) and a 76-year-old man (Patient 2) with gliomatosis cerebri II were admitted to our institution; they underwent surgical treatment and received radiotherapy and chemotherapy. At the 24-month follow-up, Patient 1 was still alive, while Patient 2 had died. The poor prognosis of Patient 2 was underlined by molecular analysis which showed that the angiogenesis related genes VCAM1 and VEGF were overexpressed, reflecting the high degree of neovascularization. Conclusion Genes involved in drug resistance and metallothioneins were highly expressed in Patient 2 and this, associated with unmethylated O6-methylguanine methyltransferase, can explain the lack of response to chemotherapy. PMID:19830138

  12. The Importance of Longitudinal Studies

    NASA Astrophysics Data System (ADS)

    Knezek, Patricia

    2014-01-01

    It has been eight years since the AAS Council unanimously endorsed the document, known as "Equity Now: The Pasadena Recommendations for Gender Equality in Astronomy," in January 2005. This document was the main product of the conference entitled “Women in Astronomy II: Ten Years After” (WIA II), held in June 2003 in Pasadena, CA. One of the key recommendations represented in that document was the need for a longitudinal study of astronomers. It was recognized that in order to understand our own field, how it is evolving, and the impact on individuals, we need to track people over time. I will discuss the fundamental questions that led to the recommendation, and set the stage for the current (ongoing) longitudinal study.

  13. Prosthetic aspects and patient satisfaction with resilient liner and clip attachments for bar- and implant-retained mandibular overdentures: a 3-year randomized clinical study.

    PubMed

    ELsyad, Moustafa Abdou

    2012-01-01

    This report aimed to compare prosthetic aspects and patient satisfaction during a 3-year randomized clinical trial of bar- and implant-retained mandibular overdentures attached with either resilient liners or clips. Thirty edentulous male patients (mean age: 62.5 years) received two implants in the anterior mandible after being allocated into two equal groups (according to attachment type received) using balanced randomization. After 3 months, implants were connected with resilient bars. New maxillary complete dentures were then constructed, and mandibular overdentures were retained to the bars with either clips (group I) or silicone resilient liners (group II). Subjects indicated satisfaction with their prostheses using a questionnaire and visual analog scale. Patient satisfaction and prosthetic complications were recorded for both attachments at 6 months and 1 and 3 years after overdenture insertion. Comfort and stability with the maxillary denture and ease of hygiene procedures were rated higher in group II, while ease of handling the dentures was rated higher in group I. No significant differences in other parameters of patient satisfaction between groups were noted after 3 years. The mean number of prosthetic adjustments and repairs in group I (11.9) was significantly higher (P = .00) compared to that in group II (4.8). The most common complication in group I was clip wear, while separation of the resilient liner from the denture base was the most common problem in group II. Hyperplasia under the bar and flabby ridge in the maxilla occurred significantly more often in group I compared to group II. Resilient liner-retained mandibular overdentures had comparable patient satisfaction, less prosthetic maintenance and costs, and less soft tissue complications when compared to clip-retained ones after 3 years.

  14. Proposal for a histopathological consensus classification of the periprosthetic interface membrane

    PubMed Central

    Morawietz, L; Classen, R‐A; Schröder, J H; Dynybil, C; Perka, C; Skwara, A; Neidel, J; Gehrke, T; Frommelt, L; Hansen, T; Otto, M; Barden, B; Aigner, T; Stiehl, P; Schubert, T; Meyer‐Scholten, C; König, A; Ströbel, P; Rader, C P; Kirschner, S; Lintner, F; Rüther, W; Bos, I; Hendrich, C; Kriegsmann, J; Krenn, V

    2006-01-01

    Aims The introduction of clearly defined histopathological criteria for a standardised evaluation of the periprosthetic membrane, which can appear in cases of total joint arthroplasty revision surgery. Methods Based on histomorphological criteria, four types of periprosthetic membrane were defined: wear particle induced type (detection of foreign body particles; macrophages and multinucleated giant cells occupy at least 20% of the area; type I); infectious type (granulation tissue with neutrophilic granulocytes, plasma cells and few, if any, wear particles; type II); combined type (aspects of type I and type II occur simultaneously; type III); and indeterminate type (neither criteria for type I nor type II are fulfilled; type IV). The periprosthetic membranes of 370 patients (217 women, 153 men; mean age 67.6 years, mean period until revision surgery 7.4 years) were analysed according to the defined criteria. Results Frequency of histopathological membrane types was: type I 54.3%, type II 19.7%, type III 5.4%, type IV 15.4%, and not assessable 5.1%. The mean period between primary arthroplasty and revision surgery was 10.1 years for type I, 3.2 years for type II, 4.5 years for type III and 5.4 years for type IV. The correlation between histopathological and microbiological diagnosis was high (89.7%), and the inter‐observer reproducibility sufficient (85%). Conclusion The classification proposed enables standardised typing of periprosthetic membranes and may serve as a tool for further research on the pathogenesis of the loosening of total joint replacement. The study highlights the importance of non‐infectious, non‐particle induced loosening of prosthetic devices in orthopaedic surgery (membrane type IV), which was observed in 15.4% of patients. PMID:16731601

  15. Proposal for a histopathological consensus classification of the periprosthetic interface membrane.

    PubMed

    Morawietz, L; Classen, R-A; Schröder, J H; Dynybil, C; Perka, C; Skwara, A; Neidel, J; Gehrke, T; Frommelt, L; Hansen, T; Otto, M; Barden, B; Aigner, T; Stiehl, P; Schubert, T; Meyer-Scholten, C; König, A; Ströbel, P; Rader, C P; Kirschner, S; Lintner, F; Rüther, W; Bos, I; Hendrich, C; Kriegsmann, J; Krenn, V

    2006-06-01

    The introduction of clearly defined histopathological criteria for a standardised evaluation of the periprosthetic membrane, which can appear in cases of total joint arthroplasty revision surgery. Based on histomorphological criteria, four types of periprosthetic membrane were defined: wear particle induced type (detection of foreign body particles; macrophages and multinucleated giant cells occupy at least 20% of the area; type I); infectious type (granulation tissue with neutrophilic granulocytes, plasma cells and few, if any, wear particles; type II); combined type (aspects of type I and type II occur simultaneously; type III); and indeterminate type (neither criteria for type I nor type II are fulfilled; type IV). The periprosthetic membranes of 370 patients (217 women, 153 men; mean age 67.6 years, mean period until revision surgery 7.4 years) were analysed according to the defined criteria. Frequency of histopathological membrane types was: type I 54.3%, type II 19.7%, type III 5.4%, type IV 15.4%, and not assessable 5.1%. The mean period between primary arthroplasty and revision surgery was 10.1 years for type I, 3.2 years for type II, 4.5 years for type III and 5.4 years for type IV. The correlation between histopathological and microbiological diagnosis was high (89.7%), and the inter-observer reproducibility sufficient (85%). The classification proposed enables standardised typing of periprosthetic membranes and may serve as a tool for further research on the pathogenesis of the loosening of total joint replacement. The study highlights the importance of non-infectious, non-particle induced loosening of prosthetic devices in orthopaedic surgery (membrane type IV), which was observed in 15.4% of patients.

  16. Structure and evolution of fossil H II regions

    NASA Technical Reports Server (NTRS)

    Mccray, R.; Schwarz, J.

    1971-01-01

    The structure and evolution of a fossil H II region created by a burst of ionizing radiation from a supernova is considered. The cooling time scale for the shell is about 10 to the 6th power years. Superposition of million-year-old fossil H II regions may account for the temperature and ionization of the interstellar medium. Fossil H II regions are unstable to growth of thermal condensations. Highly ionized filamentary structures form and dissipate in about 10,000 years. Partially ionized clouds form and dissipate in about 10 to the 6th power years.

  17. Adherence to Breastfeeding Guidelines and Maternal Weight 6 Years After Delivery

    PubMed Central

    Sharma, Andrea J.; Dee, Deborah L.; Harden, Samantha M.

    2015-01-01

    OBJECTIVES There is a dearth of information on the long-term maternal effects of breastfeeding. The objective of this study was to examine adherence to breastfeeding recommendations of exclusive breastfeeding for ≥4 months and continuation of breastfeeding for ≥1 year and maternal weight retention 6 years after delivery. METHODS Using data from the Infant Feeding Practices Study II (IFPS II), we categorized women by the degree to which they met breastfeeding recommendations. Mothers’ self-reported weight 6 years after delivery (IFPS Year 6 Follow-Up) was compared with self-reported prepregnancy weight from IFPS II. Using linear regression models, adjusting for covariates, we examined associations between breastfeeding recommendation adherence and weight retention. RESULTS Of the 726 women in our study, 17.9% never breastfed. Among those who initiated breastfeeding, 29.0% breastfed exclusively for ≥4 months, and 20.3% breastfed exclusively for ≥4 months and continued breastfeeding for ≥12 months. Prepregnancy BMI modified the association between breastfeeding recommendation adherence and weight retention. Adjusting for covariates, we found no association between breastfeeding recommendations adherence and weight retention among normal and overweight mothers. Among obese mothers, there was a significant linear trend (P = .03), suggesting that those who fully adhered to breastfeeding recommendations retained less weight (−8.0 kg) than obese women who never breastfed. CONCLUSIONS This study suggests that improving adherence to breastfeeding recommendations may help reduce long-term maternal weight retention among obese mothers. Larger studies, with diverse populations and similar longitudinal designs, are needed to explore this relationship. PMID:25183755

  18. Five-year Local Control in a Phase II Study of Hypofractionated Intensity Modulated Radiation Therapy With an Incorporated Boost for Early Stage Breast Cancer

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

    Freedman, Gary M., E-mail: Gary.Freedman@uphs.upenn.edu; Anderson, Penny R.; Bleicher, Richard J.

    Purpose: Conventional radiation fractionation of 1.8-2 Gy per day for early stage breast cancer requires daily treatment for 6-7 weeks. We report the 5-year results of a phase II study of intensity modulated radiation therapy (IMRT), hypofractionation, and incorporated boost that shortened treatment time to 4 weeks. Methods and Materials: The study design was phase II with a planned accrual of 75 patients. Eligibility included patients aged {>=}18 years, Tis-T2, stage 0-II, and breast conservation. Photon IMRT and an incorporated boost was used, and the whole breast received 2.25 Gy per fraction for a total of 45 Gy, and themore » tumor bed received 2.8 Gy per fraction for a total of 56 Gy in 20 treatments over 4 weeks. Patients were followed every 6 months for 5 years. Results: Seventy-five patients were treated from December 2003 to November 2005. The median follow-up was 69 months. Median age was 52 years (range, 31-81). Median tumor size was 1.4 cm (range, 0.1-3.5). Eighty percent of tumors were node negative; 93% of patients had negative margins, and 7% of patients had close (>0 and <2 mm) margins; 76% of cancers were invasive ductal type: 15% were ductal carcinoma in situ, 5% were lobular, and 4% were other histology types. Twenty-nine percent of patients 29% had grade 3 carcinoma, and 20% of patients had extensive in situ carcinoma; 11% of patients received chemotherapy, 36% received endocrine therapy, 33% received both, and 20% received neither. There were 3 instances of local recurrence for a 5-year actuarial rate of 2.7%. Conclusions: This 4-week course of hypofractionated radiation with incorporated boost was associated with excellent local control, comparable to historical results of 6-7 weeks of conventional whole-breast fractionation with sequential boost.« less

  19. Health Occupations Education II. Instructor's Manual.

    ERIC Educational Resources Information Center

    Day, Nancy; And Others

    This instructor's manual accompanies the 46 modules in Health Occupations Education II, the second course of a two-year course of study. Contents include a list of the modules and the performance skills covered in each module, a listing of tools and supplies required for learning activities in the modules cited by module title, an instructional…

  20. Confirmatory Factor Analysis of the KABC-II in Preschool Children

    ERIC Educational Resources Information Center

    Morgan, Kimberly E.; Rothlisberg, Barbara A.; McIntosh, David E.; Hunt, Madeline S.

    2009-01-01

    The present study assessed the Kaufman Assessment Battery for Children, Second Edition (KABC-II) in relation to the synthesized Cattell-Horn-Carroll (CHC) theory of intelligence with a preschool sample. Participants were 200 preschool children between four and five years of age. A confirmatory factor analysis (CFA) was conducted, and different…

  1. Thinking style changes among deaf, hard-of-hearing, and hearing students.

    PubMed

    Cheng, Sanyin; Zhang, Li-fang

    2015-01-01

    This study explores how university students' thinking styles changed over a single academic year by twice administering the Thinking Styles Inventory-Revised II to 256 deaf or hard-of-hearing (DHH) students and 286 hearing students from art and design academic disciplines in China. Results showed that after having studied at the university for one academic year, hearing students showed increased use of Type I thinking styles (more creativity generated, less structured, and more complex) and less use of Type II thinking styles (more norm favoring, more structured, and more simplistic), whereas DHH students demonstrated increased use of both Type I and Type II thinking styles. Moreover, students' changes in thinking styles differed across university class levels. The contributions, limitations, and implications of the present research are discussed. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Student Housing Market Analysis: Ketchikan Community College.

    ERIC Educational Resources Information Center

    Fink (Ira) and Associates, Berkeley, CA.

    This 13-part report presents the results of a study to determine whether Ketchikan Community College (KCC) should provide student housing over the next 10 years. Section I introduces the purpose of the study, the college, the prevalence of college-supplied student housing at two-year colleges, and study methodology. Section II summarizes the major…

  3. ICT Student Teachers' Pedagogical Content Knowledge: A Case Study

    ERIC Educational Resources Information Center

    Yilmaz, Nuray Parlak

    2016-01-01

    This study aimed to identify the difficulties that information technology student teachers have in teaching concepts. This qualitative study was carried out with 12 student teachers. The student teachers were fourth-year students enrolled in the Special Teaching Methods II course in the spring semester of the 2010-2011 academic year. The research…

  4. 40 CFR 33.405 - How does a recipient determine its fair share objectives?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... volume of work MBEs and WBEs have performed in recent years; (ii) Evidence from disparity studies... the market. (2) Data from a Disparity Study. Use a percentage figure derived from data in a valid, applicable disparity study conducted within the preceding ten years comparing the available MBEs and WBEs in...

  5. [Homocysteine and von Willebrand factor in chronic alcoholism].

    PubMed

    Koriakin, A M; Epifantseva, N N; Dadyka, I V; Gorbatovskiĭ, Ia A

    2010-04-01

    The levels of homocysteine (HC) and von Willebrand factor (VWF) as cardiovascular risk factors were studied in patients with Stage II chronic alcoholism. Forty-one men with Stage II chronic alcoholism without clinical signs of somatic and infectious diseases were examined. Their median age was 37 (range 32-40) years; the alcoholization period was 12 (range 8-17) years. Plasma HC and VWF (amount and activity) levels were determined. In 63.4% of chronic alcoholic patients, HC levels was twice as high as in the controls; in 80.6%, both the content and activity of VWF were increased. There was no correlation between the levels of HC and VWF. Vascular endothelial damage concurrent with hyperhomocysteinemia increases a cardiovascular risk in patients with Stage II chronic alcoholism.

  6. Identification and Construction of Combinatory Cancer Hallmark-Based Gene Signature Sets to Predict Recurrence and Chemotherapy Benefit in Stage II Colorectal Cancer.

    PubMed

    Gao, Shanwu; Tibiche, Chabane; Zou, Jinfeng; Zaman, Naif; Trifiro, Mark; O'Connor-McCourt, Maureen; Wang, Edwin

    2016-01-01

    Decisions regarding adjuvant therapy in patients with stage II colorectal cancer (CRC) have been among the most challenging and controversial in oncology over the past 20 years. To develop robust combinatory cancer hallmark-based gene signature sets (CSS sets) that more accurately predict prognosis and identify a subset of patients with stage II CRC who could gain survival benefits from adjuvant chemotherapy. Thirteen retrospective studies of patients with stage II CRC who had clinical follow-up and adjuvant chemotherapy were analyzed. Respective totals of 162 and 843 patients from 2 and 11 independent cohorts were used as the discovery and validation cohorts, respectively. A total of 1005 patients with stage II CRC were included in the 13 cohorts. Among them, 84 of 416 patients in 3 independent cohorts received fluorouracil-based adjuvant chemotherapy. Identification of CSS sets to predict relapse-free survival and identify a subset of patients with stage II CRC who could gain substantial survival benefits from fluorouracil-based adjuvant chemotherapy. Eight cancer hallmark-based gene signatures (30 genes each) were identified and used to construct CSS sets for determining prognosis. The CSS sets were validated in 11 independent cohorts of 767 patients with stage II CRC who did not receive adjuvant chemotherapy. The CSS sets accurately stratified patients into low-, intermediate-, and high-risk groups. Five-year relapse-free survival rates were 94%, 78%, and 45%, respectively, representing 60%, 28%, and 12% of patients with stage II disease. The 416 patients with CSS set-defined high-risk stage II CRC who received fluorouracil-based adjuvant chemotherapy showed a substantial gain in survival benefits from the treatment (ie, recurrence reduced by 30%-40% in 5 years). The CSS sets substantially outperformed other prognostic predictors of stage 2 CRC. They are more accurate and robust for prognostic predictions and facilitate the identification of patients with stage II disease who could gain survival benefit from fluorouracil-based adjuvant chemotherapy.

  7. Timing and structure of the penultimate deglaciation in north China constrained by a precisely dated stalagmite record

    NASA Astrophysics Data System (ADS)

    Duan, W.; Cheng, H.; Tan, M.; Li, X.; Edwards, R. L.

    2017-12-01

    The timing and structure of the penultimate deglaciation (Termination II, T-II) is still controversial due to the lack of precise-date and high-resolution paleoclimate documents. This study firstly presents high-precision stalagmite δ18O data encompassing T-II from north China, near the northern limit of the East Asian summer monsoon (EASM), an area sensitive to climate change. An obvious 2200-year long 18O-depleted excursion was identified within T-II, 1500 years later than in south China, mostly indicating it's a hitherto unidentified interstadial event, but the possibility of a local signal linked to karst hydrologic changes cannot be excluded. The sharpest T-II transition occurred at 129.20 ka BP (BP=before AD 1950), consistent with other EASM records but 3000 years later than mid-high-latitudinal cave records in Europe and North America. The different ages between them are attributed to that the original ice sheet melting during T-II did not inhibit the overturning in the Nordic Seas, leaving the heat transport to western Europe unaffected. Furthermore, the rise in EASM after the main T-II transition was interrupted by a significant "pause" in our record, whereas only expressed as a "slowdown" in south Chinese caves, further confirming the higher sensitivity of climate in north China. Compared with the last deglaciation (T-I), this climate pause could be considered as a Younger Dryas (YD)-type event that was shifted into the early stage of the last interglacial period, though its intensity and duration were not as strong as the YD during T-I. Key words: North China stalagmite record Timing and structure Termination II

  8. Predictors for switch from unipolar major depressive disorder to bipolar disorder type I or II: a 5-year prospective study.

    PubMed

    Holma, K Mikael; Melartin, Tarja K; Holma, Irina A K; Isometsä, Erkki T

    2008-08-01

    In this naturalistic study, we investigated the rate, time course, and predictors of a diagnostic switch from unipolar major depressive disorder (MDD) to bipolar disorder type I or II during a 5-year follow-up. The Vantaa Depression Study included at baseline 269 psychiatric outpatients (82.9%) and inpatients (17.1%) with DSM-IV MDD, diagnosed using structured and semi-structured interviews and followed up at 6 months, 18 months, and 5 years between February 1, 1997 and April 30, 2004. Information on 248 MDD patients (92.2%) was available for analyses of the risk of diagnostic switch. Cox proportional hazards models were used. Twenty-two subjects (8.9%) with previous unipolar MDD switched to bipolar disorder type II and 7 (2.8%) to type I. Median time for switch to bipolar type I was significantly shorter than to type II. In Cox proportional hazards analyses, severity of MDD (hazard ratio [HR] = 1.08, 95% CI = 1.00 to 1.15, p = .036), obsessive-compulsive disorder (OCD) (HR = 5.00, 95% CI = 2.04 to 12.5, p < .001), social phobia (HR = 2.33, 95% CI = 1.00 to 5.26, p = .050), and large number of cluster B personality disorder symptoms (HR = 1.10, 95% CI = 1.02 to 1.20, p = .022) predicted switch. Among outpatients with MDD in secondary level psychiatric settings, diagnostic switch to bipolar disorder usually refers to type II rather than type I. The few switching to bipolar type I do so relatively early. Predictors for diagnostic switch include not only features of mood disorder, such as severity, but may also include some features of psychiatric comorbidity, such as concurrent social phobia, OCD, and symptoms of cluster B personality disorders.

  9. Characteristics and outcome of stage II and III non-anaplastic Wilms' tumour treated according to the SIOP trial and study 93-01.

    PubMed

    Graf, Norbert; van Tinteren, Harm; Bergeron, Christophe; Pein, François; van den Heuvel-Eibrink, Marry M; Sandstedt, Bengt; Schenk, Jens-Peter; Godzinski, Jan; Oldenburger, Foppe; Furtwängler, Rhoikos; de Kraker, Jan

    2012-11-01

    To determine the prognosis of children with stage II and III of low or intermediate risk histology (SIOP classification) in unilateral localised Wilms tumour (WT) after neoadjuvant chemotherapy according to the trial and study of the International Society of Paediatric Oncology, SIOP 93-01. Patients with unilateral localised WT and stage II or III with low (LR) or intermediate risk (IR) histology between 6 months and 18 years of age, were selected from the total sample of patients registered in the SIOP 93-01 study between June 1993 and December 2001. All patients received 4 weeks of actinomycin-D/vincristine before surgery. Postoperative chemotherapy consisted of actinomycin-D, vincristine and epirubicin/doxorubicin for 27 weeks. Flank or whole abdomen irradiation was given for stage III. Event-free survival (EFS) and overall survival (OS) were analysed for various subgroups. Of 1476 registered patients 594 (40%) met the inclusion criteria for this analysis. Four hundred and two (67%) had stage II disease and 563 (95%) had intermediate risk histology. Median tumour volume was 439 ml at diagnosis and 163 ml after preoperative chemotherapy. With a median follow-up of 8 years, 5-year EFS was 90% (95% confidence interval [95% CI]: 87-92%) and OS 95% (95% CI: 93-97%). Patients with stage III, blastemal type histology and a large volume at surgery had a worse outcome. Treatment for stage II and III LR or IR WT is successful in a neoadjuvant setting as advised by the SIOP. Stage, tumour volume and blastemal type histology are the most important prognostic factors. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Predictors of spontaneous transient seizure remission in patients of medically refractory epilepsy due to mesial temporal sclerosis (MTS).

    PubMed

    Dhiman, Vikas; Sinha, Sanjib; Arimappamagan, Arivazhagan; Mahadevan, Anita; Bharath, Rose Dawn; Saini, Jitender; Rajeswaran, Jamuna; Rao, Malla Bhaskar; Shankar, Susrala K; Satishchandra, Parathasarthy

    2015-02-01

    To analyze the predictors of spontaneous transient seizure remission for ≥1 year in patients with drug-resistant epilepsy (DRE) due to mesial temporal sclerosis (MTS). This analysis included 38 patients with DRE (M:F = 20:18, age: 31.7 ± 10.9 years) diagnosed with unilateral MTS (right:left = 16:22). Group I ('remission' group) comprised of patients with seizure remission (M:F = 10:8, age: 32.8 ± 12.3 years, mean seizure free period: 2.2 ± 1.1 years; median: 2.1 years). Group II ('non-remission' group) comprised of age and gender matched 20 patients (M:F = 10:10, age: 30.7 ± 9.7 years) with unilateral MTS who never had seizure remission and subsequently underwent epilepsy surgery. Groups I and II were compared to find the predictors associated with transient seizure remission. The age at onset of seizures in group I was 13.2 ± 11.8 years and in group II was 12.0 ± 7.6 years. The duration of seizure was: group I - 19.7 ± 12.5 years and group II - 19.3 ± 7.7 years. Past history of seizure remissions (p < 0.001), frequent periods of remissions (p < 0.001), first remission within a year of onset of seizures (p = 0.04) and normal EEG (p = 0.04) were the important clinical predictors associated with seizure remission in this cohort. Fifteen patients in group I (83.3%) experienced remission following either change in AED (p ≤ 0.001) or increase in AED dosages (p < 0.001). There was no difference between the two groups regarding the type of semiology (partial vs. secondarily generalized) (p = 0.50), family history of seizures (p = 1.0), side of the lesion (p = 0.34), history of febrile seizures (p = 1.0) and the number of AEDs used (p = 0.53). The present study unfolds, some of the clinically relevant predictors associated with transient seizure remission in patients with DRE and MTS. Future molecular and network studies are required to understand its mechanism. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Affective Factors in Korean as a Foreign Language: Anxiety and Beliefs

    ERIC Educational Resources Information Center

    Jee, Min Jung

    2014-01-01

    This study investigated changes in levels of anxiety about learning a foreign language (FL) and in the language beliefs of first-year Korean-as-a-foreign-language (KFL) students in a US university throughout a year. Twelve students who enrolled in both of the two semesters of the first-year Korean I and II classes participated in this study. The…

  12. Differential effects of donor-specific HLA antibodies in living versus deceased donor transplant.

    PubMed

    Kamburova, E G; Wisse, B W; Joosten, I; Allebes, W A; van der Meer, A; Hilbrands, L B; Baas, M C; Spierings, E; Hack, C E; van Reekum, F E; van Zuilen, A D; Verhaar, M C; Bots, M L; Drop, A C A D; Plaisier, L; Seelen, M A J; Sanders, J S F; Hepkema, B G; Lambeck, A J A; Bungener, L B; Roozendaal, C; Tilanus, M G J; Voorter, C E; Wieten, L; van Duijnhoven, E M; Gelens, M; Christiaans, M H L; van Ittersum, F J; Nurmohamed, S A; Lardy, N M; Swelsen, W; van der Pant, K A; van der Weerd, N C; Ten Berge, I J M; Bemelman, F J; Hoitsma, A; van der Boog, P J M; de Fijter, J W; Betjes, M G H; Heidt, S; Roelen, D L; Claas, F H; Otten, H G

    2018-02-21

    The presence of donor-specific anti-HLA antibodies (DSAs) is associated with increased risk of graft failure after kidney transplant. We hypothesized that DSAs against HLA class I, class II, or both classes indicate a different risk for graft loss between deceased and living donor transplant. In this study, we investigated the impact of pretransplant DSAs, by using single antigen bead assays, on long-term graft survival in 3237 deceased and 1487 living donor kidney transplants with a negative complement-dependent crossmatch. In living donor transplants, we found a limited effect on graft survival of DSAs against class I or II antigens after transplant. Class I and II DSAs combined resulted in decreased 10-year graft survival (84% to 75%). In contrast, after deceased donor transplant, patients with class I or class II DSAs had a 10-year graft survival of 59% and 60%, respectively, both significantly lower than the survival for patients without DSAs (76%). The combination of class I and II DSAs resulted in a 10-year survival of 54% in deceased donor transplants. In conclusion, class I and II DSAs are a clear risk factor for graft loss in deceased donor transplants, while in living donor transplants, class I and II DSAs seem to be associated with an increased risk for graft failure, but this could not be assessed due to their low prevalence. © 2018 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of The American Society of Transplantation and the American Society of Transplant Surgeons.

  13. Group II Metabotropic Glutamate Receptors as Targets for Novel Antipsychotic Drugs

    PubMed Central

    Muguruza, Carolina; Meana, J. Javier; Callado, Luis F.

    2016-01-01

    Schizophrenia is a chronic psychiatric disorder which substantially impairs patients’ quality of life. Despite the extensive research in this field, the pathophysiology and etiology of schizophrenia remain unknown. Different neurotransmitter systems and functional networks have been found to be affected in the brain of patients with schizophrenia. In this context, postmortem brain studies as well as genetic assays have suggested alterations in Group II metabotropic glutamate receptors (mGluRs) in schizophrenia. Despite many years of drug research, several needs in the treatment of schizophrenia have not been addressed sufficiently. In fact, only 5–10% of patients with schizophrenia successfully achieve a full recovery after treatment. In recent years mGluRs have turned up as novel targets for the design of new antipsychotic medications for schizophrenia. Concretely, Group II mGluRs are of particular interest due to their regulatory role in neurotransmission modulating glutamatergic activity in brain synapses. Preclinical studies have demonstrated that orthosteric Group II mGluR agonists exhibit antipsychotic-like properties in animal models of schizophrenia. However, when these compounds have been tested in human clinical studies with schizophrenic patients results have been inconclusive. Nevertheless, it has been recently suggested that this apparent lack of efficacy in schizophrenic patients may be related to previous exposure to atypical antipsychotics. Moreover, the role of the functional heterocomplex formed by 5-HT2A and mGlu2 receptors in the clinical response to Group II mGluR agonists is currently under study. PMID:27242534

  14. Annual Report Card on California Teacher Preparation Programs for the Academic Year 2014-2015 as Required by Title II of the Higher Education Act

    ERIC Educational Resources Information Center

    Suckow, Marjorie A.

    2016-01-01

    This report presents the "Annual Report Card on California Teacher Preparation Programs for the Academic Year 2014-2015" as required by Title II of the Higher Education Act. In 2008, the law was reauthorized and changes were made to the Title II data collection and reporting requirements. The 2008-09 reporting year was the pilot year in…

  15. Cryptococcosis in patients with diabetes mellitus II in mainland China: 1993-2015.

    PubMed

    Li, Yingfang; Fang, Wenjie; Jiang, Weiwei; Hagen, Ferry; Liu, Jia; Zhang, Lei; Hong, Nan; Zhu, Yu; Xu, Xiaoguang; Lei, Xia; Deng, Danqi; Xu, Jianping; Liao, Wanqing; Boekhout, Teun; Chen, Min; Pan, Weihua

    2017-11-01

    Diabetes mellitus II (DM II) is a newly defined independent factor contributing to the morbidity and mortality of cryptococcosis. This retrospective case analysis aims to explore the epidemiology, clinical profile and strain characteristics of cryptococcosis in Chinese DM II patients. This study included 30 cases of cryptococcosis with DM II occurring from 1993 to 2015 in mainland China. The hospital-based prevalence of cryptococcosis in DM II was 0.21%. The mean age of the patients was 56.1 years (95% confidence interval: 51.5, 60.6), and 93% of the patients were older than 40 years. Sixty-two per cent of the patients experienced untreated or poorly controlled blood glucose before infection. Multilocus sequence typing analysis categorised all cultured strains as Cryptococcus neoformans and sequence type 5. Sixty-nine per cent of pulmonary cryptococcosis patients experienced misdiagnoses and treatment delays. Sixty per cent of cryptococcal meningitis patients received substandard antifungal therapy. The overall death rate was 33%. Considering the large population size of DM II patients in China, improved attention should be paid to the high prevalence of cryptococcosis as revealed by us. We also emphasised the importance of blood glucose control for infection prevention, especially among the elderly. © 2017 Blackwell Verlag GmbH.

  16. Long-term voice handicap index after type II thyroplasty using titanium bridges for adductor spasmodic dysphonia.

    PubMed

    Sanuki, Tetsuji; Yumoto, Eiji; Kodama, Narihiro; Minoda, Ryosei; Kumai, Yoshihiko

    2014-06-01

    To determine the long-term functional outcomes of type II thyroplasty using titanium bridges for adductor spasmodic dysphonia (AdSD) by perceptual analysis using the Voice Handicap Index-10 (VHI-10) and by acoustic analysis. Fifteen patients with AdSD underwent type II thyroplasty using titanium brides between August 2006 and February 2011. VHI-10 scores, a patient-based survey that quantifies a patient's perception of his or her vocal handicap, were determined before and at least 2 years after surgery. Concurrent with the VHI-10 evaluation, acoustic parameters were assessed, including jitter, shimmer, harmonic-to-noise ratio (HNR), standard deviation of F0 (SDF0), and degree of voice breaks (DVB). The average follow-up interval was 30.1 months. No patient had strangulation of the voice, and all were satisfied with the voice postoperatively. In the perceptual analysis, the mean VHI-10 score improved significantly, from 26.7 to 4.1 two years after surgery. All patients had significantly improved each score of three different aspects of VHI-10, representing improved functional, physical, and emotional well-being. All acoustic parameters improved significantly 2 years after surgery. The treatment of AdSD with type II thyroplasty significantly improved the voice-related quality of life and acoustic parameters 2 years after surgery. The results of the study suggest that type II thyroplasty using titanium bridges provides long-term relief of vocal symptoms in patients with AdSD. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Comparison Between Billroth-II with Braun and Roux-en-Y Reconstruction After Laparoscopic Distal Gastrectomy.

    PubMed

    In Choi, Chang; Baek, Dong Hoon; Lee, Si Hak; Hwang, Sun Hwi; Kim, Dae Hwan; Kim, Kwang Ha; Jeon, Tae Yong; Kim, Dong Heon

    2016-06-01

    This study aims to compare the effectiveness of Billroth-II with Braun and Roux-en-Y reconstruction after laparoscopic distal gastrectomy. From April 2010 to August 2012, 66 patients underwent laparoscopic distal gastrectomy (Billroth-II with Braun reconstruction, 26; Roux-en-Y, 40). The patients' data were collected prospectively and reviewed retrospectively. The mean operation and reconstruction times were statistically shorter for Billroth-II with Braun reconstruction than Roux-en-Y (198.1 ± 33.0 vs. 242.3 ± 58.1 min, p = 0.001). One case of postoperative stricture was observed in each group. One case each of intra-abdominal abscess and delayed gastric emptying occurred in the Billroth-II with Braun group. At 1 year postoperatively, gastric residue and reflux esophagitis were not significantly different between the groups. Gastritis and bile reflux were more frequently observed in the Billroth-II with Braun group (p = 0.004 and p < 0.001, respectively). At 2 years postoperatively, gastric residue was not significantly different, but gastritis, bile reflux, and esophagitis were more frequent in the Billroth-II with Braun group (p = 0.029, p < 0.001, and p = 0.036, respectively). The postoperative effectiveness of Roux-en-Y reconstruction may be superior to Billroth-II with Braun reconstruction after laparoscopic distal gastrectomy.

  18. The Comparative Reliability and Feasibility of the Past-Year Canadian Diet History Questionnaire II: Comparison of the Paper and Web Versions.

    PubMed

    Lo Siou, Geraldine; Csizmadi, Ilona; Boucher, Beatrice A; Akawung, Alianu K; Whelan, Heather K; Sharma, Michelle; Al Rajabi, Ala; Vena, Jennifer E; Kirkpatrick, Sharon I; Koushik, Anita; Massarelli, Isabelle; Rondeau, Isabelle; Robson, Paula J

    2017-02-13

    Advances in technology-enabled dietary assessment include the advent of web-based food frequency questionnaires, which may reduce costs and researcher burden but may introduce new challenges related to internet connectivity and computer literacy. The purpose of this study was to evaluate the intra- and inter-version reliability, feasibility and acceptability of the paper and web Canadian Diet History Questionnaire II (CDHQ-II) in a sub-sample of 648 adults (aged 39-81 years) recruited from Alberta's Tomorrow Project. Participants were randomly assigned to one of two groups: (1) paper, web, paper; or (2) web, paper, web over a six-week period. With few exceptions, no statistically significant differences in mean nutrient intake were found in the intra- and inter-version reliability analyses. The majority of participants indicated future willingness to complete the CDHQ-II online, and 59% indicated a preference for the web over the paper version. Findings indicate that, in this population of adults drawn from an existing cohort, the CDHQ-II may be administered in paper or web modalities (increasing flexibility for questionnaire delivery), and the nutrient estimates obtained with either version are comparable. We recommend that other studies explore the feasibility and reliability of different modes of administration of dietary assessment instruments prior to widespread implementation.

  19. Relative Leukocyte Telomere Length, Hematological Parameters and Anemia - Data from the Berlin Aging Study II (BASE-II).

    PubMed

    Meyer, Antje; Salewsky, Bastian; Buchmann, Nikolaus; Steinhagen-Thiessen, Elisabeth; Demuth, Ilja

    2016-01-01

    The length of the chromosome ends, telomeres, is widely accepted as a biomarker of aging. However, the dynamic of the relationship between telomere length and hematopoietic parameters in the normal aging process, which is of particular interest with respect to age-related anemia, is not well understood. We have analyzed the relationship between relative leukocyte telomere length (rLTL) and several hematological parameters in the older group of the Berlin Aging Study II (BASE-II) participants. This paper also compares rLTL between both BASE-II age groups (22-37 and 60-83 years). Genomic DNA was extracted from peripheral blood leukocytes of BASE-II participants and used to determine rLTL by a quantitative PCR protocol. Standard methods were used to determine blood parameters, and the WHO criteria were used to identify anemic participants. Telomere length data were available for 444 younger participants (28.4 ± 3.1 years old; 52% women) and 1,460 older participants (68.2 ± 3.7 years old; 49.4% women). rLTL was significantly shorter in BASE-II participants of the older group (p = 3.7 × 10-12) and in women (p = 4.2 × 10-31). rLTL of older men exhibited a statistically significant, positive partial correlation with mean corpuscular hemoglobin (MCH; p = 0.012) and MCH concentration (p = 0.002). While these correlations were only observed in men, the rLTL of older women was negatively correlated with the number of thrombocytes (p = 0.015) in the same type of analysis. Among all older participants, 6% met the criteria to be categorized as 'anemic'; however, there was no association between anemia and rLTL. In the present study, we have detected isolated correlations between rLTL and hematological parameters; however, in all cases, rLTL explained only a small part of the variation of the analyzed parameters. In disagreement with some other studies showing similar data, we interpret the association between rLTL and some of the hematological parameters studied here to be at most marginal. This applies also to the role of rLTL in anemia, at least in the age group investigated here. Since BASE-II is yet another large cohort in which women have on average shorter telomeres than men, this finding will be addressed in the discussion with respect to the ongoing debate on gender differences in telomere length. © 2016 S. Karger AG, Basel.

  20. Modified BEAM with triple autologous stem cell transplantation for patients with relapsed aggressive non-Hodgkin lymphoma.

    PubMed

    Hohloch, Karin; Zeynalova, Samira; Chapuy, Björn; Pfreundschuh, Michael; Loeffler, Markus; Ziepert, Marita; Feller, Alfred C; Trümper, Lorenz; Hasenclever, Dirk; Wulf, Gerald; Schmitz, Norbert

    2016-06-01

    Treatment of relapse and primary progression in aggressive lymphoma remains unsatisfactory; outcome is still poor. Better treatment strategies are much needed for this patient population. The R1 study is a prospective multi-center phase I/II study evaluating a dose finding approach with a triple transplant regimen in four BEAM dose levels in patients with relapsed aggressive non-Hodgkin lymphoma. The aim of the study was to determine feasibility, toxicity, and remission rate. In a total of 39 patients (pts.) enrolled in the study, 24 pts. were evaluated in the following analysis. Twenty pts. had aggressive B cell lymphoma, and two pts. had T cell lymphoma. All evaluated patients responded to DexaBEAM with a sufficient stem cell harvest. The phase I/II study was started with BEAM dose level II. Four patients were treated at dose level II, and 20 pts. were treated at dose level III. Due to the early termination of the study, dose levels I and IV were never administered. Sixteen pts. completed therapy according to protocol, and eight pts. (33.3 %) stopped treatment early. Infections (27 %) and stomatitis (13 %) were the most frequent grade III/IV non-hematologic toxicities. Thirteen percent of patients presented with severe grade III/IV lung toxicity during modified BEAM (m-BEAM). Fourteen pts. achieved a complete response (CR), one pt. achieved no change (NC), six pts. had progressive disease (PD), and two pts. died; for one pt., outcome is not known. One-year and 3-year event-free survival (EFS) was 38 and 33 %, respectively. Overall survival (OS) after 1 and 3 years was 50 and 38 %. In conclusion, dose escalation of standard BEAM is not feasible due to toxicity.

  1. CDF-II and B physics

    NASA Astrophysics Data System (ADS)

    Lockyer, Nigel S.

    1998-02-01

    This paper reports on the CDF-II B physics goals and new detector systems presently being built for Run-II of the Tevatron collider in the year 2000. The B physics goals are focused towards observing and studying CP violation and B s flavor oscillations. Estimates of expected performance are reported. The new detector systems described are: the 5-layer 3-D silicon vertex detector, the intermedia silicon tracking layers, the central tracking drift chamber, muon system upgrades, and a proposed time-of-flight system.

  2. Validation of SAM 2 and SAGE satellite

    NASA Technical Reports Server (NTRS)

    Kent, G. S.; Wang, P.-H.; Farrukh, U. O.; Yue, G. K.

    1987-01-01

    Presented are the results of a validation study of data obtained by the Stratospheric Aerosol and Gas Experiment I (SAGE I) and Stratospheric Aerosol Measurement II (SAM II) satellite experiments. The study includes the entire SAGE I data set (February 1979 - November 1981) and the first four and one-half years of SAM II data (October 1978 - February 1983). These data sets have been validated by their use in the analysis of dynamical, physical and chemical processes in the stratosphere. They have been compared with other existing data sets and the SAGE I and SAM II data sets intercompared where possible. The study has shown the data to be of great value in the study of the climatological behavior of stratospheric aerosols and ozone. Several scientific publications and user-oriented data summaries have appeared as a result of the work carried out under this contract.

  3. Nurses' health promoting lifestyle behaviors in a community hospital.

    PubMed

    Kurnat-Thoma, Emma; El-Banna, Majeda; Oakcrum, Monica; Tyroler, Jill

    2017-06-01

    To examine nurses' health-promoting lifestyle behaviors, describe their self-reported engagement in employee wellness program benefit options, and explore relationships between nurse demographic factors, health characteristics and lifestyle behaviors. Nurses adopting unhealthy lifestyle behaviors are at significantly higher risk for developing a number of chronic diseases and are at increased susceptibility to exhaustion, job dissatisfaction and turnover. Strengthening professional nurses' abilities to engage in healthy lifestyle behaviors could serve as a valuable tool in combating negative workplace stress, promote improved work-life balance and personal well-being, and help retain qualified health-care providers. In a 187-bed community hospital in the Washington D.C. metropolitan area, we conducted an IRB-approved exploratory descriptive study. We examined 127 nurses' demographic characteristics, self-reported employer wellness program use, and measured their healthy lifestyle behaviors using the 52-item Health-Promoting Lifestyle Profile-II (HPLP-II) survey instrument. Nurse demographic and HPLP-II scores were analyzed in SPSS v20.0. Inferential univariate statistical testing examined relationships between nurse demographic factors, health and job characteristics, and HPLP-II score outcomes. Nurses over 40years old were more likely to report participation in hospital wellness program options. Statistically significant age differences were identified in total HPLP-II score (p=0.005), and two subscale scores-spiritual growth (p=0.002) and interpersonal relations (p=0.000). Post-hoc testing identified nurse participants 40-49years old and ≥50years old experienced slightly lower total HPLP-II score, subscale scores in comparison to younger colleagues. Nurses ≥40years old may benefit from additional employer support and guidance to promote and maintain healthy lifestyles, personal well-being, and positive interpersonal relationships. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Fluoroscopic Caudal Epidural Injections in Managing Post Lumbar Surgery Syndrome: Two-Year Results of a Randomized, Double-Blind, Active-Control Trial

    PubMed Central

    Manchikanti, Laxmaiah; Singh, Vijay; Cash, Kimberly A.; Pampati, Vidyasagar; Datta, Sukdeb

    2012-01-01

    Study Design: A randomized, active control, double-blind trial. Objective: To evaluate the effectiveness of fluoroscopically directed caudal epidural injections with or without steroids in managing chronic low back and lower extremity pain secondary to post lumbar surgery syndrome. Summary of Background Data: There is a paucity of evidence concerning caudal epidural injections for managing chronic persistent low back pain with or without lower extremity pain caused by post lumbar surgery syndrome. Methods: This active control randomized study included 140 patients with 70 patients in each group. Group I received 0.5% lidocaine, 10 mL; Group II received 9 mL of 0.5% lidocaine mixed with 1 mL of 6 mg of nonparticulate betamethasone. The multiple outcome measures included the numeric rating scale, the Oswestry Disability Index 2.0, employment status, and opioid intake with assessments at 3, 6, 12, 18, and 24 months posttreatment. Primary outcome was defined as at least 50% improvement in pain and Oswestry Disability Index scores. Patients with a positive response to the first 2 procedures with at least 3 weeks of relief were considered to be successful. All others were considered as failures. Results: Overall in Group I, 53% and 47% of the patients and in Group II, 59% and 58% of the patients, showed significant improvement with reduction in pain scores and disability index at 12 months and 24 months. In contrast, in the successful groups, significant pain relief and improvement in function were observed in 70% and 62% of Group I at one and 2 years; in 75% and 69% of Group II at one and 2 years. The results in the successful group showed that at the end of the first year patients experienced approximately 38 weeks of relief and at the end of 2 years Group I had 62 weeks and Group II had 68 weeks of relief. Overall total relief for 2 years was 48 weeks in Group I and 54 weeks in Group II. The average procedures in the successful groups were at 4 in one year and 6 at the end of 2 years. Conclusion: Caudal epidural injections of local anesthetic with or without steroid might be effective in patients with chronic persistent low back and/or lower extremity pain in patients with post lumbar surgery syndrome. PMID:23028241

  5. Malaria burden and treatment targets in Kachin Special Region II, Myanmar from 2008 to 2016: A retrospective analysis

    PubMed Central

    Bi, Yaw

    2018-01-01

    Although drug-based treatment is the primary intervention for malaria control and elimination, optimal use of targeted treatments remains unclear. From 2008 to 2016, three targeted programs on treatment were undertaken in Kachin Special Region II (KR2), Myanmar. Program I (2008–2011) treated all confirmed, clinical and suspected cases; program II (2012–2013) treated confirmed and clinical cases; and program III (2014–2016) targeted confirmed cases only. This study aims to evaluate the impacts of the three programs on malaria burden individually based on the annual parasite incidence (API), slide positivity rate (SPR) and their relative values. The API is calculated from original collected data and the incidence rate ratio (IRR) for each year is calculated by using the first-year API as a reference in each program phase across the KR2. Same method is applied to calculate SPR and risk ratio (RR) at the sentinel hospital too. During program I (2008–2011), malaria burden was reduced by 61% (95%CI: 58%-74%) and the actual API decreased from 9.8 (95%CI: 9.6–10.1) per 100 person-years in 2008 to 3.8 (3.6–4.1) per 100 person-years in 2011. Amid program II (2012–2013), the malaria burden increased by 33% (95%CI: 22%-46%) and the actual API increased from 2.1(95%CI: 2.0–2.3) per 100 person-years in 2012 to 2.8 (95%CI: 2.7–2.9) per 100 person-years in 2013. During program III (2014–2016) the malaria burden increased furtherly by 60% (95%CI: 51% - 69%) and the actual API increased from 3.2(95%CI: 3.0–3.3) per 100 person-years in 2014 to 5.1 (95%CI: 4.9–5.2) per 100 person-years in 2016. Results of the slide positivity of the sentinel hospital also confirm these results. Resurgence of malaria was mainly due to Plasmodium vivax during program II and III. This study indicates that strategy adopted in program I (2008–2011) should be more appropriate for the KR2. Quality-assured treatment of all confirmed, clinical and suspected malaria cases may be helpful for the reduction of malaria burden. PMID:29614088

  6. Anatomy and Physiology. Module No. IV. Health Occupations Education II.

    ERIC Educational Resources Information Center

    Day, Nancy; And Others

    This package of 31 modules on anatomy and physiology is one of six such packages containing a total of 46 modules that comprise Health Occupations Education II, the second course of a two-year course of study. Each module may contain some or all of the following components: introduction, directions, objectives, a list of learning activities,…

  7. Genetic improvement of U.S. soybean in Maturity Groups II, III, and IV

    USDA-ARS?s Scientific Manuscript database

    Soybean [Glycine max (L.) Merr.] improvement via plant breeding has been critical for the success of the crop. The objective of this study was to quantify genetic change in yield and other traits that occurred over the past 80 years of North American soybean breeding in maturity groups (MGs) II, III...

  8. An Experimental Evaluation of Hyperactivity and Food Additives. 1977-Phase II.

    ERIC Educational Resources Information Center

    Harley, J. Preston; And Others

    Phase II of a study on the effectiveness of B. Feingold's recommended diet for hyperactive children involved the nine children (mean age 9 years) who had shown the "best" response to diet manipulation in Phase I. Each child served as his own control and was challenged with specified amounts of placebo and artificial color containing food…

  9. Kinetics of visual field loss in Usher syndrome Type II.

    PubMed

    Iannaccone, Alessandro; Kritchevsky, Stephen B; Ciccarelli, Maria Laura; Tedesco, Salvatore A; Macaluso, Claudio; Kimberling, William J; Somes, Grant W

    2004-03-01

    To characterize the kinetics of visual field decay in Usher syndrome type II. The area of 137 Goldmann visual fields (GVFs) delimited with the I4e and V4e targets was measured in each eye of 19 patients with an established diagnosis of Usher syndrome type II, and the average interocular GVF area for each patient at each time point was calculated. The average follow-up was 5.58 years. Symptomatic disease duration was defined as years elapsed after symptoms were first noted. The data set (n = 67 for the I4e target; n = 70 for the V4e target) was analyzed with a random coefficient mixed model to identify the best-fit model describing the decay of visual field size over time. The half-life of the residual visual field area (t(0.5)) was also calculated. The variable that best explained the decay of the GVF area was the duration of symptomatic disease. In an exponential model, the slope estimate for the natural log of the GVF area was -0.172 for the I4e target and -0.136 for the V4e target for each year of symptomatic disease. Accordingly, t(0.5) was approximately 4 years for the I4e target and 5 years for the V4e target. These estimates are very similar to those in previous studies of nonsyndromic retinitis pigmentosa (RP). This study suggests that the kinetics of GVF decline in Usher syndrome type II are, on average, very similar to other forms of RP and that, once the disease becomes symptomatic, GVF deterioration follows stereotyped kinetics, even in patients with late-onset retinal disease.

  10. Sleep duration affects risk for ulcerative colitis: a prospective cohort study.

    PubMed

    Ananthakrishnan, Ashwin N; Khalili, Hamed; Konijeti, Gauree G; Higuchi, Leslie M; de Silva, Punyanganie; Fuchs, Charles S; Richter, James M; Schernhammer, Eva S; Chan, Andrew T

    2014-11-01

    Sleep deprivation is associated with production of inflammatory cytokines. Disturbed sleep quality has been associated with increased risk of disease flare in patients with Crohn's disease (CD) or ulcerative colitis (UC). However, the association between sleep and risk of incident CD and UC has not been previously examined. We conducted a prospective study of women who were enrolled in the Nurses' Health Study (NHS) I since 1976 and NHS II since 1989 and followed through detailed biennial questionnaires with >90% follow-up. We examined the association of sleep duration reported in 1986 in NHS I and 2001 in NHS II with incident CD and UC, diagnosed through 2010, in NHS I and 2009 in NHS II. Cox proportional hazards models adjusting for potential confounders were used to calculate hazard ratios and 95% confidence intervals (CIs). Among 151,871 women, we confirmed 191 cases of CD (incidence, 8/100,000 person-years) and 230 cases of UC (incidence, 10/100,000 person-years) over 2,292,849 person-years. Compared with women with reported usual sleep durations of 7-8 h/day (incidence, 8/100,000 person-years), women with reported sleep duration <6 h/day (11/100,000 person-years) or >9 h/day (20/100,000 person-years) had a higher incidence of UC (P < .05). The multivariate hazard ratios for UC were 1.51 (95% CI, 1.10-2.09) for sleep durations <6 h/day and 2.05 (95% CI, 1.44-2.92) for sleep durations >9 h/day, compared with sleep durations of 7-8 h/day. In contrast, sleep duration did not modify risk of CD. Duration of rotating night shift work was not associated with CD or UC. On the basis of data from the NHS I and II, less than 6 hours sleep/day and more than 9 hours sleep/day are each associated with an increased risk of UC. Further studies are needed to evaluate sleep as a modifiable risk factor in the pathogenesis and progression of IBD. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

  11. The Denver II Scales and the Griffiths Scales of Mental Development: a correlational study.

    PubMed

    Luiz, Dolores M; Foxcroft, Cheryl D; Tukulu, Abigail N

    2004-10-01

    Screening measures aim to minimise the number of children being diagnosed incorrectly; however, many of these measures have been based on the "normal" white population. This study identified the need for a valid developmental assessment of black preschool children. The general aim of the study was to investigate the use of the Denver II and the Griffiths Scales on a pre-school black Xhosa-speaking sample. Specifically, the aim was to investigate the relationship between the Denver II Scales and the Griffiths Scales, in order to provide the first step in establishing the validity of the Denver II Scales on a South African black population. A correlational design was used and the sample was comprised of 60 Xhosa-speaking children between the ages of 3 and 6 years. The findings revealed that there was a significant relationship between the overall performance of the Denver II and the Griffiths Scales. However, the Personal-Social Scale of the Denver II appeared to have items that were culturally biased. Further, the Denver II further identified a higher percentage of the sample to have abnormal or questionable protocols than the Griffiths Scales did.

  12. [Affective temperaments in the bipolar and unipolar disorders: distinctive profiles and relationship with clinical features].

    PubMed

    Gassab, L; Mechri, A; Bacha, M; Gaddour, N; Gaha, L

    2008-10-01

    Recent research postulated that temperaments represent the subclinical foundations of affective disorders, and an early clue for a recurrent, prebipolar disorder. Akiskal et al. operationalized five types of temperaments: depressive, hyperthymic, irritable, cyclothymic and anxious. The aims of this study were to compare the affective temperaments scores in patients with bipolar I, II and recurrent depression disorders and to explore the relation between temperaments scores and clinical features of those affective disorders. This was a comparative cross-sectional study, concerning three groups: patients with bipolar I disorder (BIP I) (n=31, 20 men and 11 women, mean age=42.0+/-10.1 years), patients with bipolar II disorder (BIP II) (n=18, 11 men and seven women, mean age=40.7+/-10.8 years) and patients with recurrent depressive disorder (RDD) (n=66, 28 men and 38 women, mean age=45.0+/-9.3 years). All patients were in remission of a major depressive episode. The affective temperaments were assessed by the Akiskal and Mallya Affective Temperament questionnaires. Hyperthymic temperament mean scores were higher in BIP I (10.8+/-5.4) and BIP II (10.3+/-5.5) groups compared to RDD group (5.5+/-4.0) (p<10(-3)). Depressive temperament mean score was significantly higher in RDD group (10.5+/-4.3), compared to BIP I (7.3+/-4.6) and BIP II (5.4+/-2.9) groups (p<10(-3)). Cyclothymic temperament mean score was higher in BIP II group (4.7+/-5.8) compared to BIP I (3.3+/-3.9) and RDD (2.5+/-3.9) groups, but this difference was not significant (p=0.08). No difference was found between the three groups concerning irritable temperament scores. Negative correlation was found between hyperthymic and depressive temperament scores in BIP I (r=-0.81, p<0.001) and RDD (r=-0.73, p<0.001) groups, but not in BIP II group. Concerning the clinical correlates with affective temperament scores, negative correlation was found between hyperthymic temperament score and number of depressive episodes in BIP II group (r=-0.53, p=0.02). Hyperthymic temperament score was associated with psychotic features in the last depressive episode in BIP I (p=0.01) and BIP II (p=0.008) groups and seasonal features in BIP II group (p=0.02). Moreover, cyclothymic temperament score was associated with psychotic (p=0.009) and seasonal features (p=0.03) in BIP II group. Despite the small sample sizes for our study groups, we can conclude that hyperthymic and cyclothymic temperaments characterized bipolar disorders and are correlated with other markers of bipolarity such as psychotic and seasonal features. Thus, temperament assessment might become a useful tool to predict bipolarity in association with those markers.

  13. Angiotensin II mediated signal transduction. Important role of tyrosine kinases.

    PubMed

    Haendeler, J; Berk, B C

    2000-11-24

    It has been 100 years since the discovery of renin by Bergman and Tigerstedt. Since then, numerous studies have advanced our understanding of the renin-angiotensin system. A remarkable aspect was the discovery that angiotensin II (AngII) is the central product of the renin-angiotensin system and that this octapeptide induces multiple physiological responses in different cell types. In addition to its well known vasoconstrictive effects, growing evidence supports the notion that AngII may play a central role not only in hypertension, but also in cardiovascular and renal diseases. Binding of AngII to the seven-transmembrane angiotensin II type 1 receptor is responsible for nearly all of the physiological actions of AngII. Recent studies underscore the new concept that activation of intracellular second messengers by AngII requires tyrosine phosphorylation. An increasing number of tyrosine kinases have been shown to be activated by AngII, including the Src kinase family, the focal adhesion kinase family, the Janus kinases and receptor tyrosine kinases. These actions of AngII contribute to the pathophysiology of cardiac hypertrophy and remodeling, vascular thickening, heart failure and atherosclerosis. In this review, we discuss the important role of tyrosine kinases in AngII-mediated signal transduction. Understanding the importance of tyrosine phosphorylation in AngII-stimulated signaling events may contribute to new therapies for cardiovascular and renal diseases.

  14. African Studies in French for the Elementary Grades: Phase II of a Twinned Classroom Approach to the Teaching of French in the Elementary Grades. Volume II, Tapescripts and Essays.

    ERIC Educational Resources Information Center

    Jonas, Sister Ruth

    This experiment examines a new psychological approach to foreign language study at the elementary school level. A principal objective is to determine the nature and importance of second language learning motivation in monolingual societies devoid of the daily living example of the target language and culture. A five-year French language sequence,…

  15. A Study of Seton Hall University and the Attributes of Organizational Adaptation Employed in Fashioning Its Catholic Identity and Mission in the Post-Vatican II Era (1966-2006)

    ERIC Educational Resources Information Center

    Mazza, Nicholas F.

    2009-01-01

    This thesis is the first fully developed and published study of Seton Hall University. It specifically examines the organizational structures of Seton Hall University over a forty year period in light of the tumultuous changes in the Catholic Church and Catholic academia post-Vatican II. Of particular importance is change that influenced the…

  16. Better prognostic marker in ICU - APACHE II, SOFA or SAP II!

    PubMed

    Naqvi, Iftikhar Haider; Mahmood, Khalid; Ziaullaha, Syed; Kashif, Syed Mohammad; Sharif, Asim

    2016-01-01

    This study was designed to determine the comparative efficacy of different scoring system in assessing the prognosis of critically ill patients. This was a retrospective study conducted in medical intensive care unit (MICU) and high dependency unit (HDU) Medical Unit III, Civil Hospital, from April 2012 to August 2012. All patients over age 16 years old who have fulfilled the criteria for MICU admission were included. Predictive mortality of APACHE II, SAP II and SOFA were calculated. Calibration and discrimination were used for validity of each scoring model. A total of 96 patients with equal gender distribution were enrolled. The average APACHE II score in non-survivors (27.97+8.53) was higher than survivors (15.82+8.79) with statistically significant p value (<0.001). The average SOFA score in non-survivors (9.68+4.88) was higher than survivors (5.63+3.63) with statistically significant p value (<0.001). SAP II average score in non-survivors (53.71+19.05) was higher than survivors (30.18+16.24) with statistically significant p value (<0.001). All three tested scoring models (APACHE II, SAP II and SOFA) would be accurate enough for a general description of our ICU patients. APACHE II has showed better calibration and discrimination power than SAP II and SOFA.

  17. Results of the post-U.S. Food and Drug Administration-approval study with a continuous flow left ventricular assist device as a bridge to heart transplantation: a prospective study using the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support).

    PubMed

    Starling, Randall C; Naka, Yoshifumi; Boyle, Andrew J; Gonzalez-Stawinski, Gonzalo; John, Ranjit; Jorde, Ulrich; Russell, Stuart D; Conte, John V; Aaronson, Keith D; McGee, Edwin C; Cotts, William G; DeNofrio, David; Pham, Duc Thinh; Farrar, David J; Pagani, Francis D

    2011-05-10

    The aim of this study was to determine whether results with the HeartMate (HM) II left ventricular assist device (LVAD) (Thoratec Corporation, Pleasanton, California) in a commercial setting are comparable to other available devices for the same indication. After a multicenter pivotal clinical trial conducted from 2005 to 2008, the U.S. Food and Drug Administration approved the HM II LVAD for bridge to transplantation (BTT). A post-approval study was required by the U.S. Food and Drug Administration to determine whether results with the device in a commercial setting are comparable to other available devices for the same indication. The study was a prospective evaluation of the first 169 consecutive HM II patients enrolled in the national INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) who were listed for transplant or likely to be listed. Patients were enrolled from April through August 2008 at 77 U.S. centers and followed for at least 1 year after implant. A comparison group (COMP) included all patients (n = 169 at 27 centers) enrolled in the INTERMACS registry with other types of LVADs (79% HeartMate XVE, 21% Implantable Ventricular Assist Device [Thoratec Corporation]) for the same BTT indication in the same time period. Survival rates, adverse events, and quality of life with the EuroQol EQ-5D visual analog scale were obtained in the INTERMACS registry. Baseline characteristics were similar, but creatinine and blood urea nitrogen were lower in the HM II versus COMP groups, and there were fewer patients in the highest-risk INTERMACS patient profile Number 1 (24% for HM II vs. 39% for COMP). Adverse event rates were similar or lower for HM II versus COMP for all events. Bleeding was the most frequent adverse event for both groups (1.44 vs. 1.79 events/patient-year). Operative 30-day mortality for HM II was 4% versus 11% for COMP. The percentage of patients reaching transplant, cardiac recovery, or ongoing LVAD support by 6 months was 91% for HM II and 80% for COMP, and the Kaplan-Meier survival for patients remaining on support at 1 year was 85% for HM II versus 70% for COMP. Quality of life was significantly improved at 3 months of support and sustained through 12 months in both groups compared with baseline. The results in a post-market approval, actual patient care setting BTT population support the original findings from the pivotal clinical trial regarding the efficacy and risk profile of the HM II LVAD. These data suggest that dissemination of this technology after approval has been associated with continued excellent results. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  18. Stem Cell Therapy Using Bone Marrow-Derived Mononuclear Cells in Treatment of Lower Limb Lymphedema: A Randomized Controlled Clinical Trial.

    PubMed

    Ismail, Ahmed Mohammed; Abdou, Said M; Abdelnaby, Amira Y; Hamdy, Mennat Allah; El Saka, Ayman A; Gawaly, Amr

    2018-06-01

    Up till now, there is no satisfactory treatment for lymphedema. The aim of this study is to evaluate stem cell therapy in lymphedema. This prospective randomized study includes 40 patients with chronic lymphedema divided randomly into two groups: group I (stem cell therapy group) and group II (control group). In group I, bone marrow was aspirated and mononuclear cells were separated and then transplanted into the patients. In group II, patients compression therapy alone was applied. Group I included 20 patients (12 males and 8 females), their age ranged from 18 to 38 years with a mean age of 24.8 ± 6.39 years, whereas group II included 20 patients (10 males and 10 females), their age ranged from 18 to 36 years with a mean value of 25.6 ± 8.18 years. In group I, there was a decrease in the mean circumference at ankle after 6 months, which was statistically significant (t = 3.250, p = 0.014). This was associated with marked improvement of pain and walking ability. Whereas in group II, the change in the circumference was statistically insignificant (t = 1256, p = 0.349) with no satisfactory pain relief and improvement in walking ability. Biopsies examined by immunohistochemistry showed marked increase in the number of lymphatic capillaries in group I. Stem cell therapy can achieve improvement in limb circumference as well as pain relief and improvement in walking ability in patients with chronic lymphedema compared with those in control group.

  19. Evidence, Argument and Social Responsibility: First-Year Students' Experiences of Information Literacy when Researching an Essay

    ERIC Educational Resources Information Center

    Lupton, Mandy

    2008-01-01

    This paper describes a phenomenographic study of undergraduates' experiences of information literacy when researching an essay in a first-year environmental studies course. Three hierarchical categories were identified that represented students' experiences: (i) seeking evidence; (ii) developing an argument; and (iii) learning as a social…

  20. The effects of booster vaccination of hepatitis B vaccine on children 5-15 years after primary immunization: A 5-year follow-up study.

    PubMed

    Wu, Zikang; Yao, Jun; Bao, Hongdan; Chen, Yongdi; Lu, Shunshun; Li, Jing; Yang, Linna; Jiang, Zhenggang; Ren, Jingjing; Xu, Kai-Jin; Ruan, Bing; Yang, Shi-Gui; Xie, Tian-Sheng; Li, Qian

    2018-05-04

    The aim of this study was to evaluate changes in hepatitis B surface antibody titers (anti-HBs) after booster vaccinations in children aged 5-15 y and to provide suitable immunization strategies. A total of 2208 children were initially enrolled in screening, and 559 children were finally included. The participants were divided into 2 groups according to their pre-booster anti-HBs levels: Group I, <10 mIU/ml and Group II, ≥10 mIU/ml. Group I was administered 3 doses of booster hepatitis B vaccine (0-1-6 months, 10 μg), and Group II was administered 1 dose of booster hepatitis B vaccine (10 μg). The antibody titer changes were examined at 4 time points: 1 month after dose 1 and dose 3, and 1 year and 5 years after dose 3. The protective seroconversion rates at those points were 95.65%, 99.67%, 97.59% and 91.05% (p < 0.001), respectively, in Group I, and 100.00%, 99.87%, 99.66% and 98.21% (χ 2 = 6.04, p = 0.11), respectively, in Group II. The GMT in subjects aged 5-9 y were higher than that in subjects aged 10-15 y in both Group I and Group II at 1 month after dose 1, but no difference was observed at the other three time points. This study demonstrates that booster vaccination has a good medium-term effect. A booster dose for subjects with protective antibodies is not necessary but effective, and 3 doses of hepatitis B vaccination are recommended for those who have lost immunological memory. Receiving booster immunization at the age of 10-15 years may be more appropriate for individuals living in HBV high epidemic areas.

  1. Declining Use of Radiotherapy in Stage I and II Hodgkin's Disease and Its Effect on Survival and Secondary Malignancies

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

    Koshy, Matthew, E-mail: mkoshy@radonc.uchicago.edu; Department of Radiation Oncology, University of Illinois at Chicago, Chicago, IL; Rich, Shayna E.

    2012-02-01

    Purpose: Concerns regarding long-term toxicities have led some to withhold radiotherapy (RT) for the treatment of Stage I and II Hodgkin's disease (HD). The present study was undertaken to assess the use of RT for HD and its effect on overall survival and the development of secondary malignancies. Methods and Materials: The present study included data from the Surveillance, Epidemiology, and End Results database from patients aged {>=}20 years who had been diagnosed with Stage I or II HD between 1988 and 2006. Overall survival was estimated using the Kaplan-Meier method, and the Cox multivariate regression model was used tomore » analyze trends. Results: A total of 12,247 patients were selected, and 51.5% had received RT. The median follow-up for the present cohort was 4.9 years, with 21% of the cohort having >10 years of follow-up. Between 1988 and 1991, 62.9% had undergone RT, but between 2004 and 2006, only 43.7% had undergone RT (p < .001). The 5-year overall survival rate was 76% for patients who had not received RT and 87% for those who had (p < .001). The hazard ratio adjusted for other variables in the regression model showed that patients who had not undergone RT (hazard ratio, 1.72; 95% confidence interval, 1.72-2.02) was associated with significantly worse survival compared with patients who had received RT. The actuarial rate of developing a second malignancy was 14.6% vs. 15.0% at 15 years for those who had and had not undergone RT, respectively (p = .089). Conclusions: The present study is one of the largest studies to examine the role of RT for Stage I and II HD. Our results revealed a survival benefit with the addition of RT with no increase in the development of secondary malignancies compared with patients who had not received RT. Furthermore, the present nationwide study revealed a >20% absolute decrease in the use of RT from 1988 to 2006.« less

  2. Addition of Rituximab to Involved-Field Radiation Therapy Prolongs Progression-free Survival in Stage I-II Follicular Lymphoma: Results of a Multicenter Study

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

    Ruella, Marco; Center for Cellular Immunotherapies, Perelman School of Medicine, University of Pennsylvania, Philadelphia; Filippi, Andrea Riccardo

    Purpose: Rituximab (Rit) therapy added to involved-field radiation therapy (RT) has been proposed as an effective treatment for stage I-II follicular lymphoma (FL). The results of an observational multicenter study on the Rit-RT combination in limited-stage FL are here reported. Methods and Materials: Data have been collected from 2 consecutive cohorts of 94 patients with stage I-II FL treated between 1985 and 2011 at 5 Italian institutions. All patients had grade 1-3a FL, a median age of 54 years (range: 25-82). The first 51 patients received RT alone (control group), while the subsequent series of 43 patients received 4 rituximab coursesmore » (375 mg/m{sup 2}, days 1, 8, 15, 22) before RT (Rit-RT). Molecular disease was evaluated by nested bcl-2/IgH PCR or clonal IgH rearrangement was available in 33 Rit-RT patients. Results: At a median follow-up of 10.9 years (range: 1.8-22.9), the 10-year progression-free survival (PFS) and overall survival (OS) projections for the whole cohort were 57% and 87.5%, respectively. The 10-year PFS was significantly longer (P<.05) in the Rit-RT group (64.6%) compared to RT alone (50.7%), whereas the 10-year OS projections were not significantly different. On bivariate analysis controlling for stage, there was only a trend toward improved PFS for Rit-RT (HR, 0.55; P=.081). Follicular lymphoma international prognostic index and age were associated with OS but not with PFS on Cox regression analysis. Bone marrow molecular analysis showing PCR positivity at diagnosis was strongly associated with relapse risk upon univariate and multivariate analysis. Conclusions: This multicenter observational study suggests a potential benefit of adding rituximab to radiation therapy for stage I-II FL. The results of the currently ongoing randomized studies are required to confirm these results. The study underlines the importance of molecular disease monitoring also for patient with limited-stage disease.« less

  3. A predictive radiological analysis of short stems versus both shortened and long stems in primary hip replacement: A case-control study of 100 cases of Metha versus ABG II and Omnifit HA at 2-8years' follow-up.

    PubMed

    Epinette, J-A; Brax, M; Chammaï, Y

    2017-11-01

    Short hip stems, intended to conserve bone stock and ensure a more physiological distribution of stress in the femur under loading, are meeting with renewed interest. Radiologic semiology is not known exactly, particularly in relation to conventional implants; we therefore conducted a case-control study of 3 types of implant differing only in stem length: short, shortened or long. The aim was: (1) to compare radiographic aspects, (2) to attempt to systematize medium-term radiologic status for the 3 types, and (3) to assess the impact of radiographic aspect on loosening and revision rates. The short Metha stem is better adapted to the recipient bone than longer stems, without sacrificing stability. A prospective series comprising the first 100 selected cases of hip replacement using the short Metha stem was compared to two other series of 100 "long" (Omnifit HA) and 100 "shortened" (ABG II) stems at comparable follow-up: 4.05±1.44years (range: 2-8years) for Metha, 4.48±0.97years (range: 2-8years) for Omnifit, and 4.75±2.07years (range: 2-8years) for ABG II. Selection criteria in this initial phase were very strict: young age and/or high activity level, with good bone stock and femoral morphology suited to fitting a Metha stem (no "stovepipe" or "champagne-flute" femurs), for which 12.8% of primary hip replacements were selected. Matching was performed by sampling on criteria of age, gender, body-mass index and etiology. Radiographic parameters were compared between the short stem group and the two control groups and classified according to Engh-Massin score (10 points for fixation and 17 for stability). The short Metha stem provided excellent fixation scores: 7.65/10, versus 7.16 (P=0.003) and 5.92 (P=0.0001) for ABG II and Omnifit, respectively. Likewise, stability was scored 14.23/17 for Metha, vs. 14.51 (NS) and 11.83 (P=0.0001) respectively, and the total score was higher for Metha (21.88/27) than ABG II (21.67; P=0.03) or, more particularly, Omnifit (17.83; P=0.0001). The Metha stem was never associated with thigh pain or periprosthetic fracture. 8-year survival was 100%, without significant difference with respect to ABG II (100%; NS) or Omnifit (98.8%; 95% CI: 0.964-1; NS). The apparent radiologic superiority of the short Metha stem requires long-term confirmation in non-selected series. Meanwhile, Metha can be asserted to have demonstrated optimal compromise between lasting bone anchorage and respect of bone physiology under loading at medium term. III, case-control study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. Family-based association study of HLA class II with type 1 diabetes in Moroccans.

    PubMed

    Drissi Bourhanbour, A; Benseffaj, N; Ouadghiri, S; Razine, R; Touzani, A; Belafraj, A; Essakalli, M

    2015-04-01

    The T1D is a multifactorial disease; with a strong genetic control. The human leukocyte antigen (HLA) system plays a crucial role in the autoimmune process leading to childhood diabetes. About 440,000 of the childhood population of the world (1.8 billion children under 14 years of age), have type 1 diabetes, and each year an additional 70,000 develop this disorder. The objective of this study was to investigate the distribution of HLA class II in Moroccan families of diabetic children to identify susceptibility alleles of the Moroccan population. We included in this study, Moroccan families who have at least one child with T1D. The age of onset of diabetes was less than 15 years. HLA class II (DRB1* and DQB1*) was carried out by molecular biology techniques (PCR-SSP and PCR-SSO). The FBAT test (family-based association test) was used to highlight the association between T1D and the HLA-DRB1* and -DQB1* polymorphism. The association of HLA class II (DRB1*, DQB1*) in type 1 diabetes was analyzed in fifty-one Moroccan families, including 90 diabetics. The results revealed that the most susceptible haplotypes are the DRB1*03:01-DQB1*02:01, DRB1*04:05-DQB1*03:02 (Z=3.674, P=0.000239; Z=2.828, P=0.004678, respectively). And the most protective haplotype is the DRB1*15-DQB1*06. This is the first family-based association study searching for an association between HLA class II and T1D in a Moroccan population. Despite the different ethnic groups forming Morocco, Moroccan diabetics share the most susceptible and protective HLA haplotypes with other Caucasians populations, specifically the European and Mediterranean populations. Copyright © 2014. Published by Elsevier SAS.

  5. Soft tissue effects of three different Class II/1-camouflage treatment strategies.

    PubMed

    Atik, Ezgi; Akarsu-Guven, Bengisu; Kocadereli, Ilken

    2017-03-01

    Aim of this retrospective study was to compare soft tissue effects of Class II treatments with the forsus fatigue resistant device (FRD), the pendulum appliance, and the extraction of two maxillary premolars, all of which were combined with pre-adjusted fixed appliances. The sample of 54 patients with Class II malocclusions was divided in three groups: group I patients (mean age = 15.91 years) were treated with the FRD concurrently used with fixed appliances; group II patients (mean age = 16.08 years) were treated with the pendulum appliance combined with a Nance and headgear followed by fixed appliances; and group III patients (mean age = 19.04 years) were treated with the extraction of two maxillary premolars with miniscrew anchorage. Soft tissue and dentoskeletal parameters were measured on pretreatment (T1) and posttreatment (T2) lateral cephalograms. The changes from T1 to T2 were compared between the groups using Kruskal-Wallis test, and treatment differences were evaluated with the Wilcoxon test at p < 0.05. Soft tissue measurement changes related to the upper and lower lips were significantly greater in group II than in group III (p < 0.05). Upper incisor measurement changes were significantly different between groups II and III. Lower incisor measurement changes were significantly different between groups I and III and groups II and III (p < 0.05). Pendulum and extraction treatment groups showed significant differences in relation with the upper and lower lip positional changes, which were significantly greater in the pendulum group. Treatment time with the extraction treatment was statistically shorter than with the nonextraction protocols.

  6. Case report: Physical therapy management of axial dystonia.

    PubMed

    Voos, Mariana Callil; Oliveira, Tatiana de Paula; Piemonte, Maria Elisa Pimentel; Barbosa, Egberto Reis

    2014-01-01

    Few studies have described physical therapy approaches to provide functional independence and reduce pain in individuals with dystonia. This report describes the physical therapy treatment of a 46-year-old woman diagnosed with idiopathic segmental axial dystonia. For two years, the patient was treated with kinesiotherapy (active and resisted movements and stretching of neck and trunk muscles), abdominal taping (kinesiotaping techniques), functional training, and sensory tricks. She was assessed with parts I, II and III of Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS-I, TWSTRS-II and TWSTRS-III), Berg Balance Scale (BBS), Six-Minute Walk Test (6-MWT), and the motor domain of Functional Independence Measure (FIM-motor) before and after the two-year treatment and after the one year follow-up. Postural control and symmetry improved (TWSTRS-I: from 30 to 18), functional independence increased (TWSTRS-II: from 27 to 15; BBS: from 36 to 46; 6-MWT: from 0 to 480 meters (m); FIM-motor: from 59 to 81), and the pain diminished (TWSTRS-III: from 12 to 5). The functional improvement was retained after one year (TWSTRS-I: 14/35; TWRTRS-II: 12/30; TWRTRS-III: 5/20; BBS: 48/56; 6-MWT: 450 m; FIM-motor: 81/91). This program showed efficacy on providing a better control of the dystonic muscles and thus the doses of botulinum toxin needed to treat them could be reduced. Outcomes support the therapeutic strategies used to deal with this type of dystonia.

  7. Factors Associated with Neurodevelopment for Children with Single Ventricle Lesions

    PubMed Central

    Goldberg, Caren S.; Lu, Minmin; Sleeper, Lynn A.; Mahle, William T.; Gaynor, J. William; Williams, Ismee A.; Mussatto, Kathleen A.; Ohye, Richard G.; Graham, Eric M.; Frank, Deborah U.; Jacobs, Jeffrey P.; Krawczeski, Catherine; Lambert, Linda; Lewis, Alan; Pemberton, Victoria L.; Sananes, Renee; Sood, Erica; Wechsler, Stephanie B.; Bellinger, David C.; Newburger, Jane W.

    2014-01-01

    Objective To measure neurodevelopment at 3 years in children with single right ventricle anomalies and to assess its relationship to Norwood shunt type, neurodevelopment at 14 months, and patient and medical factors. Study design All subjects in the Single Ventricle Reconstruction Trial who were alive without cardiac transplant were eligible for inclusion. The Ages and Stages Questionnaire (ASQ, n=203) and other measures of behavior, and quality of life (QOL) were completed at age 3 years. Medical history, including measures of growth, feeding, and complications, was assessed through annual record review and phone interview. The Bayley Scales of Infant Development-II (BSID-II) scores from age 14 months were also evaluated as predictors. Results Scores on each ASQ domain were significantly lower than normal (p<0.001). ASQ domain scores at 3 years varied nonlinearly with 14-month BSID-II. More complications, abnormal growth, and evidence of feeding, vision, or hearing problems, were independently associated with lower ASQ scores, although models explained < 30% of variation. Shunt type was not associated with any ASQ domain score, or with behavior or QOL measures. Conclusion Children with SV have impaired neurodevelopment at 3 years. Lower ASQ scores are associated with medical morbidity, and lower BSID-II scores, but not with shunt type. However, because only a modest percentage of variation in 3-year neurodevelopmental outcome could be predicted from early measures, all children with SV should be followed longitudinally to improve recognition of delays. PMID:24952712

  8. The 2013 ACC/AHA 10-year atherosclerotic cardiovascular disease risk index is better than SCORE and QRisk II in rheumatoid arthritis: is it enough?

    PubMed

    Ozen, Gulsen; Sunbul, Murat; Atagunduz, Pamir; Direskeneli, Haner; Tigen, Kursat; Inanc, Nevsun

    2016-03-01

    To determine the ability of the new American College of Cardiology and American Heart Association (ACC/AHA) 10-year atherosclerotic cardiovascular disease (ASCVD) risk algorithm in detecting high cardiovascular (CV) risk, RA patients identified by carotid ultrasonography (US) were compared with Systematic Coronary Risk Evaluation (SCORE) and QRisk II algorithms. SCORE, QRisk II, 2013 ACC/AHA 10-year ASCVD risk and EULAR recommended modified versions were calculated in 216 RA patients. In sonographic evaluation, carotid intima-media thickness >0.90 mm and/or carotid plaques were used as the gold standard test for subclinical atherosclerosis and high CV risk (US+). Eleven (5.1%), 15 (6.9%) and 44 (20.4%) patients were defined as having high CV risk according to SCORE, QRisk II and ACC/AHA 10-year ASCVD risk, respectively. Fifty-two (24.1%) patients were US + and of those, 8 (15.4%), 7 (13.5%) and 23 (44.2%) patients were classified as high CV risk according to SCORE, QRisk II and ACC/AHA 10-year ASCVD risk, respectively. The ACC/AHA 10-year ASCVD risk index better identified US + patients than SCORE and QRisk II (P < 0.0001). With EULAR modification, reclassification from moderate to high risk occurred only in two, five and seven patients according to SCORE, QRisk II and ACC/AHA 10-year ASCVD risk, respectively. The 2013 ACC/AHA 10-year ASCVD risk estimator was better than the SCORE and QRisk II indices in RA, but still failed to identify 55% of high risk patients. Furthermore adjustment of threshold and EULAR modification did not work well. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  9. Questionnaire survey on adjuvant chemotherapy for elderly patients after gastrectomy indicates their vulnelabilities.

    PubMed

    Tanahashi, Toshiyuki; Yoshida, Kazuhiro; Yamaguchi, Kazuya; Okumura, Naoki; Takeno, Atsushi; Fujitani, Kazumasa; Fukushima, Norimasa; Takiguchi, Nobuhiro; Nishida, Yasunori; Boku, Narikazu; Yoshikawa, Takaki; Terashima, Masanori

    2018-05-24

    In Japan, S-1 adjuvant chemotherapy for 1 year is the standard of care for the treatment of stage II and III patients under 80 years old with gastric cancer after curative operation. However, the feasibility of S-1 chemotherapy in patients over 80 years old has not yet been elucidated. To clarify the current treatment situation and feasibility of S-1 treatment in patients over 80 years old, a questionnaire survey of the patients treated from January 2011 to December 2012 was conducted at 58 member institutions of the Stomach Cancer Study Group of the JCOG (Japan Clinical Oncology Group). Gastrectomy was performed in 15,573 patients of all ages, and 1,660 (10.7%) patients were over 80 years of age. Of these elderly patients, 661 (4.2%) were diagnosed as stage II and III. While S-1 adjuvant chemotherapy was recommended to 248 (37.5%) of the stageII/III patients, only 99 (15.0%) of them actually received S-1. Interestingly, the creatinine clearance rate was between 30 and 80 mL/min in 87 (87.9%) of the patients suggesting that S-1 dose modification should be considered. Moreover, S-1 compliance was poor in patients with more than 15% body weight loss. In general practice, surgery alone can be regarded as the standard of care for stage II and III gastric cancer patients over 80 years old. The feasibility and efficacy of S-1 adjuvant chemotherapy should be elucidated in a randomized control trial considering the vulnerabilities of the elderly.

  10. Botulinum toxin as a therapeutic agent to prevent relapse in deep bite patients.

    PubMed

    Mücke, Thomas; Löffel, Anja; Kanatas, Anastasios; Karnezi, Sandy; Rana, Majeed; Fichter, Andreas; Haarmann, Stephan; Wolff, Klaus-Dietrich; Loeffelbein, Denys John

    2016-05-01

    The etiology of deep bite is multifactorial. One of the causes is increased muscular activity. This makes the treatment of deep bite malocclusions difficult and often results in relapse in many cases. In this work we compared patients with surgical orthognathic treatment only and surgical orthognathic treatment with additional injections of botulinum toxin after mandibular advancement for class II division 2 malocclusion. This is a prospective study. Adult patients were assessed pretreatment (T1), posttreatment (T2), and long-term after 1 year (T3). In total, 32 patients (mean age, 30.7 years; 23 women and 9 men) reached the study end point (T3); 24 patients were treated without botulinum toxin and 8 patients received preoperative injections of botulinum toxin. Significant differences between both groups were observed, with a more stable result for the experimental group treated with botulinum toxin. In a selective group of adult patients with a class II division II incisor relationship and with a class II skeletal base, botulinum toxin injections can effectively prevent relapse. This may present an alternative to a conventional myotomy. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  11. Interrelationship of sleep and juvenile myoclonic epilepsy (JME): a sleep questionnaire-, EEG-, and polysomnography (PSG)-based prospective case-control study.

    PubMed

    Ramachandraiah, C T; Sinha, S; Taly, A B; Rao, S; Satishchandra, P

    2012-11-01

    We studied the effects of 'epilepsy on sleep and its architecture' and 'sleep on the occurrence and distribution of interictal epileptiform discharges (ED)' using 'sleep questionnaires', 'EEG', and 'PSG' in patients with JME. Forty patients with JME [20 on valproate (Group I - 20.8±4.0 years; M: F=9:11) and 20 drug-naïve (Group II - 24.4±6.7 years; M: F=9:11)] and 20 controls (M: F=9:11; age: 23.5±4.7 years) underwent assessment with Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), overnight PSG, and scalp-EEG. Epileptiform discharges (EDs) were quantified in different sleep stages. The 'ED Index' was derived as number of EDs/min per stage. Statistical Package for the Social Sciences (SPSS) vs. 11 was used for statistical analysis. A 'p' <0.05 was considered as statistically significant. There was poor sleep quality in patients compared to controls (p=0.02), while there was no significant difference in ESS scores between the groups. The PSG parameters were comparable in both groups. Routine EEG revealed EDs in 22/40 (Group I: 7 and Group II: 15) patients. Thirty-five patients had EDs in various sleep stages during PSG (Group I: 17 and Group II: 18): N1 - Group I: 9 and Group II: 14, N2 - Group I: 14 and Group II: 14, N3 - Group I: 14 and Group II: 10, and REM - Group I: 9 and Group II: 11. The ED Index was higher during N2/N3 in Group I and N1/REM in Group II. The epileptiform discharges were frequently associated with arousals in N1/REM and K-complexes in N2. There was no other significant difference between Groups I and II. In conclusion, there was poor sleep quality in patients with JME compared to controls, especially those on valproate who had altered sleep architecture. Epileptiform activity was observed more often in sleep than wakefulness. Sleep stages had variable effect on epileptiform discharges with light sleep having a facilitatory effect in the drug-naïve group and slow wave sleep having a facilitatory effect in the valproate group. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. [Study on the difference of corresponding age at cervical vertebral maturation stages among different skeletal malocclusions].

    PubMed

    Zuo, Changyan; Cong, Chao; Wang, Shihui; Gu, Yan

    2015-10-01

    To compare the difference of corresponding age at cervical vertebral maturation (CVM) stages among different skeletal malocclusions and provide clinic guideline on optimal treatment timing for skeletal malocclusion. Based on ANB angle, 2 575 cephalograms collected from Department of Orthodontics, Peking University School and Hospital of Stomatology from May, 2006 to November, 2014 were classified into skeletal Class I (ANB 0°~5°, 1 317 subjects), Class II (ANB > 5°, 685 subjects) and Class III (ANB < 0°, 573 subjects) groups. CVM stages were evaluated with the modified version of CVM method. Independent sample t test was performed to analyze the difference of age at different CVM stages among various skeletal groups. Significant gender difference of age was found at CS3 to CS6 for skeletal Class I group (P < 0.05), at CS5 and CS6 for skeletal Class II group (P < 0.05), and at CS3 and CS5 for skeletal Class III group (P < 0.05). At CS3 stage, the average age of male in skeletal Class II and skeletal Class III groups was (11.6 ± 1.5) years old and (10.3 ± 1.9) years old, respectively; the average age of females in those two groups was (11.7 ± 1.3) years old and (9.3 ± 1.5) years old, respectively, and significant difference was found in both comparisons (P < 0.05). Compared average age at CS5 and CS6 between skeletal Class II and skeletal Class III groups [the ages of male was (15.1 ± 1.7) and (16.8 ± 1.6) years old, the ages of male was (14.6 ± 1.2) and (15.7 ± 2.5) years old], significant difference was also found (P < 0.05). Significant gender differences were found when evaluated CVM stage and age in skeletal Class I, II and III groups. Significant differences of age at different CVM stage was noted when skeletal Class II was compared with skeletal Class III groups.

  13. The development of plant food processing in the Levant: insights from use-wear analysis of Early Epipalaeolithic ground stone tools

    PubMed Central

    Dubreuil, Laure; Nadel, Dani

    2015-01-01

    In recent years, the study of percussive, pounding and grinding tools has provided new insights into human evolution, more particularly regarding the development of technology enabling the processing and exploitation of plant resources. Some of these studies focus on early evidence for flour production, an activity frequently perceived as an important step in the evolution of plant exploitation. The present paper investigates plant food preparation in mobile hunter-gatherer societies from the Southern Levant. The analysis consists of a use-wear study of 18 tools recovered from Ohalo II, a 23 000-year-old site in Israel showing an exceptional level of preservation. Our sample includes a slab previously interpreted as a lower implement used for producing flour, based on the presence of cereal starch residues. The use-wear data we have obtained provide crucial information about the function of this and other percussive tools at Ohalo II, as well as on investment in tool manufacture, discard strategies and evidence for plant processing in the Late Pleistocene. The use-wear analysis indicates that the production of flour was a sporadic activity at Ohalo II, predating by thousands of years the onset of routine processing of plant foods. PMID:26483535

  14. The development of plant food processing in the Levant: insights from use-wear analysis of Early Epipalaeolithic ground stone tools.

    PubMed

    Dubreuil, Laure; Nadel, Dani

    2015-11-19

    In recent years, the study of percussive, pounding and grinding tools has provided new insights into human evolution, more particularly regarding the development of technology enabling the processing and exploitation of plant resources. Some of these studies focus on early evidence for flour production, an activity frequently perceived as an important step in the evolution of plant exploitation. The present paper investigates plant food preparation in mobile hunter-gatherer societies from the Southern Levant. The analysis consists of a use-wear study of 18 tools recovered from Ohalo II, a 23 000-year-old site in Israel showing an exceptional level of preservation. Our sample includes a slab previously interpreted as a lower implement used for producing flour, based on the presence of cereal starch residues. The use-wear data we have obtained provide crucial information about the function of this and other percussive tools at Ohalo II, as well as on investment in tool manufacture, discard strategies and evidence for plant processing in the Late Pleistocene. The use-wear analysis indicates that the production of flour was a sporadic activity at Ohalo II, predating by thousands of years the onset of routine processing of plant foods. © 2015 The Author(s).

  15. [Comparative results of Fontan surgery in patients with and without hypoplastic left heart syndrome].

    PubMed

    Becker Rencoret, Pedro; Besa Bandeira, Santiago; Riveros González, Sergio; Frangini Sanhueza, Patricia; Springmüller Pinto, Daniel; González Foretic, Rodrigo; Urcelay Montecinos, Gonzalo

    During the last few years, numerous patients with univentricular heart disease have been treated surgically with total cavopulmonary anastomosis according to a staged surgery protocol in our institution. To evaluate the perioperative outcomes and survival of patients with hypoplastic left heart syndrome (HLHS) after the Fontan procedure and compare them with other types of univentricular heart disease. A total of 102 patients underwent a Fontan procedure between April 1996 and March 2014, 25 with HLHS (group I), and 77 patients with other types of univentricular heart disease (group II). Groups survival, demographics, hemodinamic studies, morbimortality, mechanical ventilation, surgical drains, post-operative stay, isotopes score, pacemaker use, and requiriment of Fontan takedown were analyzed. Intraoperative mortality was 4% (n=1) for group I, and 7.8% (n=6) for group II (P=.451). A difference was only found in hospital length of stay (LOS), being 17 days (6-47) for group I and 12 days (5-103) for group II (P=.017). Mean follow-up was 4.24±2.08 years for group I, and 8.7±4.67 for group II. Survival rate at 8 years for both groups was 88%, and 81% at 10 years for group II. The Fontan procedure had similar mortality, but longer LOS, in patients with HLHS compared to those with another types of single ventricle anatomy. Long term survival was comparable between both groups. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Type II diabetes mellitus and the incidence of epithelial ovarian cancer in the cancer prevention study-II nutrition cohort.

    PubMed

    Gapstur, Susan M; Patel, Alpa V; Diver, W Ryan; Hildebrand, Janet S; Gaudet, Mia M; Jacobs, Eric J; Campbell, Peter T

    2012-11-01

    Despite consistent associations of type II diabetes mellitus with hormonally related cancers such as breast and endometrium, the relation between type II diabetes mellitus and ovarian cancer risk is unclear. Associations of type II diabetes mellitus status, duration, and insulin use with epithelial ovarian cancer overall, and with serous and nonserous histologic subtypes were examined in the Cancer Prevention Study-II Nutrition Cohort, a prospective study of U.S. men and women predominantly aged 50 years and older. Between 1992 and 2007, 524 incident epithelial ovarian cancer cases were identified among 63,440 postmenopausal women. Multivariable-adjusted relative risks (RR) and 95% confidence intervals (CI) were computed using extended Cox regression to update diabetes status and bilateral oophorectomy status during follow-up. Type II diabetes mellitus status (RR = 1.05; 95% CI, 0.75-1.46) and duration were not associated with epithelial ovarian cancer risk. Although not statistically significantly different (P(difference) = 0.39), the RR was higher for type II diabetes mellitus with insulin use (RR = 1.28; 95% CI, 0.74-2.24) than for type II diabetes mellitus without insulin use (RR = 0.96; 95% CI, 0.64-1.43). Diabetes seemed to be more strongly associated with nonserous (RR = 1.41; 95% CI, 0.70-2.85) than serous (RR = 0.71; 95% CI, 0.41-1.23) histologic subtypes. Type II diabetes mellitus was not associated with risk of epithelial ovarian cancer, although higher risks with nonserous subtypes and among insulin users cannot be ruled out. Larger studies are needed to clarify associations of type II diabetes mellitus with or without insulin use with risk of ovarian cancer overall and by histologic subtypes. ©2012 AACR.

  17. Triglycerides are a predictive factor for arterial stiffness: a community-based 4.8-year prospective study.

    PubMed

    Wang, Xiaona; Ye, Ping; Cao, Ruihua; Yang, Xu; Xiao, Wenkai; Zhang, Yun; Bai, Yongyi; Wu, Hongmei

    2016-05-18

    Epidemiological studies have disclosed an independent effect of triglycerides on coronary heart disease despite achievement of low-density lipoprotein cholesterol goals with statin therapy. Arterial stiffness has been increasingly recognized as a strong predictor of cardiovascular disease and atherosclerotic disease. The association between triglycerides and arterial stiffness is not well characterized. We aimed to determine the relationship between triglycerides and arterial stiffness in a community-based longitudinal sample from Beijing, China. We related levels of plasma TGs to measures of arterial stiffness (carotid-femoral pulse wave velocity [PWV] and carotid-radial PWV) in 1447 subjects (mean age, 61.3 years) from a community-based population in Beijing, China. After a median follow-up interval of 4.8 years, multiple linear regression analysis revealed that TGs were independently associated with carotid-femoral PWV (β = 0.747, P < 0.001) and carotid-radial PWV (β = 0.367, P = 0.001). In the group older than 65 years, the association between baseline TG levels and follow-up carotid-femoral PWV (β = 1.094, P = 0.001) and carotid-radial PWV (β = 0.524, P = 0.002) were strengthened. In forward stepwise multivariate logistic regression analysis, every SD increase in TGδ was associated with a 1.296-increased likelihood of the presence of carotid-femoral PWVδII (OR [per SD increase in TGδ]: 1.296; 95% CI: 1.064 ~ 1.580; P = 0.010) in Model 2, whereas the relationship between TGδ and carotid-radial PWVδII disappeared. In addition, the relationship was strengthened between TGδ and the presence of carotid-femoral PWVδII (OR 1.526, 95% CI: 1.088-2.141, P = 0.014) in the group older than 65 years but not carotid-radial PWVδII. No association was noted in subjects younger than 65 years. Lower triglyceride levels were significantly associated with decreases in carotid-femoral PWV, indicating that achieving low TG levels may be an additional therapeutic consideration in subjects with atherosclerotic disease.

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

    Bostwick, J.; Stevenson, T.R.; Nahai, F.

    Major complications of radiation directed to the breast, axilla, and mediastinum were treated in 54 patients from 1974 to 1983. A classification of these complications facilitates both an understanding of the pattern of injury and the development of a treatment plan. Classification: I. Breast necrosis; II. Radionecrosis and Chest Wall Ulceration; III. Accelerated Coronary Atherosclerosis with Median Sternotomy Wound Failure After Coronary Revascularization; IV. Brachial Plexus Pain and Paresis; V. Lymphedema and Axillary Cicatrix; VI. Radiation-induced Neoplasia. The treatment has evolved during the 10-year study period to excision of the necrotic wound, including any tumor, and closure with a transposedmore » muscle or musculocutaneous flap of latissimus dorsi (II, III, V) or rectus abdominis (I, II, VI). This strategy reflects a change from primary use of the omentum during the first years of the study. The vascularity, oxygen and antibiotic delivery of these muscle and musculocutaneous flaps promote wound healing, usually with one operation. The transfer of these muscles has not caused significant functional deficits.« less

  19. Transcatheter closure of patent ductus arteriosus using the AMPLATZER™ duct occluder II (ADO II).

    PubMed

    Gruenstein, Daniel H; Ebeid, Makram; Radtke, Wolfgang; Moore, Phillip; Holzer, Ralf; Justino, Henri

    2017-05-01

    The study purpose is to evaluate the safety and efficacy of the ADO II device for closure of patent ductus arteriosus (PDA) in children. Transcatheter treatment of PDA has been evolving for 40+ years and is the treatment of choice. The AMPLATZER™ Duct Occluder (ADO) device was developed for larger diameter ducts and is not ideal in all PDAs. ADO II was developed for small to moderate-sized ducts. This is a single-arm, multicenter study evaluating safety and efficacy of the ADO II device. Patients <18 years were screened for a PDA ≤5.5 mm in diameter and 3-12 mm in length. Right and left heart catheterization was performed, and hemodynamic data were obtained at the time of implant. The diameter of the left pulmonary artery (LPA) and descending aorta, and the presence of any pre-existing pressure gradients across the LPA or aortic arch were assessed at baseline and 6 months post-implant. A total of 192 patients were enrolled. The median implant time was 74 min. Median fluoroscopy time was 12 min. A retrograde (aortic) approach was used in 33% of procedures and demonstrated a statistically significant reduction in fluoroscopy time (P value = 0.0018) compared to an antegrade approach. The device was successfully implanted in 93% of patients, with complete closure in 98% of successful implantations. In this prospective study, the ADO II was safe and effective for closure of small to moderate PDAs. Implantation is simple and the ability for retrograde aortic delivery reduces procedure-related radiation exposure. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  20. Clinical results of Hi-tech Knee II total knee arthroplasty in patients with rheumatoid athritis: 5- to 12-year follow-up

    PubMed Central

    2012-01-01

    Background Total knee arthroplasty (TKA) is a common form of treatment to relieve pain and improve function in cases of rheumatoid arthritis (RA). Good clinical outcomes have been reported with a variety of TKA prostheses. The cementless Hi-Tech Knee II cruciate-retaining (CR)-type prosthesis, which has 6 fins at the anterior of the femoral component, posterior cruciate ligament (PCL) retention, flat-on-flat surface component geometry, all-polyethylene patella, strong initial fixation by the center screw of the tibial base plate, 10 layers of titanium alloy fiber mesh, and direct compression molded ultra high molecular weight polyethylene (UHMWPE), is appropriate for TKA in the Japanese knee. The present study was performed to evaluate the clinical results of primary TKA in RA using the cementless Hi-Tech Knee II CR-type prosthesis. Materials and methods We performed 32 consecutive primary TKAs using cementless Hi-Tech Knee II CR-type prosthesis in 31 RA patients. The average follow-up period was 8 years 3 months. Clinical evaluations were performed according to the American Knee Society (KS) system, knee score, function score, radiographic evaluation, and complications. Results The mean postoperative maximum flexion angle was 115.6°, and the KS knee score and function score improved to 88 and 70 after surgery, respectively. Complications, such as infection, occurred in 1 patient and revision surgery was performed. There were no cases of loosening in this cohort, and prosthesis survival rate was 96.9% at 12 years postoperatively. Conclusion These results suggest that TKA using the cementless Hi-Tech Knee II CR-type prosthesis is a very effective form of treatment in RA patients at 5 to 12 years postoperatively. Further long-term follow-up studies are required to determine the ultimate utility of this type of prosthesis. PMID:22356935

  1. A scoring system based on artificial neural network for predicting 10-year survival in stage II A colon cancer patients after radical surgery.

    PubMed

    Peng, Jian-Hong; Fang, Yu-Jing; Li, Cai-Xia; Ou, Qing-Jian; Jiang, Wu; Lu, Shi-Xun; Lu, Zhen-Hai; Li, Pei-Xing; Yun, Jing-Ping; Zhang, Rong-Xin; Pan, Zhi-Zhong; Wan, De Sen

    2016-04-19

    Nearly 20% patients with stage II A colon cancer will develop recurrent disease post-operatively. The present study aims to develop a scoring system based on Artificial Neural Network (ANN) model for predicting 10-year survival outcome. The clinical and molecular data of 117 stage II A colon cancer patients from Sun Yat-sen University Cancer Center were used for training set and test set; poor pathological grading (score 49), reduced expression of TGFBR2 (score 33), over-expression of TGF-β (score 45), MAPK (score 32), pin1 (score 100), β-catenin in tumor tissue (score 50) and reduced expression of TGF-β in normal mucosa (score 22) were selected as the prognostic risk predictors. According to the developed scoring system, the patients were divided into 3 subgroups, which were supposed with higher, moderate and lower risk levels. As a result, for the 3 subgroups, the 10-year overall survival (OS) rates were 16.7%, 62.9% and 100% (P < 0.001); and the 10-year disease free survival (DFS) rates were 16.7%, 61.8% and 98.8% (P < 0.001) respectively. It showed that this scoring system for stage II A colon cancer could help to predict long-term survival and screen out high-risk individuals for more vigorous treatment.

  2. The Comparative Reliability and Feasibility of the Past-Year Canadian Diet History Questionnaire II: Comparison of the Paper and Web Versions

    PubMed Central

    Lo Siou, Geraldine; Csizmadi, Ilona; Boucher, Beatrice A.; Akawung, Alianu K.; Whelan, Heather K.; Sharma, Michelle; Al Rajabi, Ala; Vena, Jennifer E.; Kirkpatrick, Sharon I.; Koushik, Anita; Massarelli, Isabelle; Rondeau, Isabelle; Robson, Paula J.

    2017-01-01

    Advances in technology-enabled dietary assessment include the advent of web-based food frequency questionnaires, which may reduce costs and researcher burden but may introduce new challenges related to internet connectivity and computer literacy. The purpose of this study was to evaluate the intra- and inter-version reliability, feasibility and acceptability of the paper and web Canadian Diet History Questionnaire II (CDHQ-II) in a sub-sample of 648 adults (aged 39–81 years) recruited from Alberta’s Tomorrow Project. Participants were randomly assigned to one of two groups: (1) paper, web, paper; or (2) web, paper, web over a six-week period. With few exceptions, no statistically significant differences in mean nutrient intake were found in the intra- and inter-version reliability analyses. The majority of participants indicated future willingness to complete the CDHQ-II online, and 59% indicated a preference for the web over the paper version. Findings indicate that, in this population of adults drawn from an existing cohort, the CDHQ-II may be administered in paper or web modalities (increasing flexibility for questionnaire delivery), and the nutrient estimates obtained with either version are comparable. We recommend that other studies explore the feasibility and reliability of different modes of administration of dietary assessment instruments prior to widespread implementation. PMID:28208819

  3. Prevalence of Dental Caries among School Children in Chennai, Based on ICDAS II

    PubMed Central

    Arangannal, Ponnudurai; Jayaprakash, Jeevarathan

    2016-01-01

    Introduction Dental caries is a common dental disease, which occurs during childhood and continues to be a major public health problem. The prevalence of dental caries was associated with oral hygiene practice, sugar consumption and implementation of the preventive oral health program. Aim The purpose of this study was to assess the prevalence of dental caries in school children aged between 6-14 years using the International Caries Detection and Assessment System (ICDAS II). Materials and Methods The study population consisted of 2796 school children living in Pallikkaranai, Chennai, India and studying in government recognized schools. Each student was examined by a single examiner using ICDAS system under natural light during normal school hours. Results The prevalence of dental caries was 68.8% in the total surveyed population. The gender-wise prevalence of dental caries shows, females to have slightly higher prevalence than male. The prevalence of dental caries at the age group of 6 years was 57%, seven year 67%, eight year 63%, nine year 74%, 10 year 76%, 11 year 74%, 12 year 69%, 13 year 71%, and 14 year 69%. The distribution of CARS (Caries associated with Sealants and Restorations) in the surveyed population was only 1.4% Conclusion The distribution of non-cavitated/early enamel lesions was higher in the studied population and indicated a requirement of a sustained dental health preventive program targeting specific segments of the population. PMID:27190939

  4. Changes in airway dimensions following functional appliances in growing patients with skeletal class II malocclusion: A systematic review and meta-analysis.

    PubMed

    Xiang, MingLi; Hu, Bo; Liu, Yang; Sun, Jicheng; Song, Jinlin

    2017-06-01

    The purpose of the study was to evaluate the treatment effects of functional appliances (FAs) on upper airway dimensions in growing Class II patients with mandibular retrognathism. Five databases and the references of identified articles were electronically searched for relevant studies that met our eligibility criteria. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. The effects of FAs on airway dimensions were combined by meta-analysis using the RevMan and STATA software. Seven studies (177 treated patients with mean age: 11.48 years and 153 untreated controls with mean age: 11.20 years) were included in this review. Compared to the control group, the oropharyngeal dimensions in the treatment group subjects were significantly increased at the superior pharyngeal space (MD = 1.73 mm/year, 95% CI, 1.13-2.32 mm, P < 0.00001), middle pharyngeal space (MD = 1.68 mm/year, 95% CI, 1.13-2.23 mm, P < 0.00001) and inferior pharyngeal space (MD = 1.21 mm/year, 95% CI, 0.48-1.95 mm, P = 0.001). No significant differences were found in nasopharyngeal and hypopharyngeal dimensions and the position of hyoid bone (P > 0.05). Soft palate length and soft palate inclination were improved significantly in the treatment group (P < 0.05). The results showed that FAs can enlarge the upper airway dimensions, specifically in the oropharyngeal region, in growing subjects with skeletal Class II malocclusion. The early intervention for mandibular retrognathism with FAs may help enlarge the airway dimensions and decrease potential risk of obstructive sleep apnea syndrome for growing patients in the future. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Age at Introduction to Solid Foods and Child Obesity at 6 Years.

    PubMed

    Barrera, Chloe M; Perrine, Cria G; Li, Ruowei; Scanlon, Kelley S

    2016-06-01

    Epidemiological evidence suggests that timing of introduction of solid foods may be associated with subsequent obesity, and the association may vary by whether an infant is breastfed or formula-fed. We included 1181 infants who participated in the Infant Feeding Practices Study II (IFPS II) and the Year 6 Follow Up (Y6FU) study. Data from IFPS II were used to calculate the primary exposure and timing of solid food introduction (<4, 4-<6, and ≥6 months), and data from Y6FU were used to calculate the primary outcome and obesity at 6 years of age (BMI ≥95th percentile). We used multivariable logistic regression to assess the association between timing of the introduction of solids and obesity at 6 years and test whether this association was modified by breastfeeding duration (breastfed for 4 months vs. not). Prevalence of obesity in our sample was 12.0%. The odds of obesity was higher among infants introduced to solids <4 months compared to those introduced at 4-<6 months (odds ratio [OR] = 1.66; 95% CI, 1.15, 2.40) in unadjusted analysis; however, this relationship was no longer significant after adjustment for covariates (OR = 1.18; 95% CI, 0.79, 1.77). Introduction of solids ≥6 months was not associated with obesity. We found no interaction between breastfeeding duration and early solid food introduction and subsequent obesity. Timing of introduction of solid foods was not associated with child obesity at 6 years in this sample. Given the inconsistency in findings with other studies, further studies in larger populations may be needed.

  6. Prepregnancy and early adulthood body mass index and adult weight change in relation to fetal loss.

    PubMed

    Gaskins, Audrey J; Rich-Edwards, Janet W; Colaci, Daniela S; Afeiche, Myriam C; Toth, Thomas L; Gillman, Matthew W; Missmer, Stacey A; Chavarro, Jorge E

    2014-10-01

    To examine prospectively the relationships of prepregnancy body mass index (BMI), BMI at age 18 years, and weight change since age 18 years with risk of fetal loss. Our prospective cohort study included 25,719 pregnancies reported by 17,027 women in the Nurses' Health Study II between 1990 and 2009. In 1989, height, current weight, and weight at age 18 years were self-reported. Current weight was updated every 2 years thereafter. Pregnancies were self-reported, with case pregnancies lost spontaneously and comparison pregnancies ending in ectopic pregnancy, induced abortion, or live birth. Incident fetal loss was reported in 4,494 (17.5%) pregnancies. Compared with those of normal BMI, the multivariate relative risks of fetal loss were 1.07 (95% CI [confidence interval] 1.00-1.15) for overweight women, 1.10 (95% CI 0.98-1.23) for class I obese women, and 1.27 (95% CI 1.11-1.45) for class II and class III obese women (P trend ≤ .001). Body mass index at age 18 years was not associated with fetal loss (P trend=.59). Compared with women who maintained a stable weight (± 4 kg) between age 18 years and before pregnancy, women who lost weight had a 20% (95% CI 9-29%) lower risk of fetal loss. This association was stronger among women who were overweight at age 18 years. Being overweight or obese before pregnancy was associated with higher risk of fetal loss. In women overweight or obese at age 18 years, losing 4 kg or more was associated with a lower risk of fetal loss. : II.

  7. Evidence for the Existence of Autotrophic Nitrate-Reducing Fe(II)-Oxidizing Bacteria in Marine Coastal Sediment

    PubMed Central

    Laufer, Katja; Røy, Hans; Jørgensen, Bo Barker

    2016-01-01

    ABSTRACT Nitrate-reducing Fe(II)-oxidizing microorganisms were described for the first time ca. 20 years ago. Most pure cultures of nitrate-reducing Fe(II) oxidizers can oxidize Fe(II) only under mixotrophic conditions, i.e., when an organic cosubstrate is provided. A small number of nitrate-reducing Fe(II)-oxidizing cultures have been proposed to grow autotrophically, but unambiguous evidence for autotrophy has not always been provided. Thus, it is still unclear whether or to what extent Fe(II) oxidation coupled to nitrate reduction is an enzymatically catalyzed and energy-yielding autotrophic process or whether Fe(II) is abiotically oxidized by nitrite from heterotrophic nitrate reduction. The aim of the present study was to find evidence for the existence of autotrophic nitrate-reducing Fe(II) oxidizers in coastal marine sediments. Microcosm incubations showed that with increasing incubation times, the stoichiometric ratio of reduced nitrate/oxidized Fe(II) [NO3−reduced/Fe(II)oxidized] decreased, indicating a decreasing contribution of heterotrophic denitrification and/or an increasing contribution of autotrophic nitrate-reducing Fe(II) oxidation over time. After incubations of sediment slurries for >10 weeks, nitrate-reducing activity ceased, although nitrate was still present. This suggests that heterotrophic nitrate reduction had ceased due to the depletion of readily available organic carbon. However, after the addition of Fe(II) to these batch incubation mixtures, the nitrate-reducing activity resumed, and Fe(II) was oxidized, indicating the activity of autotrophic nitrate-reducing Fe(II) oxidizers. The concurrent reduction of 14C-labeled bicarbonate concentrations unambiguously proved that autotrophic C fixation occurred during Fe(II) oxidation and nitrate reduction. Our results clearly demonstrated that autotrophic nitrate-reducing Fe(II)-oxidizing bacteria were present in the investigated coastal marine sediments. IMPORTANCE Twenty years after the discovery of nitrate-reducing Fe(II) oxidizers, it is still controversially discussed whether autotrophic nitrate-reducing Fe(II)-oxidizing microorganisms exist and to what extent Fe(II) oxidation in this reduction/oxidation process is enzymatically catalyzed or which role abiotic side reactions of Fe(II) with reactive N species play. Most pure cultures of nitrate-reducing Fe(II) oxidizers are mixotrophic; i.e., they need an organic cosubstrate to maintain their activity over several cultural transfers. For the few existing autotrophic isolates and enrichment cultures, either the mechanism of nitrate-reducing Fe(II) oxidation is not known or evidence for their autotrophic lifestyle is controversial. In the present study, we provide evidence for the existence of autotrophic nitrate-reducing Fe(II) oxidizers in coastal marine sediments. The evidence is based on stoichiometries of nitrate reduction and Fe(II) oxidation determined in microcosm incubations and the incorporation of carbon from CO2 under conditions that favor the activity of nitrate-reducing Fe(II) oxidizers. PMID:27496777

  8. The Watcombe housing study: the short-term effect of improving housing conditions on the indoor environment.

    PubMed

    Richardson, George; Barton, Andrew; Basham, Meryl; Foy, Chris; Eick, Susan Ann; Somerville, Margaret

    2006-05-15

    A three-year study (1999-2001) was initiated in the UK to assess the effect of improving housing conditions in 3-4 bedroom, single-family unit, social rented sector houses on the health of the occupants. The houses were randomised into two groups. Phase I houses received extensive upgrading including wet central heating, on demand ventilation, double-glazed doors, cavity wall and roof/loft insulation. An identical intervention for Phase II houses was delayed for one year. As part of this randomised waiting list study, discrete measurements were made of indoor environmental variables in each house, to assess the short-term effects of improving housing conditions on the indoor environment. Variables representative of indoor environmental conditions were measured in the living room, bedroom and outdoors in each of the three years of the study. In 2000, there was a significant difference between the changes from 1999 to 2000 between Phase I (upgraded) and II (not then upgraded) houses for bedroom temperatures (p=0.002). Changes in wall surface dampness and wall dampness in Phase I houses were also significantly different to the change in Phase II houses in 2000 (p=0.001), but by 2001 the Phase I houses had reverted to the same dampness levels they had before upgrading. The housing upgrades increased bedroom temperatures in all houses. Other indoor environmental variables were not affected.

  9. High-energy extracorporeal shock wave therapy for nontraumatic osteonecrosis of the femoral head.

    PubMed

    Xie, Kai; Mao, Yuanqing; Qu, Xinhua; Dai, Kerong; Jia, Qingwei; Zhu, Zhenan; Yan, Mengning

    2018-02-02

    Nontraumatic osteonecrosis of the femoral head (ONFH) is treated with a series of methods. High-energy extracorporeal shock wave therapy (ESWT) is an option with promising mid-term outcomes. The objective of this study was to determine the long-term outcomes of ESWT for ONFH. Fifty-three hips in 39 consecutive patients were treated with ESWT in our hospital between January 2005 and July 2006. Forty-four hips in 31 patients with stage I-III nontraumatic ONFH, according to the Association Research Circulation Osseous (ARCO) system, were reviewed in the current retrospective study. The visual analog pain scale (VAS), Harris hip score, radiography, and magnetic resonance imaging were used to estimate treatment results. The progression of ONFH was evaluated by imaging examination and clinical outcomes. The results were classified as clinical success (no progression of hip symptoms) and imaging success (no progression of stage or substage on radiography and MRI). The mean follow-up duration was 130.6 months (range, 121 to 138 months). The mean VAS decreased from 3.8 before ESWT to 2.2 points at the 10-year follow-up (p < 0.001). The mean Harris hip score improved from 77.4 before ESWT to 86.9 points at the 10-year follow-up. The clinical success rates were 87.5% in ARCO stage I patients, 71.4% in ARCO stage II patients, and 75.0% in ARCO stage III patients. Imaging success was observed in all stage I hips, 64.3% of stage II hips, and 12.5% of stage III hips. Seventeen hips showed progression of the ARCO stage/substage on imaging examination. Eight hips showed femoral head collapse at the 10-year follow-up. Four hips in ARCO stage III and one hip in ARCO stage II were treated with total hip arthroplasty during the follow-up. Three were performed 1 year after ESWT, one at 2 years, and one at 5 years. The results of the current study indicated that ESWT is an effective treatment method for nontraumatic ONFH, resulting in pain relief and function restoration, especially for patients with ARCO stage I-II ONFH.

  10. Nimotuzumab combined with radiotherapy for esophageal cancer: preliminary study of a Phase II clinical trial.

    PubMed

    Liang, Jun; E, Mingyan; Wu, Gang; Zhao, Lujun; Li, Xia; Xiu, Xia; Li, Ning; Chen, Bo; Hui, Zhouguang; Lv, Jima; Fang, Hui; Tang, Yu; Bi, Nan; Wang, Wenqing; Zhai, Yirui; Li, Tao; Chen, Dongfu; Zou, Shuangmei; Lu, Ning; Perez-Rodríguez, Rolando; Zheng, Junqi; Wang, Luhua

    2013-01-01

    To determine the safety and therapeutic effects of nimotuzumab (h-R3) combined with radiotherapy in esophageal cancer. This Phase II clinical trial involved 42 patients with stage II (inoperable or refused surgery) to stage IV (supraclavicular lymph node metastasis only) esophageal cancers treated between November 2008 and July 2010. All patients had squamous cell carcinomas, and all received three-dimensional conformal radiotherapy and 200 mg nimotuzumab per week during radiotherapy. There were 9, 25, and 8 patients with stage II, III and IV disease, respectively. All except two patients received 50-70 Gy radiation; 37 patients (88.1%) received more than five nimotuzumab doses. Grade III toxicities (21.4% of all adverse events) included esophagitis and gastrointestinal, dermatological and hematological toxicities. Complete response, partial response, stable disease, and progressive disease were observed in 0, 22 (52.4%), 17 (40.5%) and 3 (7.1%) patients at 1 month after the treatment. The epidermal growth factor receptor (EGFR) overexpression rate was 95.2%. After a median follow-up of 37 months, the median survival time (MST) was 14 months. The 2 year and 3 year overall survival (OS) rates were 33.3% and 26.2%, respectively. The median progression-free survival (PFS) time was 10 months. The 2 year and 3 year PFS rates were 24.5% and 22.1%, respectively. The MST in the 13 patients with (+++) EGFR expression (group A) and 7 patients with (++) EGFR expression (group B) was 15 and 11 months, respectively. The 2 year and 3 year OS rates were 46.2% and 38.5% in group A and 28.6% and 28.6% in group B, respectively (P = 0.405). Although concurrent chemoradiotherapy was the standard care for locally advanced esophageal cancer, radiotherapy was the choice for those who were refused or could not tolerate chemoradiotherapy. Our study shows that nimotuzumab combined with radiotherapy was well tolerated in patients with esophageal cancer. EGFR overexpression was more common than previously reported. OS was higher after combined therapy than after historical control radiotherapy alone. Further studies are required to confirm the therapeutic efficacy of nimotuzumab in esophageal cancer.

  11. Phase II Study of Chemoradiotherapy With 5-Fluorouracil and Cisplatin for Stage II-III Esophageal Squamous Cell Carcinoma: JCOG Trial (JCOG 9906)

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

    Kato, Ken, E-mail: kenkato@ncc.go.jp; Muro, Kei; Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi

    Purpose: In this Phase II study, we evaluated the efficacy and toxicity of chemoradiotherapy (CRT) with cisplatin (CDDP) and 5-fluorouracil (5-FU) for Stage II-III esophageal squamous cell carcinoma (ESCC). Patients and Methods: Patients with clinical Stage II-III (T1N1M0 or T2-3N0-1M0) thoracic ESCC were enrolled between April 2000 and March 2002. Chemotherapy comprised two courses of protracted infusion of 5-FU (400 mg/m{sup 2}/day) on Days 1-5 and 8-12, and 2-h infusion of CDDP (40 mg/m{sup 2}) on Days 1 and 8; this regimen was repeated every 5 weeks. Concurrent radiotherapy involved 60-Gy irradiation (30 fractions) for 8 weeks with a 2-weekmore » break. Responders received two courses of 5-FU (800 mg/m{sup 2}/day) on Days 1-5 and CDDP (80 mg/m{sup 2}) on Day 1. Final analysis was conducted in March 2007. Survival and late toxicities were monitored for 5 years. Results: The characteristics of the 76 patients enrolled were as follows: median age, 61 years; male/female, 68/8; performance status 0/1, 59/17 patients; Stage IIA/IIB/III, 26/12/38 patients. Of the 74 eligible patients, 46 (62.2%) achieved complete response. Median survival time was 29 months, with 3- and 5-year survival rates of 44.7% and 36.8%, respectively. Acute toxicities included Grade 3/4 esophagitis (17%), nausea (17%), hyponatremia (16%), and infection without neutropenia (12%). Late toxicities comprised Grade 3/4 esophagitis (13%), pericardial (16%) and pleural (9%) effusion, and radiation pneumonitis (4%), causing 4 deaths. Conclusions: CRT is effective for Stage II-III ESCC with manageable acute toxicities and can provide a nonsurgical treatment option. However, further improvement is required for reduction in late toxicity.« less

  12. Ginkgo biloba leaf extract induces DNA damage by inhibiting topoisomerase II activity in human hepatic cells.

    PubMed

    Zhang, Zhuhong; Chen, Si; Mei, Hu; Xuan, Jiekun; Guo, Xiaoqing; Couch, Letha; Dobrovolsky, Vasily N; Guo, Lei; Mei, Nan

    2015-09-30

    Ginkgo biloba leaf extract has been shown to increase the incidence in liver tumors in mice in a 2-year bioassay conducted by the National Toxicology Program. In this study, the DNA damaging effects of Ginkgo biloba leaf extract and many of its constituents were evaluated in human hepatic HepG2 cells and the underlying mechanism was determined. A molecular docking study revealed that quercetin, a flavonoid constituent of Ginkgo biloba, showed a higher potential to interact with topoisomerase II (Topo II) than did the other Ginkgo biloba constituents; this in silico prediction was confirmed by using a biochemical assay to study Topo II enzyme inhibition. Moreover, as measured by the Comet assay and the induction of γ-H2A.X, quercetin, followed by keampferol and isorhamnetin, appeared to be the most potent DNA damage inducer in HepG2 cells. In Topo II knockdown cells, DNA damage triggered by Ginkgo biloba leaf extract or quercetin was dramatically decreased, indicating that DNA damage is directly associated with Topo II. DNA damage was also observed when cells were treated with commercially available Ginkgo biloba extract product. Our findings suggest that Ginkgo biloba leaf extract- and quercetin-induced in vitro genotoxicity may be the result of Topo II inhibition.

  13. Ginkgo biloba leaf extract induces DNA damage by inhibiting topoisomerase II activity in human hepatic cells

    PubMed Central

    Zhang, Zhuhong; Chen, Si; Mei, Hu; Xuan, Jiekun; Guo, Xiaoqing; Couch, Letha; Dobrovolsky, Vasily N.; Guo, Lei; Mei, Nan

    2015-01-01

    Ginkgo biloba leaf extract has been shown to increase the incidence in liver tumors in mice in a 2-year bioassay conducted by the National Toxicology Program. In this study, the DNA damaging effects of Ginkgo biloba leaf extract and many of its constituents were evaluated in human hepatic HepG2 cells and the underlying mechanism was determined. A molecular docking study revealed that quercetin, a flavonoid constituent of Ginkgo biloba, showed a higher potential to interact with topoisomerase II (Topo II) than did the other Ginkgo biloba constituents; this in silico prediction was confirmed by using a biochemical assay to study Topo II enzyme inhibition. Moreover, as measured by the Comet assay and the induction of γ-H2A.X, quercetin, followed by keampferol and isorhamnetin, appeared to be the most potent DNA damage inducer in HepG2 cells. In Topo II knockdown cells, DNA damage triggered by Ginkgo biloba leaf extract or quercetin was dramatically decreased, indicating that DNA damage is directly associated with Topo II. DNA damage was also observed when cells were treated with commercially available Ginkgo biloba extract product. Our findings suggest that Ginkgo biloba leaf extract- and quercetin-induced in vitro genotoxicity may be the result of Topo II inhibition. PMID:26419945

  14. Study of relapse and failure cases of CAT I retreated with CAT II under RNTCP--an eleven year follow up.

    PubMed

    Mehra, R K; Dhingra, V K; Nish, Aggarwal; Vashist, R P

    2008-10-01

    To analyse the treatment outcome of Cat I smear positive relapse and failure cases and their fate when treated with Cat II regimen under RNTCP. All Cat I smear positive relapse and failure TB patients treated with Category II regimen from 1994 to 2005 in a chest clinic of Delhi were analysed in this retrospective study. The re-treatment outcome data for relapse and failure cases of Cat I when treated with Cat II regimen was reviewed. The study population included 5576 registered as Cat I sputum positive cases in Gulabi Bagh chest clinic from 1994 to 2005. A total of 190 (3.4%) failed on Cat I regimen. Further out of 4905 (87.9%) successfully treated Cat I patients, 442 (9%) presented as relapses. The treatment success rate for relapse and failure cases of Cat I when subsequently treated with Cat II regimen were 76.4% and 48.8% respectively, with a significantly higher failure rate (27.6%) among Cat I failures subsequently treated with Cat II regimen. The failure cases of Cat I subsequently treated with Cat II were observed to have a significantly lower success rates (p < 0.05) as compared to relapse cases. The need for reappraisal of Cat II re-treatment regimen for failure cases among Cat I is suggested.

  15. The National Heart, Lung, and Blood Institute retrovirus epidemiology donor studies (Retrovirus Epidemiology Donor Study and Retrovirus Epidemiology Donor Study-II): twenty years of research to advance blood product safety and availability.

    PubMed

    Kleinman, Steven; King, Melissa R; Busch, Michael P; Murphy, Edward L; Glynn, Simone A

    2012-10-01

    The Retrovirus Epidemiology Donor Study (REDS), conducted from 1989 to 2001, and the REDS-II, conducted from 2004 to 2012, were National Heart, Lung, and Blood Institute-funded, multicenter programs focused on improving blood safety and availability in the United States. The REDS-II also included international study sites in Brazil and China. The 3 major research domains of REDS/REDS-II have been infectious disease risk evaluation, blood donation availability, and blood donor characterization. Both programs have made significant contributions to transfusion medicine research methodology by the use of mathematical modeling, large-scale donor surveys, innovative methods of repository sample storage, and establishing an infrastructure that responded to potential emerging blood safety threats such as xenotropic murine leukemia virus-related virus. Blood safety studies have included protocols evaluating epidemiologic and/or laboratory aspects of human immunodeficiency virus, human T-lymphotropic virus 1/2, hepatitis C virus, hepatitis B virus, West Nile virus, cytomegalovirus, human herpesvirus 8, parvovirus B19, malaria, Creutzfeldt-Jakob disease, influenza, and Trypanosoma cruzi infections. Other analyses have characterized blood donor demographics, motivations to donate, factors influencing donor return, behavioral risk factors, donors' perception of the blood donation screening process, and aspects of donor deferral. In REDS-II, 2 large-scale blood donor protocols examined iron deficiency in donors and the prevalence of leukocyte antibodies. This review describes the major study results from over 150 peer-reviewed articles published by these 2 REDS programs. In 2011, a new 7-year program, the Recipient Epidemiology and Donor Evaluation Study-III, was launched. The Recipient Epidemiology and Donor Evaluation Study-III expands beyond donor-based research to include studies of blood transfusion recipients in the hospital setting and adds a third country, South Africa, to the international program. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. ECG-ViEW II, a freely accessible electrocardiogram database

    PubMed Central

    Park, Man Young; Lee, Sukhoon; Jeon, Min Seok; Yoon, Dukyong; Park, Rae Woong

    2017-01-01

    The Electrocardiogram Vigilance with Electronic data Warehouse II (ECG-ViEW II) is a large, single-center database comprising numeric parameter data of the surface electrocardiograms of all patients who underwent testing from 1 June 1994 to 31 July 2013. The electrocardiographic data include the test date, clinical department, RR interval, PR interval, QRS duration, QT interval, QTc interval, P axis, QRS axis, and T axis. These data are connected with patient age, sex, ethnicity, comorbidities, age-adjusted Charlson comorbidity index, prescribed drugs, and electrolyte levels. This longitudinal observational database contains 979,273 electrocardiograms from 461,178 patients over a 19-year study period. This database can provide an opportunity to study electrocardiographic changes caused by medications, disease, or other demographic variables. ECG-ViEW II is freely available at http://www.ecgview.org. PMID:28437484

  17. Treatment of liver injuries at level I and level II centers in a multi-institutional metropolitan trauma system. The Midwest Trauma Society Liver Trauma Study Group.

    PubMed

    Helling, T S; Morse, G; McNabney, W K; Beggs, C W; Behrends, S H; Hutton-Rotert, K; Johnson, D J; Reardon, T M; Roling, J; Scheve, J; Shinkle, J; Webb, J M; Watkins, M

    1997-06-01

    The development of trauma systems and trauma centers has had a major impact on the fate of the critically injured patient. However, some have suggested that care may be compromised if too many trauma centers are designated for a given area. As of 1987, the state of Missouri had designated six adult trauma centers, two Level I and four Level II, for the metropolitan Kansas City, Mo, area, serving a population of approximately 1 million people. To determine whether care was comparable between the Level I and II centers, we conducted a concurrent evaluation of the fate of patients with a sentinel injury, hepatic trauma, over a 6-year period (1987-1992) who were treated at these six trauma centers. All patients during the 6-year study period who suffered liver trauma and who survived long enough to be evaluated by computerized tomography or celiotomy were entered into the study. Patients with central nervous system trauma were excluded from analysis. Information concerning mechanism of injury, RTS, Injury Severity Score (ISS), presence of shock, liver injury scoring, mode of treatment, mortality, and length of stay were recorded on abstract forms for analysis. Care was evaluated by mortality, time to the operating room (OR), and intensive care unit (ICU) and hospital length of stay. Over the 6-year period 300 patients with non-central nervous system liver trauma were seen. Level I centers cared for 195 patients and Level II centers cared for 105. There was no difference in mean ISS or ISS > 25 between Level I and II centers. Fifty-five (28%) patients arrived in shock at Level I centers and 24 (23%) at Level II centers. Forty-eight patients (16%) died. Thirty-two (16%) died at Level I centers, and 16 (15%) died at Level II centers. Twenty of 55 patients (36%) in shock died at Level I centers, and 11 of 24 (46%) died at Level II centers (p = 0.428). Forty-three patients (22%) had liver scaling scores of IV-VI at Level I centers, and 10 (10%) had similar scores at Level II centers (p < 0.01). With liver scores IV-VI, 22 of 43 (51%) died at Level I centers and 10 of 14 (71%) died at Level II centers (p = 0.184). There was no difference in mean time or in delays beyond 1 hour to the OR for those patients in shock between Level I and II centers. There was a longer ICU stay at Level II centers (5.0 +/- 8.3 vs. 2.8 +/- 8.4 days, p = 0.04). This difference was confined to penetrating injuries. There was no difference in hospital length of stay. In a metropolitan trauma system, when Level I and II centers were compared for their ability to care for victims of hepatic trauma, there was no discernible difference in care rendered with respect to severity of injury, mortality, delays to the OR, or hospital length of stay. It was observed that more severe liver injuries were seen at Level I centers, but this did not seem to significantly affect care at Level II centers. There was a longer ICU stay observed at Level II centers owing to penetrating injuries, possibly because there were fewer penetrating injuries treated at these facilities. Although the bulk of patients were seen at Level I centers, care throughout the system was equivalent.

  18. Effect of Phosphate levels on vegetables irrigated with wastewater

    NASA Astrophysics Data System (ADS)

    Oladeji, S. O.; Saeed, M. D.

    2018-04-01

    This study examined accumulation of phosphate ions in wastewater and vegetables through man-made activities. Phosphate level was determined in wastewater and vegetables collected on seasonal basis along Kubanni stream in Zaria using UV/Visible and Smart Spectro Spectrophotometers for their analyses. Results obtained show that phosphate concentrations ranged from 3.85 – 42.33 mg/L in the first year and 15.60 – 72.80 mg/L in the second year for wastewater whereas the vegetable had levels of 3.80 – 23.65 mg/kg in the year I and 7.48 – 27.15 mg/kg in the year II. Further statistical tests indicated no significant difference in phosphate levels across the locations and seasons for wastewater and vegetables evaluated. Correlation results for these two years indicated negative (r = -0.062) relationship for wastewater while low (r = 0.339) relationship noticed for vegetables planted in year I to that of year II. Phosphate concentrations obtained in this study was higher than Maximum Contaminant Levels set by Standard Organization such as WHO and FAO for wastewater whereas vegetables of the sampling sites were not contaminated with phosphate ions. Irrigating farmland with untreated wastewater has negative consequence on the crops grown with it.

  19. Increasing Trends in Schedule II Opioid Use and Doctor Shopping during 1999–2007 in California

    PubMed Central

    Han, Huijun; Kass, Philip H.; Wilsey, Barth L.; Li, Chin-Shang

    2013-01-01

    Purpose To examine the age and gender-specific trends of schedule II opioid use among California residents, with special reference to multiple provider users (“doctor shoppers”). Methods Utilizing data from the California Prescription Drug Monitoring Program, we examined age and gender-specific trends of Schedule II opioid use during calendar years 1999–2007. Specifically, we analyzed: 1) the prevalence of Schedule II opioid users among California’s population, and 2) the proportion of these opioid users who were doctor shoppers (defined as an individual who used more than five different prescribers for all schedule II opioids he/she obtained in a calendar year). Results Among all age and gender groups, the prevalence of Schedule II opioid users in California increased by 150%–280% and the prevalence of doctor shoppers among users increased by 111%–213% over nine years. The prevalence of opioid users was lowest among 18–44 year-old males (1.25%) and highest among 65 years and older females (5.31%) by 2007. The prevalence of doctor shoppers was approximately 1.4% among those up to age 64 and 0.5% among those 65 years and older. The gender difference in doctor shoppers among all age groups was negligible. On average, the cumulative morphine-equivalent amount of Schedule II opioid per individual obtained per year was three- to six-fold higher for doctor shoppers than for the general population across different age and gender groups. Conclusions Age and gender differences in opioid use were relatively small, while the trends for use of opioids and multiple providers grew at a disquieting rate. PMID:23956137

  20. Excessive and premature new-onset cardiovascular disease among adults with bipolar disorder in the US NESARC cohort.

    PubMed

    Goldstein, Benjamin I; Schaffer, Ayal; Wang, Shuai; Blanco, Carlos

    2015-02-01

    Cross-sectional studies demonstrate increased prevalence of cardiovascular disease (CVD) among adults with bipolar disorder. However, there is a paucity of prospective data regarding new-onset CVD among adults with bipolar disorder. Analyses compared the 3-year incidence of CVD (via participant-reported physician diagnoses) among participants with DSM-IV diagnoses of bipolar I disorder (n = 1,047), bipolar II disorder (n = 392), major depressive disorder (MDD; n = 4,396), or controls (n = 26,266), who completed Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Analyses also compared the age of participants with new-onset CVD across groups. Multivariable analyses controlled for age, sex, race, cigarette smoking, hypertension, obesity, and alcohol and drug use disorders. The 3-year incidence of CVD among adults with bipolar I disorder, bipolar II disorder, MDD, and among controls was 6.30%, 5.74%, 3.98%, and 3.70%, respectively. The covariate-adjusted incidence of CVD was significantly greater among participants with bipolar I and II disorders versus controls and versus participants with MDD. Adjusted odds ratios (95% CI) were 2.58 (1.84-3.61; P < .0001) for bipolar I disorder vs controls; 2.76 (1.60-4.74; P = .0004) for bipolar II disorder vs controls; 2.11 (1.46-3.04; P = .0001) for bipolar I disorder vs MDD; 2.25 (1.26-4.01; P = .007) for bipolar II disorder vs MDD; and 1.22 (0.99-1.51; P = .06) for MDD vs controls. Bipolar I disorder participants with new-onset CVD were 10.70 ± 2.77 years younger than MDD participants with new-onset CVD and 16.78 ± 2.51 years younger than controls. Bipolar II disorder participants with new-onset CVD were 7.92 ± 3.27 years younger than MDD participants with new-onset CVD and 13.99 ± 2.79 years younger than controls. Adults with bipolar disorder are at significantly and meaningfully increased risk to develop CVD over the course of 3 years, even as compared to adults with MDD, and despite controlling for multiple potential confounds. Combined with very early age of CVD onset, this finding underscores the need for early and assertive CVD prevention strategies for people with bipolar disorder. © Copyright 2015 Physicians Postgraduate Press, Inc.

  1. Brief Report: Adaptive Behavior and Cognitive Skills for Toddlers on the Autism Spectrum

    ERIC Educational Resources Information Center

    Ray-Subramanian, Corey E.; Huai, Nan; Weismer, Susan Ellis

    2011-01-01

    This study examined adaptive behavior and cognitive skills for 125 toddlers on the autism spectrum using the recently updated Vineland-II and Bayley-III. Delays in adaptive skills were apparent at 2 years of age. As a group, toddlers on the autism spectrum had a profile of Vineland-II standard scores in which Motor Skills greater than Daily Living…

  2. Waging the War on Clinical Grade Inflation: The Ongoing Quest.

    PubMed

    Seldomridge, Lisa A; Walsh, Catherine M

    This study examined the presence of grade inflation in clinical courses 9 years after implementing strategies to improve grading precision. A comparison of clinical grades for cohort I (1997-2002) with cohort II (2009-2016) showed statistically lower grades in 2 courses (Adult 1 and Maternity) for cohort II. Suggestions for changing the way clinical experiences are planned, executed, and evaluated are provided.

  3. Confirmatory Factor Structure of the Kaufman Assessment Battery for Children-Second Edition with Preschool Children: Too Young for Differentiation?

    ERIC Educational Resources Information Center

    Potvin, Deborah C. H.; Keith, Timothy Z.; Caemmerer, Jacqueline M.; Trundt, Katherine M.

    2015-01-01

    With an age range from 3 to 13 years, the Kaufman Assessment Battery for Children-Second Edition (KABC-II) offers an appealing option for the assessment of cognitive abilities for children. Although independent research has provided evidence of the construct validity of the KABC-II for school-age children, previous studies have rarely included an…

  4. Prevalence of musculoskeletal and balance disorders in patients enrolled in phase II cardiac rehabilitation.

    PubMed

    Goel, Kashish; Shen, Jennifer; Wolter, Anne D; Beck, Kathryn M; Leth, Shawn E; Thomas, Randal J; Squires, Ray W; Perez-Terzic, Carmen M

    2010-01-01

    To determine the prevalence of musculoskeletal, neurological, and balance problems in patients enrolled in early outpatient (phase II) cardiac rehabilitation. Data were assessed retrospectively for 284 consecutive patients who attended the phase II Mayo Clinic Cardiac Rehabilitation program from April 2005 to August 2006. All participants completed a questionnaire that identified the presence of musculoskeletal pain, history of falls, joint replacements, osteoporosis, neurological disorders, and difficulties in performing activities of daily living. Balance assessment was evaluated using the single leg stance and the tandem gait tests. Of the total study population (mean age, 62.1 +/- 12.3 years), 25% reported musculoskeletal pain. A significantly higher prevalence of pain was noted in women than men (37% vs 20%, P = .004) and in those > 65 years than those < or = 65 years (35% vs 17%, P = .001). Back (29%), knee (17%), and hip (8%) pain were the most common symptoms, in order of decreasing frequency. Pain was worse with any activity in 32% of participants while 16% of participants had worsening at night. An abnormality in balance was present in 58% of the study participants and was significantly more common in women (71%) and those > 65 years (83%). Falls or gait instability or both were reported by 11% of participants. Musculoskeletal and balance limitations are common in persons enrolled in early outpatient cardiac rehabilitation, particularly in women and patients > 65 years. Cardiac rehabilitation programs should screen patients for musculoskeletal limitations and incorporate adaptations for treatment strategies of such patients.

  5. R-wave peak time at lead II in Chinese healthy adults.

    PubMed

    Deng, Jinhua; Chen, Tingting; Zeng, Chujuan; Lu, Nan; Zhou, Lihong; Tan, Xuerui; Yu, Min

    2016-05-10

    Wide QRS complex tachycardia (WCT) is a common arrhythmia. How to differentiate between WCTs is a challenge in clinical practice. Recently R-wave peak time (RWPT) at lead II was reported to be a helpful and simple tool for differentiating WCTs. However, it has remained unknown about the reference range of RWPT at lead II. In present study, we aimed to investigate the reference range of RWPT at lead II in Chinese healthy adults. A retrospective study was conducted in the First Affiliated Hospital of Shantou University Medical College in Southern China. Two thousand four hundred healthy adults aged 21-80 years with no history of structural heart diseases were included. RWPT at lead II was determined. Of 2400 healthy adults, 1200 men and 1200 women were included. The differences of age, mean heart rate and mean QRS duration at lead II between male and female were not significant. RWPT ranged from 16 to 42 ms in male while from 16 to 44 ms in female. The 95 % reference range of RWPT in normal male and female are 19.91 ~ 39.55 ms and 21.75 ~ 37.67 ms, respectively. Compared with the female, the male had a significantly longer RWPT at lead II (29.73 ± 5.01 ms vs 29.71 ± 4.06 ms in female, P = 0.000). Our study showed that RWPT at lead II is different between male and female. The male had a significantly longer RWPT at lead II than the female.

  6. Annual Research Progress Report, Fiscal Year 1988. Volume 2. (Brooke Army Medical Center)

    DTIC Science & Technology

    1988-10-01

    Phase III. (0) SWOG 8221 Treatment of Advanced Bladder Cancer with Preoperative Irradi- 362 ation and Radical Cystectomy vs. Radical Cystectomy Alone...Disease, Phase II. (0) POG 8731 Phase II Study of Low-dose "Continuous" Oral Methotrexate in 530 the Treatment of Children with Progressive or Recurrent...the other will receive a diet high in protein and carbohydrates but with minimal fiber. The remainder of the study will be conducted as outlined in the

  7. Hearing loss in Usher syndrome type II is nonprogressive.

    PubMed

    Reisser, Christoph F V; Kimberling, William J; Otterstedde, Christian R

    2002-12-01

    Usher syndrome is an autosomal recessive disorder characterized by sensorineural hearing loss and progressive visual loss secondary to retinitis pigmentosa. In the literature, a possible progression of the moderate to severe hearing loss in Usher syndrome type II (Usher II) is controversial. We studied the development of the hearing loss of 125 patients with a clinical diagnosis of Usher syndrome type II intraindividually and interindividually by repeatedly performing complete audiological and neuro-otologic examinations. Our data show a very characteristic slope of the hearing curve in all Usher II patients and no clinically relevant progression of the hearing loss over up to 17 years. The subjective impression of a deterioration of the communicative abilities of Usher II patients must therefore be attributed to the progressive visual loss. The patients should be reassured that changes in their hearing abilities are unlikely and should be provided with optimally fitted modern hearing aids.

  8. [Diabetic foot risk in patients with type II diabetes mellitus in a family medicine unit].

    PubMed

    Márquez-Godínez, S A; Zonana-Nacach, A; Anzaldo-Campos, M C; Muñoz-Martínez, J A

    2014-01-01

    To determine the risk of diabetic foot in patients with type II diabetes mellitus (DM) seen in a Family Medicine Unit. The study included type II DM patients with a disease duration ≥ 5 years seen in a Family Medicine Unit, Tijuana, Mexico, during September-December 2011. Neuropathy was assessed with the Diabetic Neuropathy Symptom questionnaire, and pressure sensation using a 10-g Semmes-Weinstein monofilament. A patient had a high risk of diabetic foot if there was sensitivity loss, foot deformities, and non-palpable pedal pulses. We studied 205 patients with an average (± SD) age and DM duration of 59 ± 10 years and 10.7 ± 6.7 years, respectively. Ninety one patients (44%) had a high risk of developing diabetic foot, and it was associated with; an education of less than 6 years (OR 2.3; 95%CI: 1-1-4.1), DM disease duration ≥ 10 years (OR 5.1; 95%CI: 2.8-9.4), female gender (OR 2.0; 95%CI: 1.1-3.6), monthly familiar income <236 euros (OR 2.0; 95%CI: 1.1-3.8), and a glycosylated hemoglobin ≥ 7.0% (OR 2.8; 95%CI: 1.5-5.0). It is necessary that all DM patients seen in a family medicine clinic have a yearly screening for the early detection of diabetic neuropathy, since they have a high risk of diabetic foot. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  9. Age is not a prognostic factor in children with Wilms tumor beyond stage I in Africa.

    PubMed

    Aronson, D C; Hadley, G P

    2014-06-01

    Patients under age 4 with stage I favorable histology (FH) Wilms tumor have a reported survival advantage. Among children above 10 years, a poorer prognosis has been associated with a higher prevalence of diffuse anaplasia. To determine if, in our practice, patients with Wilms tumors >8 years of age (stage II-V) have a poorer prognosis than those aged <8 years or <4 years. Case-control study of 19 patients >8 years with Wilms tumor stages II-V who were identified from a cohort of 192 new patients (2002-2012). For each patient two controls were chosen matched for stage and histology, one 0-3 years and one 4-7 years. Neo-adjuvant chemotherapy was offered to all, combined with intensive supportive care. Postoperative treatment was determined by local stage and histology. OS and EFS at 5 years for the different age groups were compared. Each age group contained 19 patients, of whom 6 had stage II tumors, 3 stage III, 8 stage IV, and 2 stage V. Histology was intermediate risk (IR) in 17 and high risk (HR) in 2. OS at 5 years was 80.8% and EFS was 79.2% for the whole group. No significant difference in outcome could be shown between age groups. Loss to follow up was 6/57 (11%). The survival advantage of young age (<4 years) associated with stage I FH could not be demonstrated in higher stages. Age had no significant impact on prognosis although a trend to better outcome was seen in children <4 years. © 2014 Wiley Periodicals, Inc.

  10. Lesion complexity drives the cost of superficial femoral artery endovascular interventions

    PubMed Central

    Walker, Karen L.; Nolan, Brian W.; Columbo, Jesse A.; Rzucidlo, Eva M.; Goodney, Philip P.; Walsh, Daniel B.; Atkinson, Benjamin J.; Powell, Richard J.

    2017-01-01

    Objective Patients who undergo endovascular treatment of superficial femoral artery (SFA) disease vary greatly in lesion complexity and treatment options. This study examined the association of lesion severity and cost of SFA stenting and to determine if procedure cost affects primary patency at 1 year. Methods A retrospective record review identified patients undergoing initial SFA stenting between January 1, 2010, and February 1, 2012. Medical records were reviewed to collect data on demographics, comorbidities, indication for the procedure, TransAtlantic Inter-Society Consensus (TASC) II severity, and primary patency. The interventional radiology database and hospital accounting database were queried to determine cost drivers of SFA stenting. Procedure supply cost included any item with a bar code used for the procedure. Associations between cost drivers and lesion characteristics were explored. Primary patency was determined using Kaplan-Meier survival curves and a log-rank test. Results During the study period, 95 patients underwent stenting in 98 extremities; of these, 61% of SFA stents were performed for claudication, with 80% of lesions classified as TASC II A or B. Primary patency at 1 year was 79% for the entire cohort. The mean total cost per case was $10,333. Increased procedure supply cost was associated with adjunct device use, the number of stents, and TASC II severity. Despite higher costs of treating more complex lesions, primary patency at 1 year was similar at 80% for high-cost (supply cost >$4000) vs 78% for low-cost (supply cost <$4000) interventions. Conclusions SFA lesion complexity, as defined by TASC II severity, drives the cost of endovascular interventions but does not appear to disadvantage patency at 1 year. Reimbursement agencies should consider incorporating disease severity into reimbursement algorithms for lower extremity endovascular interventions. PMID:26206581

  11. Lesion complexity drives the cost of superficial femoral artery endovascular interventions.

    PubMed

    Walker, Karen L; Nolan, Brian W; Columbo, Jesse A; Rzucidlo, Eva M; Goodney, Philip P; Walsh, Daniel B; Atkinson, Benjamin J; Powell, Richard J

    2015-10-01

    Patients who undergo endovascular treatment of superficial femoral artery (SFA) disease vary greatly in lesion complexity and treatment options. This study examined the association of lesion severity and cost of SFA stenting and to determine if procedure cost affects primary patency at 1 year. A retrospective record review identified patients undergoing initial SFA stenting between January 1, 2010, and February 1, 2012. Medical records were reviewed to collect data on demographics, comorbidities, indication for the procedure, TransAtlantic Inter-Society Consensus (TASC) II severity, and primary patency. The interventional radiology database and hospital accounting database were queried to determine cost drivers of SFA stenting. Procedure supply cost included any item with a bar code used for the procedure. Associations between cost drivers and lesion characteristics were explored. Primary patency was determined using Kaplan-Meier survival curves and a log-rank test. During the study period, 95 patients underwent stenting in 98 extremities; of these, 61% of SFA stents were performed for claudication, with 80% of lesions classified as TASC II A or B. Primary patency at 1 year was 79% for the entire cohort. The mean total cost per case was $10,333. Increased procedure supply cost was associated with adjunct device use, the number of stents, and TASC II severity. Despite higher costs of treating more complex lesions, primary patency at 1 year was similar at 80% for high-cost (supply cost >$4000) vs 78% for low-cost (supply cost <$4000) interventions. SFA lesion complexity, as defined by TASC II severity, drives the cost of endovascular interventions but does not appear to disadvantage patency at 1 year. Reimbursement agencies should consider incorporating disease severity into reimbursement algorithms for lower extremity endovascular interventions. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  12. A randomized 10-year prospective follow-up of Class II nanohybrid and conventional hybrid resin composite restorations.

    PubMed

    van Dijken, Jan W V; Pallesen, Ulla

    2014-12-01

    To evaluate the 10-year durability of a nanohybrid resin composite in Class II restorations in a randomized controlled intraindividual comparison with its conventional hybrid resin composite predecessor. Each of 52 participants received at least two Class II restorations that were as similar as possible. The cavities were chosen at random to be restored with a nanohybrid resin composite (Excite/Tetric EvoCeram (TEC); n=61) and a conventional hybrid (Excite/Tetric Ceram (TC); n=61). The restorations were evaluated with slightly modified USPHS criteria at baseline and then annually for 10 years. The overall performance of the experimental restorations was tested after intra-individual comparison and their ranking was tested using Friedman's two-way ANOVA. The level of significance was set at 5%. Four patient drop-outs with 8 restorations (4TEC, 4TC) were registered during the follow-up. A prediction of the caries risk showed that 16 of the evaluated 52 patients were considered as high risk patients. In total, 22 restorations, 11 TEC (3 premolars, 8 molars) and 11 TC (3 premolars, 8 molars) restorations failed during the 10 years. The main reason for failure was secondary caries (50%). 63% of the recurrent caries lesions were found in high caries risk participants. The overall success rate at 10 years was 80.7%, with an annual failure rate of 1.9%. No statistically significant difference was found in the overall survival rate between the two investigated resin composites. The nanohybrid and the conventional hybrid resin composite showed good clinical effectiveness in extensive Class II restorations during the 10-year study.

  13. Commentary on the management of type II odontoid process fractures in octogenarians: Article by Graffeo et al. and Editorial by Falavigna (J Neurosurgery Spine August 19, 2016).

    PubMed

    Epstein, Nancy E

    2016-01-01

    Establishing a clear treatment paradigm for octogenarians with type II odontoid fractures in hampered by a literature replete with level III articles. In the study by Graffeo et al ., the authors evaluated 111 patients over the age of 79 (average age: 87) with type II odontoid fractures undergoing nonoperative (94 patients) vs. operative intervention (17 total; 15 posterior and 2 anterior). They studied multiple variables and utilized several scales [abbreviated injury scale (AIS), injury severity score (ISS), and the Glasgow coma scale (GCS)] to determine the outcomes of nonoperative vs. operative management. Graffeo et al . concluded that there were no significant differences between nonoperative and operative management for type II odontoid fractures in octogenarians. They found similar frequencies of additional cervical fractures, mechanisms of injury, GCS of 8 or under, AIS/ISS scores, and disposition to "nonhome" facilities. Furthermore, both appeared to have increased mortality rates at 1-year post injury; 13% during hospitalization, 26% within the first post-injury month, and 41% at 1 year. In the editorial by Falavigna, his major criticism of Graffeo's article was the marked disparity in the number of patients in the operative (17 patients) vs. the nonoperative group (94 patients), making it difficult to accept any conclusions as "significant". He further noted that few prior studies provided level I evidence, and that most, like this one, were level III analyses that did not "significantly" advance our knowledge as to whether to treat octogenarians with type II odontoid fractures operatively vs. nonoperatively.

  14. Insulin-Like Growth Factors and Metabolic Syndrome in Obese Children.

    PubMed

    Inzaghi, Elena; Baldini Ferroli, Barbara; Fintini, Danilo; Grossi, Armando; Nobili, Valerio; Cianfarani, Stefano

    2017-01-01

    Insulin-like growth factor (IGF)-I is related to cardiometabolic risk in adults, whereas the metabolic role of IGF-II is unclear. The aim of this study was to assess IGFs in obese children and correlate them with metabolic syndrome (MetS) components. This is a retrospective study including 574 obese children (11.34 ± 3.16 years). All subjects underwent complete anthropometry and biochemical assessment. In a subgroup of 136 subjects, body composition was evaluated. IGF-I was measured in 300 obese subjects and IGF-II in 77 obese and 15 lean children. 177 subjects were divided according to the presence of 1 or more MetS criteria: group 1, subjects with 1 MetS criterion; group 2, subjects with 2 components; and group 3, subjects with MetS diagnosis. IGF-I, IGF-II, and IGF-I/insulin-like growth factor-binding protein-3 ratio were not different among subjects with an increasing number of MetS criteria and were not associated with single components of MetS as well as with body composition parameters. In children younger than 10 years, IGF-I directly correlated with high-density lipoprotein cholesterol (p < 0.005) even after controlling for confounders. IGF-II was significantly higher in obese children and correlated with parameters of insulin sensitivity (p < 0.05). IGFs were neither related to MetS nor to body composition parameters in obese children. Further studies are needed to clarify the mechanisms underlying the relationship between IGF-II and insulin sensitivity. © 2017 S. Karger AG, Basel.

  15. Analysis of Morphological Characteristics and Origins of Idiopathic Premature Ventricular Contractions Under a 12-Lead Electrocardiogram in Children with Structurally Normal Hearts.

    PubMed

    Jiang, Jianbin; He, Yuee; Qiu, Huixian; Zhang, Yuanhai; Chu, Maoping; Li, Yuechun; Chen, Qi

    2017-10-21

    Up to 40% of healthy children have premature ventricular complexes or contractions (PVCs) detected with 24-hour Holter monitoring. We aimed to investigate the morphological characteristics and origins of idiopathic PVCs under a 12-lead electrocardiogram in children with structurally normal hearts. All asymptomatic monomorphic PVC patients with structurally normal hearts under 18 years of age were included in this retrospective study. Characteristics of PVCs in lead V 1 under a 12-lead electrocardiogram were classified as left bundle branch block (PVC-LBBB) or right bundle branch block (PVC-RBBB). According to limb leads, PVC-LBBB or PVC-RBBB was divided into: PVCs-LBBB type I; PVCs-LBBB type II; PVCs-RBBB type I; PVCs-RBBB type II; and PVCs-RBBB type III. Out of 178 PVC patients, 94 cases of PVCs-LBBB (PVCs-LBBB type I = 60; PVCs-LBBB type II = 34) and 84 cases of PVCs-RBBB (PVCs-RBBB type I = 3; PVCs-RBBB type II = 55; PVCs-RBBB type III = 26) were identified. The frequency of PVCs-LBBB type I increased with age and the frequency of PVCs-RBBB type II and III decreased with age. Among the children monitor tested, from 1 years old to 18 years old, PVCs originating from the left or right ventricular outflow tract gradually increased with age, while PVCs originating from the branch sources decreased with age.

  16. Comment on “Reconciliation of the Devils Hole climate record with orbital forcing”

    USGS Publications Warehouse

    Coplen, Tyler B.

    2016-01-01

    Moseley et al.’s (Reports, 8 January 2016, p. 165) preferred-Termination-II age is subjective, as evidenced by variation in their Termination-II ages of 2500 years per meter. Termination-II-age bias decreases to zero at ~1.5 meters below the present-day water table, if one assumes linear variation with core-sample height. Maintaining the required gradient of thorium isotope 230Th over 3.6 meters for 1000 years, much less 10,000 years, seems exceedingly unlikely.

  17. Comment on “Reconciliation of the Devils Hole climate record with orbital forcing”

    NASA Astrophysics Data System (ADS)

    Coplen, Tyler B.

    2016-10-01

    Moseley et al.’s (Reports, 8 January 2016, p. 165) preferred-Termination-II age is subjective, as evidenced by variation in their Termination-II ages of 2500 years per meter. Termination-II-age bias decreases to zero at ~1.5 meters below the present-day water table, if one assumes linear variation with core-sample height. Maintaining the required gradient of thorium isotope 230Th over 3.6 meters for 1000 years, much less 10,000 years, seems exceedingly unlikely.

  18. Metabolic alterations and neurodevelopmental outcome of infants with transposition of the great arteries.

    PubMed

    Park, I Sook; Yoon, S Young; Min, J Yeon; Kim, Y Hwue; Ko, J Kok; Kim, K Soo; Seo, D Man; Lee, J Hee

    2006-01-01

    Abnormal neurodevelopment has been reported for infants who were born with transposition of the great arteries (TGA) and underwent arterial switch operation (ASO). This study evaluates the cerebral metabolism of TGA infants at birth and before ASO and neurodevelopment 1 year after ASO. Proton magnetic resonance spectroscopy (1H-MRS) was performed on 16 full-term TGA brains before ASO within 3-6 days after birth. The brain metabolite ratios of [NAA/Cr], [Cho/Cr], and [mI/Cr] evaluated measured. Ten infants were evaluated at 1 year using the Bayley Scales of Infants Development II (BSED II). Cerebral metabolism of infants with TGA was altered in parietal white matter (PWM) and occipital gray matter (OGM) at birth before ASO. One year after ASO, [Cho/Cr] in PWM remained altered, but all metabolic ratios in OGM were normal. The results of BSID II at 1 year showed delayed mental and psychomotor development. This delayed neurodevelopmental outcome may reflect consequences of the altered cerebral metabolism in PWM measured by 1H-MRS. It is speculated that the abnormal hemodynamics due to TGA in utero may be responsible for the impaired cerebral metabolism and the subsequent neurodevelopmental deficit.

  19. Type II odontoid fractures in the elderly: an evidence-based narrative review of management.

    PubMed

    Pal, D; Sell, P; Grevitt, M

    2011-02-01

    Considerable controversy exists regarding the optimal management of elderly patients with type II odontoid fractures. There is uncertainty regarding the consequences of non-union. The best treatment remains unclear because of the morbidity associated with prolonged cervical immobilisation versus the risks of surgical intervention. The objective of the study was to evaluate the published literature and determine the current evidence for the management of type II odontoid fractures in elderly. A search of the English language literature from January 1970 to date was performed using Medline and the following keywords: odontoid, fractures, cervical spine and elderly. The search was supplemented by cross-referencing between articles. Case reports and review articles were excluded although some were referred to in the discussion. Studies in patients aged 65 years with a minimum follow-up of 12 months were selected. One-hundred twenty-six articles were reviewed. No class I study was identified. There were two class II studies and the remaining were class III. Significant variability was found in the literature regarding mortality and morbidity rates in patients treated with and without halo vest immobilisation. In recent years several authors have claimed satisfactory results with anterior odontoid screw fixation while others have argued that this may lead to increased complications in this age group. Lately, the posterior cervical (Goel-Harms) construct has also gained popularity amongst surgeons. There is insufficient evidence to establish a standard or guideline for odontoid fracture management in elderly. While most authors agree that cervical immobilisation yields satisfactory results for type I and III fractures in the elderly, the optimal management for type II fractures remain unsolved. A prospective randomised controlled trial is recommended.

  20. Meta-Analysis of the Risk of Subsequent Mood Episodes in Bipolar Disorder.

    PubMed

    Radua, Joaquim; Grunze, Heinz; Amann, Benedikt L

    2017-01-01

    Reported relapse and recurrence rates in bipolar disorder (BD) differ significantly between studies. Most data originate from highly selective patients participating in sponsored randomized controlled trials with narrow inclusion criteria. To estimate the true risk of a subsequent mood episode (SME) under real-world conditions, we conducted a meta-analysis of rates of SME as reported in naturalistic BD studies. PubMed, ScienceDirect, Scopus, and Web of Knowledge were searched until July 2015. Studies reporting the time until the emergence of an SME, from which individual data or Kaplan-Meier plots with censors marked could be retrieved, were included. Twelve studies comprising 5,837 patients met the inclusion criteria. The median time to an SME in adults after an index episode was 1.44 years. The risk of an SME was 44% during the first year. Not having a SME during this first year lowered this risk to 19% in the second year. The risk was higher in bipolar II disorder (BD-II) than in bipolar I disorder (BD-I; HR = 1.5). In BD-I, the risk of a subsequent manic, mixed, or depressive mood episode was higher after an index episode of the same polarity (HR = 1.89-5.14). The overall risk of an SME was higher in patients with persisting subsyndromal symptoms (HR = 2.17). The data from this study provide a more reliable estimate of the risk of an SME in BD in real-world settings. Further research into the longitudinal course of BD-II is warranted to confirm its role as a risk factor for SME. © 2017 S. Karger AG, Basel.

  1. Growth in individuals with Majewski osteodysplastic primordial dwarfism type II caused by pericentrin mutations.

    PubMed

    Bober, Michael B; Niiler, Tim; Duker, Angela L; Murray, Jennie E; Ketterer, Tara; Harley, Margaret E; Alvi, Sabah; Flora, Christina; Rustad, Cecilie; Bongers, Ernie M H F; Bicknell, Louise S; Wise, Carol; Jackson, Andrew P

    2012-11-01

    Microcephalic primordial dwarfism (MPD) is a class of disorders characterized by intrauterine growth restriction (IUGR), impaired postnatal growth and microcephaly. Majewski osteodysplastic primordial dwarfism type II (MOPD II) is one of the more common conditions within this group. MOPD II is caused by truncating mutations in pericentrin (PCNT) and is inherited in an autosomal recessive manner. Detailed growth curves for length, weight, and OFC are presented here and derived from retrospective data from 26 individuals with MOPD II confirmed by molecular or functional studies. Severe pre- and postnatal growth failure is evident in MOPD II patients. The length, weight, and OFC at term (when corrected for gestational age) were -7.0, -3.9, and -4.6 standard deviation (SD) below the population mean and equivalent to the 50th centile of a 28-29-, 31-32-, and 30-31-week neonate, respectively. While at skeletal maturity, the height, weight, and OFC were -10.3, -14.3, and -8.5 SD below the population mean and equivalent to the size of 3-year 10- to 11-month-old, a 5-year 2- to 3-month-old, and 5- to 6-month-old, respectively. During childhood, MOPD II patients grow with slowed, but fairly constant growth velocities and show no evidence of any pubertal growth spurt. Treatment with human growth hormone (n = 11) did not lead to any significant improvement in final stature. The growth charts presented here will be of assistance with diagnosis and management of MOPD II, and should have particular utility in nutritional management of MOPD II during infancy. Copyright © 2012 Wiley Periodicals, Inc.

  2. A missense mutation encoding Cys73Phe in neurophysin II is associated with autosomal dominant neurohypophyseal diabetes insipidus.

    PubMed

    Santiprabhob, Jeerunda; Browning, James; Repaske, David

    2002-01-01

    Autosomal dominant neurohypophyseal diabetes insipidus (ADNDI) is an inherited disease caused by progressive deficiency of the hormone arginine vasopressin (AVP) that typically becomes clinically apparent in the first decade of life. The genetic locus of ADNDI is the arginine vasopressin-neurophysin II (AVP-NPII) gene and mutations that cause ADNDI have been found in the nucleotides encoding the signal peptide, vasopressin, and neurophysin II peptides. In this study we have analyzed the AVP-NPII gene in a 20-year-old female who was diagnosed with ADNDI at 2 years of age. A heterozygous missense mutation (1684G>T) was found in exon 2 that predicts replacement of cysteine with phenylalanine at position 73 of neurophysin II. The mutation was confirmed by subcloning exon 2 PCR products to sequence each allele independently. Two out of four clones were found to have the missense mutation and two have the normal sequence, confirming the presence of the mutation and heterozygosity. Neurophysin II is an intracellular carrier protein for AVP during axonal transport from the hypothalamus to the posterior pituitary and contains 14 cysteine residues forming 7 disulfide bonds. This mutation is predicted to disrupt the disulfide bridge between Cys73 and Cys61 within the neurophysin II moiety. This finding of a novel mutation substituting cysteine with phenylalanine in one AVP-NPII gene allele supports the hypothesis that inability to form normal disulfide bonds in neurophysin II leads to ADNDI.

  3. Quality of reporting in oncology phase II trials: A 5-year assessment through systematic review

    PubMed Central

    Langrand-Escure, Julien; Rivoirard, Romain; Oriol, Mathieu; Tinquaut, Fabien; Rancoule, Chloé; Chauvin, Frank; Magné, Nicolas; Bourmaud, Aurélie

    2017-01-01

    Background Phase II clinical trials are a cornerstone of the development in experimental treatments They work as a "filter" for phase III trials confirmation. Surprisingly the attrition ratio in Phase III trials in oncology is significantly higher than in any other medical specialty. This suggests phase II trials in oncology fail to achieve their goal. Objective The present study aims at estimating the quality of reporting in published oncology phase II clinical trials. Data sources A literature review was conducted among all phase II and phase II/III clinical trials published during a 5-year period (2010–2015). Study eligibility criteria All articles electronically published by three randomly-selected oncology journals with Impact-Factors>4 were included: Journal of Clinical Oncology, Annals of Oncology and British Journal of Cancer. Intervention Quality of reporting was assessed using the Key Methodological Score. Results 557 articles were included. 315 trials were single-arm studies (56.6%), 193 (34.6%) were randomized and 49 (8.8%) were non-randomized multiple-arm studies. The Methodological Score was equal to 0 (lowest level), 1, 2, 3 (highest level) respectively for 22 (3.9%), 119 (21.4%), 270 (48.5%) and 146 (26.2%) articles. The primary end point is almost systematically reported (90.5%), while sample size calculation is missing in 66% of the articles. 3 variables were independently associated with reporting of a high standard: presence of statistical design (p-value <0.001), multicenter trial (p-value = 0.012), per-protocol analysis (p-value <0.001). Limitations Screening was mainly performed by a sole author. The Key Methodological Score was based on only 3 items, making grey zones difficult to translate. Conclusions & implications of key findings This literature review highlights the existence of gaps concerning the quality of reporting. It therefore raised the question of the suitability of the methodology as well as the quality of these trials, reporting being incomplete in the corresponding articles. PMID:29216190

  4. 12 CFR 702.107 - Alternative components for standard calculation.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... to 12 years; (ii) Twelve percent (12%) of the amount of such loans with a remaining maturity of greater than 12 years, but less than or equal to 20 years; and (iii) Fourteen percent (14%) of the amount... than or equal to 12 years; (ii) Ten percent (10%) of the amount of such loans with a documented call...

  5. Effect of angiotensin-converting enzyme (ACE) gene polymorphism on progression of renal disease and the influence of ACE inhibition in IDDM patients: findings from the EUCLID Randomized Controlled Trial. EURODIAB Controlled Trial of Lisinopril in IDDM.

    PubMed

    Penno, G; Chaturvedi, N; Talmud, P J; Cotroneo, P; Manto, A; Nannipieri, M; Luong, L A; Fuller, J H

    1998-09-01

    We examined whether the ACE gene insertion/deletion (I/D) polymorphism modulates renal disease progression in IDDM and how ACE inhibitors influence this relationship. The EURODIAB Controlled Trial of Lisinopril in IDDM is a multicenter randomized placebo-controlled trial in 530 nonhypertensive, mainly normoalbuminuric IDDM patients aged 20-59 years. Albumin excretion rate (AER) was measured every 6 months for 2 years. Genotype distribution was 15% II, 58% ID, and 27% DD. Between genotypes, there were no differences in baseline characteristics or in changes in blood pressure and glycemic control throughout the trial. There was a significant interaction between the II and DD genotype groups and treatment on change in AER (P = 0.05). Patients with the II genotype showed the fastest rate of AER progression on placebo but had an enhanced response to lisinopril. AER at 2 years (adjusted for baseline AER) was 51.3% lower on lisinopril than placebo in the II genotype patients (95% CI, 15.7 to 71.8; P = 0.01), 14.8% in the ID group (-7.8 to 32.7; P = 0.2), and 7.7% in the DD group (-36.6 to 37.6; P = 0.7). Absolute differences in AER between placebo and lisinopril at 2 years were 8.1, 1.7, and 0.8 microg/min in the II, ID, and DD groups, respectively. The significant beneficial effect of lisinopril on AER in the II group persisted when adjusted for center, blood pressure, and glycemic control, and also for diastolic blood pressure at 1 month into the study. Progression from normoalbuminuria to microalbuminuria (lisinopril versus placebo) was 0.27 (0.03-2.26; P = 0.2) in the II group, and 1.30 (0.33-5.17; P = 0.7) in the DD group (P = 0.6 for interaction). Knowledge of ACE genotype may be of value in determining the likely impact of ACE inhibitor treatment.

  6. Increased plasma DPP4 activities predict new-onset atherosclerosis in association with its proinflammatory effects in Chinese over a four year period: A prospective study.

    PubMed

    Zheng, T P; Yang, F; Gao, Y; Baskota, A; Chen, T; Tian, H M; Ran, X W

    2014-08-01

    DPP4, a novel proinflammatory cytokine, is involved in the inflammatory process through its interaction with IGF-II/M6P receptor. We aimed to investigate whether it could predict new-onset atherosclerosis in Chinese. A prospective study was conducted of 590 adults (213 men and 377 women) aged 18-70 years without atherosclerosis examined in 2007(baseline) and 2011(follow-up). Circulating DPP4 activity, inflammatory markers, IGF-II/M6P receptor and common carotid artery Intima-Media Thickness (C-IMT) were measured at baseline and four years later. At baseline, individuals in the highest quartile of DPP4 activity had higher age, WHR, BMI, SBP, fasting insulin, 2h-PG, TG, LDL-C, IL-6, hs-CRP, IGF-II/M6P-R, C-IMT and lower HDL-C compared with individuals in the lowest quartile. After a 4-year follow-up, 71 individuals developed atherosclerosis. In multiple linear regression analysis, baseline DPP4 activity was an independent predictor of an increase in inflammatory markers, IGF-II/M6P receptor, and C-IMT over a 4-year period (all P < 0.01). In multivariable-adjusted models, the odds ratio (OR) for incident atherosclerosis comparing the highest with the lowest quartiles of DPP4 activity was 3.17 (95%CI 1.33-7.58) after adjustment for confounding risk factors (P = 0.009). The incidence of atherosclerosis owing to DPP4 activity increased by 12.41%. DPP4 activity is an important predictor of the onset of inflammation and atherosclerosis in apparently healthy Chinese. This finding may have important implications for understanding the proinflammatory role of DPP-4 in the pathogenesis of atherosclerosis. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Family Studies of Sensorimotor and Neurocognitive Heterogeneity Spectrum Disorders (ASD)

    DTIC Science & Technology

    2012-09-01

    attention deficit / hyperactivity disorder ( ADHD ) behaviors in individuals ages 18 and older. ii. Conners 3rd Edition (Conners 3) is a screening...questionnaire that uses observer and self-report ratings to assess attention deficit / hyperactivity disorder ( ADHD ) and evaluate problem behavior in... deficits in these disorders . II: BODY a. Overall Progress. We have successfully completed each of the first year tasks laid out in our original

  8. Relapse and disease specific survival in 1143 Danish women diagnosed with borderline ovarian tumours (BOT).

    PubMed

    Karlsen, Nikoline Marie Schou; Karlsen, Mona Aarenstrup; Høgdall, Estrid; Nedergaard, Lotte; Christensen, Ib Jarle; Høgdall, Claus

    2016-07-01

    The aim of the study was to evaluate the rate of relapse as well as disease-free, overall, and disease-specific survival in women with borderline ovarian tumour (BOT). Furthermore, the study aims to identify the clinical parameters correlated to relapse. National clinical data of women diagnosed with BOT from January 2005 to January 2013 constituted the basis for our study population. The prognostic influence of clinical variables was evaluated using univariate and multivariate analyses. A total of 1143 women were eligible for analysis, with 87.9% in FIGO stage I and 12.1% in FIGO stages II-IV. Relapse of BOT was detected in 3.7%, hereof 40.5% with malignant transformation. The five-year disease-free survival was 97.6% in FIGO stage I and 87.3% in FIGO stages II-IV. Younger age, laparoscopic surgical approach, fertility sparing surgery, FIGO stages II-IV, bilateral tumour presence, serous histology, implants and microinvasion of the tumour were significantly associated with relapse in univariate analyses. The overall five-year survival rate was 92.2% in FIGO stage I and 89.0% in FIGO stages II-IV. Out of 77 deaths in total, only seven women died from BOT. A general favourable prognosis in women with BOT was confirmed in our study. Our findings indicate that systematic, long-term follow-up does not seem necessary in women treated for FIGO stage IA BOT with no residual disease or microinvasion. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Long-term skeletal effects of high-pull headgear followed by fixed appliances for the treatment of Class II malocclusions.

    PubMed

    Bilbo, E Erin; Marshall, Steven D; Southard, Karin A; Allareddy, Verrasathpurush; Holton, Nathan; Thames, Allyn M; Otsby, Marlene S; Southard, Thomas E

    2018-04-18

    The long-term skeletal effects of Class II treatment in growing individuals using high-pull facebow headgear and fixed edgewise appliances have not been reported. The purpose of this study was to evaluate the long-term skeletal effects of treatment using high-pull headgear followed by fixed orthodontic appliances compared to an untreated control group. Changes in anteroposterior and vertical cephalometric measurements of 42 Class II subjects (n = 21, mean age = 10.7 years) before treatment, after headgear correction to Class I molar relationship, after treatment with fixed appliances, and after long-term retention (mean 4.1 years), were compared to similar changes in a matched control group (n = 21, mean age = 10.9 years) by multivariable linear regression models. Compared to control, the study group displayed significant long-term horizontal restriction of A-point (SNA = -1.925°, P < .0001; FH-NA = -3.042°, P < .0001; linear measurement A-point to Vertical Reference = -3.859 mm, P < .0001) and reduction of the ANB angle (-1.767°, P < .0001), with no effect on mandibular horizontal growth or maxillary and mandibular vertical skeletal changes. A-point horizontal restriction and forward mandibular horizontal growth accompanied the study group correction to Class I molar, and these changes were stable long term. One phase treatment for Class II malocclusion with high-pull headgear followed by fixed orthodontic appliances resulted in correction to Class I molar through restriction of horizontal maxillary growth with continued horizontal mandibular growth and vertical skeletal changes unaffected. The anteroposterior molar correction and skeletal effects of this treatment were stable long term.

  10. Autofluorescence bronchoscopy with white light bronchoscopy compared with white light bronchoscopy alone for the detection of precancerous lesions: a European randomised controlled multicentre trial.

    PubMed

    Häussinger, K; Becker, H; Stanzel, F; Kreuzer, A; Schmidt, B; Strausz, J; Cavaliere, S; Herth, F; Kohlhäufl, M; Müller, K-M; Huber, R-M; Pichlmeier, U; Bolliger, Ch T

    2005-06-01

    The potential of autofluorescence bronchoscopy (AFB) to detect precancerous lesions in the central airways and its role in lung cancer screening is uncertain. A study was undertaken to evaluate the prevalence of moderate/severe dysplasia (dysplasia II-III) and carcinoma in situ (CIS) using a newly developed AFB system in comparison with conventional white light bronchoscopy (WLB) alone. In a prospective randomised multicentre trial, smokers > or = 40 years of age (> or = 20 pack-years) were stratified into four different risk groups and investigated with either WLB+AFB (arm A) or WLB alone (arm B). 1173 patients (916 men) of mean age 58.7 years were included. Overall (arms A and B), preinvasive lesions (dysplasia II-III and CIS) were detected in 3.9% of the patients. The prevalence of patients with preinvasive lesions in the WLB arm was 2.7% compared with 5.1% in the WLB+AFB arm (p = 0.037). For patients with dysplasia II-III, WLB+AFB increased the detection rate by a factor of 2.1 (p = 0.03), while for CIS the factor was only 1.24 (p = 0.75). The biopsy based sensitivity of WLB alone and WLB+AFB for detecting dysplasia II-III and CIS was 57.9% compared with 82.3% (1.42-fold increase). The corresponding specificity was 62.1% compared with 58.4% (0.94-fold decrease). This first randomised study of AFB showed that the combination of WLB+AFB was significantly superior to WLB alone in detecting preneoplastic lesions. Our findings do not support the general use of AFB as a screening tool for lung cancer, but suggest that it may be of use in certain groups. The precise indications await further study.

  11. Effect of a Shortened Duration of FOLFOX Chemotherapy on the Survival Rate of Patients with Stage II and III Colon Cancer.

    PubMed

    Ji, Woong Bae; Hong, Kwang Dae; Kim, Jung-Sik; Joung, Sung-Yup; Um, Jun Won; Min, Byung-Wook

    2018-01-01

    FOLFOX chemotherapy is widely used as an adjuvant treatment for advanced colon cancer. The duration of adjuvant chemotherapy is usually set to 6 months, which is based on a former study of 5-fluorouracil/leucovorin chemotherapy. However, the FOLFOX regimen is known to have complications, such as peripheral neuropathy. The aim of this study was to compare the survival rates and complications experienced by patients receiving either 4 or 6 months of FOLFOX chemotherapy. Retrospective data analysis was performed for stage II and III patients who underwent radical resection of colon cancer. We compared the 5-year survival rates and the occurrence of complications in patients who completed only 8 cycles of FOLFOX chemotherapy with patients who completed 12 cycles of chemotherapy. Among 188 patients who underwent adjuvant FOLFOX chemotherapy for stage II or III colon cancer, 83 (44.1%) completed 6 months of FOLFOX chemotherapy and 64 (34.0%) patients discontinued after 4 months of chemotherapy. The 5-year overall survival and disease-free survival rates did not show a significant difference. Patients in the 6-month group had peripheral neuropathy more frequently (p = 0.028). Five-year overall and disease-free survival were not significantly different between the 2 groups. Large-scale prospective studies are necessary for the analysis of complications and survival rates. © 2017 S. Karger AG, Basel.

  12. [Coping skills and social support in German long-time survivors of rape in the end of World War II].

    PubMed

    Eichhorn, Svenja; Klauer, Thomas; Grundke, Elena; Freyberger, Harald J; Brähler, Elmar; Kuwert, Philipp

    2012-05-01

    The aim of the study was to document perceived social support in a sample of German war-raped women in World War II. Furthermore the impact of this potential resource on today's posttraumatic symptoms should be pointed out. 27 women (M = 80.3 years, SD = 3.1 years) answered each a semi-structured interview and several questionnaires. Perceived social support shows clearly lower values than in the comparative samples. The measured degree of the variable in the present sample bears negative relationship to the actual posttraumatic symptoms of the women. In World War II sexually traumatized women could profit only few from the examined resource. The found negative relationship between perceived social support and posttraumatic symptoms shows additionally the potentially long-lasting impact of these form of coping on psychological health in trauma victims. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Analyses of outcomes of one-stage operation for treatment of late-diagnosed developmental dislocation of the hip: 864 hips followed for 3.2 to 8.9 years.

    PubMed

    Ning, Bo; Yuan, Yi; Yao, Jie; Zhang, Sichng; Sun, Jun

    2014-11-28

    The one-stage procedure for treatment of older developmental dislocation of the hip (DDH) is used widely. However, the best age group for this operation is still unknown. The aims of our study were to evaluate middle-term outcomes of one-stage surgical treatment of a large number of patients with late-diagnosed DDH, and to explore the best age group for treatment. We retrospectively reviewed 652 patients with a total of 864 hip joints with DDH, all aged >18 months. All the hip joints were treated with one-stage procedures including open reduction, pelvic osteotomy, and femoral shortening. The patients were divided into three groups according to age at surgery: Group I: 1.5-2.5 years; Group II: 2.5-8 years; and Group III: >8 years. The latest clinical and radiographic outcomes, complications and avascular necrosis (AVN) of the femoral head were evaluated and compared among the three groups. The mean age at surgery was 5.8 years (range: 1.5-13.2 years). The average time of follow-up was 6.2 years (range: 3.2-8.9 years). A total of 79.4% of good or excellent outcomes were obtained for clinical functional evaluation according to the McKay classification. For radiographic outcomes, 732 hips (84.7%) were classified as good or excellent according to the Severin classification. A total of 27.4% of all hips had a poor outcome according to the Kalamchi and MacEwen classification for AVN. The poorest outcomes were observed for clinical, radiographic and AVN results in Group III (p < 0.001). Compared with Group I, the better results for clinical and AVN outcomes were found in Group II (p < 0.001). However, similar clinical outcomes were observed between Groups I and II (p > 0.05). A significantly higher incidence of redislocation and residual acetabular dysplasia was observed in Tonnis grade II and III hip dislocation (p < 0.001). One-stage treatment of late-diagnosed DDH had a good outcome in young and middle group. Younger patients achieved better results than older patients. However, the best age group was 2.5-8 years. Tonnis grade II and III DDH is a risk factor for redislocation and residual acetabular dysplasia after the one-stage operation.

  14. The radical mechanism of biological methane synthesis by methyl-coenzyme M reductase

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

    Wongnate, T.; Sliwa, D.; Ginovska, B.

    2016-05-19

    Methyl-coenzyme M reductase (MCR), the rate-limiting enzyme in methanogenesis and anaerobic methane oxidation, is responsible for the production of over one billion tons of methane per year. The mechanism of methane synthesis is unknown, with the two leading proposals involving either a methyl-nickel(III) (Mechanism I) or methyl radical/Ni(II)-thiolate (Mechanism II) intermediate(s). When the reaction between the active Ni(I) enzyme with substrates was studied by transient kinetic, spectroscopic and computational methods, formation of an EPR-silent Ni(II)-thiolate intermediate was positively identified by magnetic circular dichroism spectroscopy. There was no evidence for an EPR-active methyl-Ni(III) species. Temperature-dependent transient kinetic studies revealed that themore » activation energy for the initial catalytic step closely matched the value computed by density functional theory for Mechanism II. Thus, our results demonstrate that biological methane synthesis occurs by generation of a methyl radical.« less

  15. Executive Function and Adaptive Behavior in Muenke Syndrome.

    PubMed

    Yarnell, Colin M P; Addissie, Yonit A; Hadley, Donald W; Guillen Sacoto, Maria J; Agochukwu, Nneamaka B; Hart, Rachel A; Wiggs, Edythe A; Platte, Petra; Paelecke, Yvonne; Collmann, Hartmut; Schweitzer, Tilmann; Kruszka, Paul; Muenke, Maximilian

    2015-08-01

    To investigate executive function and adaptive behavior in individuals with Muenke syndrome using validated instruments with a normative population and unaffected siblings as controls. Participants in this cross-sectional study included individuals with Muenke syndrome (P250R mutation in FGFR3) and their mutation-negative siblings. Participants completed validated assessments of executive functioning (Behavior Rating Inventory of Executive Function [BRIEF]) and adaptive behavior skills (Adaptive Behavior Assessment System, Second Edition [ABAS-II]). Forty-four with a positive FGFR3 mutation, median age 9 years, range 7 months to 52 years were enrolled. In addition, 10 unaffected siblings served as controls (5 males, 5 females; median age, 13 years; range, 3-18 years). For the General Executive Composite scale of the BRIEF, 32.1% of the cohort had scores greater than +1.5 SD, signifying potential clinical significance. For the General Adaptive Composite of the ABAS-II, 28.2% of affected individuals scored in the 3rd-8th percentile of the normative population, and 56.4% were below the average category (<25th percentile). Multiple regression analysis did not identify craniosynostosis as a predictor of BRIEF (P = .70) or ABAS-II scores (P = .70). In the sibling pair analysis, affected siblings performed significantly poorer on the BRIEF General Executive Composite and the ABAS-II General Adaptive Composite. Individuals with Muenke syndrome are at an increased risk for developing adaptive and executive function behavioral changes compared with a normative population and unaffected siblings. Published by Elsevier Inc.

  16. The Influence of Age and Sexual Drive on the Predictive Validity of the Juvenile Sex Offender Assessment Protocol-Revised.

    PubMed

    Wijetunga, Charity; Martinez, Ricardo; Rosenfeld, Barry; Cruise, Keith

    2018-01-01

    The Juvenile Sex Offender Assessment Protocol-Revised (J-SOAP-II) is the most commonly used measure in the assessment of recidivism risk among juveniles who have committed sexual offenses (JSOs), but mixed support exists for its predictive validity. This study compared the predictive validity of the J-SOAP-II across two offender characteristics, age and sexual drive, in a sample of 156 JSOs who had been discharged from a correctional facility or a residential treatment program. The J-SOAP-II appeared to be a better predictor of sexual recidivism for younger JSOs (14-16 years old) than for older ones (17-19 years old), with significant differences found for the Dynamic Summary Scale and Scale III (Intervention). In addition, several of the measure's scales significantly predicted sexual recidivism for JSOs with a clear pattern of sexualized behavior but not for those without such a pattern, indicating that the J-SOAP-II may have greater clinical utility for JSOs with heightened sexual drive. The implications of these findings are discussed.

  17. A clinical trial of Empress II porcelain inlays luted to vital teeth with a dual-curing adhesive system and a self-curing resin cement.

    PubMed

    Fabianelli, Andrea; Goracci, Cecilia; Bertelli, Egidio; Davidson, Carel L; Ferrari, Marco

    2006-12-01

    The aim of the study was to clinically evaluate Empress II inlays cemented with a dual-curing bonding agent and a self-curing luting system. Forty patients were selected to receive one Empress II inlay. Empress II is a heat-pressed glass ceramic containing lithium disilicate and lithium orthophosphate crystals, purported to provide higher stress resistance and improved strength. The restorations were placed between March and May 2000. Recalls were performed after 6, 12, 24, and 36 months. At the 3-year recall, 7 patients were lost to follow-up. Inlays were evaluated for postoperative sensitivity, marginal integrity, marginal leakage, color stability, surface staining, retention, and surface crazing (microcracks). At the 3-year recall, all the restorations were in place and only one showed postoperative sensitivity (at the first recall, 1 week after placement). Only 3 inlays showed slight marginal staining, and 4 inlays showed gaps, with little surface staining or microcracks. No inlay debonded or fractured during theobservation period. All the evaluated inlays were in place and acceptable.

  18. Treatment effects of fixed functional appliances in patients with Class II malocclusion: a systematic review and meta-analysis

    PubMed Central

    Zymperdikas, Vasileios F.; Koretsi, Vasiliki; Papageorgiou, Spyridon N.

    2016-01-01

    Summary Objective: To assess the treatment effects of fixed functional appliances (FFAs) in treated versus untreated Class II patients by means of lateral cephalometric radiographs. Search methods: Unrestricted electronic search of 18 databases and additional manual searches up to October 2014. Selection criteria: Prospective randomized and non-randomized controlled trials reporting on cephalometric angular measurements of Class II patients treated with FFAs and their matched untreated controls. Data collection and analysis: Skeletal, dental, and soft tissue cephalometric data were annualized and stratified according to the time of evaluation in effects. Following risk of bias evaluation, the mean differences (MDs) and 95 % confidence intervals (CIs) were calculated with random-effects models. Patient- and appliance-related subgroup analyses and sensitivity analyses were performed with mixed-effects models. Results: Nine studies were included (244 patients; mean age: 13.5 years and 174 untreated controls; mean age: 12.8 years) reporting on cephalometric effects directly after the removal of FFAs. FFAs were found to induce a small reduction of SNA angle (MD = −0.83 degree/year, 95 % CI: −1.17 to −0.48), a small increase of SNB angle (MD = 0.87 degree/year, 95 % CI: 0.30–1.43), and moderate decrease of ANB angle (MD = −1.74 degree/year, 95 % CI: −2.50 to −0.98) compared to untreated Class II patients. FFA treatment resulted in significant dentoalveolar and soft tissue changes. Several patient- or appliance-related factors seem to affect the treatment outcome. Long-term effectiveness of FFAs could not be assessed due to limited evidence. Conclusions: According to existing evidence, FFAs seem to be effective in improving Class II malocclusion in the short term, although their effects seem to be mainly dentoalveolar rather than skeletal. PMID:25995359

  19. [Prevalence of irritable bowel syndrome in Veracruz City, Mexico: a community-based survey].

    PubMed

    Valerio-Ureña, J; Vásquez-Fernández, F; Jiménez-Pineda, A; Cortázar-Benítez, L F; Azamar-Jácome, A A; Duarte-Velázquez, M E; Torres-Medina, V

    2010-01-01

    Irritable bowel syndrome (IBS) is recognized as the most frequent functional digestive disorder around the world. In Latin America and Mexico there are few studies in order to demonstrate its real prevalence in general population. To determine the prevalence of IBS in general population from Veracruz City Mexico, using the Rome II criteria. Using basic information given by bureau for planning urban services from Veracruz country, a 10% random population sample was obtained. Subjects between 16-80 years old were interviewed using a questionnaire based on Rome II criteria and a visual analogous scale in order to estimate the negative effect of IBS symptoms on daily activities. We interviewed 459 subjects with a median age of 31.2 +/- 13.6 years old detecting 78 subjects (16.9%) with IBS symptoms: 25 males and 53 females (gender prevalence of 11.3% and 22.1%, respectively). 28.2% of them had IBS with diarrhea, 50% had IBS with constipation and 21.8% alternating bowel movements, diarrhea and constipation. Negative effect of IBS symptoms on daily activities was significant. The prevalence of IBS in open population was 16.9% according to Rome II criteria, being higher in those older than 35 years old. Constipation was the predominant pattern. Further studies should evaluate associated factors of these findings.

  20. Self-esteem in adolescents with Angle Class I, II and III malocclusion in a Peruvian sample.

    PubMed

    Florián-Vargas, Karla; Honores, Marcos J Carruitero; Bernabé, Eduardo; Flores-Mir, Carlos

    2016-01-01

    To compare self-esteem scores in 12 to 16-year-old adolescents with different Angle malocclusion types in a Peruvian sample. A cross-sectional study was conducted in a sample of 276 adolescents (159, 52 and 65 with Angle Class I, II and III malocclusions, respectively) from Trujillo, Peru. Participants were asked to complete the Rosenberg Self-Esteem Scale (RSES) and were also clinically examined, so as to have Angle malocclusion classification determined. Analysis of covariance (ANCOVA) was used to compare RSES scores among adolescents with Class I, II and III malocclusions, with participants' demographic factors being controlled. Mean RSES scores for adolescents with Class I, II and III malocclusions were 20.47 ± 3.96, 21.96 ± 3.27 and 21.26 ± 4.81, respectively. The ANCOVA test showed that adolescents with Class II malocclusion had a significantly higher RSES score than those with Class I malocclusion, but there were no differences between other malocclusion groups. Supplemental analysis suggested that only those with Class II, Division 2 malocclusion might have greater self-esteem when compared to adolescents with Class I malocclusion. This study shows that, in general, self-esteem did not vary according to adolescents' malocclusion in the sample studied. Surprisingly, only adolescents with Class II malocclusion, particularly Class II, Division 2, reported better self-esteem than those with Class I malocclusion. A more detailed analysis assessing the impact of anterior occlusal features should be conducted.

  1. Construct Validation of Three Nutrition Questions Using Health and Diet Ratings in Older Canadian Males Living in the Community.

    PubMed

    Akhtar, Usman; Keller, Heather H; Tate, Robert B; Lengyel, Christina O

    2015-12-01

    Brief nutrition screening tools are desired for research and practice. Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN-II, 14 items) and the abbreviated version SCREEN-II-AB (8 items) are valid and reliable nutrition screening tools for older adults. This exploratory study used a retrospective cross-sectional design to determine the construct validity of a subset of 3 items (weight loss, appetite, and swallowing difficulty) currently on the SCREEN-II and SCREEN-II-AB tools. Secondary data on community-dwelling senior males (n = 522, mean ± SD age = 86.7 ± 3.0 years) in the Manitoba Follow-up Study (MFUS) study were available for analysis. Participants completed the mailed MFUS Nutrition Survey that included SCREEN-II items and questions pertaining to self-rated health, diet healthiness, and rating of the importance of nutrition towards successful aging as the constructs for comparison. Self-perceived health status (F = 14.7, P < 0.001), diet healthiness (ρ = 0.17, P = 0.002) and the rating of nutrition's importance to aging (ρ = 0.10, P = 0.03) were correlated with the 3-item score. Inferences were consistent with associations between these construct variables and the full SCREEN-II. Three items from SCREEN-II and SCREEN-II-AB demonstrate initial construct validity with self-perceived health status and diet healthiness ratings by older males; further exploration for criterion and predictive validity in more diverse samples is needed.

  2. Composite Sickles and Cereal Harvesting Methods at 23,000-Years-Old Ohalo II, Israel

    PubMed Central

    Weiss, Ehud; Nadel, Dani

    2016-01-01

    Use-wear analysis of five glossed flint blades found at Ohalo II, a 23,000-years-old fisher-hunter-gatherers’ camp on the shore of the Sea of Galilee, Northern Israel, provides the earliest evidence for the use of composite cereal harvesting tools. The wear traces indicate that tools were used for harvesting near-ripe semi-green wild cereals, shortly before grains are ripe and disperse naturally. The studied tools were not used intensively, and they reflect two harvesting modes: flint knives held by hand and inserts hafted in a handle. The finds shed new light on cereal harvesting techniques some 8,000 years before the Natufian and 12,000 years before the establishment of sedentary farming communities in the Near East. Furthermore, the new finds accord well with evidence for the earliest ever cereal cultivation at the site and the use of stone-made grinding implements. PMID:27880839

  3. Composite Sickles and Cereal Harvesting Methods at 23,000-Years-Old Ohalo II, Israel.

    PubMed

    Groman-Yaroslavski, Iris; Weiss, Ehud; Nadel, Dani

    2016-01-01

    Use-wear analysis of five glossed flint blades found at Ohalo II, a 23,000-years-old fisher-hunter-gatherers' camp on the shore of the Sea of Galilee, Northern Israel, provides the earliest evidence for the use of composite cereal harvesting tools. The wear traces indicate that tools were used for harvesting near-ripe semi-green wild cereals, shortly before grains are ripe and disperse naturally. The studied tools were not used intensively, and they reflect two harvesting modes: flint knives held by hand and inserts hafted in a handle. The finds shed new light on cereal harvesting techniques some 8,000 years before the Natufian and 12,000 years before the establishment of sedentary farming communities in the Near East. Furthermore, the new finds accord well with evidence for the earliest ever cereal cultivation at the site and the use of stone-made grinding implements.

  4. Spectroscopic evidence for the role of a site of the di-iron catalytic center of ferritins in tuning the kinetics of Fe(ii) oxidation.

    PubMed

    Ebrahimi, Kourosh Honarmand; Bill, Eckhard; Hagedoorn, Peter-Leon; Hagen, Wilfred R

    2016-11-15

    Ferritin is a nanocage protein made of 24 subunits. Its major role is to manage intracellular concentrations of free Fe(ii) and Fe(iii) ions, which is pivotal for iron homeostasis across all domains of life. This function of the protein is regulated by a conserved di-iron catalytic center and has been the subject of extensive studies over the past 50 years. Yet, it has not been fully understood how Fe(ii) is oxidized in the di-iron catalytic center and it is not known why eukaryotic and microbial ferritins oxidize Fe(ii) with different kinetics. In an attempt to obtain a new insight into the mechanism of Fe(ii) oxidation and understand the origin of the observed differences in the catalysis of Fe(ii) oxidation among ferritins we studied and compared the mechanism of Fe(ii) oxidation in the eukaryotic human H-type ferritin (HuHF) and the archaeal ferritin from Pyrococcus furiosus (PfFtn). The results show that the spectroscopic characteristics of the intermediate of Fe(ii) oxidation and the Fe(iii)-products are the same in these two ferritins supporting the proposal of unity in the mechanism of Fe(ii) oxidation among eukaryotic and microbial ferritins. Moreover, we observed that a site in the di-iron catalytic center controls the distribution of Fe(ii) among subunits of HuHF and PfFtn differently. This observation explains the reported differences between HuHF and PfFtn in the kinetics of Fe(ii) oxidation and the amount of O 2 consumed per Fe(ii) oxidized. These results provide a fresh understanding of the mechanism of Fe(ii) oxidation by ferritins.

  5. Complete Reversibility of the Chiari Type II Malformation After Postnatal Repair of Myelomeningocele.

    PubMed

    Beuriat, Pierre-Aurélien; Szathmari, Alexandru; Rousselle, Christophe; Sabatier, Isabelle; Di Rocco, Federico; Mottolese, Carmine

    2017-12-01

    It was believed that Chiari type II malformation (CM-II) was always present in a myelomeningocele (MMC). In fact, it is associated in about 80% of cases. Improvement of the hindbrain herniation after prenatal closure of MMC has challenged the idea that this condition was irreversible. Only 2 studies report ascent of the cerebellar tonsil after postnatal closure. This work aimed to study a large group of patients with MMC who benefited from a postnatal repair to evaluate the rate of long-term total reversibility of CM-II. Sixty-one patients were included. Mean time of follow-up was 8.1 years. The presence of CM-II after closure of the MMC was assessed on the most recent brain scan available for each patient. Forty-seven patients (77%) had a CM-II at birth (confirmed before the MMC repair). There was a significant correlation between the level of the malformation and the presence of a CM-II at birth (P = 0.003). After MMC closure, only 28 (45.9%) patients had a remaining CM-II. The reversibility rate was 40.4%. The reversibility was higher in lower level malformations (P = 0.004). The number of patients treated for hydrocephalus was significantly higher in the group of patients with remaining CM-II (P = 0.004). Only 11.5% of the children needed surgery for a symptomatic CM-II. MMC is not always associated with CM-II. The outcome of CM-II has improved. Postnatal closure can reverse the CM-II. This must be kept in mind when analyzing the result of prenatal series. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. S-1 chemotherapy and intensity-modulated radiotherapy after D1/D2 lymph node dissection in patients with node-positive gastric cancer: a phase I/II study.

    PubMed

    Wang, X; Zhao, D B; Yang, L; Chi, Y; Tang, Y; Li, N; Wang, S L; Song, Y W; Liu, Y P; Liu, W Y; Ren, H; Zhang, T; Wang, J Y; Chen, X S; Fang, H; Wang, W H; Li, Y X; Jin, J

    2018-02-06

    This phase I/II clinical trial investigated S-1 administered with intensity-modulated radiotherapy (IMRT) as adjuvant therapy for node-positive gastric cancer. Patients had undergone radical resection and D1/D2 lymph node dissection. In phase I, patients received adjuvant chemoradiotherapy of IMRT (45 Gy in 25 fractions) with concurrent S-1 administered on a dose-escalation schedule to determine the recommended dose (RD). In phase II, the safety and efficacy of the RD of S-1 combined with IMRT were assessed. We consecutively enrolled 73 patients (56 men; median age, 53 years; range, 29-73 years) and the phase I portion of the study included 27 patients. The RD of S-1 administered concomitantly with IMRT was 80 mg m -2  day -1 orally, twice daily. The phase II analysis included 52 patients (46 new patients plus 6 from phase I). 8 patients (15.4%) developed grade 3 or 4 toxicities. There were 21 recurrence events and 15 deaths (1 bowel obstruction, 14 gastric cancer). Three-year disease-free survival and overall survival were 62.2% (95% confidence interval (CI), 48.5-75.9) and 70.0% (95% CI, 56.3-83.7), respectively. The median time to recurrence was 17.5 months (range, 3.8-42.0). The median time from recurrence to death was 7.0 months (range, 1.5-28.7). S-1 combined with IMRT adjuvant chemoradiotherapy is safe and efficacious for advanced gastric cancer.

  7. Observational Prospective study to esTIMAte the rates of outcomes in patients undergoing PCI with drug-eluting stent implantation who take statins -follow-up (OPTIMA II).

    PubMed

    Karpov, Yu; Logunova, N; Tomilova, D; Buza, V; Khomitskaya, Yu

    2017-02-01

    The OPTIMA II study sought to evaluate rates of major adverse cardiac and cerebrovascular events (MACCEs) during the long-term follow-up of chronic statin users who underwent percutaneous coronary intervention (PCI) with implantation of a drug-eluting stent (DES). OPTIMA II was a non-interventional, observational study conducted at a single center in the Russian Federation. Included patients were aged ≥18 years with stable angina who had received long-term (≥1 month) statin therapy prior to elective PCI with DES implantation and who had participated in the original OPTIMA study. Patients received treatment for stable angina after PCI as per routine study site clinical practice. Study data were collected from patient medical records and a routine visit 4 years after PCI. NCT02099565. Rate of MACCEs 4 years after PCI. Overall, 543 patients agreed to participate in the study (90.2% of patients in the original OPTIMA study). The mean (± standard deviation [SD]) duration of follow-up from the date of PCI to data collection was 4.42 ± 0.58 (range: 0.28-5.56) years. The frequency of MACCEs (including data in patients who died) was 30.8% (95% confidence interval: 27.0-34.7); half of MACCEs occurred in the first year of follow-up. After PCI, the majority of patients had no clinical signs of angina. Overall, 24.3% of patients discontinued statin intake in the 4 years after PCI. Only 7.7% of patients achieved a low-density lipoprotein (LDL) cholesterol goal of <1.8 mmol/L. Key limitations of this study related to its observational nature; for example, the sample size was small, the clinical results were derived from outpatients and hospitalized medical records, only one follow-up visit was performed at the end of the study (after 4 years' follow-up), only depersonalized medical information was made available for statistical analysis, and adherence to statin treatment was evaluated on the basis of patient questionnaire. Long-term follow-up of patients who underwent PCI with DES implantation demonstrated MACCEs in nearly one-third of patients, which is comparable to data from other studies. PCI was associated with relief from angina or minimal angina frequency, but compliance with statin therapy and the achievement of LDL cholesterol targets 4 years after PCI were suboptimal.

  8. Determination of Teacher Candidates' Views Concerning V Diagrams Used in General Biology Laboratories

    ERIC Educational Resources Information Center

    Kayacan, Kadriye

    2018-01-01

    This study was conducted within the scope of the General Biology Laboratory II course, which was taught in the Science Teaching Department in the Spring semester of the 2016-2017 academic year. The study group consisted of 40 teacher candidates in their second year in the Science Teaching Department at a state university in Konya. The purpose of…

  9. Short-term effects of air pollution on respiratory morbidity at Rio de Janeiro--Part II: health assessment.

    PubMed

    Sousa, S I V; Pires, J C M; Martins, E M; Fortes, J D N; Alvim-Ferraz, M C M; Martins, F G

    2012-08-01

    The effects of air pollution on health have been studied worldwide. Given that air pollution triggers oxidative stress and inflammation, it is plausible that high levels of air pollutants cause higher number of hospitalisations. This study aimed to assess the impact of air pollution on the emergency hospitalisation for respiratory disease in Rio de Janeiro, Brazil. The study was divided in two parts: Part I specifically addressing the air pollution assessment and Part II addressing the health assessment. Accordingly, this Part II aimed to estimate the association between the concentrations of PM₁₀, SO₂ and CO observed in Rio de Janeiro and the number of emergency hospitalisations at a central hospital due to respiratory diseases. The pollutant concentrations were measured at two different sites in Rio de Janeiro, but the excess relative risks were calculated based on the concentrations observed at one of the sites, where limits were generally exceeded more frequently, between September 2000 and December 2005. A time series analysis was performed using the number of hospitalisations, divided in three categories (children until 1 year old, children aged between 1 and 5 years old and elderly with 65 years old or more) as independent variable, the concentrations of pollutants as dependent variables and temperature, relative humidity, long term trend, and seasonality as confounders. Data were analysed using generalised additive models with smoothing for some of the dependent variables. Results showed an excess risk of hospitalisation for respiratory disease higher than 2% per 10 μg m⁻³ increase in PM₁₀ concentrations for children under 5 years old, of 2% per 10 μg m⁻³ increase in SO₂ for elderly above 65 years old and around 0.1% per 10 μg m⁻³ increase in CO for children under 1 year and elderly. Other studies have found associations that are in agreement with the results achieved in this study. The study suggests that the ambient levels of air pollutants experienced in Rio de Janeiro between 2000 and 2005 were linked to the number of hospitalisations for respiratory diseases among children and elderly. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Microbial strategy for potential lead remediation: a review study.

    PubMed

    Pan, Xiaohong; Chen, Zhi; Li, Lan; Rao, Wenhua; Xu, Zhangyan; Guan, Xiong

    2017-02-01

    The extensive exploitation and usage of lead compounds result in severe lead(II) pollution in water and soil environments, even in agricultural land, threatening the health of animals and humans via food chains. The recovery and remediation of lead(II) from water and soil environments have been intensively concerned in recent years. Compared with the traditional physic-chemistry treatment, microbial remediation strategy is a promising alternative to remediate lead(II)-contaminated environments due to its cost-effective and environmentally-friendly properties. Various microorganisms are capable of removing or immobilizing lead(II) from water and soil environments through bioaccumulation, precipitation or accelerated transformation of lead(II) into a very stable mineral, resulting in significant effects on lead(II) mobility and bioavailability. In the present review, we investigated a wide diversity of lead(II) bioremediation induced by different microbes and its multi-mechanisms. Moreover, we also discussed the progress and limitations, summarized the common rules of lead(II)-microbe interaction, and evaluated the environmental significance of microbes in lead biogeochemistry process. In addition, we further deliberated the feasibility and potential application of microbes in developing cost-effective, eco-friendly bioremediation or long-term management strategy for lead(II) contaminated repositories.

  11. The Impact of Reclassification from Division II to DI-AA and from Division I-AA to I-A on NCAA Member Institutions from 1993 to 2003

    ERIC Educational Resources Information Center

    Frieder, Laura L., Comp.; Fulks, Daniel L., Comp.

    2007-01-01

    Recent years have seen a number of National Collegiate Athletic Association (NCAA) Division II institutions seeking reclassification to Division I-AA and Division I-AA institutions moving to Division I-A. Yet, other schools that seem like natural candidates to reclassify have resisted. The purpose of this study is to investigate the impact of the…

  12. Fifteenth Annual Technical Report, 1 June 1974 to 31 May 1975,

    DTIC Science & Technology

    1975-05-31

    of oxygen and nitric oxide catalysed by iron(II) and cobalt(II) macrocycles. One example is the catalytic reactions of alcohols with nitric ... of experimental and theoretical techniques are being em- ployed by thrust area members. One must study experimentally the structure of the bonding...design, worked out in a collaborative way based on research that was being carried out for a number of years by McMahon and

  13. Contract for Manpower and Personnel Research and Studies II (COMPRS-II) Annual Report - Year Four

    DTIC Science & Technology

    2002-10-01

    Wonderlic and the Prueba de Aptitud Academica (PAA) will be evaluated in the pilot "Foreign Language Recruiting Initiative" project. Starting in October...Spanish Wonderlic and the Prueba de Aptitud Academica (PAA) will be evaluated in the pilot "Foreign Language Recruiting Initiative" project. Starting...implemented by linear programming software , which optimizes the Army’s enlisted personnel classification system, while accounting for realistic

  14. Motor and Cognitive Outcomes Through Three Years Of Age In Children Exposed To Prenatal Methamphetamine

    PubMed Central

    Smith, Lynne M.; LaGasse, Linda L.; Derauf, Chris; Newman, Elana; Shah, Rizwan; Haning, William; Arria, Amelia; Huestis, Marilyn; Strauss, Arthur; Grotta, Sheri Della; Dansereau, Lynne M.; Lin, Hai; Lester, Barry M.

    2010-01-01

    Background Methamphetamine (MA) use among pregnant women is an increasing problem in the United States. The impact of prenatal MA exposure on development in childhood is unknown. Objective To examine the effects of prenatal MA exposure on motor and cognitive development in children at 1, 2, and 3 years of age. Design/Methods IDEAL enrolled 412 mother-infant pairs at four sites (Tulsa OK, Des Moines IA, Los Angeles CA, and Honolulu HI). MA subjects (n=204) were identified by self-report or GC/MS confirmation of amphetamine and metabolites in infant meconium. Comparison subjects (n=208) were matched (race, birth weight, maternal education, type of insurance), denied amphetamine use, and had a negative meconium screen. Both groups included prenatal alcohol, tobacco and marijuana use, but excluded use of opiates, lysergic acid diethylamide, phencyclidine or cocaine only. The Peabody Developmental Motor Scales (PDMS-2) were administered to the infants at the 1 and 3 year visits. This analysis includes a subsample (n=350) of the IDEAL study with completed 1 and/or 3 year visits (n= 330 and 281, respectively). At each annual visit we also conducted the Bayley Scales of Infant Development (BSID-II) as a general evaluation of mental and motor development. The BSID-II analysis includes a subsample (n=356) of the IDEAL study with completed 1, 2, and/or 3 year visits (n= 331, 288, and 278 respectively). GLM analysis conducted on the PDMS-2 and BSID-II examined the effects of MA exposure and heavy MA exposure (≥3 days of use/week), with and without covariates. Longitudinal analyses were used to examine the effects of MA exposure on changes in motor and cognitive performance over time. Results Heavy MA exposure was associated with significantly lower grasping scores than some and no use at 1 year (P = 0.018). In longitudinal analysis, lower grasping scores associated with any MA exposure and heavy exposure persisted to 3 years. There were no effects of MA exposure, including heavy exposure, on the Bayley Mental Development Index (MDI) or Psychomotor Development Index (PDI) at any or across age. Conclusions There were no differences in cognition as assessed by the BSID-II between the groups. There was a subtle MA exposure effect on fine motor performance at 1 year with the poorest performance observed in the most heavily exposed children. By 3 years, no differences in fine motor performance were observed. These findings suggest MA exposure has modest motor effects at 1 year that are mostly resolved by 3 years. PMID:21256431

  15. Motor and cognitive outcomes through three years of age in children exposed to prenatal methamphetamine.

    PubMed

    Smith, Lynne M; LaGasse, Linda L; Derauf, Chris; Newman, Elana; Shah, Rizwan; Haning, William; Arria, Amelia; Huestis, Marilyn; Strauss, Arthur; Della Grotta, Sheri; Dansereau, Lynne M; Lin, Hai; Lester, Barry M

    2011-01-01

    Methamphetamine (MA) use among pregnant women is an increasing problem in the United States. The impact of prenatal MA exposure on development in childhood is unknown. To examine the effects of prenatal MA exposure on motor and cognitive development in children at 1, 2, and 3 years of age. IDEAL enrolled 412 mother-infant pairs at four sites (Tulsa OK, Des Moines IA, Los Angeles CA, and Honolulu HI). MA subjects (n=204) were identified by self report or GC/MS confirmation of amphetamine and metabolites in infant meconium. Comparison subjects (n=208) were matched (race, birth weight, maternal education, and type of insurance), denied amphetamine use, and had a negative meconium screen. Both groups included prenatal alcohol, tobacco and marijuana use, but excluded use of opiates, lysergic acid diethylamide, phencyclidine or cocaine only. The Peabody Developmental Motor Scales (PDMS-2) were administered to the infants at the 1 and 3 year visits. This analysis includes a subsample (n=350) of the IDEAL study with completed 1 and/or 3 year visits (n=330 and 281, respectively). At each annual visit we also conducted the Bayley Scales of Infant Development (BSID-II) as a general evaluation of mental and motor development. The BSID-II analysis includes a subsample (n=356) of the IDEAL study with completed 1, 2, and/or 3 year visits (n=331, 288, and 278 respectively). GLM analysis conducted on the PDMS-2 and BSID-II examined the effects of MA exposure and heavy MA exposure (≥3 days of use/week), with and without covariates. Longitudinal analyses were used to examine the effects of MA exposure on changes in motor and cognitive performance over time. Heavy MA exposure was associated with significantly lower grasping scores than some and no use at 1 year (P=0.018). In longitudinal analysis, lower grasping scores associated with any MA exposure and heavy exposure persisted to 3 years. There were no effects of MA exposure, including heavy exposure, on the Bayley Mental Development Index (MDI) or Psychomotor Development Index (PDI) at any or across age. There were no differences in cognition as assessed by the BSID-II between the groups. There was a subtle MA exposure effect on fine motor performance at 1 year with the poorest performance observed in the most heavily exposed children. By 3 years, no differences in fine motor performance were observed. These findings suggest MA exposure has modest motor effects at 1 year that are mostly resolved by 3 years. Copyright © 2010 Elsevier Inc. All rights reserved.

  16. Australian Biology Test Item Bank, Years 11 and 12. Volume II: Year 12.

    ERIC Educational Resources Information Center

    Brown, David W., Ed.; Sewell, Jeffrey J., Ed.

    This document consists of test items which are applicable to biology courses throughout Australia (irrespective of course materials used); assess key concepts within course statement (for both core and optional studies); assess a wide range of cognitive processes; and are relevant to current biological concepts. These items are arranged under…

  17. Insulin-like growth factor (IGF)-I, IGF-II and IGF-binding protein (IGFBP)-3 levels in Arab subjects with coronary heart disease.

    PubMed

    Akanji, A O; Suresh, C G; Al-Radwan, R; Fatania, H R

    2007-01-01

    Insulin-like growth factors (IGF-I, IGF-II) and their binding protein (IGFBP-3) may be risk markers for coronary heart disease (CHD). This study aimed to assess the levels and determinants of the serum levels of IGF-I, IGF-II and IGFBP-3 in Arab patients with established CHD. Two groups of subjects were matched for age, gender, BMI and waist-hip ratio (WHR): (i) CHD (n = 105), median age 51.0 (range 40.0-60.0) years; (ii) controls (n = 97) aged 49.0 (range 37.0-60.0) years. We measured fasting serum levels of glucose and lipoproteins (total cholesterol, triglycerides, LDL, HDL, apo B), insulin, HOMA-IR, IGF-I, IGF-II and IGFBP-3 and compared the results between groups. The effects of body mass and the metabolic syndrome (MS) on IGF levels were also examined, and linear correlations were sought between the various parameters. The levels of IGF-I, IGF-II and IGFBP-3 were significantly lower (all p<0.01) for the CHD group than for the control group. These differences were not influenced by BMI or with the presence of MS. In CHD, there were no significant correlations between levels of IGF-I and IGF-II and age, BMI, WHR, lipoprotein concentrations and insulin sensitivity, although IGFBP-3 had weakly significant relationships with some of the lipoproteins. Levels of IGF-I, IGF-II and IGFBP3 are reduced in male Arab patients with CHD, and did not appear influenced by traditional CHD risk factors such as age, BMI, insulin sensitivity and presence of MS. Perturbations in the IGF/IGFBP-3 axis may be potential additional targets for pharmacological manipulation in CHD.

  18. Phase II study of mitoguazone, cyclophosphamide, doxorubicin, vincristine and prednisone for patients with diffuse histologic subtypes of non-Hodgkin's lymphoma: an Eastern Cooperative Oncology Group Study (PE481).

    PubMed

    Wiernik, P H; Moore, D F; Bennett, J M; Vogl, S E; Harris, J E; Luger, S; Oken, M M; Glick, J H

    1998-08-01

    Mitoguazone, an investigational agent with significant activity in advanced lymphoma, was added to a modified CHOP regimen (COPA) in an effort to improve the activity of standard therapy in 66 previously untreated patients with stages II-IV lymphoma and diffuse histology of intermediate or high grade other than lymphoblastic in this phase II pilot study. The regimen was well tolerated and the complete response rate in diffuse large cell lymphoma was 55%. Sixty-five percent of all complete responders were in complete response for at least one year. Despite these excellent results. it is unlikely that the addition of mitoguazone improved results compared with those obtained with standard therapy alone, since similar results have been frequently reported with the latter.

  19. Adjuvant sunitinib following chemoradiotherapy and surgery for locally advanced esophageal cancer: a phase II trial.

    PubMed

    Horgan, A M; Darling, G; Wong, R; Guindi, M; Liu, G; Jonker, D J; Lister, J; Xu, W; MacKay, H M; Dinniwell, R; Kim, J; Pierre, A; Shargall, Y; Asmis, T R; Agboola, O; Seely, A J; Ringash, J; Wells, J; Marginean, E C; Haider, M; Knox, J J

    2016-11-01

    The prognosis for locally advanced esophageal cancer is poor despite the use of trimodality therapy. In this phase II study, we report the feasibility, tolerability and efficacy of adjuvant sunitinib. Included were patients with stage IIa, IIB or III cancer of the thoracic esophagus or gastroesophageal junction. Neoadjuvant therapy involved Irinotecan (65 mg/m 2 ) + Cisplatin (30 mg/m 2 ) on weeks 1 and 2, 4 and 5, 7 and 8 with concurrent radiation (50Gy/25 fractions) on weeks 4-8. Sunitinib was commenced 4-13 weeks after surgery and continued for one year. Sixty-one patients were included in the final analysis, 36 patients commenced adjuvant sunitinib. Fourteen patients discontinued sunitinib due to disease recurrence (39%) within the 12-month period, 12 (33%) discontinued due to toxicity, and 3 (8%) requested cessation of therapy. In the overall population, median survival was 26 months with a 2 and 3-year survival rate of 52% and 35%, respectively. The median survival for the 36 patients treated with sunitinib was 35 months and 2-year survival probability of 68%. In a historical control, a prior phase II study with the same trimodality therapy (n = 43), median survival was 36 months, with a 2-year survival of 67%. Initiation of adjuvant sunitinib is feasible, but poorly tolerated, with no signal of additional benefit over trimodality therapy for locally advanced esophageal cancer. © 2015 International Society for Diseases of the Esophagus.

  20. Effect of Baseline Nutritional Status on Long-term Multivitamin Use and Cardiovascular Disease Risk

    PubMed Central

    Rautiainen, Susanne; Gaziano, J. Michael; Christen, William G.; Bubes, Vadim; Kotler, Gregory; Glynn, Robert J.; Manson, JoAnn E.; Buring, Julie E.

    2017-01-01

    Importance Long-term multivitamin use had no effect on risk of cardiovascular disease (CVD) in the Physicians’ Health Study II. Baseline nutritional status may have modified the lack of effect. Objective To investigate effect modification by various baseline dietary factors on CVD risk in the Physicians’ Health Study II. Design, Setting, and Participants The Physicians’ Health Study II was a randomized, double-blind, placebo-controlled trial testing multivitamin use (multivitamin [Centrum Silver] or placebo daily) among US male physicians. The Physicians’ Health Study II included 14 641 male physicians 50 years or older, 13 316 of whom (91.0%) completed a baseline 116-item semiquantitative food frequency questionnaire and were included in the analyses. This study examined effect modification by baseline intake of key foods, individual nutrients, dietary patterns (Alternate Healthy Eating Index and Alternate Mediterranean Diet Score), and dietary supplement use. The study began in 1997, with continued treatment and follow-up through June 1, 2011. Interventions Multivitamin or placebo daily. Main Outcomes and Measures Major cardiovascular events, including nonfatal myocardial infarction, nonfatal stroke, and CVD mortality. Secondary outcomes included myocardial infarction, total stroke, CVD mortality, and total mortality individually. Results In total, 13 316 male physicians (mean [SD] age at randomization, 64.0 [9.0] years in those receiving the active multivitamin and 64.0 [9.1] years in those receiving the placebo) were observed for a mean (SD) follow-up of 11.4 (2.3) years. There was no consistent evidence of effect modification by various foods, nutrients, dietary patterns, or baseline supplement use on the effect of multivitamin use on CVD end points. Statistically significant interaction effects were observed between multivitamin use and vitamin B6 intake on myocardial infarction, between multivitamin use and vitamin D intake on CVD mortality, and between multivitamin use and vitamin B12 intake on CVD mortality and total mortality. However, there were inconsistent patterns in hazard ratios across tertiles of each dietary factor that are likely explained by multiple testing. Conclusions and Relevance The results suggest that baseline nutritional status does not influence the effect of randomized long-term multivitamin use on major CVD events. Future studies are needed to investigate the role of baseline nutritional biomarkers on the effect of multivitamin use on CVD and other outcomes. Trial Registration clinicaltrials.gov Identifier: NCT00270647 PMID:28384735

  1. Phase I/II Trial and Pharmacokinetic Study of Cixutumumab in Pediatric Patients With Refractory Solid Tumors and Ewing Sarcoma: A Report From the Children's Oncology Group

    PubMed Central

    Malempati, Suman; Weigel, Brenda; Ingle, Ashish M.; Ahern, Charlotte H.; Carroll, Julie M.; Roberts, Charles T.; Reid, Joel M.; Schmechel, Stephen; Voss, Stephan D.; Cho, Steven Y.; Chen, Helen X.; Krailo, Mark D.; Adamson, Peter C.; Blaney, Susan M.

    2012-01-01

    Purpose A phase I/II study of cixutumumab (IMC-A12) in children with refractory solid tumors was conducted. This study was designed to assess the toxicities, pharmacokinetics, and pharmacodynamics of cixutumumab in children to determine a recommended phase II dose and to assess antitumor activity in Ewing sarcoma (ES). Patients and Methods Pediatric patients with relapsed or refractory solid tumors were treated with cixutumumab as a 1-hour intravenous infusion once per week. Two dose levels—6 and 9 mg/kg—were evaluated using a standard three-plus-three cohort design. Patients with refractory ES were treated in an expanded phase II cohort at each dose level. Results Forty-seven eligible patients with a median age of 15 years (range, 4 to 28 years) were enrolled. Twelve patients were treated in the dose-finding phase. Hematologic and nonhematologic toxicities were generally mild and infrequent. Dose-limiting toxicities included grade 4 thrombocytopenia at 6 mg/kg and grade 3 dehydration at 9 mg/kg. Mean trough concentration (± standard deviation) at 9 mg/kg was 106 ± 57 μg/mL, which exceeded the effective trough concentration of 60 μg/mL observed in xenograft models. Three patients with ES had confirmed partial responses: one of 10 at 6 mg/kg and two of 20 at 9 mg/kg. Serum insulin-like growth factor I (IGF-I) levels consistently increased after one dose of cixutumumab. Tumor IGF-I receptor expression by immunohistochemistry did not correlate with response in patients with ES. Conclusion Cixutumumab is well tolerated in children with refractory solid tumors. The recommended phase II dose is 9 mg/kg. Limited single-agent activity of cixutumumab was seen in ES. PMID:22184397

  2. Post-treatment occlusal changes in Class II division 2 subjects treated with the Herbst appliance.

    PubMed

    Bock, Niko; Ruf, Sabine

    2008-12-01

    The aim of this retrospective study was to analyse and compare the post-treatment occlusal changes of Class II division 2 treatment with the Herbst appliance in early adolescent, late adolescent, and adult subjects. The subjects were 37 Class II division 2 patients (19 females and 18 males) treated at the Orthodontic Department, University of Giessen, Germany. All were in the late mixed or permanent dentition and exhibited a Class II molar relationship > or =0.5 cusp width (CW) bilaterally or > or =1.0 CW unilaterally, an overbite (OB) >3.0 mm, and two upper central incisors retroclined. The subjects were divided into three skeletal maturity groups based on evaluation of hand wrist radiographs: early adolescent (n = 10, stages MP3-E to MP3-FG at start of treatment, age range: 11.3-13.2 years), late adolescent (n = 14, stages MP3-G to MP3-I at start of treatment, age range: 14.1-16.4 years), and adult (n = 13, stages R-I to R-J at the start of treatment, age range: 16.3-25.6 years). Study casts from before treatment (T1), after Herbst-Tip-Edge-Multibracket appliance treatment (T2), and after an average retention time of 27 months (T3) were analysed. Statistical analysis was undertaken using t-tests for paired and unpaired samples. For the whole sample, the molar relationship at T3 was stable in 82.4 per cent, the canine relationship in 82.9 per cent, and OB in 75.7 per cent of the cases. In the different skeletal maturity groups, the stability of the molars, canines, and overbite was as follows: early adolescents: 95.0, 100.0, and 70.0 per cent, respectively; late adolescents: 92.9, 74.1, and 85.7 per cent, respectively; and adults 61.5, 80.8, 69.2 per cent, respectively. Occlusal correction of Class II division 2 malocclusions with Herbst treatment was relatively stable 2 years post-treatment. The outcome of treatment of adolescents was more stable than that of adults.

  3. Outcomes and Effect of Radiotherapy in Patients With Stage I or II Diffuse Large B-Cell Lymphoma: A Surveillance, Epidemiology, and End Results Analysis

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

    Ballonoff, Ari; Rusthoven, Kyle E.; Schwer, Amanda

    2008-12-01

    Purpose: To assess disease-specific survival (DSS), overall survival (OS), and the effect of radiotherapy (RT) in patients with localized diffuse large B-cell lymphoma (DLBCL). Patients and Methods: The Surveillance, Epidemiology, and End Results database was queried for all patients diagnosed with Stage I, IE, II, or IIE DLBCL between 1988 and 2004. The analyzable data included gender, age, race, stage, presence of extranodal disease, and RT administration. Patients who had died or were lost to follow-up within 6 months of diagnosis were excluded. Results: A total of 13,420 patients met the search criteria. Of these, 5,547 (41%) had received RTmore » and 7,873 (59%) had not. RT was associated with a significant DSS (hazard ratio, 0.82, p <0.0001) and OS benefit that persisted during the 15 years of follow-up. Elderly patients, defined either as those >60 or >70 years old, had significantly improved DSS and OS associated with RT. On multivariate analysis, RT was significantly associated with increased DSS and OS. The 5-year DSS outcomes were highly variable among patient subsets, defined by age, stage, and extranodal disease (range for RT-treated patients, 70% for Stage II, age >60 years to 87% for Stage I, age {<=}60 years). Conclusion: This analysis presents the largest detailed data set of Stage I-II DLBCL patients. The results of our study have demonstrated that RT is associated with a survival advantage in patients with localized DLBCL, a benefit that extends to elderly patients. Outcomes for discrete patient subsets varied greatly. The development of tailored therapy according to the relapse risk is warranted, rather than uniform treatment of all early-stage DLBCL.« less

  4. Biweekly Carboplatin Plus Gemcitabine as First-Line Treatment of Elderly Patients With Advanced Squamous Non-Small-cell Lung Cancer: A Multicenter Phase I-II Trial by the Hellenic Oncology Research Group.

    PubMed

    Karampeazis, Athanasios; Vamvakas, Lambros; Kentepozidis, Nikolaos; Polyzos, Aris; Chandrinos, Vassilis; Rigas, Georgios; Christofyllakis, Charalambos; Kotsakis, Athanasios; Hatzidaki, Dora; Pallis, Athanasios G; Georgoulias, Vassilis

    2016-11-01

    The present study was a phase I/II study to determine the maximum tolerated doses (MTDs) and dose-limiting toxicities of the biweekly carboplatin/gemcitabine combination and evaluate its safety and efficacy in patients aged ≥ 70 years with advanced squamous non-small-cell lung cancer (NSCLC). Patients aged ≥ 70 years with advanced or metastatic squamous NSCLC received escalated doses of carboplatin (area under the curve [AUC] 2-2.5 intravenously) and gemcitabine (800-1100 mg/m 2 intravenously) every 2 weeks (phase I). In the phase II, the drugs were administered at their previously defined MTDs (carboplatin, AUC 2.5; gemcitabine, 1100 mg/m 2 ). The primary endpoint was the overall response rate. A total of 69 patients were enrolled (phase I, n = 15). The median age was 76 years (range, 70-84 years); 52 patients had stage IV disease, and 61 and 8 patients had Eastern Cooperative Oncology Group performance status of 0 to 1 and 2, respectively. The MTDs could not be reached at the predefined last dose levels. The dose-limiting toxicities were grade 5 renal toxicity and grade 3 thrombocytopenia. In the phase II study, the overall response rate was 35.8% (95% confidence interval [CI], 23.0%-48.8%). In the intention-to-treat analysis, the median progression-free survival was 6.7 months (95% CI, 4.2-8.8 months), and the median overall survival was 13.3 months (95% CI, 7.1-19.6 months). Grade 3 or 4 neutropenia was observed in 7 patients (12.3%), grade 3 or 4 thrombocytopenia in 4 patients (7.1%), and grade 2 or 3 fatigue in 10 patients (17.5%). One toxic death occurred in the phase I of the study. The biweekly regimen of gemcitabine and carboplatin showed satisfactory efficacy and a favorable toxicity profile in elderly patients with advanced or metastatic squamous cell NSCLC. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Intrafamilial variability in the clinical manifestations of mucopolysaccharidosis type II: Data from the Hunter Outcome Survey (HOS)

    PubMed Central

    Giugliani, Roberto; Harmatz, Paul; Mendelsohn, Nancy J.; Jego, Virginie; Parini, Rossella

    2017-01-01

    Several cases of phenotypic variability among family members with mucopolysaccharidosis type II (MPS II) have been reported, but the data are limited. Data from patients enrolled in the Hunter Outcome Survey (HOS) were used to investigate intrafamilial variability in male siblings with MPS II. As of July 2015, data were available for 78 patients aged ≥5 years at last visit who had at least one affected sibling (39 sibling pairs). These patients were followed prospectively (i.e., they were alive at enrollment in HOS). The median age at the onset of signs and symptoms was the same for the elder and younger brothers (2.0 years); however, the younger brothers were typically diagnosed at a younger age than the elder brothers (median age, 2.5 and 5.1 years, respectively). Of the 39 pairs, eight pairs were classified as being discordant (the status of four or more signs and symptoms differed between the siblings); 21 pairs had one, two, or three signs and symptoms that differed between the siblings, and 10 pairs had none. Regression status of the majority of the developmental milestones studied was generally concordant among siblings. Functional classification, a measure of central nervous system involvement, was the same in 24/28 pairs, although four pairs were considered discordant as functional classification differed between the siblings. Overall, this analysis revealed similarity in the clinical manifestations of MPS II among siblings. This information should help to improve our understanding of the clinical presentation of the disease, including phenotype prediction in affected family members. PMID:29210515

  6. Fluoride Alters Serum Elemental (Calcium, Magnesium, Copper, and Zinc) Homeostasis Along with Erythrocyte Carbonic Anhydrase Activity in Fluorosis Endemic Villages and Restores on Supply of Safe Drinking Water in School-Going Children of Nalgonda District, India.

    PubMed

    Khandare, Arjun L; Validandi, Vakdevi; Boiroju, Naveen

    2018-02-17

    The present study aimed to determine the serum trace elements (copper (Cu), zinc (Zn), calcium (Ca), magnesium (Mg)) along with erythrocyte carbonic anhydrase (CA) activity and effect of intervention with safe drinking water for 5 years in the school children of fluorosis endemic area. For this purpose, three categories of villages were selected based on drinking water fluoride (F): Category I (control, F = 1.68 mg/L), category II (affected F = 3.77 mg/L), and category III (intervention village) where initial drinking water F was 4.51 mg/L, and since the last 5 years, they were drinking water containing < 1.0 mg/L F. The results revealed that urinary F was significantly (P < 0.05) higher in category II compared to categories I and III. A significant (P < 0.05) increase in serum Cu and Mg was observed in category II compared to category I. Serum Zn and Ca was significantly (P < 0.05) decreased in categories II and III compared to category I. The erythrocyte CA activity was decreased in the category II compared to category I. However, in the category III, erythrocyte CA activity was comparable to the control group. In conclusion, F exposure altered elemental homeostasis which has restored to some extent on intervention by safe drinking water for 5 years in school-going children.

  7. Non-malignant consequences of decreasing asbestos exposure in the Brazil chrysotile mines and mills.

    PubMed

    Bagatin, E; Neder, J A; Nery, L E; Terra-Filho, M; Kavakama, J; Castelo, A; Capelozzi, V; Sette, A; Kitamura, S; Favero, M; Moreira-Filho, D C; Tavares, R; Peres, C; Becklake, M R

    2005-06-01

    To investigate the consequences of improvement in the workplace environment over six decades (1940-96) in asbestos miners and millers from a developing country (Brazil). A total of 3634 Brazilian workers with at least one year of exposure completed a respiratory symptoms questionnaire, chest radiography, and a spirometric evaluation. The study population was separated into three groups whose working conditions improved over time: group I (1940-66, n = 180), group II (1967-76, n = 1317), and group III (1977-96, n = 2137). Respiratory symptoms were significantly related to spirometric abnormalities, smoking, and latency time. Breathlessness, in particular, was also associated with age, pleural abnormality and increased cumulative exposure to asbestos fibres. The odds ratios (OR) for parenchymal and/or non-malignant pleural disease were significantly lower in groups II and III compared to group I subjects (0.29 (0.12-0.69) and 0.19 (0.08-0.45), respectively), independent of age and smoking status. Similar results were found when groups were compared at equivalent latency times (groups I v II: 30-45 years; groups II v III: 20-25 years). Ageing, dyspnoea, past and current smoking, and radiographic abnormalities were associated with ventilatory impairment. Lower spirometric values were found in groups I and II compared to group III: lung function values were also lower in higher quartiles of latency and of cumulative exposure in these subjects. Progressive improvement in occupational hygiene in a developing country is likely to reduce the risk of non-malignant consequences of dust inhalation in asbestos miners and millers.

  8. [Clinical results of double versus single mammary artery myocardiac revascularization: 15 years of follow-up].

    PubMed

    López Rodríguez, F J; Voces, R; Lima, P; Reyes, G; Silva, J; Ruiz, M; Rico, M; González De Diego, F; Fortuny, R; Garrido, G; González Santos, J M; Albertos, J; Fernández Calella, D; Vallejo, J L

    2001-07-01

    Use of the left internal mammary artery to bypass the left anterior descending coronary artery reduces cardiac events and increases survival. However, there is some controversy as to the benefits of using both mammary arteries. To assess the long-term outcome of the use of both mammary arteries in comparison with the use of only one. A retrospective cohort study with a mean follow-up of 9.0 +/- 4.2 years was performed including 108 patients consecutively revascularized using both mammary arteries (II) and 108 patients randomly chosen in whom one mammary artery (I) was used for this purpose. Both groups were similar. There were no differences between the groups in operative morbidity or mortality. The survival at 10 years was similar (II: 84.61 +/- 4%; I: 85.18 +/- 3.8%), whereas recurrence of angina (II: 29.63 +/- 5.3%; I: 47.55 +/- 5.6%) (p = 0.012), the requirement for percutaneous angioplasty (II: 3.98 +/- 2%; I: 12.99 +/- 4.1%) (p = 0.009) and cardiologic events (II: 33.48 +/- 5.5%; I: 48.48 +/- 5.5%)(p = 0.022) were all lower in the group in which both mammary arteries were used. In the multivariate analysis, the use of both mammary arteries was an independent protective factor against angina recurrence (RR = 0.55), angioplasty (RR = 0.18) and cardiologic event (RR = 0.60). The use of both mammary arteries for revascularization does not increase operative morbidity. Since this procedure acts as an independent factor against angina recurrence, angioplasty and cardiologic event

  9. The functional performance of the Argus II retinal prosthesis

    PubMed Central

    Stronks, H Christiaan; Dagnelie, Gislin

    2014-01-01

    Summary Visual prostheses are devices to treat profound vision loss by stimulating secondary nerve cells anywhere along the visual pathway, typically with electrical pulses. The Argus® II implant, developed by Second Sight Medical Products (SSMP, Sylmar, CA, USA), targets the retina and features 60 electrodes that electrically stimulate the surviving retinal neurons. Of the approximately 20 research groups that are actively developing visual prostheses, SSMP has the longest track record. The Argus II was the first visual prosthesis to become commercially available: It received the CE mark in Europe in 2011 and FDA approval was granted in early 2013 for humanitarian use in the USA. Meanwhile, the Argus II safety/benefit study has been extended for research purposes, and is ongoing. In this review we will discuss the performance of the Argus II in restoring sight to the blind, and we will shed light on its expected developments in the coming years. PMID:24308734

  10. Treatment of varicoceles in childhood and adolescence with Tauber's antegrade scrotal sclerotherapy.

    PubMed

    Fette, A; Mayr, J

    2000-08-01

    The aim of this study was to evaluate surgical complications and the outcome of grade II and III varicoceles treated with Tauber's antegrade scrotal sclerotherapy. A total of 21 patients with a median age of 13 (range, 10 to 21) years and left-sided grade II and III varicoceles were treated with Tauber's antegrade scrotal sclerotherapy and underwent follow-up over a median period of 23 months (range, 9 to 35). One grade II varicocele persisted after antegrade sclerotherapy for 6 months. After a second sclerotherapy 6 months later, no further recurrence was detected. One patient with a grade II to III varicocele had a grade I varicocele recurrence 14 months after operation. Three patients showed a slight hydrocele postoperatively. This limited series indicates that Tauber's antegrade scrotal sclerotherapy is a safe and effective treatment for grade II and III varicoceles in children and adolescents.

  11. Effects of Appropriate Prolonged Sacral Neuromodulation Testing in Improving Implantation Rate of a Permanent Implantable Pulse Generator in Patients with Refractory Lower Urinary Tract Dysfunctions in Mainland China.

    PubMed

    Zhang, Peng; Zhang, Jian-Zhong; Wu, Li-Yang; Zhang, Xiao-Dong

    2017-02-20

    Sacral neuromodulation (SNM) has become an effective method for treating lower urinary tract voiding dysfunction during the past 20 years. Because of the expensive cost, the number of implantable pulse generator (IPG) implantations per year in China is far lower than that in Western developed countries since 2012. This study was to summarize the effects of the appropriate prolonged SNM testing time in improving the implantation rate of a permanent IPG in patients with refractory lower urinary tract symptoms (LUTS) in mainland China. From January 2013 to June 2016, 51 patients with refractory LUTS received SNM therapy. In this study, we compared the conversion rate 2 weeks after the Stage I test and final actual conversion rate. We also observed the complications (such as pain, infection, and electrode displacement) and effectiveness. We tried to improve an appropriate prolonged test time which was favorable for improving the SNM conversion rate while ensuring safety and effectiveness. Among 51 patients receiving SNM therapy, 19 patients (mean age 45.0 ± 16.9 years) had poor Stage I test results, and on an average, the electrode was removed 27.4 ± 9.6 days after the surgery. In one patient, the electrode was removed within 2 weeks; when the remaining 18 patients were questioned 2 weeks after testing, none of the patients wanted to terminate the test, and all the 18 patients desired to prolong the testing time to further observe the treatment effect. The remaining 32 patients (mean age 46.7 ± 15.3 years) received Stage II permanent implantation at 19.6 ± 10.4 days after the surgery. The overall Stage I-II conversion was 62.7% (32/51) in this study. Within 2 weeks after the surgery, only eight patients received Stage II permanent implantation, and the conversion rate was only 15.7% (8/51), which was much lower than the overall conversion rate of 62.7%. Nearly 84.4% (27/32) of the patients received Stage II implantation within 4 weeks. None of the patients had incision infections. In one patient, the entire system was removed 1 month after Stage II implantation due to pain in the implantation site. Appropriate extension of the Stage I testing time of an SNM-barbed electrode could significantly improve the Stage II permanent implantation rate in Chinese refractory LUTS patients; there were no wound infections, and the postoperative complication rate was low. This study recommended that Stage I period of SNM therapy should be 4 weeks according to safety and successful conversion rate.

  12. Quality of reporting in oncology phase II trials: A 5-year assessment through systematic review.

    PubMed

    Langrand-Escure, Julien; Rivoirard, Romain; Oriol, Mathieu; Tinquaut, Fabien; Rancoule, Chloé; Chauvin, Frank; Magné, Nicolas; Bourmaud, Aurélie

    2017-01-01

    Phase II clinical trials are a cornerstone of the development in experimental treatments They work as a "filter" for phase III trials confirmation. Surprisingly the attrition ratio in Phase III trials in oncology is significantly higher than in any other medical specialty. This suggests phase II trials in oncology fail to achieve their goal. Objective The present study aims at estimating the quality of reporting in published oncology phase II clinical trials. A literature review was conducted among all phase II and phase II/III clinical trials published during a 5-year period (2010-2015). All articles electronically published by three randomly-selected oncology journals with Impact-Factors>4 were included: Journal of Clinical Oncology, Annals of Oncology and British Journal of Cancer. Quality of reporting was assessed using the Key Methodological Score. 557 articles were included. 315 trials were single-arm studies (56.6%), 193 (34.6%) were randomized and 49 (8.8%) were non-randomized multiple-arm studies. The Methodological Score was equal to 0 (lowest level), 1, 2, 3 (highest level) respectively for 22 (3.9%), 119 (21.4%), 270 (48.5%) and 146 (26.2%) articles. The primary end point is almost systematically reported (90.5%), while sample size calculation is missing in 66% of the articles. 3 variables were independently associated with reporting of a high standard: presence of statistical design (p-value <0.001), multicenter trial (p-value = 0.012), per-protocol analysis (p-value <0.001). Screening was mainly performed by a sole author. The Key Methodological Score was based on only 3 items, making grey zones difficult to translate. This literature review highlights the existence of gaps concerning the quality of reporting. It therefore raised the question of the suitability of the methodology as well as the quality of these trials, reporting being incomplete in the corresponding articles.

  13. Age related differences of selected Hatha yoga practices on anthropometric characteristics, muscular strength and flexibility of healthy individuals

    PubMed Central

    Halder, Kaushik; Chatterjee, Abhirup; Pal, Rameshwar; Tomer, Omveer S; Saha, Mantu

    2015-01-01

    Background: Physiological benefits of yoga on volunteers of a particular age group are available. However, reports on efficacy of a specific yoga package on the populace of different age groups from similar occupational background is still very limited. Therefore, the present study was conducted to appraise the effect of a specific Hatha yoga package on anthropometric characteristics, flexibility and muscular strength of healthy individuals of different age groups from similar occupational trade. Materials and Methods: A total of 71 participants (Group All) from Indian Air Force ground personnel volunteered and age wise divided into 3 groups - (i) Group I (Gr. - I) (n1 = 27, 20-29 years), (ii) Group II (Gr. - II) (n2 = 21, 30-39 years) and (iii) Group III (Gr. - III) (n3 = 23, 40-49 years). All the participants undergone selected Hatha yoga training for 1 h daily for a period of 12 weeks. Parameters were recorded before and after the training. Pre and post training differences were assessed by Student's t-test. Results: Body weight (All, Gr. - II and Gr. - III [all P < 0.05]), body mass index (Gr. - II and Gr. - III [both P < 0.01]) and fat% (Gr. - II and III [both P < 0.05]) were decreased significantly. Neck circumference was increased significantly in Gr. - I (P < 0.05) but decreased significantly in Gr. - III (P < 0.05). Chest circumference (All (P < 0.001), in Gr. - I and II [both P < 0.05]), grip strength (All [left: P < 0.01 and right: P < 0.05], in Gr. - I [left: P < 0.05 and right: P < 0.01], in Gr. - II [right: P < 0.05] and in Gr. - III [left: P < 0.05 and right: P < 0.01]), back leg strength (group wise P < 0.001, P < 0.05, P < 0.01 and P < 0.05 respectively) and flexibility (all P < 0.001) were increased significantly. Summary and Conclusion: Hatha yoga can improve anthropometric characteristics, muscular strength and flexibility among volunteers of different age group and can also be helpful in preventing and attenuating age related deterioration of these parameters. PMID:25558132

  14. Outcomes from ovarian cancer screening in the PLCO trial: Histologic heterogeneity impacts detection, overdiagnosis and survival.

    PubMed

    Temkin, Sarah M; Miller, Eric A; Samimi, Goli; Berg, Christine D; Pinsky, Paul; Minasian, Lori

    2017-12-01

    A mortality benefit from screening for ovarian cancer has never been demonstrated. The aim of this study was to evaluate the screening outcomes for different histologic subtypes of ovarian cancers. Women in the screening arm of the Prostate, Lung, Colorectal and Ovarian Screening Trial underwent CA-125 and transvaginal ultrasound annually for 3-5 years. We compared screening test characteristics (including overdiagnosis) and outcomes by tumour type (type II versus other) and study arm (screening versus usual care). Of 78,215 women randomised, 496 women were diagnosed with ovarian cancer. Of the tumours that were characterised (n = 413; 83%), 74% (n = 305) were type II versus 26% other (n = 108). Among screened patients, 70% of tumours were type II compared to 78% in usual care (p = 0.09). Within the screening arm, 29% of type II tumours were screen detected compared to 54% of the others (p < 0.01). The sensitivity of screening was 65% for type II tumours versus 86% for other types (p = 0.02). 15% of type II screen-detected tumours were stage I/II, compared to 81% of other tumours (p < 0.01). The overdiagnosis rate was lower for type II compared to other tumours (28.2% versus 72.2%; p < 0.01). Ovarian cancer-specific survival was worse for type II tumours compared to others (p < 0.01). Survival was similar for type II (p = 0.74) or other types (p = 0.32) regardless of study arm. Test characteristics of screening for ovarian cancer differed for type II tumours compared to other ovarian tumours. Type II tumours were less likely to be screen diagnosed, early stage at diagnosis or overdiagnosed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Comparison of SBUV and SAGE II ozone profiles: Implications for ozone trends

    NASA Technical Reports Server (NTRS)

    Mcpeters, R. D.; Miles, T.; Flynn, L. E.; Wellemeyer, C. G.; Zawodny, J. M.

    1994-01-01

    Solar backscattered ultraviolet (SBUV) ozone profiles have been compared with Stratospheric Aerosol and Gas Experiment (SAGE) II profiles over the period October 1984 through June 1990, when data are available from both instruments. SBUV measurements were selected to closely match the SAGE II latitude/longitude measurement pattern. There are significant differences between the SAGE II sunrise and the sunset zonal mean ozone profiles in the equatorial zone, particularly in the upper stratosphere, that may be connected with extreme SAGE II solar azimuth angles for tropical sunrise measurements. Calculation of the average sunset bias between SBUV and SAGE II ozone profiles shows that allowing for diurnal variation in Umkehr layer 10, SBUV and SAGE II agree to within +/- 5% for the entire stratosphere in the northern midlatitude zone. The worst agreement is seen at southern midlatitudes near the ozone peak (disagreements of +/- 10%), apparently the result of the SBUV ozone profile peaking at a lower altitude than SAGE. The integrated ozone columns (cumulative above 15 km) agree very well, to within +/- 2.3% in all zones for both sunset and sunrise measurements. A comparison of the time dependence of SBUV and SAGE II shows that there was less than +/- 5% relative drift over the 5.5 years for all altitudes except below 25 km, where the SBUV vertical resolution is poor. The best agreement with SAGE is seen in the integrated column ozone (cumulative above 15 km), where SAGE II has a 1% negative trend relative to SBUV over the comparison period. There is a persistent disagreement of the two instruments in Umkehr layers 9 and 10 of +/- 4% over the 5.5-year comparison period. In the equatorial zone this disagreement may be caused in part by a large positive trend (0.8 K per year) in the National Meteorologica Center temperatures used to convert the SAGE II measurement of ozone density versus altitude to a pressure scale for comparison with SBUV. In the middle stratosphere (30-40 km), SBUV shows a 2-4% negative drift relative to SAGE II. If the actual ozone trends are considered, SBUV and SAGE II agree in showing little ozone change (less than 2%) between 1984 and 1990, except in layer 3 where SAGE II measures a large ozone decrease. But over 11 years, SBUV measured a 7% per decade ozone decrease between 40 and 50 km, decreasing in magnitude at lower altitudes, in good agreement with 11-year trends derived from the average of 5 Umkehr stations.

  16. Perthes' disease or late avascular necrosis after developmental dislocation of the hip? 10 children followed for 6-35 years.

    PubMed

    Koczewski, P; Napiontek, M

    2001-08-01

    We studied 10 patients treated because of late avascular necrosis (AVN) mimicking Legg-Calvé-Perthes' disease (LCPD) after developmental dislocation of the hip (DDH). DDH was recognized late at an average age of 5.4 months and in all children it was treated without surgery. In 4 children, the treatment was complicated by mild AVN of the femoral head, which had disappeared before 3 years of age. The first clinical signs of LCPD were noted at a mean age of 5.8 years. They all had Catterall's type III or IV of LCPD. The course was typical of LCPD. 8 children were operated on at mean age of 7.4 (5-12) years. In 7 of them, subtrochanteric derotation-varisation osteotomy of the femur with shortening combined mainly with Dega's pelvic osteotomy was done. The operative treatment resulted in a concentric position of the femoral head and good coverage of the acetabulum. Follow-ups were done at 10 (6-35) years. Shortened femoral neck and trochanteric overgrowth occurred in 4 operated hips. According to the Stulberg classification, 2 hips were classified as type I, 1 as I/II, 5 as II/I as II/III and 1 as IV. We conclude that LCPD mimicking late AVN can occur in hips treated because of developmental dislocation.

  17. Sports and Exercise at Different Ages and Leukocyte Telomere Length in Later Life--Data from the Berlin Aging Study II (BASE-II).

    PubMed

    Saßenroth, Denise; Meyer, Antje; Salewsky, Bastian; Kroh, Martin; Norman, Kristina; Steinhagen-Thiessen, Elisabeth; Demuth, Ilja

    2015-01-01

    Physical activity and sports have repeatedly been reported to be associated with telomere length. We studied the association of different types of sports across different stages of life on relative leukocyte telomere length (rLTL) in advanced age.815 participants (397 men) from the Berlin Aging Study II aged over 61 years were included in the analysis. rLTL was measured by real time PCR and physical activity was determined retrospectively by questionnaire, assessing type and duration of sports in the past as well as currently. Five separate multiple linear regression models adjusted for various control variables were performed. 67.3% of participants exercised currently, whereas 19.4% performed sports only between the age of 20 and 30. rLTL was higher in subjects who stated to exercise currently (N = 456), and in subjects who engaged in endurance (N = 138) or intensive activity sports (N = 32). Current physical activity was positively associated with rLTL in the risk factor adjusted regression model (β = 0.26, p < 0.001) and practicing sports for a minimum of 10 years preceding the assessment had a significant effect on rLTL (β = 0.39, p = 0.011). The highest impact was seen for intensive activity sports (β = 0.79, p < 0.001) and physical activity since at least 42 years (β = 0.47, p = 0.001). However, physical activity only between 20 and 30 years of age did not affect rLTL in old age when compared to no sports at all (β = -0.16, p = 0.21). Physical activity is clearly associated with longer rLTL. The effect is seen with longer periods of physical activity (at least 10 years), with intensive sports activities having the greatest impact on rLTL. Our data suggest that regular physical activity for at least 10 years is necessary to achieve a sustained effect on rLTL.

  18. Primary Amenorrhea Associated with Hyperprolactinemia in Polyglandular Autoimmune Syndrome Type II: A Case Report.

    PubMed

    Cottas, Luiza Tizziotti; Borges, Maria de Fátima; Oliveira, Lívia Prata Santos; Resende, Ana Luísa Mantovani; Ataíde, Meire Soares; Resende, Elisabete Aparecida Mantovani Rodrigues

    2018-06-27

    Polyglandular autoimmune syndrome type II (PGA-II) is a rare immunoendocrinopathy syndrome characterized by the occurrence of autoimmune Addison disease along with diabetes mellitus type 1 and/or autoimmune thyroid disease. Here, we report the case of a 23-year-old female with PGA-II who was followed up at the dermatology and endocrinology clinics of the Universidade Federal do Triângulo Mineiro, located in the state of Minas Gerais, Brazil. First, the patient presented diffuse skin hyperpigmentation, vitiligo; and in sequence, due to vomiting, appetite and weight loss, hypoglycemia, amenorrhea, and galactorrhea, the patient was then diagnosed with PGA-II. The patient also presented intense hyperprolactinemia due to primary hypothyroidism. The late diagnosis of PGA-II is frequent because the disorder is uncommon and has non-specific clinical manifestations. This report emphasizes the significance of a timely diagnosis and appropriate treatment to reduce morbidity and mortality associated with these diseases, especially Addison disease. The present study reports a rare case of a patient with PGA-II with primary amenorrhea associated with hyperprolactinemia. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

  19. Passive ozone network of Dallas: a modeling opportunity with community involvement. 2.

    PubMed

    Sather, M E; Varns, J L; Mulik, J D; Glen, G; Smith, L; Stallings, C

    2001-11-15

    Attaining the current lower tropospheric U.S. ozone standards continues to be a difficult task for many areas in the U.S. Concentrations of ozone above the standards negatively affects human health, agricultural crops, forests, and other ecosystem elements. This paper describes year two (1999) of a regional networking of passive and continuous ozone monitoring sites in the Dallas-Fort Worth (DFW) Metroplex region. The objectives of the second year of study were to (1) validate conclusions of the 1998 Passive Ozone Network of Dallas (POND) I study, (2) define the value of taking 12-h diurnal samples in addition to 24-h samples, and (3) add to the scientific knowledge base of rural/urban ozone comparison studies. Results of the POND II (1999) study demonstrated that ozone concentrations exceeding the new 8-h ozone standard could be recorded at least 130 km, or 80 miles, from the DFW Metroplex core in more rural areas. In addition, results of the POND II study indicated that ozone concentrations exceeding the 8-h standard probably occurred in areas recording a 12-h daytime ozone concentration above 60 parts per billion (ppb). The 12-h passive ozone data from POND II also suggests the relative magnitude of anthropogenic pollution influence could be assessed for rural passive ozone sites. The data from the POND II study provide modelers a rich database for future photochemical subgrid development for the DFW ozone nonattainment area. Indeed, the POND database provides a great amount of additional ozone ambient data covering 26 8-h and 13 1-h ozone standard exceedance days over an approximate 25000 km2 region. These data should help decrease uncertainties derived from future DFW ozone model exercises.

  20. Primary radiation therapy for medically inoperable patients with endometrial carcinoma--stages I-II.

    PubMed

    Varia, M; Rosenman, J; Halle, J; Walton, L; Currie, J; Fowler, W

    1987-01-01

    Surgery with or without adjuvant radiation is the established method of treating patients with Stage I and II adenocarcinoma of the endometrium. However, patients who are poor operative risks must be treated with radiation therapy only. We report on 73 such patients treated at the University of North Carolina between 1969 and 1980. All patients had an adenocarcinoma of the endometrium; 41 were FIGO Stage I, 32 Stage II. The minimum follow-up period was 4 years. Life table analysis shows a disease-free survival of 72% at 3 years and 57% at 5 years for Stage I patients. There was a strong correlation between histologic tumor grade and survival in these patients; the 5-year survival for grade 1 was 72%, for grade 2 59%, and for grade 3 31%. The difference between G1 and G3 is significant at the p = .045 level. Coexisting medical conditions were responsible for 12 deaths; almost as many as the 16 cancer-related deaths. Stage II patients have an actuarial disease-free survival of 36% at 3 years and 26% at 5 years, significantly worse than Stage I patients (p = .029 at 3 years). Failures were seen in 16/41 (39%) Stage I and 19/32 (59%) Stage II patients; 29/35 (83%) of these recurrences had component of local/pelvic failure and 15/35 (43%) of the recurrences were local/pelvic only. Specific suggestions on how to improve local therapy for these patients are presented.

  1. The prevalence rate of internet addiction among Japanese college students: two cross-sectional studies and reconsideration of cut-off points of Young's internet addiction test in Japan.

    PubMed

    Tateno, Masaru; Teo, Alan R; Shiraishi, Masaki; Tayama, Masaya; Kawanishi, Chiaki; Kato, Takahiro A

    2018-05-30

    Due to variation in estimates of the prevalence of internet addiction (IA) in prior research, we conducted two cross-sectional studies over two years and investigated the prevalence rate of IA in college students in Japan, and reconsidered appropriate cut-off points of self-rating scale to screen possible IA. This study is composed of two parts: survey I in 2014 and survey II in 2016, which were conducted in the same schools with an interval of two years. The study questionnaire included questions about demographics and internet use, and the Young's Internet Addiction Test (IAT). Additionally, the subjects in survey II were asked about self-reported IA. There were 1,005 respondents in total with a mean age of 18.9±1.3. The mean IAT scores remained stable between 2014 and 2016: 45.2±12.6 in survey I and 45.5±13.1 in survey II (overall mean IAT score of 45.4±13.0). With respect to self-reported IA in survey II, a total of 21.6% agreed (score of 5 or 6 on a 6-point Likert scale). We categorized these subjects as IA, and the remainder as non-IA. The mean IAT score showed significant difference between these two groups (57.8±14.3 vs 42.1±10.7, p<0.001). The severity of symptoms of IA among Japanese college students appears stable in recent years, with a mean IAT scores of over 40. Our results suggest that a screening score cut-off of 40 on the IAT could be reconsidered and that of 50 might be proposed for the cut-off. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  2. Description and Survival of Stage I and II Lung Cancer Patients.

    PubMed

    Pérez-Martínez, Olaia; Vidal-García, Iria; Montero-Martínez, Carmen; Provencio, Mariano; Ruano-Ravina, Alberto

    2018-03-16

    The objective of our study was to describe the characteristics of patients diagnosed with stage I and II lung cancer in the health area of A Coruña (Galicia) and to determine their overall survival according to certain variables. Retrospective case series in patients diagnosed between January 2011 and December 2015 with stage I and II primary lung cancer with a minimum follow-up of 18 months. 158 patients were included, 99 at stage I, with a median age of 69 years [range 20-90], predominantly men (81%). Adenocarcinoma was the most common histology (52.9%), followed by epidermoid carcinoma (33.1%). Asymptomatic patients (35.9%) presented more frequently in stage I. Median survival was 57 months (95% CI 48.1-65.9), with higher survival among women, patients under 70 years of age, and those who received surgical treatment. Early stage lung cancer in the health area of A Coruña occurs predominantly in men, in advanced age, and with adenocarcinoma histology. Survival was greater among patients with stage I disease, women, individuals aged under 70 years, and those treated surgically. Despite early diagnosis, median survival was less than 5 years. Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Characterization of full-length MHC class II sequences in Indonesian and Vietnamese cynomolgus macaques.

    PubMed

    Creager, Hannah M; Becker, Ericka A; Sandman, Kelly K; Karl, Julie A; Lank, Simon M; Bimber, Benjamin N; Wiseman, Roger W; Hughes, Austin L; O'Connor, Shelby L; O'Connor, David H

    2011-09-01

    In recent years, the use of cynomolgus macaques in biomedical research has increased greatly. However, with the exception of the Mauritian population, knowledge of the MHC class II genetics of the species remains limited. Here, using cDNA cloning and Sanger sequencing, we identified 127 full-length MHC class II alleles in a group of 12 Indonesian and 12 Vietnamese cynomolgus macaques. Forty two of these were completely novel to cynomolgus macaques while 61 extended the sequence of previously identified alleles from partial to full length. This more than doubles the number of full-length cynomolgus macaque MHC class II alleles available in GenBank, significantly expanding the allele library for the species and laying the groundwork for future evolutionary and functional studies.

  4. 40 CFR 63.163 - Standards: Pumps in light liquid service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... later than 1 year after the compliance date; and (C) Phase III, beginning no later than 21/2 years after... requirements; and (B) Beginning no later than 1 year after initial start-up, comply with the Phase III... parts per million or greater. (ii) For Phase II, an instrument reading of 5,000 parts per million or...

  5. 40 CFR 63.163 - Standards: Pumps in light liquid service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... later than 1 year after the compliance date; and (C) Phase III, beginning no later than 21/2 years after... requirements; and (B) Beginning no later than 1 year after initial start-up, comply with the Phase III... parts per million or greater. (ii) For Phase II, an instrument reading of 5,000 parts per million or...

  6. 40 CFR 63.163 - Standards: Pumps in light liquid service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... later than 1 year after the compliance date; and (C) Phase III, beginning no later than 21/2 years after... requirements; and (B) Beginning no later than 1 year after initial start-up, comply with the Phase III... parts per million or greater. (ii) For Phase II, an instrument reading of 5,000 parts per million or...

  7. 48 CFR 9904.412-60 - Illustrations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 9904.412-50(c)(2)(ii)(B). The following year, 2018, Contractor K computes an unfunded actuarial... loss to be amortized over a ten-year period beginning in 2018 in accordance with 9904.412-50(c)(2)(ii... year, 2018, Contractor K must eliminate $233,280 ($216,000 × 1.08) from the $4 million so that only $3...

  8. History of kidney stones and the risk of coronary heart disease.

    PubMed

    Ferraro, Pietro Manuel; Taylor, Eric N; Eisner, Brian H; Gambaro, Giovanni; Rimm, Eric B; Mukamal, Kenneth J; Curhan, Gary C

    2013-07-24

    Kidney stone disease is common and may be associated with an increased risk of coronary heart disease (CHD). Previous studies of the association between kidney stones and CHD have often not controlled for important risk factors, and the results have been inconsistent. To examine the association between a history of kidney stones and the risk of CHD in 3 large prospective cohorts. A prospective study of 45,748 men and 196,357 women in the United States without a history of CHD at baseline who were participants in the Health Professionals Follow-up Study (HPFS) (45,748 men aged 40-75 years; follow-up from 1986 to 2010), Nurses' Health Study I (NHS I) (90,235 women aged 30-55 years; follow-up from 1992 to 2010), and Nurses' Health Study II (NHS II) (106,122 women aged 25-42 years; follow-up from 1991 to 2009). The diagnoses of kidney stones and CHD were updated biennially during follow-up. Coronary heart disease was defined as fatal or nonfatal myocardial infarction (MI) or coronary revascularization. The outcome was identified by biennial questionnaires and confirmed through review of medical records. RESULTS Of a total of 242,105 participants, 19,678 reported a history of kidney stones. After up to 24 years of follow-up in men and 18 years in women, 16,838 incident cases of CHD occurred. After adjusting for potential confounders, among women, those with a reported history of kidney stones had an increased risk of CHD than those without a history of kidney stones in NHS I (incidence rate [IR], 754 vs 514 per 100,000 person-years; multivariable hazard ratio [HR], 1.18 [95% CI, 1.08-1.28]) and NHS II (IR, 144 vs 55 per 100,000 person-years; multivariable HR, 1.48 [95% CI, 1.23-1.78]). There was no significant association in men (IR, 1355 vs 1022 per 100,000 person-years; multivariable HR, 1.06 [95% CI, 0.99-1.13]). Similar results were found when analyzing the individual end points (fatal and nonfatal MI and revascularization). Among the 2 cohorts of women, a history of kidney stones was associated with a modest but statistically significantly increased risk of CHD; there was no significant association in a separate cohort of men. Further research is needed to determine whether the association is sex-specific.

  9. One year treatment effects of the eruption guidance appliance in 7- to 8-year-old children: a randomized clinical trial.

    PubMed

    Myrlund, Rita; Dubland, Mari; Keski-Nisula, Katri; Kerosuo, Heidi

    2015-04-01

    The eruption guidance appliance (EGA) aims to correct sagittal and vertical occlusal relations concomitantly with alignment of the incisors. Few reports have been published on treatment effects with the EGA but no randomized studies have been available. The aim was to find out if 1 year active treatment time with EGA was sufficient for achieving normal occlusal relationships and dental alignment in 7- to 8-year-old children. Eligibility criteria for participants were: fully erupted upper central incisors, and Angle's Class I or Class II molar relationship combined with any of the following traits: deep bite, increased overjet ≥5mm, moderate anterior crowding with overjet ≥4mm. After screening of 148 children, 48 7- to 8-year-old children were recruited in the study. The participants were randomly assigned into a treatment group (N = 25) and a control group (N = 23). Children in the treatment group received treatment with the EGA for 1 year. The controls had no orthodontic treatment. Changes in overjet, overbite, Angle's Class, and crowding were used as primary outcome measures. Occlusal assessments were performed on dental casts obtained from all subjects at start of the study (T1) and after 1 year (T2). Lateral cephalograms were obtained from all subjects at T1 and from the treatment group at T2. All measurements on dental casts and cephalograms were carried out blinded. Forty-six children completed the study. Mean overjet and overbite decreased significantly in the treated subjects during 1 year, in contrast to a slight increase in the controls. Class II molar relationship decreased from 46 to 4 per cent in the treatment group, with no significant change in the control group. Mandibular anterior crowding decreased significantly in the treated subjects, while the controls showed a slight increase. In short term, the EGA seems to be effective in correcting increased overjet and overbite, Class II malocclusion, and lower anterior crowding in the early mixed dentition. Follow-up data are needed to assess long-term effects of this treatment. This study was not registered. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  10. Pathognomonic features of Angle's Class II division 2 malocclusion: A comparative cephalometric and arch width study

    PubMed Central

    Prasad, Singamsetty E.R.V.; Indukuri, Ravikishore Reddy; Singh, Rupesh; Nooney, Anitha; Palagiri, Firoz Babu; Narayana, Veera

    2014-01-01

    Background: A thorough knowledge of the salient features of malocclusion helps the clinician in arriving at a proper diagnosis and treatment plan, and also to predict the prognosis, prior to the onset of treatment process. Among the four classes of Angle's classification of malocclusion, Class II division 2 occurs with the least frequency. There is still continuing debate in the literature whether the Class II division 2 patients ascribe the pathognomonic skeletal and dental features. Aim of the study: The aim of this study is to describe the unique features of Angle's Class II division 2 malocclusion to differentiate it from Angle's Class II division 1 malocclusion. Materials and Methods: A total of 582 pre-treatment records (study models and cephalograms), with the age of patients ranging from 15 to 22 years, were obtained from the hospital records of Vishnu Dental College, Bhimavaram and Geetam's Dental College, Visakhapatnam. Out of these, 11 pre-treatment records were excluded because of lack of clarity. In the rest of the sample, 283 were Class II division 1 and 288 were Class II division 2. The lateral cephalograms were analyzed by using digiceph and the arch width analysis was done based on the anatomical points described by Staley et al. and Sergl et al. Results: An intergroup evaluation was done by using unpaired Student's “t” test. The skeletal vertical parameters, dental parameters, and the maxillary arch width parameters revealed a statistically significant difference between the two groups of malocclusion. Conclusion: Angle's Class II division 2 malocclusion has a pronounced horizontal growth pattern with decreased lower anterior facial height, retroclined upper anteriors, and significantly increased maxillary arch width parameters. PMID:25558449

  11. A Retrospective Survival Analysis of Anatomic and Prognostic Stage Group Based on the American Joint Committee on Cancer 8th Edition Cancer Staging Manual in Luminal B Human Epidermal Growth Factor Receptor 2-negative Breast Cancer.

    PubMed

    Xu, Ling; Li, Jiang-Hong; Ye, Jing-Ming; Duan, Xue-Ning; Cheng, Yuan-Jia; Xin, Ling; Liu, Qian; Zhou, Bin; Liu, Yin-Hua

    2017-08-20

    Current understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outcome information. The American Joint Committee on Cancer (AJCC) expert panel updated the 8th edition of the staging manual with prognostic stage groups by incorporating biomarkers into the anatomic stage groups. In this study, we retrospectively analyzed the data from our center in China using the anatomic and prognostic staging system based on the AJCC 8th edition staging manual. We reviewed the data from January 2008 to December 2014 for cases with Luminal B Human Epidermal Growth Factor Receptor 2 (HER2)-negative breast cancer in our center. All cases were restaged using the AJCC 8th edition anatomic and prognostic staging system. The Kaplan-Meier method and log-rank test were used to compare the survival differences between different subgroups. SPSS software version 19.0 (IBM Corp., Armonk, NY, USA) was used for the statistical analyses. This study consisted of 796 patients with Luminal B HER-negative breast cancer. The 5-year disease-free survival (DFS) of 769 Stage I-III patients was 89.7%, and the 5-year overall survival (OS) of all 796 patients was 91.7%. Both 5-year DFS and 5-year OS were significantly different in the different anatomic and prognostic stage groups. There were 372 cases (46.7%) assigned to a different group. The prognostic Stage II and III patients restaged from anatomic Stage III had significant differences in 5-year DFS (χ2 = 11.319, P= 0.001) and 5-year OS (χ2 = 5.225, P= 0.022). In addition, cases restaged as prognostic Stage I, II, or III from the anatomic Stage II group had statistically significant differences in 5-year DFS (χ2 = 6.510, P= 0.039) but no significant differences in 5-year OS (χ2 = 5.087, P= 0.079). However, the restaged prognostic Stage I and II cases from anatomic Stage I had no statistically significant differences in either 5-year DFS (χ2 = 0.440, P= 0.507) or 5-year OS (χ2 = 1.530, P= 0.216). The prognostic staging system proposed in the AJCC 8th edition refines the anatomic stage group in Luminal B HER2-negative breast cancer and will lead to a more personalized approach to breast cancer treatment.

  12. The Moral, Epistemic, and Mindreading Components of Children's Vigilance towards Deception

    ERIC Educational Resources Information Center

    Mascaro, Olivier; Sperber, Dan

    2009-01-01

    Vigilance towards deception is investigated in 3- to-5-year-old children: (i) In Study 1, children as young as 3 years of age prefer the testimony of a benevolent rather than of a malevolent communicator. (ii) In Study 2, only at the age of four do children show understanding of the falsity of a lie uttered by a communicator described as a liar.…

  13. Physical Self-Concept, Trait Depression and Readiness for Physical Activity of Obese Patients

    ERIC Educational Resources Information Center

    Boros, Szilvia; Halmy, Laszlo

    2009-01-01

    Study aim: To assess the physical self-concept, trait depression and readiness for physical activity in relation to the degree of obesity. Material and methods: Obese (Grade I and II; n = 59) and morbidly obese (Grade III; n = 42) patients aged 30-66 years, as well as 83 non-obese college students aged 30 [plus or minus] 7.3 years were studied.…

  14. Applications for Micrographics in Large Scale Information Systems of the Future. Volume I: Part I. Summary. Part II. Five-Year Plan for DDC Micrographic Development Actions.

    ERIC Educational Resources Information Center

    Information Dynamics Corp., Reading, MA.

    A study intended to provide the Defense Documentation Center (DDC) with a five-year plan for the development of improved and new microfiche products, services, and production capabilities is summarized in this report. In addition, the major findings, conclusions, and recommendations developed during the study are noted. The results of the research…

  15. Fragrance contact allergy: a 4-year retrospective study.

    PubMed

    Cuesta, Laura; Silvestre, Juan Francisco; Toledo, Fernando; Lucas, Ana; Pérez-Crespo, María; Ballester, Irene

    2010-08-01

    Fragrance chemicals are the second most frequent cause of contact allergy. The mandatory labelling of 26 fragrance chemicals when present in cosmetics has facilitated management of patients allergic to fragrances. The study was aimed to define the characteristics of the population allergic to perfumes detected in our hospital district, to determine the usefulness of markers of fragrance allergy in the baseline GEIDAC series, and to describe the contribution made by the fragrance series to the data obtained with the baseline series. We performed a 4-year retrospective study of patients tested with the Spanish baseline series and/or fragrance series. There are four fragrance markers in the baseline series: fragrance mix I (FM I), Myroxylon pereirae, fragrance mix II (FM II), and hydroxyisohexyl 3-cyclohexene carboxaldehyde. A total of 1253 patients were patch tested, 117 (9.3%) of whom were positive to a fragrance marker. FM I and M. pereirae detected 92.5% of the cases of fragrance contact allergy. FM II and hydroxyisohexyl 3-cyclohexene carboxaldehyde detected 6 additional cases and provided further information in 8, enabling improved management. A fragrance series was tested in a selected group of 86 patients and positive results were obtained in 45.3%. Geraniol was the allergen most frequently found in the group of patients tested with the fragrance series. Classic markers detect the majority of cases of fragrance contact allergy. We recommend incorporating FM II in the Spanish baseline series, as in the European baseline series, and using a specific fragrance series to study patients allergic to a fragrance marker.

  16. Upgrade for Phase II of the Gerda experiment

    NASA Astrophysics Data System (ADS)

    Agostini, M.; Bakalyarov, A. M.; Balata, M.; Barabanov, I.; Baudis, L.; Bauer, C.; Bellotti, E.; Belogurov, S.; Belyaev, S. T.; Benato, G.; Bettini, A.; Bezrukov, L.; Bode, T.; Borowicz, D.; Brudanin, V.; Brugnera, R.; Caldwell, A.; Cattadori, C.; Chernogorov, A.; D'Andrea, V.; Demidova, E. V.; Di Marco, N.; Domula, A.; Doroshkevich, E.; Egorov, V.; Falkenstein, R.; Frodyma, N.; Gangapshev, A.; Garfagnini, A.; Grabmayr, P.; Gurentsov, V.; Gusev, K.; Hakenmüller, J.; Hegai, A.; Heisel, M.; Hemmer, S.; Hiller, R.; Hofmann, W.; Hult, M.; Inzhechik, L. V.; Ioannucci, L.; Janicskó Csáthy, J.; Jochum, J.; Junker, M.; Kazalov, V.; Kermaïdic, Y.; Kihm, T.; Kirpichnikov, I. V.; Kirsch, A.; Kish, A.; Klimenko, A.; Kneißl, R.; Knöpfle, K. T.; Kochetov, O.; Kornoukhov, V. N.; Kuzminov, V. V.; Laubenstein, M.; Lazzaro, A.; Lebedev, V. I.; Lehnert, B.; Lindner, M.; Lippi, I.; Lubashevskiy, A.; Lubsandorzhiev, B.; Lutter, G.; Macolino, C.; Majorovits, B.; Maneschg, W.; Medinaceli, E.; Miloradovic, M.; Mingazheva, R.; Misiaszek, M.; Moseev, P.; Nemchenok, I.; Nisi, S.; Panas, K.; Pandola, L.; Pelczar, K.; Pullia, A.; Ransom, C.; Riboldi, S.; Rumyantseva, N.; Sada, C.; Salamida, F.; Salathe, M.; Schmitt, C.; Schneider, B.; Schönert, S.; Schreiner, J.; Schütz, A.-K.; Schulz, O.; Schwingenheuer, B.; Selivanenko, O.; Shevchik, E.; Shirchenko, M.; Simgen, H.; Smolnikov, A.; Stanco, L.; Vanhoefer, L.; Vasenko, A. A.; Veresnikova, A.; von Sturm, K.; Wagner, V.; Wegmann, A.; Wester, T.; Wiesinger, C.; Wojcik, M.; Yanovich, E.; Zhitnikov, I.; Zhukov, S. V.; Zinatulina, D.; Zsigmond, A. J.; Zuber, K.; Zuzel, G.

    2018-05-01

    The Gerda collaboration is performing a sensitive search for neutrinoless double beta decay of ^{76}Ge at the INFN Laboratori Nazionali del Gran Sasso, Italy. The upgrade of the Gerda experiment from Phase I to Phase II has been concluded in December 2015. The first Phase II data release shows that the goal to suppress the background by one order of magnitude compared to Phase I has been achieved. Gerda is thus the first experiment that will remain "background-free" up to its design exposure (100 kg year). It will reach thereby a half-life sensitivity of more than 10^{26} year within 3 years of data collection. This paper describes in detail the modifications and improvements of the experimental setup for Phase II and discusses the performance of individual detector components.

  17. Southernmost carriers of HTLV-I/II in the world.

    PubMed

    Cartier, L; Araya, F; Castillo, J L; Zaninovic, V; Hayami, M; Miura, T; Imai, J; Sonoda, S; Shiraki, H; Miyamoto, K

    1993-01-01

    To clarify the real distribution of HTLV-I and -II carriers among indigenous people in central and South America, blood samples collected from indigenous people in isolated regions of Southern Chile were examined. Among 199 inhabitants from Chiloe Island and Pitrufquen town, three cases (1.5%) showed positive anti-HTLV-I antibodies. Two out of the three (82-year-old male and 58-year-old female) reacted to HTLV-II-specific Gag and/or Env proteins but not to HTLV-I-specific ones. The latter case was confirmed as an HTLV-II carrier by polymerase chain reaction test.

  18. Study of the GERDA Phase II background spectrum

    NASA Astrophysics Data System (ADS)

    Agostini, M.; Allardt, M.; Bakalyarov, A. M.; Balata, M.; Barabanov, I.; Baudis, L.; Bauer, C.; Bellotti, E.; Belogurov, S.; Belyaev, S. T.; Benato, G.; Bettini, A.; Bezrukov, L.; Bode, T.; Borowicz, D.; Brudanin, V.; Brugnera, R.; Caldwell, A.; Cattadori, C.; Chernogorov, A.; D'Andrea, V.; Demidova, E. V.; Di Marco, N.; Domula, A.; Doroshkevich, E.; Egorov, V.; Falkenstein, R.; Frodyma, N.; Gangapshev, A.; Garfagnini, A.; Gooch, C.; Grabmayr, P.; Gurentsov, V.; Gusev, K.; Hakenmüller, J.; Hegai, A.; Heisel, M.; Hemmer, S.; Hofmann, W.; Hult, M.; Inzhechik, L. V.; Janicskó Csáthy, J.; Jochum, J.; Junker, M.; Kazalov, V.; Kihm, T.; Kirpichnikov, I. V.; Kirsch, A.; Kish, A.; Klimenko, A.; Kneißl, R.; Knöpfle, K. T.; Kochetov, O.; Kornoukhov, V. N.; Kuzminov, V. V.; Laubenstein, M.; Lazzaro, A.; Lebedev, V. I.; Lehnert, B.; Liao, H. Y.; Lindner, M.; Lippi, I.; Lubashevskiy, A.; Lubsandorzhiev, B.; Lutter, G.; Macolino, C.; Majorovits, B.; Maneschg, W.; Medinaceli, E.; Miloradovic, M.; Mingazheva, R.; Misiaszek, M.; Moseev, P.; Nemchenok, I.; Palioselitis, D.; Panas, K.; Pandola, L.; Pelczar, K.; Pullia, A.; Riboldi, S.; Rumyantseva, N.; Sada, C.; Salamida, F.; Salathe, M.; Schmitt, C.; Schneider, B.; Schönert, S.; Schreiner, J.; Schulz, O.; Schütz, A.-K.; Schwingenheuer, B.; Selivanenko, O.; Shevzik, E.; Shirchenko, M.; Simgen, H.; Smolnikov, A.; Stanco, L.; Vanhoefer, L.; Vasenko, A. A.; Veresnikova, A.; von Sturm, K.; Wagner, V.; Wegmann, A.; Wester, T.; Wiesinger, C.; Wojcik, M.; Yanovich, E.; Zhitnikov, I.; Zhukov, S. V.; Zinatulina, D.; Zuber, K.; Zuzel, G.

    2017-09-01

    The Gerda experiment, located at the Laboratori Nazionali del Gran Sasso (LNGS) of INFN in Italy, searches for the neutrinoless double beta (0νββ) decay of 76Ge. Gerda Phase II is aiming to reach a sensitivity for the 0νββ half life of 1026 yr in ˜ 3 years of physics data taking with 100 kg·yr of exposure and a background index of ˜ 10-3 cts/(keV·kg·yr). After 6 months of acquisition a first data release with 10.8 kg·yr of exposure is performed, showing that the design background is achieved. In this work a study of the Phase II background spectrum, the main spectral structures and the background sources will be presented and discussed.

  19. E-READING II: words database for reading by students from Basic Education II.

    PubMed

    Oliveira, Adriana Marques de; Capellini, Simone Aparecida

    2016-01-01

    To develop a database of words of high, medium and low frequency in reading for Basic Education II. The words were taken from the teaching material for Portuguese Language, used by the teaching network of the State of São Paulo in the 6th to the 9th year of Basic Education. Only nouns were selected. The frequency with which each word occurred was recorded and a single database was created. In order to classify the words as of high, medium and low frequency, the decision was taken to work with the distribution terciles, mean frequency and the cutoff point of the terciles. In order to ascertain whether the words of high, medium and low frequency corresponded to this classification, 224 students were assessed: G1 (6th year, n= 61); G2 (7th year, n= 44); G3 (8th year, n= 65); and G4 (9th year, n= 54). The lists of words were presented to the students for reading out loud, in two sessions: 1st) words of high and medium frequency and 2nd) words of low-frequency. Words which encompassed the exclusion criteria, or which caused discomfort or joking on the part of the students, were excluded. The word database was made up of 1659 words and was titled 'E - LEITURA II' ('E-READING II', in English). The E-LEITURA II database is a useful resource for the professionals, as it provides a database which can be used for research, educational and clinical purposes among students of Basic Education II. The professional can choose the words according to her objectives and criteria for elaborating evaluation or intervention procedures involving reading.

  20. Compound heterozygous mutations in electron transfer flavoprotein dehydrogenase identified in a young Chinese woman with late-onset glutaric aciduria type II.

    PubMed

    Xue, Ying; Zhou, Yun; Zhang, Keqin; Li, Ling; Kayoumu, Abudurexiti; Chen, Liye; Wang, Yuhui; Lu, Zhiqiang

    2017-09-26

    Glutaric aciduria type II (GA II) is an autosomal recessive disorder affecting fatty acid and amino acid metabolism. The late-onset form of GA II disorder is almost exclusively associated with mutations in the electron transfer flavoprotein dehydrogenase (ETFDH) gene. Till now, the clinical features of late-onset GA II vary widely and pose a great challenge for diagnosis. The aim of the current study is to characterize the clinical phenotypes and genetic basis of a late-onset GAII patient. In this study, we described the clinical and biochemical manifestations of a 23-year-old female Chinese patient with late-onset GA II, and performed genomic DNA-based PCR amplifications and sequence analysis of ETFDH gene of the whole pedigree. We also used in-silicon tools to analyze the mutation and evaluated the pathogenicity of the mutation according to the criteria proposed by American College of Medical Genetics and Genomics (ACMG). The muscle biopsy of this patient revealed lipid storage myopathy. Blood biochemical test and urine organic acid analyses were consistent with GA II. Direct sequence analysis of the ETFDH gene (NM_004453) revealed compound heterozygous mutations: c.250G > A (p.A84T) on exon 3 and c.920C > G (p.S307C) on exon 8. Both mutations were classified as "pathogenic" according to ACMG criteria. In conclusion, our study described the phenotype and genotype of a late-onset GA II patient, reiterating the importance of ETFDH gene screening in these patients.

  1. Risk of second malignancies in patients with early-stage classical Hodgkin's lymphoma treated in a modern era.

    PubMed

    LeMieux, Melissa H; Solanki, Abhishek A; Mahmood, Usama; Chmura, Steven J; Koshy, Matthew

    2015-04-01

    Second malignancies remain an issue affecting morbidity and mortality in long-term survivors of early stage Hodgkin's lymphoma (HL). We undertook this study to determine if treatment in the modern era resulted in decreased second malignancies. Patients diagnosed with stage I-II cHL between 1988 and 2009 who received radiation therapy (RT) were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Freedom from second malignancy (FFSM) was estimated using the Kaplan-Meier method. Univariate analysis (UVA) was performed using the Log-Rank test, and included age, gender, year of diagnosis, and stage. Multivariable analysis (MVA) was performed using Cox Proportional Hazards modeling. The study cohort included 8807 patients. The median age at diagnosis was 32 years (range: 2-85). The majority of patients had stage II disease (n = 6044, 69%), 597 (7%) had extranodal involvement (ENI), and 1925 (22%) had B symptoms. Median follow-up for the entire cohort was 7.2 years (range: 0-22). Five hundred twenty-three (6%) patients developed a second malignancy. Median latency to second malignancy was 5.8 years (range: 0.1-21.5). Of the 523 patients that developed a second malignancy, 228 (44%) occurred in the first 5 years, 139 (27%) were diagnosed between years 5-10, and 156 (30%) beyond 10 years. The 10 year FFSM for patients treated between 1988 and 1999 was 93.0% versus 95.1% for patients treated between 2000 and 2009 (P = 0.04), On MVA, treatment between 2000 and 2009 was associated with a HR for second malignancy of 0.77 (95% Confidence Interval: 0.62-0.96, P = 0.02) compared to the treatment between 1988 and 1999. Our analysis suggests that in patients treated with RT for stage I or II cHL, treatment prior to 2000 had a slightly higher risk of second malignancy compared to treatment in 2000 and later. Further studies, with longer follow-up of patients treated in the modern era are needed to confirm these findings. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  2. Evaluating Voucher Programs: The Milwaukee Parental Choice Program

    ERIC Educational Resources Information Center

    Witte, John F.

    2016-01-01

    This paper is the first summary of two studies and 10 years of evaluating the Milwaukee Parental Choice (voucher) Program (MPCP). This paper discusses school voucher evaluations in general terms and how these studies are carried out. The paper outlines the types of studies completed in "Study I" and "Study II" and the results…

  3. Comparison of Laparoscopic and Microscopic Subinguinal Varicocelectomy in terms of Postoperative Scrotal Pain

    PubMed Central

    Penbegül, Necmettin; Atar, Murat; Bozkurt, Yaşar; Sancaktutar, Ahmet Ali; Altunoluk, Bülent

    2012-01-01

    Background and Objectives: In this study, 2 different varicocelectomy methods were compared with regard to postoperative scrotal pain, length of operation, and complications. Methods: Forty varicocele patients, who visited our clinic because of infertility or scrotal pain between 2008 and 2009, were enrolled in this clinical study. Microscopic subinguinal varicocelectomy was performed on 20 patients in Group I, and laparoscopic varicocelectomy was performed on 20 patients in Group II. Following surgery, the patients were assessed for postoperative requirements for analgesia; return to normal activity; varicocele recurrence; hydrocele formation; scrotal pain at postoperative days 1, 3, and 7; and other complications. Results: Mean age was 24.2±3.4 years in Group I and 25.1±2.1 years in Group II. Mean pain scores at postoperative 1, 3, and 7 days in Group I were (5.20±1.14, 4.60±0.97, and 3.50±0.97, respectively) significantly higher than those of Group II (0.70±0.82, 0.60±0.84, and 0.10±0.32, respectively). Time to return to normal activity was significantly shorter in Group II (3.7±2.1 days) compared with Group I (6.8±3.4 days) (p=0.028). However, the number of recurrences and hydroceles, as a complication of varicocelectomy, was 2 times higher in Group II (10%) than in Group I (5%). Conclusions: We believe that laparoscopic varicocelectomy is a safe, effective, and minimally invasive procedure. Furthermore, reduced postoperative discomfort and earlier return to normal activity are additional advantages of this method. PMID:23477168

  4. Post-Retention Changes in Class II Correction With the Forsus (trademark) Appliance

    DTIC Science & Technology

    2015-06-01

    headgear combination showed long-term stability of Class II correction 12- 15 years out of 5 retention.25 One recent study on the FR-2 functional...L1-MP (deg) 4) U1-NA (mm) 5 ) L1-NB (mm) 6) Overjet (mm) 15 Figure 3: Points/Landmarks for Skeletal Vertical Measurements...extraction patients treated with the Forsus Fatigue Resistant Device versus intermaxillary elastics. Angle Orthod. 2008 Mar; 78(2):332-8. 5 ) Mihalik CA

  5. Dietary Vitamin K and Association with Hepatic Vitamin K Status in a Yup'ik Study Population from Southwestern Alaska.

    PubMed

    Au, Nicholas T; Ryman, Tove; Rettie, Allan E; Hopkins, Scarlett E; Boyer, Bert B; Black, Jynene; Philip, Jacques; Yracheta, Joseph; Fohner, Alison E; Reyes, Morayma; Thornton, Timothy A; Austin, Melissa A; Thummel, Kenneth E

    2018-02-01

    The relationship between dietary vitamin K and plasma PIVKA-II concentration, a biomarker of hepatic vitamin K status, in a Yup'ik study population in southwestern Alaska is investigated. A total of 659 male and female, self-reported Yup'ik people, ≥14 years of age, were enrolled. Blood is collected for genotyping and plasma PIVKA-II biomarker analysis. A Yup'ik-specific dietary food frequency questionnaire is used to assess vitamin K intake. Among the participants, 22% report not consuming foods rich in vitamin K during the past year and 36% have a PIVKA-II concentration ≥ 2 ng mL -1 , indicating vitamin K insufficiency. The odds of an elevated PIVKA-II concentration are 33% lower in individuals reporting any versus no consumption of vitamin-K-rich foods. The association is significant after adjusting for CYP4F2*3 genotype. Tundra greens are high in vitamin K1 content, but an exploratory analysis suggests that subsistence meat sources have a greater effect on vitamin K status. A substantial proportion of the Yup'ik population exhibits vitamin K insufficiency, which is associated with low consumption of vitamin K rich foods and which might affect an individual's response to anticoagulant drugs such as warfarin that target the vitamin K cycle. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. A Survey of College Reading Programs in New York State, Part II: Diagnosis, Placement and Program Components.

    ERIC Educational Resources Information Center

    Malinowski, Patricia A.

    During spring 1988, an initial survey was conducted among two- and four-year colleges in New York State to identify the primary reading test used for diagnosis and placement. In order to address several questions raised by the study, a follow-up survey of participating two-year colleges was conducted during fall 1989. Of the 28 two-year colleges…

  7. Occlusal status in Asian male adults: prevalence and ethnic variation.

    PubMed

    Soh, Jen; Sandham, Andrew; Chan, Yiong Huak

    2005-09-01

    The purpose of this study was to determine the occlusal status in young Asian male adults of three ethnic groups. Study models of a sample of male army recruits (N = 339, age 17-22 years) with no history of orthodontic treatment were assessed. The ethnic proportions of the sample were Chinese 76.1% (n = 258), Malay 17.7% (n = 60), and Indian 6.2% (n = 21). British Standard Institute (BSI) and Angle's classification were used to determine incisor and molar relationships, respectively. Chi-square test or Fisher's Exact test was performed to compare the occlusal traits between ethnic groups. The distribution of incisor relationships of the total sample consisted of Class I = 48.1%, Class II/1 = 26.3%, Class II/2 = 3.2%, and Class III = 22.4%. Right Angle's molar relationships were 49.9%, 24.5%, and 24.2% whereas left Angle's molar relationships were 53.1%, 25.1%, and 21.2% for Class I, II, and III, respectively. Comparison between ethnic groups found that Indian subjects were more likely to have Class II/1 malocclusions and clinically missing permanent teeth (P < .05). The study found that the overall prevalence of malocclusion (BSI) was Class I, Class II/1, Class III, and Class II/2 in descending order of proportions. Angle's Class I molar was most prevalent followed by Class II and Class III relations. A significant difference in occlusal status between the ethnic groups was found regarding incisor relationship and missing permanent teeth (P < .05).

  8. A novel method for detection of apoptosis

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

    Zagariya, Alexander M., E-mail: zagariya@uic.edu

    2012-04-15

    There are two different Angiotensin II (ANG II) peptides in nature: Human type (ANG II) and Bovine type (ANG II*). These eight amino acid peptides differ only at position 5 where Valine is replaced by Isoleucine in the Bovine type. They are present in all species studied so far. These amino acids are different by only one atom of carbon. This difference is so small, that it will allow any of ANG II, Bovine or Human antibodies to interact with all species and create a universal method for apoptosis detection. ANG II concentrations are found at substantially higher levels inmore » apoptotic, compared to non-apoptotic, tissues. ANG II accumulation can lead to DNA damage, mutations, carcinogenesis and cell death. We demonstrate that Bovine antiserum can be used for universal detection of apoptosis. In 2010, the worldwide market for apoptosis detection reached the $20 billion mark and significantly increases each year. Most commercially available methods are related to Annexin V and TUNNEL. Our new method based on ANG II is more widely known to physicians and scientists compared to previously used methods. Our approach offers a novel alternative for assessing apoptosis activity with enhanced sensitivity, at a lower cost and ease of use.« less

  9. A Phase II, Randomized, Safety and Immunogenicity Trial of a Re-Derived, Live-Attenuated Dengue Virus Vaccine in Healthy Children and Adults Living in Puerto Rico.

    PubMed

    Bauer, Kristen; Esquilin, Ines O; Cornier, Alberto Santiago; Thomas, Stephen J; Quintero Del Rio, Ana I; Bertran-Pasarell, Jorge; Morales Ramirez, Javier O; Diaz, Clemente; Carlo, Simon; Eckels, Kenneth H; Tournay, Elodie; Toussaint, Jean-Francois; De La Barrera, Rafael; Fernandez, Stefan; Lyons, Arthur; Sun, Wellington; Innis, Bruce L

    2015-09-01

    This was a double-blind, randomized, controlled, phase II clinical trial, two dose study of re-derived, live-attenuated, tetravalent dengue virus (TDEN) vaccine (two formulations) or placebo in subjects 1-50 years of age. Among the 636 subjects enrolled, 331 (52%) were primed, that is, baseline seropositive to at least one dengue virus (DENV) type. Baseline seropositivity prevalence increased with age (10% [< 2 years], 26% [2-4 years], 60% [5-20 years], and 93% [21-50 years]). Safety profiles of TDEN vaccines were similar to placebo regardless of priming status. No vaccine-related serious adverse events (SAEs) were reported. Among unprimed subjects, immunogenicity (geometric mean antibody titers [GMT] and seropositivity rates) for each DENV increased substantially in both TDEN vaccine groups with at least 74.6% seropositive for four DENV types. The TDEN vaccine candidate showed an acceptable safety and immunogenicity profile in children and adults ranging from 1 to 50 years of age, regardless of priming status. ClinicalTrials.gov: NCT00468858. © The American Society of Tropical Medicine and Hygiene.

  10. Profile of renal AA amyloidosis in older and younger individuals: a single-centre experience.

    PubMed

    Erdogmus, Siyar; Kendi Celebi, Zeynep; Akturk, Serkan; Kumru, Gizem; Duman, Neval; Ates, Kenan; Erturk, Sehsuvar; Nergizoglu, Gokhan; Kutlay, Sim; Sengul, Sule; Keven, Kenan

    2018-05-18

    In epidemiological studies of amyloid A (AA) amyloidosis from Turkey, the most frequently cause was familial Mediterranean fever (FMF) and it occurs generally in young age population. However, there are no sufficient data regarding aetiology, clinical presentation and prognosis of renal AA amyloidosis in advanced age patients. In this study, we aimed to investigate demographic, clinical presentation, aetiology and outcomes of adults aged 60 years or older patients with biopsy-proven renal AA amyloidosis. This is a retrospective study involving 53 patients who were diagnosed with AA amyloidosis by kidney biopsy from 2006 to 2016. In all patients, kidney biopsies were performed due to asymptomatic proteinuria, nephrotic syndrome and/or renal insufficiency. The patients were separated into two groups on the basis of age (group I: ≥60 years and group II: <60 years). Outcomes of patients in terms of the requirement of renal replacement therapy and mortality were recorded. In patients with group I, the causes of AA amyloidosis were as follows: FMF 16 (50%), bronchiectasis 7 (23%), chronic osteomyelitis 2 (6%), inflammatory bowel disease 2 (6%), rheumatoid arthritis 2 (6%), ankylosing spondylitis 1 (3%) and unknown aetiology 2 (6%). The underlying disorders of AA amyloidosis in group II patients were as follows: FMF 17 (81%), Behcet's disease 1 (5%) and unknown aetiology 3 (14%). No statistically significant differences were detected between two groups with regard to systolic and diastolic blood pressures, albumin, proteinuria and lipids. The combination of chronic kidney disease and nephrotic syndrome was the most common clinical presentation in group I (73%) and group II (43%) (p = .05). Compared to the group II, estimated glomerular filtration rate was significantly lower in group I at the time of kidney biopsy (p = .003). At 12-month follow-up, 61% of the group I and 33% of the group II developed end-stage kidney disease requiring dialysis, while 11% of the group I died. Our results indicated that renal AA amyloidosis is a rare disease in advanced age patients. At baseline and follow-up period, advanced age patients had worse kidney disease and outcomes.

  11. Prevalence of malocclusion among mouth breathing children: do expectations meet reality?

    PubMed

    Souki, Bernardo Q; Pimenta, Giovana B; Souki, Marcelo Q; Franco, Leticia P; Becker, Helena M G; Pinto, Jorge A

    2009-05-01

    The aim of this study was to report epidemiological data on the prevalence of malocclusion among a group of children, consecutively admitted at a referral mouth breathing otorhinolaryngological (ENT) center. We assessed the association between the severity of the obstruction by adenoids/tonsils hyperplasia or the presence of allergic rhinitis and the prevalence of class II malocclusion, anterior open bite and posterior crossbite. Cross-sectional, descriptive study, carried out at an Outpatient Clinic for Mouth-Breathers. Dental inter-arch relationship and nasal obstructive variables were diagnosed and the appropriate cross-tabulations were done. Four hundred and one patients were included. Mean age was 6 years and 6 months (S.D.: 2 years and 7 months), ranging from 2 to 12 years. All subjects were evaluated by otorhinolaryngologists to confirm mouth breathing. Adenoid/tonsil obstruction was detected in 71.8% of this sample, regardless of the presence of rhinitis. Allergic rhinitis alone was found in 18.7% of the children. Non-obstructive mouth breathing was diagnosed in 9.5% of this sample. Posterior crossbite was detected in almost 30% of the children during primary and mixed dentitions and 48% in permanent dentition. During mixed and permanent dentitions, anterior open bite and class II malocclusion were highly prevalent. More than 50% of the mouth breathing children carried a normal inter-arch relationship in the sagital, transversal and vertical planes. Univariate analysis showed no significant association between the type of the obstruction (adenoids/tonsils obstructive hyperplasia or the presence of allergic rhinitis) and malocclusions (class II, anterior open bite and posterior crossbite). The prevalence of posterior crossbite is higher in mouth breathing children than in the general population. During mixed and permanent dentitions, anterior open bite and class II malocclusion were more likely to be present in mouth breathers. Although more children showed these malocclusions, most mouth breathing children evaluated in this study did not match the expected "mouth breathing dental stereotype". In this population of mouth breathing children, the obstructive size of adenoids or tonsils and the presence of rhinitis were not risk factors to the development of class II malocclusion, anterior open bite or posterior crossbite.

  12. 40 CFR Appendix II to Subpart E - Sampling Tables

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Sampling Tables II Appendix II to Subpart E Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) NOISE ABATEMENT PROGRAMS... II to Subpart E—Sampling Tables Table 1—Model Year Production Volume of 50-99 Vehicles Cumulative...

  13. 40 CFR Appendix II to Subpart E - Sampling Tables

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Sampling Tables II Appendix II to Subpart E Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) NOISE ABATEMENT PROGRAMS... II to Subpart E—Sampling Tables Table 1—Model Year Production Volume of 50-99 Vehicles Cumulative...

  14. A Multicenter Phase II Study of Local Radiation Therapy for Stage IEA Mucosa-Associated Lymphoid Tissue Lymphomas: A Preliminary Report From the Japan Radiation Oncology Group (JAROG)

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

    Isobe, Koichi; Kagami, Yoshikazu; Higuchi, Keiko

    2007-11-15

    Purpose: The aim of this study was to evaluate the efficacy and toxicity of moderate dose radiation therapy (RT) for mucosa-associated lymphoid tissue (MALT) lymphoma in a prospective multicenter phase II trial. Methods and Materials: The subjects in this study were 37 patients with MALT lymphoma between April 2002 and November 2004. There were 16 male and 21 female patients, ranging in age from 24 to 82 years, with a median of 56 years. The primary tumor originated in the orbit in 24 patients, in the thyroid and salivary gland in 4 patients each, and 5 in the others. Themore » median tumor dose was 30.6 Gy (range, 30.6-39.6 Gy), depending on the primary site and maximal tumor diameter. The median follow-up was 37.3 months. Results: Complete remission (CR) or CR/unconfirmed was achieved in 34 patients (92%). The 3-year overall survival, progression-free survival, and local control probability were 100%, 91.9%, and 97.3%, respectively. Thirteen patients experienced Grade 1 acute toxicities including dermatitis, mucositis, and conjunctivitis. One patient developed Grade 2 taste loss. Regarding late toxicities, Grade 2 reactions including hypothyroidism, and radiation pneumonitis were observed in three patients, and Grade 3 cataract was seen in three patients. Conclusions: This prospective phase II study demonstrated that moderate dose RT was highly effective in achieving local control with acceptable morbidity in 37 patients with MALT lymphoma.« less

  15. Attitude toward Mathematics among the Students at Nazarbayev University Foundation Year Programme

    ERIC Educational Resources Information Center

    Karjanto, N.

    2017-01-01

    This article investigates the attitude toward mathematics among the students enrolled in the Foundation Year Programme at Nazarbayev University. The study is conducted quantitatively and an inventory developed by Tapia and Marsh II is adopted in this research. The inventory consists of 40 statements on the five-point Likert scale. Gender,…

  16. The Aged Samaritan: Heroes of the Holocaust Forty Years Later.

    ERIC Educational Resources Information Center

    Midlarsky, Elizabeth; Oliner, Samuel P.

    Recent research indicates that helping others is associated with competence, personal control, and a sense of well-being and that the elderly often express altruistic attitudes and help others. The current period, 40 years after the termination of World War II, presents a final opportunity to study those individuals who had engaged in extreme…

  17. Continuity Between DSM-5 Section II and III Personality Disorders in a Dutch Clinical Sample.

    PubMed

    Orbons, Irene M J; Rossi, Gina; Verheul, Roel; Schoutrop, Mirjam J A; Derksen, Jan L L; Segal, Daniel L; van Alphen, Sebastiaan P J

    2018-05-14

    The goal of this study was to evaluate the continuity across the Section II personality disorders (PDs) and the proposed Section III model of PDs in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013a ). More specifically, we analyzed association between the DSM-5 Section III pathological trait facets and Section II PDs among 110 Dutch adults (M age = 35.8 years, range = 19-60 years) receiving mental health care. We administered the Structured Clinical Interview for DSM-IV Axis II Disorders to all participants. Participants also completed the self-report Personality Inventory for DSM-5 (PID-5) as a measure of pathological trait facets. The distributions underlying the dependent variable were modeled as criterion counts, using negative binomial regression. The results provided some support for the validity of the PID-5 and the DSM-5 Section III Alternative Model, although analyses did not show a perfect match. Both at the trait level and the domain level, analyses showed mixed evidence of significant relationships between the PID-5 trait facets and domains with the traditional DSM-IV PDs.

  18. Interim analysis of postoperative chemoradiotherapy with capecitabine and oxaliplatin versus capecitabine alone for pathological stage II and III rectal cancer: a randomized multicenter phase III trial.

    PubMed

    Feng, Yan-Ru; Zhu, Yuan; Liu, Lu-Ying; Wang, Wei-Hu; Wang, Shu-Lian; Song, Yong-Wen; Wang, Xin; Tang, Yuan; Liu, Yue-Ping; Ren, Hua; Fang, Hui; Zhang, Shi-Ping; Liu, Xin-Fan; Yu, Zi-Hao; Li, Ye-Xiong; Jin, Jing

    2016-05-03

    The aim of this study is to present an interim analysis of a phase III trial (NCT00714077) of postoperative concurrent capecitabine and radiotherapy with or without oxaliplatin for pathological stage II and III rectal cancer. Patients with pathologically confirmed stage II and III rectal cancer were randomized to either radiotherapy with concurrent capecitabine (Cap-RT group) or with capecitabine and oxaliplatin (Capox-RT group). The primary endpoint was 3-year disease-free survival rate (DFS). The 3-year DFS rate was 73.9% in the Capox-RT group and 71.6% in the Cap-RT group (HR 0.92, p = 0.647), respectively. No significant difference was observed in overall survival, cumulative incidence of local recurrence and distant metastasis between the two groups (p > 0.05). More grade 3-4 acute toxicity was observed in the Capox-RT group than in the Cap-RT group (38.1% vs. 29.2%, p = 0.041). Inclusion of oxaliplatin in the capecitabine-based postoperative regimen did not improve DFS but increased toxicities for pathological stage II and III rectal cancer in this interim analysis.

  19. Spinal muscular atrophy type II (intermediary) and III (Kugelberg-Welander). Evolution of 50 patients with physiotherapy and hydrotherapy in a swimming pool.

    PubMed

    Cunha, M C; Oliveira, A S; Labronici, R H; Gabbai, A A

    1996-09-01

    We added hydrotherapy to 50 patients with spinal muscular atrophy (SMA) who were being treated with individual conventional physiotherapy. Hydrotherapy performed at an approximate temperature of 30 degrees Celsius, twice a week, for thirty minutes in children and forty-five minutes in adults during a 2-year period. The outcome derived from this combined modality of treatment was rated according to physiotherapeutic evaluations, the MMT (Manual Muscular Test), and the Barthel Ladder. Patients were reevaluated at 2-month intervals. After two years of ongoing treatment, we were able to observe that the deformities in hip, knee and foot were progressive in all SMA Type II patients, and in some Type III. Muscle strength stabilized in most SMA Type III patients, and improved in some. MMT was not done in SMA Type II. In all patients we were able to detect an improvement in the Barthel Ladder scale. This study suggests that a measurable improvement in the quality of daily living may be obtained in patients with SMA Types II and III subjected to conventional physiotherapy when associated with hydrotherapy.

  20. Arm anthropometry indices in Turkish children and adolescents: changes over a three-year period.

    PubMed

    Çiçek, Betül; Öztürk, Ahmet; Mazıcıoğlu, Mustafa Mümtaz; Kurtoğlu, Selim

    2014-12-01

    Time-related changes and comparisons for mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), arm fat area (AFA) are lacking for Turkish children and adolescents. To determine the arm anthropometry indices (MUAC, TSF, AFA) in children and adolescents and to also assess the changes in these indices over a 3-year time period. The data of the Anthropometry of Turkish Children Aged 0-6 Years (ATCA-06) study and the Second Study of Determination of the Anthropometric Measurements of Turkish Children and Adolescents (DAMTCA-II) were used to calculate the arm anthropometry percentiles in a total group of 6982 children and adolescents aged 28 days to 17 years. The 3rd-97th percentiles were computed by the LMS method. In girls, 50th percentile MUAC values linearly increased with age. In boys, 50th percentile TSF values linearly increased until 10 years of age and decreased after age 11 years, while in girls, TSF values increased linearly with age. 50th percentile values for AFA showed a linear increase in both genders with age. Significant differences were found between the 5th, 50th and 95th percentile values for MUAC and AFA obtained in the two studies (DAMTCA-II and DAMTCA-I) in both boys and girls. The prominent finding was the significant and alarming increase in arm anthropometry indices in both genders within as short period of time as three years.

  1. Three-year clinical performance of cast gold vs ceramic partial crowns.

    PubMed

    Federlin, M; Wagner, J; Männer, T; Hiller, K-A; Schmalz, G

    2007-12-01

    Cast gold partial crowns (CGPC) and partial ceramic crowns (PCC) are both accepted for restoring posterior teeth with extended lesions today. However, as esthetics in dentistry becomes increasingly important, CGPC are being progressively replaced by PCC. The aim of the present prospective split-mouth study was the comparison of the clinical performance of PCC and CGPC after 3 years of clinical service. Twenty-eight patients (11 men and 17 women) participated in the 3-year recall with a total of 56 restorations. In each patient, one CGPC (Degulor C) and one PCC (Vita Mark II ceramic/Cerec III) had been inserted at baseline. CGPC were placed using a zinc phosphate cement (Harvard); PCC were adhesively luted (Variolink II/Excite). All restorations were clinically assessed using modified US Public Health Service (USPHS) criteria at baseline, 1 year, 2 years, and 3 years after insertion. Twenty-eight CGPC and 14 PCC were placed in molars, and 14 PCC were placed in premolars. Early data were reported previously under the same study design. After 3 years, the evaluation according to USPHS criteria revealed no statistically significant differences between both types of restorations with the exception of marginal adaptation and marginal discoloration: A statistically significant difference within the PCC group (baseline/3 years) was determined for the criterion marginal adaptation. For the 3-year recall period, overall failure was 0% for CGPC and 6.9% for PCC. At 3 years, PCC meet American Dental Association Acceptance Guidelines criteria for tooth-colored restorative materials for posterior teeth.

  2. A 15-year randomized controlled study of a reduced shrinkage stress resin composite.

    PubMed

    van Dijken, Jan W V; Lindberg, Anders

    2015-09-01

    The aim of this randomized controlled study was to evaluate the long term effectiveness of a reduced shrinkage stress resin composite in Class II restorations. The material was compared intra-individually with a microhybrid resin composite. Each of 50 patients with at least one pair of two similar sized Class II cavities participated (22 female, 28 male, mean age 43 years, range 18-64). Each participant received in each pair, in a randomized way, one Class II restoration performed with a reduced shrinkage stress resin composite (InTen-S) and the other restoration with a microhybrid resin composite restoration (Point 4). Both restorations were placed with an etch-and-rinse bonding system and an oblique layering technique. A total of 106 restorations, 33 premolar and 73 molars, were placed. The restorations were evaluated blindly each year using modified USPHS criteria. The overall performance of the experimental restorations was tested after intra-individual comparison using the Friedmańs two-way analysis of variance test. The hypothesis was rejected at the 5% level. At 15 years, 91 restorations were evaluated. The drop out frequency was 15 restorations (5 male, 3 female participants; 2 premolar and 13 molar restorations). Except for 2 participants, who reported slight symptoms during a few weeks after placement, no post-operative sensitivity was observed at the recalls. The overall success rate at 15 years was 77%. Twenty-one non acceptable restorations were observed during the 15 years follow up, 10 InTen-S (21.7%) and 11 Point 4 (24.4%) restorations (p>0.05). Annual failure rates for the resin composites were 1.5% and 1.6%, respectively. The main reasons for failure were secondary caries (8) and resin composite fracture (7). The differences between premolar vs. molar restorations and between restorations in male vs. female participants were not significant. Significant differences were observed between 2-surface vs. 3-surface restorations. During the 15-year follow up, the reduced shrinkage stress resin composite showed a good clinical durability in Class II cavities, but not significantly better than the control microhybrid resin composite. Secondary caries and material fracture were the main reasons of failure. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  3. The Influence of Antithyroid Drug Discontinuation to the Therapeutic Efficacy of (131)I in Hyperthyroidism.

    PubMed

    Kartamihardja, A Hussein Sundawa; Massora, Stepanus

    2016-01-01

    The influence of antithyroid drugs (ATDs) on the therapeutic efficacy of radioactive iodine in hyperthyroidism is still controversial. The aim of this study was to evaluate the effect of ATD discontinuation to the therapeutic efficacy of I-131 in hyperthyroidism patients with long-term ATD treatment. Retrospective study was done to 39 subjects with hyperthyroidism who had been treated with doses of 300 MBq radioactive iodine. The subjects were divided into three groups: Group I (n = 14) had been using ATDs for more than one year and discontinued more than three days; group II (n = 14) had been using ATDs for more than one year but discontinued only for three days or less, and group III (n = 11) has never been used any ATD before radioactive iodine treatment. There was a significant difference in the therapeutic efficacy after three months of radioactive iodine treatment between group I and group II (P = 0.018), group II and group III (P = 0.017), but not between group I and group III (P = 1.0). There was no observed difference on the therapeutic efficacy between the three groups at 6 months after radioactive iodine therapy (P = 0.143). Administration of ATDs more than 1 year without discontinuation decreased response of radioactive iodine treatment in 3 months follow-up. Discontinuation of ATDs for more than 3 days before radioactive iodine treatment is recommended.

  4. The Influence of Antithyroid Drug Discontinuation to the Therapeutic Efficacy of 131I in Hyperthyroidism

    PubMed Central

    Kartamihardja, A. Hussein Sundawa; Massora, Stepanus

    2016-01-01

    The influence of antithyroid drugs (ATDs) on the therapeutic efficacy of radioactive iodine in hyperthyroidism is still controversial. The aim of this study was to evaluate the effect of ATD discontinuation to the therapeutic efficacy of I-131 in hyperthyroidism patients with long-term ATD treatment. Retrospective study was done to 39 subjects with hyperthyroidism who had been treated with doses of 300 MBq radioactive iodine. The subjects were divided into three groups: Group I (n = 14) had been using ATDs for more than one year and discontinued more than three days; group II (n = 14) had been using ATDs for more than one year but discontinued only for three days or less, and group III (n = 11) has never been used any ATD before radioactive iodine treatment. There was a significant difference in the therapeutic efficacy after three months of radioactive iodine treatment between group I and group II (P = 0.018), group II and group III (P = 0.017), but not between group I and group III (P = 1.0). There was no observed difference on the therapeutic efficacy between the three groups at 6 months after radioactive iodine therapy (P = 0.143). Administration of ATDs more than 1 year without discontinuation decreased response of radioactive iodine treatment in 3 months follow-up. Discontinuation of ATDs for more than 3 days before radioactive iodine treatment is recommended. PMID:27134556

  5. Troponin rise in hospitalized patients with nonacute coronary syndrome: retrospective assessment of outcomes and predictors.

    PubMed

    Dhesi, Sumandeep; Shanks, Miriam; Tymchak, Wayne J

    2015-03-01

    Cardiac troponin is elevated in several clinical settings apart from thrombotic acute coronary syndrome (ACS) and is associated with increased adverse events. It is not clear whether troponin elevation in type II myocardial infarction (MI) is associated with increased cardiovascular events. Our objectives were to identify the cause of mortality in type II MI and to attempt to establish the threshold range of cardiac troponin-I (cTnI) elevation as well as clinical factors associated with adverse outcomes in type II MI. This retrospective cohort study included 245 patients presenting with a noncardiac primary diagnosis associated with cTnI elevation at a single centre from January 2003 to December 2011. Primary outcome was a composite of cardiovascular and noncardiovascular mortality. Secondary outcomes included subsequent stroke, ACS, and heart failure (HF). At 1 year, ACS occurred in 13 patients (5.3%), stroke was seen in 10 (4.1%) patients, and HF occurred in 19 (7.8%) patients. Overall 1-year mortality included 102 events (41.6%), with 10 cardiovascular deaths (9.8%), 65 noncardiovascular deaths (63.7%), and 27 (26.5%) deaths from unknown causes. In multivariable analysis, factors independently associated with increased overall 1-year mortality included cTnI elevation ≥ 4.63 μg/L (odds ratio [OR], 3.37; 95% confidence interval [CI], 1.55-7.34; P = 0.002), age ≥ 70 years (OR, 2.44; 95% CI, 1.40-4.29; P = 0.002), and estimated glomerular filtration rate < 30 mL/min/1.73m(2) (OR, 2.40; 95% CI 1.31-4.40; P = 0.005). Unlike the published literature, our study includes a variety of both operative and nonoperative clinical settings associated with troponin elevation. We illustrate that although overall mortality is high after type II MI, the majority of mortality is caused by noncardiovascular events. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  6. Clinical characteristics and surgical history of Taiwanese patients with mucopolysaccharidosis type II: data from the hunter outcome survey (HOS).

    PubMed

    Lin, Hsiang-Yu; Chuang, Chih-Kuang; Chen, Ming-Ren; Lin, Shio Jean; Chiu, Pao Chin; Niu, Dau-Ming; Tsai, Fuu-Jen; Hwu, Wuh-Liang; Chien, Yin-Hsiu; Lin, Ju-Li; Lin, Shuan-Pei

    2018-06-04

    Mucopolysaccharidosis type II (MPS II) is the most frequently occurring MPS in Taiwan, with an incidence of 2.05 per 100,000 live male births, but little is known about clinical characteristics and surgical history in Taiwanese patients. Medical history, demographics, signs and symptoms, and surgical history were analysed in all patients from Taiwanese centres in the Hunter Outcome Survey (HOS; NCT 03292887), a global, multicentre registry that collects real-world data on patients with MPS II. As of January 2016, 61 male Taiwanese patients were enrolled; 49% (24/49) had received at least one infusion of idursulfase. Median (10th, 90th percentiles) ages at signs and symptom onset and at diagnosis were 2.5 (0.2, 5.5) years (n = 55) and 3.5 (1.2, 11.9) years (n = 56), respectively. Hernia, facial features consistent with MPS II and claw hands were the earliest presenting signs and symptoms (median ages of 3.2 [0.4, 12.0] years, 4.3 [1.1, 12.0] years and 4.7 [2.5, 12.2] years [n = 45, 53 and 50], respectively). More than 75% of patients had undergone a surgical procedure, most commonly hernia repair (57% of patients). Median age at first surgery for hernia repair was 4.2 (0.5, 9.8) years (n = 35). Almost one-third (31.1%) of patients had at least one surgical procedure before diagnosis, and of the 20 procedures before diagnosis, 16 were hernia repair. This information from patients in HOS highlights the importance of both medical and surgical history in diagnosing MPS II in Taiwanese patients.

  7. Effect of aminglycoside administration on the occurrence and multiplication of resistant bacteria.

    PubMed

    Milas, Josip; Kalenić, Smilja; Milas, Vesna; Miskulin, Maja; Vuković, Dubravka; Rudan, Stjepan; Puntarić, Dinko

    2009-06-01

    In the prospective study the susceptibility of 41 Escherichia coli strains and 55 Pseudomonas aeruginosa strains to gentamicin, netilmicin and amikacin was tested at a 2-year interval (period I April 1998 to March 1999, and period II April to July 2001). Genotyping was performed by pulsed-field gel electrophoresis, and a clone based on 80% or 90% similarity was determined for each of the study bacteria. In 24 (32.0%) clones, strains showed no variation over 2-year interval, supporting the hypothesis on a priori susceptible strains. Transformation from susceptibility in period I to resistance in period II was demonstrated in 5 (6.7%) clones, a pattern consistent with the concept of bacterial development of resistance under the influence of antibiotics. However, there were 10 (13.3%) clones whose strains exhibited an inverse pattern. Accordingly, two-way transformation of susceptibility took place during the study period. The utilization of the study aminoglycosides had no major impact on the variation of microbial susceptibility. Changes in microbial susceptibility were found to follow some regular patterns, which were not influenced by the study aminoglycosides. Two phenomena were observed: (i) there were stable clones that did not develop resistance in spite of selective antibiotic challenge; and (ii) changes of susceptibility in isolated bacteria from both inpatient and outpatient strains of the same clone were two-way and reversible.

  8. 34 CFR 643.3 - Who is eligible to participate in a project?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... meets all the following requirements: (1)(i) Is a citizen or national of the United States; (ii) Is a... elementary education or is at least 11 years of age but not more than 27 years of age. (ii) However, an individual who is more than 27 years of age may participate in a Talent Search project if the individual...

  9. 34 CFR 643.3 - Who is eligible to participate in a project?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... meets all the following requirements: (1)(i) Is a citizen or national of the United States; (ii) Is a... elementary education or is at least 11 years of age but not more than 27 years of age. (ii) However, an individual who is more than 27 years of age may participate in a Talent Search project if the individual...

  10. 34 CFR 643.3 - Who is eligible to participate in a project?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... meets all the following requirements: (1)(i) Is a citizen or national of the United States; (ii) Is a... elementary education or is at least 11 years of age but not more than 27 years of age. (ii) However, an individual who is more than 27 years of age may participate in a Talent Search project if the individual...

  11. 34 CFR 643.3 - Who is eligible to participate in a project?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... meets all the following requirements: (1)(i) Is a citizen or national of the United States; (ii) Is a... elementary education or is at least 11 years of age but not more than 27 years of age. (ii) However, an individual who is more than 27 years of age may participate in a Talent Search project if the individual...

  12. National Educational Technology Trends: 2010. Innovation Through State Leadership

    ERIC Educational Resources Information Center

    State Educational Technology Directors Association, 2010

    2010-01-01

    This annual report provides a national perspective on Title II-D for federal fiscal year (FY) 2008 (2008-09 school year), as well as emergent trends based on data from the past seven years. Title II-D is the only federal education program with funds explicitly targeted to support state and local effective uses of educational technology in the …

  13. Influence of warfarin therapy on the occurrence of postoperative endoleaks and aneurysm sac enlargement after endovascular abdominal aortic aneurysm repair.

    PubMed

    Seike, Yoshimasa; Tanaka, Hiroshi; Fukuda, Tetsuya; Itonaga, Tatsuya; Morita, Yoshiaki; Oda, Tatsuya; Inoue, Yosuke; Sasaki, Hiroaki; Minatoya, Kenji; Kobayashi, Junjiro

    2017-04-01

    This study aims to determine whether warfarin therapy influences the occurrence of endoleaks or aneurysm sac enlargement after endovascular aortic repair (EVAR). A total of 367 patients who underwent EVAR for abdominal aortic aneurysm between 2007 and 2013 were recruited for this study. Satisfactory follow-up data including completed computed tomography scan follow-up for more than 2 years were available for 209 patients, and the mean follow-up time was 37 ± 12 months. Twenty-nine (16%) patients were on warfarin therapy (warfarin group), whereas 180 (84%) patients were not on warfarin therapy (control group). Two- and four-year freedom rates for persistent type II endoleaks were significantly lower in patients of the warfarin group compared with the control group (85 and 49% vs 93 and 91%, respectively; P = 0.0001). Similarly, 2- and 4-year freedom rates for sac enlargement (>5 mm) were significantly lower in patients of the warfarin group compared with the control group (83 and 61% vs 92 and 82%, respectively; P = 0.0036). Using Cox regression analysis, the warfarin therapy was identified to be an independent positive predictor of sac enlargement after EVAR [hazard ratio (HR): 2.4; 95% confidence interval (CI): 1.08-5.40; P = 0.032], together with persistent type II endoleak. Warfarin therapy was also an independent predictor for persistent type II endoleak (HR: 3.7; 95% CI: 1.81-7.41; P < 0.0001) together with the number of patent lumbar arteries. Results suggested that warfarin therapy was significantly associated with an increased risk for persistent II endoleak and sac enlargement after EVAR. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  14. Examining mortality risk and rate of ageing among Polish Olympic athletes: a survival follow-up from 1924 to 2012

    PubMed Central

    Lin, Yuhui; Gajewski, Antoni; Poznańska, Anna

    2016-01-01

    Objectives Population-based studies have shown that an active lifestyle reduces mortality risk. Therefore, it has been a longstanding belief that individuals who engage in frequent exercise will experience a slower rate of ageing. It is uncertain whether this widely-accepted assumption holds for intense wear-and-tear. Here, using the 88 years survival follow-up data of Polish Olympic athletes, we report for the first time on whether frequent exercise alters the rate of ageing. Design Longitudinal survival data of male elite Polish athletes who participated in the Olympic Games from year 1924 to 2010 were used. Deaths occurring before the end of World War II were excluded for reliable estimates. Setting and participants Recruited male elite athletes N=1273 were preassigned to two categorical birth cohorts—Cohort I 1890–1919; Cohort II 1920–1959—and a parametric frailty survival analysis was conducted. An event-history analysis was also conducted to adjust for medical improvements from year 1920 onwards: Cohort II. Results Our findings suggest (1) in Cohort I, for every threefold reduction in mortality risk, the rate of ageing decelerates by 1%; (2) socioeconomic transitions and interventions contribute to a reduction in mortality risk of 29% for the general population and 50% for Olympic athletes; (3) an optimum benefit gained for reducing the rate of ageing from competitive sports (Cohort I 0.086 (95% CI 0.047 to 0.157) and Cohort II 0.085 (95% CI 0.050 to 0.144)). Conclusions This study further suggests that intensive physical training during youth should be considered as a factor to improve ageing and mortality risk parameters. PMID:27091824

  15. Endocrine actions of pesticides measured in the Flemish environment and health studies (FLEHS I and II).

    PubMed

    Croes, K; Den Hond, E; Bruckers, L; Govarts, E; Schoeters, G; Covaci, A; Loots, I; Morrens, B; Nelen, V; Sioen, I; Van Larebeke, N; Baeyens, W

    2015-10-01

    Within the Flemish Environment and Health studies (FLEHS I, 2002-2006, and FLEHS II, 2007-2012), pesticide exposure, hormone levels and degree of sexual maturation were measured in 14-15-year-old adolescents residing in Flanders (Belgium). In FLEHS II, geometric mean concentrations (with 95 % confidence interval (CI)) of 307 (277-341) and 36.5 ng L(-1) (34.0-39.2) were found for p,p'-dichlorophenyldichloroethylene (p,p'-DDE) and hexachlorobenzene (HCB). These values were respectively 26 and 60 % lower than levels in FLEHS I, 5 years earlier. Metabolites of organophosphorus pesticides (OPPs) and of para-dichlorobenzene were measured for the first time in FLEHS II, yielding concentrations of 11.4, 3.27 and 1.57 μg L(-1) for the sum of dimethyl- and diethyl phosphate metabolites and 2,5-dichlorophenol (2,5-DCP), respectively. Data on internal exposure of HCB showed a positive correlation with sexual maturation, testosterone and the aromatase index for boys and with free thyroxine (fT4) and thyroid stimulating hormone (TSH) (both boys and girls). For both p,p'-DDE and HCB, a negative association with sexual development in girls was found. The OPP metabolites were negatively associated with sex hormone levels in the blood of boys and with sexual maturation (both boys and girls). The pesticide metabolite 2,5-DCP was negatively correlated with free T4, while a positive association with TSH was reported (boys and girls). These results show that even exposure to relatively low concentrations of pesticides can have significant influences on hormone levels and the degree of sexual maturation in 14-15-year-old adolescents.

  16. Impact of 6-month earlier versus postponed initiation of rotigotine on long-term outcome: post hoc analysis of patients with early Parkinson's disease with mild symptom severity.

    PubMed

    Timmermann, Lars; Asgharnejad, Mahnaz; Boroojerdi, Babak; Dohin, Elisabeth; Woltering, Franz; Elmer, Lawrence W

    2015-01-01

    Investigate impact of 6-month earlier versus postponed initiation of rotigotine in patients with early Parkinson's disease (PD) with mild symptom severity. Long-term benefit of rotigotine in early-PD has been demonstrated: SP702 (NCT00594165) and SP716 (NCT00599196) were long-term, open-label extensions of double-blind, placebo-controlled studies of 6-month maintenance; rotigotine was well tolerated for up to 6 years, and demonstrated efficacy (Unified Parkinson's Disease Rating Scale [UPDRS] II + III below baseline) for ∼ 2 years (SP702) and ∼ 4 years (SP716). Post hoc analysis of patients at Hoehn and Yahr 1-2; groups defined by treatment received in 6-month double-blind studies: 'Rotigotine-Rotigotine' received rotigotine (n = 221), 'Placebo-Rotigotine' received placebo (n = 125). At the start of open-label rotigotine maintenance, UPDRS II + III mean ± SD change from double-blind baseline was: -8.5 ± 10.6 'Rotigotine-Rotigotine', -7.7 ± 9.0 'Placebo-Rotigotine.' After this initial improvement scores gradually increased: It took ∼ 45 months for mean scores to cross baseline in 'Rotigotine-Rotigotine', and ∼ 21 months in 'Placebo-Rotigotine.' At the time mean UPDRS II + III had crossed baseline in 'Placebo-Rotigotine' (open-label week 84; ∼ 21 months), treatment difference (LS-mean) to 'Rotigotine-Rotigotine' change from baseline was -3.89 (95% CI -6.94, -0.84); p = 0.013. In this post hoc analysis, 6-month earlier initiation of rotigotine resulted in slower return to baseline mean UPDRS II + III; initiation of rotigotine in patients with minimal/no functional disability or impairment may lead to an extended benefit.

  17. Function and regulation of the Mediator complex.

    PubMed

    Conaway, Ronald C; Conaway, Joan Weliky

    2011-04-01

    Over the past few years, advances in biochemical and genetic studies of the structure and function of the Mediator complex have shed new light on its subunit architecture and its mechanism of action in transcription by RNA polymerase II (pol II). The development of improved methods for reconstitution of recombinant Mediator subassemblies is enabling more in-depth analyses of basic features of the mechanisms by which Mediator interacts with and controls the activity of pol II and the general initiation factors. The discovery and characterization of multiple, functionally distinct forms of Mediator characterized by the presence or absence of the Cdk8 kinase module have led to new insights into how Mediator functions in both Pol II transcription activation and repression. Finally, progress in studies of the mechanisms by which the transcriptional activation domains (ADs) of DNA binding transcription factors target Mediator have brought to light unexpected complexities in the way Mediator participates in signal transduction. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. Prevalence of Axis II disorders in a sample of clients undertaking psychiatric evaluation for sex reassignment surgery.

    PubMed

    Madeddu, Fabio; Prunas, Antonio; Hartmann, Diamante

    2009-12-01

    The aim of the present study is to assess the prevalence of Axis II disorders (DSM-IV-TR) in a sample of clients requesting sex reassignment surgery (SRS), consecutively admitted to a Gender Identity Disorder (GID) psychiatric unit. Fifty clients self-referred as transsexuals (34 biological males and 16 biological females; mean age = 31.74 +/- 7.06 years) were assessed through the SCID-II after a preliminary evaluation to exclude current major psychiatric disorders. Prevalence of any Axis II disorder was 52% (N = 26), with no significant differences related to biological sex. The most frequent personality disorders were Cluster B PDs (22% of total sample), followed by Cluster C (12%) and Cluster A PDs (2%). A significant prevalence of NOS PD (16%) was also found. Our data offers prevalence estimates slightly higher than those found in previous studies and does not provide evidence for any differences in the psychopathological profile and severity between MtF and FtM transsexuals.

  19. The Life-Long Mortality Risks Of World War II Experiences

    PubMed Central

    Elder, Glen H.; Brown, James Scott; Martin, Leslie R.; Friedman, Howard W.

    2009-01-01

    Objective This longitudinal study of American veterans investigated the mortality risks of five World War II military experiences (i.e., combat exposure) and their variation among veterans in the post-war years. Methods The male subjects (N=854) are members of the Stanford-Terman study, and 38 percent served in World War II. Cox models (proportional hazards regressions) compared the relative mortality risk associated with each military experience. Results Overseas duty, service in the Pacific and exposure to combat significantly increased the mortality risks of veterans in the study. Individual differences in education, mental health in 1950, and age at entry into the military, as well as personality factors made no difference in these results. Conclusions A gradient is observable such that active duty on the home front, followed by overseas duty, service in the Pacific, and combat exposure markedly increased the risk of relatively early mortality. Potential linking mechanisms include heavy drinking. PMID:20161074

  20. Predictors of Persistent Milk Allergy in Children: A Retrospective Cohort Study.

    PubMed

    Koike, Yumi; Sato, Sakura; Yanagida, Noriyuki; Asaumi, Tomoyuki; Ogura, Kiyotake; Ohtani, Kiyotaka; Imai, Takanori; Ebisawa, Motohiro

    2018-01-01

    Cow's milk (CM) allergy is the second most common food allergy developed during infancy in Japan. To identify predictors of persistent CM allergy, we investigated the tolerance acquisition rate based on an oral food challenge in children under 6 years of age, diagnosed with immediate-type CM allergy. This retrospective cohort study included 131 children born in 2005 with a history of immediate allergic reaction to CM, of whom 39 were excluded because of ongoing oral immunotherapy (n = 18) or a lack of follow-up data (n = 21). The 92 remaining participants were followed for 6 years. Tolerance was defined as no adverse reaction to 200 mL of CM and regular intake of milk at home. Subjects were divided into 3 groups based on age at tolerance acquisition: group I (<3 years; n = 31), group II (3-6 years; n = 42), and group III (persistent allergic group; n = 19). Tolerance acquisition rates by 3, 5, and 6 years of age were 32.6% (30/92), 64.1% (59/92), and 84.8% (70/92), respectively. Age at first hospital visit was significantly higher in groups II and III than in group I (p < 0.001). The incidence of anaphylaxis to other foods was also higher in group III than in group I (p = 0.04), as was CM-induced anaphylaxis (p = 0.03). Furthermore, milk and casein-specific immunoglobulin E (IgE) levels were significantly higher in group III than in group II after birth and remained high thereafter (p < 0.05). The history of anaphylaxis and high milk-specific IgE levels were associated with persistent CM allergy. © 2018 S. Karger AG, Basel.

  1. Three-Year Follow-Up of an Alectinib Phase I/II Study in ALK-Positive Non-Small-Cell Lung Cancer: AF-001JP.

    PubMed

    Tamura, Tomohide; Kiura, Katsuyuki; Seto, Takashi; Nakagawa, Kazuhiko; Maemondo, Makoto; Inoue, Akira; Hida, Toyoaki; Yoshioka, Hiroshige; Harada, Masao; Ohe, Yuichiro; Nogami, Naoyuki; Murakami, Haruyasu; Kuriki, Hiroshi; Shimada, Tadashi; Tanaka, Tomohiro; Takeuchi, Kengo; Nishio, Makoto

    2017-05-10

    Purpose Alectinib is an anaplastic lymphoma kinase (ALK) -specific kinase inhibitor that seems to be effective against non-small-cell lung cancer (NSCLC) with a variety of ALK mutations. The primary analysis of AF-001JP reported a promising overall response rate. To assess progression-free survival (PFS) and overall survival (OS), patients from the phase II part of AF-001JP were followed up for approximately 3 years. Patients and Methods Oral alectinib 300 mg was administered twice per day to patients with ALK inhibitor-naïve, ALK-positive NSCLC who had progressed after one or more regimens of previous chemotherapy. In this long-term follow-up, efficacy (PFS, OS), correlation between tumor shrinkage and PFS, safety of alectinib, and relief of cancer symptoms were evaluated. Results At the updated data cutoff (September 10, 2015; first patient in August 30, 2011, last patient in April 18, 2012), 25 of 46 phase II patients were still receiving alectinib. Disease progression was confirmed in 18 patients (39%); median PFS was not reached (3-year PFS rate, 62%; 95% CI, 45 to 75). Fourteen patients had brain metastases at baseline; of these, 6 remained in the study without CNS and systemic progression. Tumor shrinkage and PFS showed no correlation. The 3-year OS rate was 78% (13 events). The most common treatment-related adverse event (all grades) was increased blood bilirubin (36.2%). Most cancer symptoms were relieved early, and medication for symptoms was dramatically decreased during alectinib therapy. Conclusion Alectinib was effective in this 3-year follow-up with a favorable safety profile over a long administration period in ALK-positive NSCLC without previous ALK inhibitor treatment.

  2. Three-Year Follow-Up of an Alectinib Phase I/II Study in ALK-Positive Non–Small-Cell Lung Cancer: AF-001JP

    PubMed Central

    Tamura, Tomohide; Kiura, Katsuyuki; Seto, Takashi; Nakagawa, Kazuhiko; Maemondo, Makoto; Inoue, Akira; Hida, Toyoaki; Yoshioka, Hiroshige; Harada, Masao; Ohe, Yuichiro; Nogami, Naoyuki; Murakami, Haruyasu; Kuriki, Hiroshi; Shimada, Tadashi; Tanaka, Tomohiro; Takeuchi, Kengo; Nishio, Makoto

    2017-01-01

    Purpose Alectinib is an anaplastic lymphoma kinase (ALK) –specific kinase inhibitor that seems to be effective against non–small-cell lung cancer (NSCLC) with a variety of ALK mutations. The primary analysis of AF-001JP reported a promising overall response rate. To assess progression-free survival (PFS) and overall survival (OS), patients from the phase II part of AF-001JP were followed up for approximately 3 years. Patients and Methods Oral alectinib 300 mg was administered twice per day to patients with ALK inhibitor–naïve, ALK-positive NSCLC who had progressed after one or more regimens of previous chemotherapy. In this long-term follow-up, efficacy (PFS, OS), correlation between tumor shrinkage and PFS, safety of alectinib, and relief of cancer symptoms were evaluated. Results At the updated data cutoff (September 10, 2015; first patient in August 30, 2011, last patient in April 18, 2012), 25 of 46 phase II patients were still receiving alectinib. Disease progression was confirmed in 18 patients (39%); median PFS was not reached (3-year PFS rate, 62%; 95% CI, 45 to 75). Fourteen patients had brain metastases at baseline; of these, 6 remained in the study without CNS and systemic progression. Tumor shrinkage and PFS showed no correlation. The 3-year OS rate was 78% (13 events). The most common treatment-related adverse event (all grades) was increased blood bilirubin (36.2%). Most cancer symptoms were relieved early, and medication for symptoms was dramatically decreased during alectinib therapy. Conclusion Alectinib was effective in this 3-year follow-up with a favorable safety profile over a long administration period in ALK-positive NSCLC without previous ALK inhibitor treatment. PMID:28296581

  3. [Dynamics and spatial differentiation of premature mortality in the productive age group of the population--premise for in depth studies of causes and conditions of this phenomenon].

    PubMed

    Andryszek, C; Indulski, J A; Worach-Kardas, H

    1996-01-01

    The increased mortality in Poland compared to that observed just after the war was mainly caused by the elevated frequency of premature deaths (under 65 years of age). The aim of the work was to assess: the premature mortality in the population of the productive age in Poland in comparison with other countries of Central and Eastern Europe, Scandinavian and Western European countries as well as with other developed countries in the world; the dynamics of premature mortality; the spatial differentiation of premature mortality in our country. Two age phases: I = 20 - 44 years, and II = 45 - 64 years were identified in premature mortality. A considerable increase in male premature mortality in phase II of the productive age which began in the second half of the sixties and had continued until 1991 doubled the mortality ratio in Poland when compared with the average ratio observed in all Scandinavian and Western European countries. The analysis of spatial differentiation of premature mortality indicates clearly the relationship between mortality and environmental conditions: the highest ratios are noted in highly urbanized and industrialized voivodships (provinces). It accounts for possible reasons of shortened by 7-8 years period of men's life in Poland as compared to Western countries or even by 10 year in comparison with Japan, for example. The situation among women is more favorable. These alarming data on premature mortality, especially among men in phase II of the productive age emphasize the urgent need for in-depth studies of causes, circumstances and factors contributing to deaths at the most active productive age.

  4. Portal response related to shunt occlusion by balloon-occluded retrograde transvenous obliteration may determine the prognosis of cirrhosis.

    PubMed

    Kobayashi, Kazufumi; Maruyama, Hitoshi; Kiyono, Soichiro; Sekimoto, Tadashi; Kondo, Takayuki; Shimada, Taro; Takahashi, Masanori; Okugawa, Hidehiro; Yokosuka, Osamu

    2016-12-01

    To determine the prognostic effect of portal hemodynamic responses after balloon-occluded retrograde transvenous obliteration (B-RTO) for gastric varices (GV) in cirrhosis patients. This retrospective study consisted of 37 cirrhosis patients (aged 62.5 ± 9.7 years) with medium- or large-grade GV treated with B-RTO. Portal hemodynamic response was assessed by the changes in flow volume in the portal trunk (PFV, mL/min) before and after the treatment. Group I showed increased PFV and group II showed no increase in PFV. The median observation period was 49.8 months (range, 4.7-150.3 months). All patients showed complete embolization of GV without any recurrence. There were 30 patients in group I and 7 patients in group II (decreased PFV in 6 and unchanged PFV in 1). The PFV at baseline was significantly lower in the former (583.5 ± 232.0 mL/min) than in the latter (880.7 ± 345.9 mL/min; P = 0.009). The survival rate was significantly lower in group II (83.3% at 1 year and 66.7% at 3 years) than in group I (96.7% at 1 year, 81.5% at 3 years, and 61.8% at 5 years; P = 0.012). The incidence of deterioration of the esophageal varices was 18/30 (60%) in group I and 5/7 (71.4%; P = 0.687) in group II. Multivariate analysis identified only no increase in portal response (hazard ratio, 8.086; P = 0.005) as an independent factor for poor prognosis. Balloon-occluded retrograde transvenous obliteration for GV may result in a poor prognosis when portal hemodynamics shows no increase in portal response. © 2016 The Japan Society of Hepatology.

  5. [Melatonin production in hypertonic patients during magnetic storms].

    PubMed

    Rapoport, S I; Shatalova, A M; Oraevskiĭ, V N; Malinovskaia, N K; Vetterberg, L

    2001-01-01

    To study mechanisms of action of natural magnetic field of the Earth on arterial pressure (AP) and melatonin production in patients with essential hypertension (EH) stage II. Clinical, laboratory and device investigations covered 52 men with EH stage II (mean age 42 +/- 0.92 years) and 11 healthy men (mean age 23 +/- 1.46 years). Mean 24-hour, mean daytime, mean night systolic and diastolic pressures, 24-h index, time hypertensive index, standard deviation were registered. Melatonin was measured in the urine by radioimmunoassay. Geomagnetic situation was assessed by K-index (quiet--under 15, disturbed--15-25, magnetic storm--above 25). In hypertensive patients AP grew with growth of geomagnetic activity. In normal subjects AP remained normal. The 24-h rhythm of AP variability in hypertensives was normal. Magnetic storm affected melatonin production in EH patients noticeably: night and daytime production of melatonin was low. In normal subjects night melatonin production was high. AH stage II patients respond to magnetic storm with maladaptation, i.e. a rise in AP and low melatonin production.

  6. Comparison of aortic media changes in patients with bicuspid aortic valve stenosis versus bicuspid valve insufficiency and proximal aortic aneurysm.

    PubMed

    Girdauskas, Evaldas; Rouman, Mina; Borger, Michael A; Kuntze, Thomas

    2013-12-01

    The aim of this study was to evaluate aortic media changes in bicuspid aortic valve (BAV) patients who underwent aortic valve replacement (AVR) and simultaneous replacement of the proximal aorta for BAV stenosis vs BAV insufficiency. Review of our institutional BAV database identified a subgroup of 79 consecutive BAV patients (mean age 52.3 ± 13 years, 81% men) with BAV stenosis or insufficiency and concomitant proximal aortic dilatation of ≥50 mm who underwent AVR and simultaneous replacement of proximal aorta from 1995 through 2005. All cases of BAV disease and concomitant ascending aortic dilatation of 40-50 mm underwent isolated AVR and therefore were excluded from this analysis. Proximal aortic media elastic fibre loss (EFL) was assessed (graded 0 to 3+) and compared between patients with BAV stenosis (Group I, n = 44) vs BAV insufficiency (Group II, n = 35). Follow-up (690 patient-years) was 100% complete and 9.1 ± 4.6 years long. Mean aortic media EFL was 1.3 ± 0.7 in Group I vs 2.5 ± 0.8 in Group II (P = 0.03). Moderate/severe EFL (i.e. defined as grade 2+/3+) was found in 13 patients (29%) in Group I vs 28 patients (80%) in Group II (P < 0.001). Logistic regression identified BAV insufficiency as the strongest predictor of moderate/severe EFL (OR 9.3; 95% CI 3.2-29.8, P < 0.001). Valve-related event-free survival was 64 ± 8% in Group I vs 93% ± 5% in Group II at 10 years postoperatively (P = 0.05). A total of 4 patients (5%, 3 from Group I and 1 from Group II) underwent redo aortic root surgery for prosthetic valve endocarditis during follow-up. Patients with BAV insufficiency and a proximal aorta of ≥50 mm have a significantly higher rate of moderate/severe EFL as compared to their counterparts with BAV stenosis.

  7. Effects of the pendulum appliance, cervical headgear, and 2 premolar extractions followed by fixed appliances in patients with Class II malocclusion.

    PubMed

    de Almeida-Pedrin, Renata Rodrigues; Henriques, José Fernando Castanha; de Almeida, Renato Rodrigues; de Almeida, Marcio Rodrigues; McNamara, James A

    2009-12-01

    In this retrospective study, we compared the cephalometric effects, the dental-arch changes, and the efficiency of Class II treatment with the pendulum appliance, cervical headgear, or extraction of 2 maxillary premolars, all associated with fixed appliance therapy. The sample of 82 patients with Class II malocclusion was divided into 3 groups: group 1 patients (n = 22; treatment time, 3.8 years) were treated with the pendulum appliance and fixed orthodontic appliances. Group 2 patients (n = 30; treatment time, 3.2 years) were treated with cervical headgear followed by fixed appliances; group 3 patients (n = 30; treatment time, 2.1 years) were treated with 2 maxillary premolar extractions and fixed appliances. The average starting ages of the groups ranged from 13.2 to 13.8 years. Data were obtained from serial cephalometric measurements and dental casts. The dental casts were analyzed with the treatment priority index. The treatment efficiency index was also used. The 3 treatment protocols produced similar cephalometric effects, especially skeletally. Comparisons among the 2 distalizing appliances (pendulum and cervical headgear) and extraction of 2 maxillary premolars for Class II treatment showed changes primarily in the maxillary dentoalveolar component and dental relationships. The facial profile was similar after treatment, except for slightly more retrusion of the upper lip in the extraction patients. The treatment priority index demonstrated that occlusal outcomes also were similar among the groups. The treatment efficiency index had higher values for the extraction group. The effects of treatment with the pendulum appliance or cervical headgear and extraction of 2 maxillary premolars associated with fixed appliances were similar from both occlusal and cephalometric standpoints. Class II treatment with extraction of maxillary teeth was more efficient because of the shorter treatment time. Differences in maxillary incisor retraction should be noted, but these differences might have been due to greater maxillary dentoalveolar protrusion in the extraction group before treatment.

  8. Intimate partner violence: relationships between alexithymia, depression, attachment styles, and coping strategies of battered women.

    PubMed

    Craparo, Giuseppe; Gori, Alessio; Petruccelli, Irene; Cannella, Vincenza; Simonelli, Chiara

    2014-06-01

    One of the most common forms of violence against women is the intimate partner violence (IPV). This term includes physical, sexual, and emotional abuse and controlling behaviors by an intimate partner. This exploratory study investigates the relationship between alexithymia, adult attachment styles, depression, and coping strategies in a group of female victims of IPV and a control group. Participants were 80 female victims of IPV with an age range from 18 years to 54 years (mean 31.62; standard deviation 9.81). The control group included 80 women with no history of IPV with an age range from 19 years to 37 years (mean 25.05; standard deviation 3.67). We administered the following self-report questionnaires: (i) 20-Item Toronto Alexithymia Scale (TAS-20); (ii) Coping Orientation Problems Experienced; (iii) Beck Depression Inventory (BDI)-II; and (iv) Attachment Style Questionnaire (ASQ). Compared with control group, the IPV group showed higher mean scores on TAS-20 (52.9 vs. 41.1, P < 0.001) and BDI-II (19.50 vs. 9.95, P < 0.001). In both groups, we found significant correlations between BDI-II and TAS-20 total scores (P < 0.001) and between BDI-II and the following dimensions of ASQ: confidence (P < 0.001), discomfort with closeness (P = 0.002), relationships as secondary (P < 0.001), need for approval (P < 0.001), and preoccupation with relationships (P < 0.001). Differently from the control group, in the IPV group, social support correlated significantly and positively (P < 0.001) with the dimension preoccupation with relationships on ASQ, but not with the secure attachment style. In comparison to the control group, alexithymia, depressive symptoms, and an insecure attachment style were negatively correlated with the ability to cope with stress for women in the IPV group. © 2014 International Society for Sexual Medicine.

  9. [Usefulness of continuous glucose monitoring system (CGMS) in monitoring glycaemic profile in small children with diabetes type 1].

    PubMed

    Głowińska-Olszewska, Barbara; Urban, Mirosława; Peczyńska, Jadwiga; Florys, Bozena; Kowalewski, Marek

    2005-01-01

    Improved methods of diabetes therapy result in a near normoglycaemic state in many patients. This leads however unfortunately to more frequent hypoglycaemic incidents. Particularly small children, whose nervous system is not fully mature, are at high risk of central nervous system damage in case of hypoglycaemia. A new method of detail monitoring of glycaemia provides CGMS system. The aim of the study was to compare the glycaemic profile, with high attention to hypoglycaemia in groups of young and older children with diabetes type 1, using CGMS and routine glucose meter. We studied 32 children with diabetes type 1. Children were divided into groups: group I--small children, n=17 (<7 yrs of age), mean age 5,8 years, with disease duration--2,46 years, with mean HbA1c level--7,22%, and group II--older children, n=15 (>10 years of age), mean age--12 years, with disease duration--3 years, with HbA1c level--7,21%. Continuous glucose monitoring system (CGMS), by MiniMed, was applied in outpatient or hospital conditions, after short training of patient and parents; together with routine glucose meter measurements, 4-8 times/24 hours. In 9 patients from small children group CGMS was repeated after 2 months. Hypoglycaemic incidents detected with CGMS were similar in both groups: 4,6 in I group vs. 4,2 in II group (ns). Hypoglycaemic incidents found with meter were lower in I group--1,6 vs. 2,3 in II group (ns). Mean hypoglycaemic time/24 hour was longer in small children group: 101 min vs. 74 min in group II (p<00,05). In I group we found higher number of hypoglycaemic incidents during the night compared to group II--1,7 vs. 0,8 (p<00,05) and longer duration of night hypoglycaemia: in I group--56 min vs. 32 min in group II (p<00,05). Repeated CGMS study in 9 children from I group revealed decreased mean time of hypoglycaemia/24 hours from 134 min/24 h to 90 min/24 h (p<00,05) and decreased time of night hypoglycaemia from 65 min to 40 min (p<00,05), with a comparable number of hypoglycaemic incidents. Hypoglycaemic incidents found with routine meter measurements in small children were 1,6 vs. 4,6 hypoglycaemia found with CGMS (p<00,05), in the older children group routine measurement found 2,3 hypoglycaemia vs. 4,2 detected with CGMS (ns). 1. CGMS can be particularly usefull in monitoring glucose profile and detecting hypoglycaemia incidents, mainly nocturnal in small children. 2. CGMS allows to verify meal dose of insulin and to decrease postprandial hyperglycaemia. 3. Modification of insulin therapy on the base of CGMS helps to decrease the time of hypoglycaemia and hyperglycemia, particularly during the night.

  10. Clinical and laboratorial impact of antiretroviral therapy in a cohort of Portuguese patients chronically infected with HIV-2.

    PubMed

    Miranda, Ana; Peres, Susana; Moneti, Virginia; Azevedo, Telma; Aldir, Isabel; Mansinho, Kamal

    2014-01-01

    HIV-2 infection is endemic in West Africa and some European countries, namely Portugal. HIV-2 antiretroviral (ARV) treatment presents some restrains related to intrinsic resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) and fusion inhibitors, and poorer response to protease inhibitors (PI). Retrospective observational study of a cohort of 135 infected HIV-2 patients, diagnosed between 1989 and 2008. Evaluation of epidemiologic, clinical, immunologic and virologic progression, comparing to groups of patients (naïve vs ARV experienced); characterization of therapeutic, immunologic and virologic response. SPSS version 20.0 was used for statistical analysis. The study included 135 patients: 41% (n=55) naïve and 59% (n=80) with ARV experience. The comparison between groups (naïve vs ARV) revealed: male prevalence 76% vs 50%; mean age 54.5 years vs 54.8 (p=0.90); main geographic origin Guiné Bissau (47% vs 44%) and Portugal (22% vs 33%); and transmission mainly acquired by heterosexual contact (87% vs 80%). Mean time since diagnosis was 14 vs 13 years (p=0.31); 2% vs 50% presented AIDS criteria at diagnosis (p<0.001) and 93% vs 38% registered TCD4>350 cell/mm(3) at diagnosis (p<0.001). Immunological evolution showed no significant decline in naïve population (Δ=-67 cell/mm(3) - p=0.18) and a significant recovery in ARV experienced (Δ=+207 cell/mm(3) - p<0.001). Global mortality rate found was 18% (6% vs 13% - p=0.122). Eighty patients initiated ARV: 84% presented a time interval of ARV exposure between 0-5 years (42%) and 5-10 years (42%). Fifty percent experienced ≤2 ARV regimens and the remaining >2 regimes. Considering the first ARV therapy: 56% initiated PI, 30% NTRI and 5% integrase inhibitor (II)-based regimens. Currently, 54 patients maintain regular follow-up and ARV therapy: 60% NTRI+PI; 37% NRTI+PI+II and 3% NRTI+II. TDF/FTC is the backbone in 56%. Most frequent PIs are LPV/r (54%), DRV/r (19%) and ATV/r (12%). Mean time of exposure to NRTI=3 years, PI=7 years and II=2 years. Immunologic recovery was sustained for each of the ARV class considered (NRTI Δ=+144 cell/mm(3); PI=Δ+92 cell/mm(3); II=Δ=+116 cell/mm(3)). This is a cohort accompanied for a long period and the majority of patients present extensive ARV experience. The ARV-experienced patients registered a favourable response to treatment, with sustained immune recovery (Δ=+207 cell/mm(3)) and virologic control in 74%. Immunologic behaviour evidenced a sustained gain for each of the ARV class considered.

  11. Research protocol for an epidemiological study on estimating disease burden of pediatric HIV in Belgaum district, India.

    PubMed

    Sinha, Anju; Nath, Anita; Sethumadhavan, Rajeev; Isac, Shajy; Washington, Reynold

    2016-05-26

    Pediatric HIV is poised to become a major public health problem in India with the rising trend of HIV infection in pregnant women (Department of AIDS Control, Ministry of Health and Family Welfare, http://www.naco.gov.in). There is lack of information on the epidemiology of pediatric HIV infection in India. Existing surveillance systems tend to underestimate the Pediatric burden. The overall aim of the present study is to estimate the disease burden of pediatric HIV among children in Belgaum district in the state of Karnataka in Southern India. An innovative multipronged epidemiological approach to comb the district is proposed. The primary objectives of the study would be attained under three strategies. A prospective cohort design for objective (i) to determine the incidence rate of HIV by early case detection in infants and toddlers (0-18 months) born to HIV infected pregnant women; and cross sectional design for objectives (ii) to determine the prevalence of HIV infection in children (0-14 years) of HIV infected parents and (iii) to determine the prevalence of HIV in sick children (0-14 years) presenting with suspected signs and symptoms using age specific criteria for screening. Burden of pediatric HIV will be calculated as a product of cases detected in each strategy multiplied by a net inflation factor for each strategy. Study participants (i) (ii) (iii): HIV infected pregnant women and their live born children (ii) Any HIV-infected man/woman, of age 18-49 years, having a biological child of age 0-14 years (iii) Sick children of age 0-14 years presenting with suspected signs and symptoms and satisfying age-specific criteria for screening. Setting and conduct: Belgaum district which is a Category 'A' district (with more than 1 % antenatal prevalence in the district over the last 3 years before the study). Age-appropriate testing is used to detect HIV infection. There is a need to strengthen existing pediatric HIV estimation methods in India and other developing countries. We hope that the novel methodology emanating from this study would be applicable for estimating the burden of HIV in other settings and it would be adaptable for estimating the burden of other infectious/chronic diseases. Findings from this study will give future direction to the national program for prevention and control of HIV in India and other developing countries.

  12. Staged surgical management of hypoplastic left heart syndrome: a single institution 12 year experience

    PubMed Central

    McGuirk, S P; Griselli, M; Stumper, O F; Rumball, E M; Miller, P; Dhillon, R; de Giovanni, J V; Wright, J G; Barron, D J; Brawn, W J

    2006-01-01

    Objective To describe a 12 year experience with staged surgical management of the hypoplastic left heart syndrome (HLHS) and to identify the factors that influenced outcome. Methods Between December 1992 and June 2004, 333 patients with HLHS underwent a Norwood procedure (median age 4 days, range 0–217 days). Subsequently 203 patients underwent a bidirectional Glenn procedure (stage II) and 81 patients underwent a modified Fontan procedure (stage III). Follow up was complete (median interval 3.7 years, range 32 days to 11.3 years). Results Early mortality after the Norwood procedure was 29% (n  =  95); this decreased from 46% (first year) to 16% (last year; p < 0.05). Between stages, 49 patients died, 27 before stage II and 22 between stages II and III. There were one early and three late deaths after stage III. Actuarial survival (SEM) was 58% (3%) at one year and 50% (3%) at five and 10 years. On multivariable analysis, five factors influenced early mortality after the Norwood procedure (p < 0.05). Pulmonary blood flow supplied by a right ventricle to pulmonary artery (RV‐PA) conduit, arch reconstruction with pulmonary homograft patch, and increased operative weight improved early mortality. Increased periods of cardiopulmonary bypass and deep hypothermic circulatory arrest increased early mortality. Similar factors also influenced actuarial survival after the Norwood procedure. Conclusion This study identified an improvement in outcome after staged surgical management of HLHS, which was primarily attributable to changes in surgical technique. The RV‐PA conduit, in particular, was associated with a notable and independent improvement in early and actuarial survival. PMID:15939721

  13. Significant expression of thyroid transcription factor-1 in pulmonary squamous cell carcinoma detected by SPT24 monoclonal antibody and CSA-II system.

    PubMed

    Kashima, Kenji; Hashimoto, Hisashi; Nishida, Haruto; Arakane, Motoki; Yada, Naomi; Daa, Tsutomu; Yokoyama, Shigeo

    2014-01-01

    In contrast to the usefulness of thyroid transcription factor-1 (TTF-1) in distinguishing primary adenocarcinoma of the lung from metastatic lesions, TTF-1 expression in pulmonary squamous cell carcinoma is reported to be at low level and not a suitable immunohistochemical marker. We hypothesized that the highly sensitive detection system, CSA-II, can visualize even faint expression of TTF-1 in pulmonary squamous cell carcinoma. In this study, 2 commercially available clones of TTF-1 monoclonal antibody, 8G7G3/1 and SPT24, were used for staining 38 cases of pulmonary squamous cell carcinoma, in combination with the CSA-II and the conventional detection system, EnVision. The combined use of the 8G7G3/1 clone with EnVision and CSA-II showed a positive reaction in only 1 and 4 cases, respectively. The use of SPT24 clone showed positive staining in 5 cases with EnVision and in 20 of 38 cases (52.6%) with the CSA-II. Interestingly, positive staining by the SPT24-CSA-II technique of samples from tissue blocks preserved for <2 years was 73.6% compared with only 31.5% in those preserved for >2 years. In addition, a 6-month preservation of the cut sections resulted in stain fading and decreased positivity (50%), compared with freshly cut sections. We conclude that the use of the SPT24 monoclonal antibody with the CSA-II system can detect even weak expression of TTF-1 in pulmonary squamous cell carcinoma. This staining technique can potentially allow the discrimination of primary squamous cell carcinoma of the lung from metastatic lesions, especially in freshly prepared paraffin sections.

  14. Treatment timing for functional jaw orthopaedics followed by fixed appliances: a controlled long-term study.

    PubMed

    Pavoni, Chiara; Lombardo, Elisabetta Cretella; Lione, Roberta; Faltin, Kurt; McNamara, James A; Cozza, Paola; Franchi, Lorenzo

    2017-11-01

    To evaluate the role of treatment timing on long-term dentoskeletal effects of Class II treatment with removable functional appliances followed by full-fixed appliance therapy. A group of 46 patients (23 females and 23 males) with Class II malocclusion treated consecutively with either Bionator or Activator, followed by fixed appliances was compared with a matched control group of 31 subjects (16 females and 15 males) with untreated Class II malocclusion. The treated sample was evaluated at T1, start of treatment (mean age: 9.9 ± 1.3 years); T2, end of functional treatment and prior to fixed appliances (mean age: 11.9 ± 1.3 years); and T3, long-term observation (mean age: 18.3 ± 2.1 years). The treated and the control samples were divided into pre-pubertal and pubertal groups according to skeletal maturity observed at the start of treatment. Statistical comparisons were performed with independent sample t-tests. When treatment was initiated before puberty, Class II correction was mostly confined to the dentoalveolar changes, with significant improvements of both overjet and molar relationships. On the other hand, treatment with the outset at puberty produced significant long-term improvement of sagittal skeletal relationships, which were mainly sustained by mandibular changes. Treatment with removable functional appliances (Bionator or Activator) followed by full-fixed appliances produced significant skeletal long-term changes when it begins at puberty. Prepubertal Class II treatment results primarily in dentoalveolar changes. © The Author 2017. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

  15. Trends in food consumption and nutrient intake in Germany between 2006 and 2012: results of the German National Nutrition Monitoring (NEMONIT).

    PubMed

    Gose, Maria; Krems, Carolin; Heuer, Thorsten; Hoffmann, Ingrid

    2016-04-01

    The German National Nutrition Monitoring (NEMONIT) is a longitudinal and nationwide study to assess changes in food consumption and nutrient intake in Germany. A sample of 1840 participants (baseline age: 14-80 years) was drawn from the nationally representative German National Nutrition Survey (NVS) II (2005-2007). The participants have been interviewed by telephone annually since 2008. Food consumption was assessed by two 24-h recalls in the NVS II and the 4 years of NEMONIT (2008-2012/2013), respectively. Energy and nutrient intakes were calculated using the German Nutrient Database 3.02. Diet quality was evaluated using the Healthy Eating Index-NVS (HEI-NVS) II. Time trends were analysed by generalised estimating equation. Consumption of fruit/fruit products and fruit juice/nectar among men and women decreased, whereas consumption of water, soft drinks and coffee/tea increased over the 6-year period. Furthermore, increased consumption of confectionery and animal fats was observed among women. HEI-NVS II did not change since NVS II in both sexes. There were no changes in energy and protein intakes, but carbohydrate intake declined while fat intake increased over time. Regarding micronutrients, a decreasing intake of thiamin, riboflavin and vitamin B6 was observed in both sexes, but intake of Mg, Fe and niacin increased among women over time. In conclusion, food consumption and nutrient intake remained relatively stable between 2005-2007 and 2012/2013 within this German cohort. A few favourable and unfavourable changes were observed. Compared with national dietary guidelines, consumption of food of plant origin remained too low and consumption of meat/meat products remained too high in Germany.

  16. Epidemiology of the functional gastrointestinal disorders diagnosed according to Rome II criteria: an Australian population-based study.

    PubMed

    Boyce, P M; Talley, N J; Burke, C; Koloski, N A

    2006-01-01

    Population-based studies of the prevalence of all functional gastrointestinal disorders (FGID) using the Rome II criteria are lacking. It is also not certain whether subjects who meet the Rome II criteria for an FGID are different in terms of demographic and psychological characteristics from those subjects meeting exclusively the more restrictive Rome I criteria. To determine whether using the more restrictive Rome I criteria would result in a more biologically determined group of FGID than when the Rome II is applied. Subjects included individuals aged 18 years and older (n = 1,225) from the Penrith population who were initially surveyed with the Penrith District Health Survey in 1997. Subjects were sent a self-report questionnaire that contained items on gastrointestinal symptoms applying the Rome II criteria. Subjects were also assessed on psychological and personality factors and on physical and mental functioning. A total of 36.1% (n = 275) of respondents was diagnosed with an FGID according to Rome II criteria. The five most prevalent FGID were functional heartburn (10.4%), irritable bowel syndrome (8.9%), functional incontinence (7.6%), proctalgia fugax (6.5%) and functional chest pain (5.1%). Subjects meeting Rome II only criteria for FGID scored significantly higher on measures of psychological caseness and emotionality than Rome I only subjects, and these were independently associated with meeting Rome I only versus Rome II only criteria for FGID. The Rome II criteria FGID are common and do not appear to identify a vastly different group of FGID sufferers compared with the earlier Rome I criteria.

  17. Survival follow-up and ipilimumab retreatment of patients with advanced melanoma who received ipilimumab in prior phase II studies

    PubMed Central

    Lebbé, C.; Weber, J. S.; Maio, M.; Neyns, B.; Harmankaya, K.; Hamid, O.; O'Day, S. J.; Konto, C.; Cykowski, L.; McHenry, M. B.; Wolchok, J. D.

    2014-01-01

    Background This report provides a survival update at a follow-up of >5 years (5.5–6 years) for patients with advanced melanoma who previously received ipilimumab in phase II clinical trials. Safety and efficacy data following ipilimumab retreatment are also reported. Patients and methods Patients who previously received ipilimumab 0.3, 3, or 10 mg/kg in one of six phase II trials (CA184-004, CA184-007, CA184-008, CA184-022, MDX010-08, and MDX010-15) were eligible to enroll in the companion study, CA184-025. Upon enrollment, patients initially received ipilimumab retreatment, extended maintenance therapy, or were followed for survival only. Overall survival (OS) rates were evaluated in patients from studies CA184-004, CA184-007, CA184-008, and CA184-022. Safety and best overall response during ipilimumab retreatment at 10 mg/kg were assessed in study CA184-025. Results Five-year OS rates for previously treated patients who received ipilimumab induction at 0.3, 3, or 10 mg/kg were 12.3%, 12.3%–16.5%, and 15.5%–28.4%, respectively. Five-year OS rates for treatment-naive patients who received ipilimumab induction at 3 or 10 mg/kg were 26.8% and 21.4%–49.5%, respectively. Little to no change in OS was observed from year 5 up to year 6. The objective response rate among retreated patients was 23%. Grade 3/4 immune-related adverse events occurred in 25%, 5.9%, and 13.2% of retreated patients who initially received ipilimumab 0.3, 3, and 10 mg/kg, with the most common being observed in the skin (4.2%, 2.9%, 3.8%) and gastrointestinal tract (12.5%, 2.9%, 3.8%), respectively. Conclusions At a follow-up of 5–6 years, ipilimumab continues to demonstrate durable, long-term survival in a proportion of patients with advanced melanoma. In some patients, ipilimumab retreatment can re-establish disease control with a safety profile that is comparable with that observed during ipilimumab induction. Further studies are needed to determine the contribution of ipilimumab retreatment to OS. ClinicalTrials.gov NCT00162123. PMID:25210016

  18. Randomized Phase III Trial Comparing ABVD Plus Radiotherapy With the Stanford V Regimen in Patients With Stages I or II Locally Extensive, Bulky Mediastinal Hodgkin Lymphoma: A Subset Analysis of the North American Intergroup E2496 Trial.

    PubMed

    Advani, Ranjana H; Hong, Fangxin; Fisher, Richard I; Bartlett, Nancy L; Robinson, K Sue; Gascoyne, Randy D; Wagner, Henry; Stiff, Patrick J; Cheson, Bruce D; Stewart, Douglas A; Gordon, Leo I; Kahl, Brad S; Friedberg, Jonathan W; Blum, Kristie A; Habermann, Thomas M; Tuscano, Joseph M; Hoppe, Richard T; Horning, Sandra J

    2015-06-10

    The phase III North American Intergroup E2496 Trial (Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Hodgkin's Lymphoma) compared doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) with mechlorethamine, doxorubicin, vincristine, bleomycin, vinblastine, etoposide, and prednisone (Stanford V). We report results of a planned subgroup analysis in patients with stage I or II bulky mediastinal Hodgkin lymphoma (HL). Patients were randomly assigned to six to eight cycles of ABVD every 28 days or Stanford V once per week for 12 weeks. Two to 3 weeks after completion of chemotherapy, all patients received 36 Gy of modified involved field radiotherapy (IFRT) to the mediastinum, hila, and supraclavicular regions. Patients on the Stanford V arm received IFRT to additional sites ≥ 5 cm at diagnosis. Primary end points were failure-free survival (FFS) and overall survival (OS). Of 794 eligible patients, 264 had stage I or II bulky disease, 135 received ABVD, and 129 received Stanford V. Patient characteristics were matched. The overall response rate was 83% with ABVD and 88% with Stanford V. At a median follow-up of 6.5 years, the study excluded a difference of more than 21% in 5-year FFS and more than 16% in 5-year OS between ABVD and Stanford V (5-year FFS: 85% v 79%; HR, 0.68; 95% CI, 0.37 to 1.25; P = .22; 5-year OS: 96% v 92%; HR, 0.49; 95% CI, 0.16 to 1.47; P = .19). In-field relapses occurred in < 10% of the patients in each arm. For patients with stage I or II bulky mediastinal HL, no substantial statistically significant differences were detected between the two regimens, although power was limited. To the best of our knowledge, this is the first prospective trial reporting outcomes specific to this subgroup, and it sets a benchmark for comparison of ongoing and future studies. © 2015 by American Society of Clinical Oncology.

  19. Long-term treatment effects of the FR-2 appliance: a prospective evalution 7 years post-treatment

    PubMed Central

    Franchi, Lorenzo; Cevidanes, Lucia H. S.; Scanavini, Marco A.; McNamara, James A.

    2014-01-01

    AIM To examine the long-term effects induced by treatment with the function regulator (FR-2) appliance 7 years post-treatment compared with untreated class II subjects. SUBJECTS AND METHODS The FR-2 sample was collected prospectively and comprised 17 subjects (10 boys and 7 girls, mean age 10.8 years) who were treated with the FR-2 appliance for 1.7 years and re-evaluated 7.1 years after treatment. The step-by-step mandibular advancement was performed gradually (increments up to 3–4 mm), until a ‘super class I’ molar relationship was obtained. The control group consisted of 17 class II subjects (9 boys and 8 girls, mean age 11.3 years) with class II malocclusion, excessive overjet, and class II molar relationship, matched to the treated group as to ages at all times, gender distribution, and stages of skeletal maturity (evaluated by the cervical vertebral maturation method). The lateral cephalograms were analysed at T1 (initial), T2 (final), and T3 (7.1 years post-treatment). The compatibility between the groups and the comparisons of their changes at T1–T2, T2–T3, and T1–T3 intervals were examined by independent sample t-tests (P < 0.05). RESULTS FR-2 treatment provided a significant improvement in the maxillomandibular relationship due to an increase in mandibular length compared with controls, which remained stable over time. Also overjet, overbite, and molar relationship corrections demonstrated stability. Among dentoalveolar changes, only the increased mesial movement of the mandibular molars in the FR-2 group demonstrated stability. CONCLUSIONS Correction of class II malocclusion remained stable 7 years after FR-2 treatment mainly due to the stability of the skeletal changes. PMID:23736378

  20. History of respiratory mechanics prior to World War II.

    PubMed

    West, John B

    2012-01-01

    The history of respiratory mechanics is reviewed over a period of some 2,500 years from the ancient Greeks to World War II. A cardinal early figure was Galen (130-199 AD) who made remarkably perceptive statements on the diaphragm and the anatomy of the phrenic nerves. The polymath Leonardo da Vinci (1452-1519) contributed observations on pulmonary mechanics including the pleural space and bronchial airflow that still make good reading. Vesalius (1514-1564) produced magnificent illustrations of the lung, ribcage, and diaphragm. In the 17th century, the Oxford School including Boyle, Hooke, Lower, and Mayow were responsible for many contributions on mechanical functions including the intercostal muscles and the pleura. Hales (1677-1761) calculated the size and surface area of the alveoli, the time spent by the blood in the pulmonary capillaries, and intrathoracic pressures. Poiseuille (1799-1869) carried out classical studies of fluid mechanics including one of the first demonstrations of flow limitation in collapsible vessels. The culmination of the pre-World War II period was the outstanding contributions of Rohrer (1888-1926) and his two Swiss countrymen, Wirz (1896-1978) and von Neergaard (1887-1947). Rohrer developed the first comprehensive, quantitative treatment of respiratory mechanics in the space of 10 years including an analysis of flow in airways, and the pressure-volume behavior of the respiratory system. von Neergaard performed landmark studies on the effects of surface tension on pressure-volume behavior. Progress over the 2,500 years was slow and erratic at times, but by 1940 the stage was set for the spectacular developments of the next 70 years. © 2012 American Physiological Society

  1. SERT II thrusters - Still ticking after eleven years

    NASA Technical Reports Server (NTRS)

    Kerslake, W. R.

    1981-01-01

    The Space Electric Rocket Test II (SERT II) spacecraft was launched in 1970 with a primary objective of demonstrating long-term operation of a space electric thruster system. An overview is presented of all the SERT II testing conducted during the time from 1970 to 1981. Thruster testing and interaction results are considered, taking into account ion beam thrusting, distant neutralization, and the plasma beam thrust. In a discussion of durability testing, attention is given to the main cathodes, the neutralizer cathodes, the main keeper insulator, the H.V. grid insulators, the neutralizer propellant tanks, and the main propellant tanks. The most important result of the study is related to the confidence gained that mercury bombardment ion thruster systems can be built and operated in space on a routine basis with the same lifetime and performance as measured in ground testing.

  2. Obesity Cardiometabolic Comorbidity Prevalence in Children in a Rural Weight-Management Program.

    PubMed

    O'Hara, Valerie; Browne, Nancy; Fathima, Samreen; Sorondo, Barbara; Bayleran, Janet; Johnston, Starr; Hastey, Kathrin

    2017-01-01

    This descriptive study examines the prevalence of obesity-related cardiometabolic (CM) risk factors using CM laboratory metrics, in 3 to 19 year olds presenting to a rural American Academy of Pediatrics stage 3 multidisciplinary weight management clinic based on gender, age ranges, and obesity classes. From 2009 to 2016, 382 children (body mass index ≥85th percentile) enrolled. Multiple logistic regression determined the effects of age, gender, or obesity class on CM risk factors. Odds of elevated insulin were more significant in 15 to 19 year olds than in 3 to 5 year olds, or in 6 to 11 year olds. Obesity class III had higher odds than class II, class I, and overweight in having elevated insulin; twice likely than class II for having low high-density lipoprotein; and twice as likely than class I for high triglycerides. Adolescents and obesity class III categories have significant CM risk but the burden in younger and less severe obesity cohorts cannot be underestimated.

  3. Multi-Objective Scheduling for the Cluster II Constellation

    NASA Technical Reports Server (NTRS)

    Johnston, Mark D.; Giuliano, Mark

    2011-01-01

    This paper describes the application of the MUSE multiobjecctive scheduling framework to the Cluster II WBD scheduling domain. Cluster II is an ESA four-spacecraft constellation designed to study the plasma environment of the Earth and it's magnetosphere. One of the instruments on each of the four spacecraft is the Wide Band Data (WBD) plasma wave experiment. We have applied the MUSE evolutionary algorithm to the scheduling problem represented by this instrument, and the result has been adopted and utilized by the WBD schedulers for nearly a year. This paper describes the WBD scheduling problem, its representation in MUSE, and some of the visualization elements that provide insight into objective value tradeoffs.

  4. Neurologic aspects of microcephalic osteodysplastic primordial dwarfism type II.

    PubMed

    Galasso, Cinzia; Lo-Castro, Adriana; Lalli, Cristina; Cerminara, Caterina; Curatolo, Paolo

    2008-06-01

    Microcephalic osteodysplastic primordial dwarfism type II is a specific disorder characterized by severe intrauterine and postnatal growth retardation, acquired microcephaly, cerebrovascular abnormalities, progressive bone dysplasia, and a characteristic face. Whereas the diagnostic features of this syndrome are well-recognized, the neurologic aspects have not been clearly defined. We report on a detailed neurodevelopmental follow-up study of a new case of microcephalic osteodysplastic primordial dwarfism type II, followed from the first years of life to adolescence, and we discuss the neurocognitive features of our patient. We also review the neurologic aspects of this disorder compared with syndromes with overlapping phenotypes, such as microcephalic osteodysplastic primordial dwarfism types I and III and Seckel syndrome.

  5. The Value of the SYNTAX Score II in Predicting Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation.

    PubMed

    Ryan, Nicola; Nombela-Franco, Luis; Jiménez-Quevedo, Pilar; Biagioni, Corina; Salinas, Pablo; Aldazábal, Andrés; Cerrato, Enrico; Gonzalo, Nieves; Del Trigo, María; Núñez-Gil, Iván; Fernández-Ortiz, Antonio; Macaya, Carlos; Escaned, Javier

    2017-11-27

    The predictive value of the SYNTAX score (SS) for clinical outcomes after transcatheter aortic valve implantation (TAVI) is very limited and could potentially be improved by the combination of anatomic and clinical variables, the SS-II. We aimed to evaluate the value of the SS-II in predicting outcomes in patients undergoing TAVI. A total of 402 patients with severe symptomatic aortic stenosis undergoing transfemoral TAVI were included. Preprocedural TAVI angiograms were reviewed and the SS-I and SS-II were calculated using the SS algorithms. Patients were stratified in 3 groups according to SS-II tertiles. The coprimary endpoints were all-cause death and major adverse cardiovascular events (MACE), a composite of all-cause death, cerebrovascular event, or myocardial infarction at 1 year. Increased SS-II was associated with higher 30-day mortality (P=.036) and major bleeding (P=.015). The 1-year risk of death and MACE was higher among patients in the 3rd SS-II tertile (HR, 2.60; P=.002 and HR, 2.66; P<.001) and was similar among patients in the 2nd tertile (HR, 1.27; P=.507 and HR, 1.05; P=.895) compared with patients in the 1st tertile. The highest SS-II tertile was an independent predictor of long-term mortality (P=.046) and MACE (P=.001). The SS-II seems more suited to predict clinical outcomes in patients undergoing TAVI than the SS-I. Increased SS-II was associated with poorer clinical outcomes at 1 and 4 years post-TAVI, independently of the presence of coronary artery disease. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Risk factors of Coxiella burnetii (Q fever) seropositivity in veterinary medicine students.

    PubMed

    de Rooij, Myrna M T; Schimmer, Barbara; Versteeg, Bart; Schneeberger, Peter; Berends, Boyd R; Heederik, Dick; van der Hoek, Wim; Wouters, Inge M

    2012-01-01

    Q fever is an occupational risk for veterinarians, however little is known about the risk for veterinary medicine students. This study aimed to assess the seroprevalence of Coxiella burnetii among veterinary medicine students and to identify associated risk factors. A cross-sectional study with questionnaire and blood sample collection was performed among all veterinary medicine students studying in The Netherlands in 2006. Serum samples (n = 674), representative of all study years and study directions, were analyzed for C. burnetii IgG and IgM phase I and II antibodies with an immunofluorescence assay (IFA). Seropositivity was defined as IgG phase I and/or II titer of 1:32 and above. Of the veterinary medicine students 126 (18.7%) had IgG antibodies against C. burnetii. Seropositivity associated risk factors identified were the study direction 'farm animals' (Odds Ratio (OR) 3.27 [95% CI 2.14-5.02]), advanced year of study (OR year 6: 2.31 [1.22-4.39] OR year 3-5 1.83 [1.07-3.10]) having had a zoonosis during the study (OR 1.74 [1.07-2.82]) and ever lived on a ruminant farm (OR 2.73 [1.59-4.67]). Stratified analysis revealed study direction 'farm animals' to be a study-related risk factor apart from ever living on a farm. In addition we identified a clear dose-response relation for the number of years lived on a farm with C. burnetii seropositivity. C. burnetii seroprevalence is considerable among veterinary medicine students and study related risk factors were identified. This indicates Q fever as an occupational risk for veterinary medicine students.

  7. Risk Factors of Coxiella burnetii (Q Fever) Seropositivity in Veterinary Medicine Students

    PubMed Central

    de Rooij, Myrna M. T.; Schimmer, Barbara; Versteeg, Bart; Schneeberger, Peter; Berends, Boyd R.; Heederik, Dick; van der Hoek, Wim; Wouters, Inge M.

    2012-01-01

    Background Q fever is an occupational risk for veterinarians, however little is known about the risk for veterinary medicine students. This study aimed to assess the seroprevalence of Coxiella burnetii among veterinary medicine students and to identify associated risk factors. Methods A cross-sectional study with questionnaire and blood sample collection was performed among all veterinary medicine students studying in the Netherlands in 2006. Serum samples (n = 674), representative of all study years and study directions, were analyzed for C. burnetii IgG and IgM phase I and II antibodies with an immunofluorescence assay (IFA). Seropositivity was defined as IgG phase I and/or II titer of 1∶32 and above. Results Of the veterinary medicine students 126 (18.7%) had IgG antibodies against C. burnetii. Seropositivity associated risk factors identified were the study direction ‘farm animals’ (Odds Ratio (OR) 3.27 [95% CI 2.14–5.02]), advanced year of study (OR year 6: 2.31 [1.22–4.39] OR year 3–5 1.83 [1.07–3.10]) having had a zoonosis during the study (OR 1.74 [1.07–2.82]) and ever lived on a ruminant farm (OR 2.73 [1.59–4.67]). Stratified analysis revealed study direction ‘farm animals’ to be a study-related risk factor apart from ever living on a farm. In addition we identified a clear dose-response relation for the number of years lived on a farm with C. burnetii seropositivity. Conclusions C. burnetii seroprevalence is considerable among veterinary medicine students and study related risk factors were identified. This indicates Q fever as an occupational risk for veterinary medicine students. PMID:22363803

  8. Encouraging Active School Travel by Making it "Cool": A Quasi-Experimental Study Using Boltage, Phase II

    DOT National Transportation Integrated Search

    2015-05-01

    The research on childrens school travel has studied the impacts of the built environment on children walking or biking to school. This three-year research project contributes to current literature by investigating the role played by socio-psycholo...

  9. The safety and tolerability of rotigotine transdermal system over a 6-year period in patients with early-stage Parkinson's disease.

    PubMed

    Giladi, Nir; Boroojerdi, Babak; Surmann, Erwin

    2013-09-01

    This open-label extension (SP716; NCT00599196) of a 6-month, double-blind, randomized study (SP513) investigated the safety and tolerability of rotigotine transdermal system over up to ~6 years in patients with Parkinson's disease (PD; early-stage PD at double-blind enrollment). Eligible patients completing the 6-month study received optimal dose open-label rotigotine (≤ 16 mg/24 h) for up to ~6 years. Adjunctive levodopa was permitted. Primary outcomes included adverse events (AEs) and extent of rotigotine exposure. Analysis of adjunctive levodopa use, dyskinesias [unified Parkinson's disease rating scale (UPDRS) IV], and efficacy (UPDRS II + III total score) were also assessed. Of 381 patients enrolled in the open-label extension, 52 % were still in the study at time of closure; 24 % withdrew because of AEs and 6 % because of lack of efficacy. Patients received rotigotine for a median duration of 1,564.5 days (~4 years, 3 months; range 5-2, 145 days). 69 % of patients started supplemental levodopa; median time to levodopa was 485 days (~1 year, 4 months). Most common AEs (% per patient-year) were somnolence (18 %), application site reactions (12 %), nausea (9 %), peripheral edema (7 %), and fall (7 %). AEs indicative of impulsive-compulsive behavior were recorded in 25 (7 %) patients. Dyskinesias were experienced by 65 (17 %) patients; the majority [47 of 65 (72 %)] reported first dyskinesia after starting levodopa. Mean UPDRS II + III total scores remained below double-blind baseline for 4 years (assessment of all patients). In conclusion, rotigotine was generally well tolerated for up to ~6 years in patients with early-stage PD. The AEs reported were in line with previous studies of rotigotine transdermal system, with typical dopaminergic side effects and application site reactions seen.

  10. Simplified Acute Physiology Score II as Predictor of Mortality in Intensive Care Units: A Decision Curve Analysis.

    PubMed

    Allyn, Jérôme; Ferdynus, Cyril; Bohrer, Michel; Dalban, Cécile; Valance, Dorothée; Allou, Nicolas

    2016-01-01

    End-of-life decision-making in Intensive care Units (ICUs) is difficult. The main problems encountered are the lack of a reliable prediction score for death and the fact that the opinion of patients is rarely taken into consideration. The Decision Curve Analysis (DCA) is a recent method developed to evaluate the prediction models and which takes into account the wishes of patients (or surrogates) to expose themselves to the risk of obtaining a false result. Our objective was to evaluate the clinical usefulness, with DCA, of the Simplified Acute Physiology Score II (SAPS II) to predict ICU mortality. We conducted a retrospective cohort study from January 2011 to September 2015, in a medical-surgical 23-bed ICU at University Hospital. Performances of the SAPS II, a modified SAPS II (without AGE), and age to predict ICU mortality, were measured by a Receiver Operating Characteristic (ROC) analysis and DCA. Among the 4.370 patients admitted, 23.3% died in the ICU. Mean (standard deviation) age was 56.8 (16.7) years, and median (first-third quartile) SAPS II was 48 (34-65). Areas under ROC curves were 0.828 (0.813-0.843) for SAPS II, 0.814 (0.798-0.829) for modified SAPS II and of 0.627 (0.608-0.646) for age. DCA showed a net benefit whatever the probability threshold, especially under 0.5. DCA shows the benefits of the SAPS II to predict ICU mortality, especially when the probability threshold is low. Complementary studies are needed to define the exact role that the SAPS II can play in end-of-life decision-making in ICUs.

  11. Simplified Acute Physiology Score II as Predictor of Mortality in Intensive Care Units: A Decision Curve Analysis

    PubMed Central

    Allyn, Jérôme; Ferdynus, Cyril; Bohrer, Michel; Dalban, Cécile; Valance, Dorothée; Allou, Nicolas

    2016-01-01

    Background End-of-life decision-making in Intensive care Units (ICUs) is difficult. The main problems encountered are the lack of a reliable prediction score for death and the fact that the opinion of patients is rarely taken into consideration. The Decision Curve Analysis (DCA) is a recent method developed to evaluate the prediction models and which takes into account the wishes of patients (or surrogates) to expose themselves to the risk of obtaining a false result. Our objective was to evaluate the clinical usefulness, with DCA, of the Simplified Acute Physiology Score II (SAPS II) to predict ICU mortality. Methods We conducted a retrospective cohort study from January 2011 to September 2015, in a medical-surgical 23-bed ICU at University Hospital. Performances of the SAPS II, a modified SAPS II (without AGE), and age to predict ICU mortality, were measured by a Receiver Operating Characteristic (ROC) analysis and DCA. Results Among the 4.370 patients admitted, 23.3% died in the ICU. Mean (standard deviation) age was 56.8 (16.7) years, and median (first-third quartile) SAPS II was 48 (34–65). Areas under ROC curves were 0.828 (0.813–0.843) for SAPS II, 0.814 (0.798–0.829) for modified SAPS II and of 0.627 (0.608–0.646) for age. DCA showed a net benefit whatever the probability threshold, especially under 0.5. Conclusion DCA shows the benefits of the SAPS II to predict ICU mortality, especially when the probability threshold is low. Complementary studies are needed to define the exact role that the SAPS II can play in end-of-life decision-making in ICUs. PMID:27741304

  12. The Role of Healthy Lifestyle in the Implementation of Regressing Suboptimal Health Status among College Students in China: A Nested Case-Control Study

    PubMed Central

    Chen, Jieyu; Xiang, Hongjie; Jiang, Pingping; Yu, Lin; Jing, Yuan; Li, Fei; Wu, Shengwei; Fu, Xiuqiong; Liu, Yanyan; Kwan, Hiuyee; Luo, Ren; Zhao, Xiaoshan; Sun, Xiaomin

    2017-01-01

    Background: Suboptimal health status (SHS) is the intermediate health state between health and disease, it is medically undiagnosed and is also termed functional somatic syndrome. Although its clinical manifestations are complicated and various, SHS has not reached the disease status. Unhealthy lifestyle is associated with many chronic diseases and mortality. In accordance with the impact of lifestyle on health, it is intriguing to determine the association between unhealthy lifestyle and SHS risk. Methods: We conducted a nested case-control study among healthy Chinese college students from March 2012 to September 2013, which was nested in a prospective cohort of 5676 students. We performed 1:1 incidence density sampling with matched controls for birth year, sex, grade, specialty and individual character. SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Exposure was defined as an unhealthy lifestyle per the frequency of six behavioral dimensions from the Health-promoting Lifestyle Profile (HPLP-II). Results: We matched 543 cases of SHS (42.66%) in a cohort of 1273 students during the 1.5 years mean follow-up time with controls. A significant difference (t = 9.79, p < 0.001) and a reduction in HPLP-II total score was present at 1.5 years follow-up (135.93 ± 17.65) compared to baseline (144.48 ± 18.66). A level-response effect was recorded with an increase of the total HPLP-II (every dimension was correlated with a decreased SHS risk). Compared to respondents with the least exposure (excellent level), those reporting a general HPLP-II level were approximately 2.3 times more likely to develop SHS (odd ratio = 2.333, 95% CI = 1.471 to 3.700); and those with less HPLP-II level (good level) were approximately 1.6 times more likely (1.644, 1.119–2.414) to develop SHS (p < 0.05). Our data indicated that unhealthy lifestyle behavior with respect to behavioral dimensions significantly affected SHS likelihood. Further analyses revealed a marked increase (average increased 14.73 points) in lifestyle level among those SHS regression to health after 1.5 years, with respect to the HPLP-II behavioral dimensions, in addition to the total score (t = −15.34, p < 0.001). Conclusions: SHS is highly attributable to unhealthy lifestyles, and the mitigation of modifiable lifestyle risk factors may lead to SHS regression. Increased efforts to modify unhealthy lifestyles are necessary to prevent SHS. PMID:28264509

  13. The Role of Healthy Lifestyle in the Implementation of Regressing Suboptimal Health Status among College Students in China: A Nested Case-Control Study.

    PubMed

    Chen, Jieyu; Xiang, Hongjie; Jiang, Pingping; Yu, Lin; Jing, Yuan; Li, Fei; Wu, Shengwei; Fu, Xiuqiong; Liu, Yanyan; Kwan, Hiuyee; Luo, Ren; Zhao, Xiaoshan; Sun, Xiaomin

    2017-02-28

    Suboptimal health status (SHS) is the intermediate health state between health and disease, it is medically undiagnosed and is also termed functional somatic syndrome. Although its clinical manifestations are complicated and various, SHS has not reached the disease status. Unhealthy lifestyle is associated with many chronic diseases and mortality. In accordance with the impact of lifestyle on health, it is intriguing to determine the association between unhealthy lifestyle and SHS risk. We conducted a nested case-control study among healthy Chinese college students from March 2012 to September 2013, which was nested in a prospective cohort of 5676 students. We performed 1:1 incidence density sampling with matched controls for birth year, sex, grade, specialty and individual character. SHS was evaluated using the medical examination report and Sub-health Measurement Scale V1.0 (SHMS V1.0). Exposure was defined as an unhealthy lifestyle per the frequency of six behavioral dimensions from the Health-promoting Lifestyle Profile (HPLP-II). We matched 543 cases of SHS (42.66%) in a cohort of 1273 students during the 1.5 years mean follow-up time with controls. A significant difference (t = 9.79, p < 0.001) and a reduction in HPLP-II total score was present at 1.5 years follow-up (135.93 ± 17.65) compared to baseline (144.48 ± 18.66). A level-response effect was recorded with an increase of the total HPLP-II (every dimension was correlated with a decreased SHS risk). Compared to respondents with the least exposure (excellent level), those reporting a general HPLP-II level were approximately 2.3 times more likely to develop SHS (odd ratio = 2.333, 95% CI = 1.471 to 3.700); and those with less HPLP-II level (good level) were approximately 1.6 times more likely (1.644, 1.119-2.414) to develop SHS (p < 0.05). Our data indicated that unhealthy lifestyle behavior with respect to behavioral dimensions significantly affected SHS likelihood. Further analyses revealed a marked increase (average increased 14.73 points) in lifestyle level among those SHS regression to health after 1.5 years, with respect to the HPLP-II behavioral dimensions, in addition to the total score (t = -15.34, p < 0.001). SHS is highly attributable to unhealthy lifestyles, and the Int. J. Environ. Res. Public Health 2017, 14, 240 2 of 17 mitigation of modifiable lifestyle risk factors may lead to SHS regression. Increased efforts to modify unhealthy lifestyles are necessary to prevent SHS.

  14. The Impact of Patient Education on Anthropometric, Lipidemic, and Glycemic Parameters Among Patients With Poorly Controlled Type II Diabetes Mellitus: A 3-Month Prospective Single-Center Turkish Study.

    PubMed

    Cander, Soner; Gul, Ozen Oz; Gul, Cuma B; Keles, Saadet B; Yavas, Sibel; Ersoy, Canan

    2014-12-01

    This study evaluated the impact of patient education on adherence to a diabetes care plan (e.g., anthropometric, lipidemic, and glycemic parameters) among adults with type II diabetes mellitus without adequate glycemic control. A total of 61 ambulatory adults with type II diabetes mellitus (mean age: 53.6 ± 8.2 years, 70.5% female) were evaluated for anthropometrics, duration of diabetes mellitus, type of anti-diabetic treatment, blood biochemistry, and glycemic parameters in this 3-month prospective observational single-center study. During the course of the study, participants demonstrated a significant decrease in body weight and fat percentage and HbA1c (p < .001 for each). None of the factors evaluated was a significant determinant for glycemic parameters. These findings revealed that adults with type II diabetes mellitus who received education on adherence to routine self-monitoring of blood glucose, standard diabetic diet, and an exercise program delivered by certified diabetes educators had better glycemic control and significant decrease in body weight and fat percentage over a 3-month monitoring period. Copyright 2014, SLACK Incorporated.

  15. A multigene prognostic assay for selection of adjuvant chemotherapy in patients with T3, stage II colon cancer: impact on quality-adjusted life expectancy and costs.

    PubMed

    Hornberger, John; Lyman, Gary H; Chien, Rebecca; Meropol, Neal J

    2012-12-01

    Uncertainty exists regarding appropriate and affordable use of adjuvant chemotherapy in stage II colon cancer (T3, proficient DNA mismatch repair). This study aimed to estimate the effectiveness and costs from a US societal perspective of a multigene recurrence score (RS) assay for patients recently diagnosed with stage II colon cancer (T3, proficient DNA mismatch repair) eligible for adjuvant chemotherapy. RS was compared with guideline-recommended clinicopathological factors (tumor stage, lymph nodes examined, tumor grade, and lymphovascular invasion) by using a state-transition (Markov) lifetime model. Data were obtained from published literature, a randomized controlled trial (QUick And Simple And Reliable) of adjuvant chemotherapy, and rates of chemotherapy use from the National Cooperative Cancer Network Colon/Rectum Cancer Outcomes study. Life-years, quality-adjusted life expectancy, and lifetime costs were examined. The RS is projected to reduce adjuvant chemotherapy use by 17% compared with current treatment patterns and to increase quality-adjusted life expectancy by an average of 0.035 years. Direct medical costs are expected to decrease by an average of $2971 per patient. The assay was cost saving for all subgroups of patients stratified by clinicopathologic factors. The most influential variables affecting treatment decisions were projected years of life remaining, recurrence score, and patients' disutilities associated with adjuvant chemotherapy. Use of the multigene RS to assess recurrence risk after surgery in stage II colon cancer (T3, proficient DNA mismatch repair) may reduce the use of adjuvant chemotherapy without decreasing quality-adjusted life expectancy and be cost saving from a societal perspective. These findings need to be validated in additional cohorts, including studies of clinical practice as assay use diffuses into nonacademic settings. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  16. Experience of a Maastrich type II non heart beating donor program in a small city: preliminary results.

    PubMed

    Miñambres, E; Suberviola, B; Guerra, C; Lavid, N; Lassalle, M; González-Castro, A; Ballesteros, M A

    2015-10-01

    To study the results of a non-controlled cardiac death (Maastricht type II) donor program in a city of 200,000 inhabitants. The study was initially focused on lung donation and was extended to kidney donation after 9 months. A prospective observational study was conducted between October 2012 and December 2013. The Intensive Care Unit of Marqués de Valdecilla University Hospital in Santander (Spain), and surrounding areas. Patients (< 55 years) who died of out-of-hospital cardiac arrest. All out-of-hospital cardiac arrests were treated with mechanical cardiac compression (LUCAS II). The diagnosis of death and organ preservation were performed in the ICU. A total of 14 calls were received, of which three were discarded. Of the 11 potential donors, 7 were effective donors with a median age of 39.5 years (range: 32-48). A total of 5 single lung transplants and four kidney transplants were performed. In addition, corneas and tissues were harvested. The non-valid donors were rejected mainly due to technical problems. There were no donation refusals on the part of the patient relatives. The lung transplant patient survival rate was 100% after one month and 80% after one year. One month after transplantation, the kidney recipients had a serum creatinine concentration of<2mg/dl. The interval from cardiac arrest to renal preservation was 80minutes (range: 71-89), and the interval from cardiac arrest to lung preservation was 84minutes (range: 77-94). A Maastricht type II donation program in a small city is viable for both abdominal and thoracic organs. The program was initially very cautious, but its potential is easily improvable by increasing donor and by equipping mobile ICU ambulances with mechanical cardiac compression systems. Full management of the donor in the ICU, avoiding the emergency department or operating rooms, reduces the warm ischemia time, thereby improving transplant outcomes. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  17. Successful transcatheter closure of a congenital high-flow portosystemic venous shunt with the Amplatzer vascular plug II.

    PubMed

    Guneyli, Serkan; Cinar, Celal; Bozkaya, Halil; Parildar, Mustafa; Oran, Ismail; Akin, Yigit

    2012-12-01

    Congenital portosystemic venous shunt is extremely rare and should be treated. Advances in treatment techniques allow for patients to be treated safely. We present a 9-year-old boy with a large congenital portosystemic venous shunt. The shunt was occluded interventionally with the Amplatzer vascular plug II. Our case was unique with its clinical manifestation, the use of a 22-mm Amplatzer vascular plug II, and the presence of the patient's 1-year follow-up.

  18. Rotation in [C II]-emitting gas in two galaxies at a redshift of 6.8

    NASA Astrophysics Data System (ADS)

    Smit, Renske; Bouwens, Rychard J.; Carniani, Stefano; Oesch, Pascal A.; Labbé, Ivo; Illingworth, Garth D.; van der Werf, Paul; Bradley, Larry D.; Gonzalez, Valentino; Hodge, Jacqueline A.; Holwerda, Benne W.; Maiolino, Roberto; Zheng, Wei

    2018-01-01

    The earliest galaxies are thought to have emerged during the first billion years of cosmic history, initiating the ionization of the neutral hydrogen that pervaded the Universe at this time. Studying this ‘epoch of reionization’ involves looking for the spectral signatures of ancient galaxies that are, owing to the expansion of the Universe, now very distant from Earth and therefore exhibit large redshifts. However, finding these spectral fingerprints is challenging. One spectral characteristic of ancient and distant galaxies is strong hydrogen-emission lines (known as Lyman-α lines), but the neutral intergalactic medium that was present early in the epoch of reionization scatters such Lyman-α photons. Another potential spectral identifier is the line at wavelength 157.4 micrometres of the singly ionized state of carbon (the [C II] λ = 157.74 μm line), which signifies cooling gas and is expected to have been bright in the early Universe. However, so far Lyman-α-emitting galaxies from the epoch of reionization have demonstrated much fainter [C II] luminosities than would be expected from local scaling relations, and searches for the [C II] line in sources without Lyman-α emission but with photometric redshifts greater than 6 (corresponding to the first billion years of the Universe) have been unsuccessful. Here we identify [C II] λ = 157.74 μm emission from two sources that we selected as high-redshift candidates on the basis of near-infrared photometry; we confirm that these sources are two galaxies at redshifts of z = 6.8540 ± 0.0003 and z = 6.8076 ± 0.0002. Notably, the luminosity of the [C II] line from these galaxies is higher than that found previously in star-forming galaxies with redshifts greater than 6.5. The luminous and extended [C II] lines reveal clear velocity gradients that, if interpreted as rotation, would indicate that these galaxies have similar dynamic properties to the turbulent yet rotation-dominated disks that have been observed in Hα-emitting galaxies two billion years later, at ‘cosmic noon’.

  19. Rotation in [C ii]-emitting gas in two galaxies at a redshift of 6.8.

    PubMed

    Smit, Renske; Bouwens, Rychard J; Carniani, Stefano; Oesch, Pascal A; Labbé, Ivo; Illingworth, Garth D; van der Werf, Paul; Bradley, Larry D; Gonzalez, Valentino; Hodge, Jacqueline A; Holwerda, Benne W; Maiolino, Roberto; Zheng, Wei

    2018-01-10

    The earliest galaxies are thought to have emerged during the first billion years of cosmic history, initiating the ionization of the neutral hydrogen that pervaded the Universe at this time. Studying this 'epoch of reionization' involves looking for the spectral signatures of ancient galaxies that are, owing to the expansion of the Universe, now very distant from Earth and therefore exhibit large redshifts. However, finding these spectral fingerprints is challenging. One spectral characteristic of ancient and distant galaxies is strong hydrogen-emission lines (known as Lyman-α lines), but the neutral intergalactic medium that was present early in the epoch of reionization scatters such Lyman-α photons. Another potential spectral identifier is the line at wavelength 157.4 micrometres of the singly ionized state of carbon (the [C ii] λ = 157.74 μm line), which signifies cooling gas and is expected to have been bright in the early Universe. However, so far Lyman-α-emitting galaxies from the epoch of reionization have demonstrated much fainter [C ii] luminosities than would be expected from local scaling relations, and searches for the [C ii] line in sources without Lyman-α emission but with photometric redshifts greater than 6 (corresponding to the first billion years of the Universe) have been unsuccessful. Here we identify [C ii] λ = 157.74 μm emission from two sources that we selected as high-redshift candidates on the basis of near-infrared photometry; we confirm that these sources are two galaxies at redshifts of z = 6.8540 ± 0.0003 and z = 6.8076 ± 0.0002. Notably, the luminosity of the [C ii] line from these galaxies is higher than that found previously in star-forming galaxies with redshifts greater than 6.5. The luminous and extended [C ii] lines reveal clear velocity gradients that, if interpreted as rotation, would indicate that these galaxies have similar dynamic properties to the turbulent yet rotation-dominated disks that have been observed in Hα-emitting galaxies two billion years later, at 'cosmic noon'.

  20. Long-term results from an epiretinal prosthesis to restore sight to the blind

    PubMed Central

    Ho, Allen C.; Humayun, Mark S.; Dorn, Jessy D.; da Cruz, Lyndon; Dagnelie, Gislin; Handa, James; Barale, Pierre-Olivier; Sahel, José-Alain; Stanga, Paulo E.; Hafezi, Farhad; Safran, Avinoam B.; Salzmann, Joel; Santos, Arturo; Birch, David; Spencer, Rand; Cideciyan, Artur V.; de Juan, Eugene; Duncan, Jacque L.; Eliott, Dean; Fawzi, Amani; Olmos de Koo, Lisa C.; Brown, Gary C.; Haller, Julia A.; Regillo, Carl D.; Del Priore, Lucian V.; Arditi, Aries; Geruschat, Duane R.; Greenberg, Robert J.

    2015-01-01

    Purpose Retinitis Pigmentosa (RP) is a group of inherited retinal degenerations leading to blindness due to photoreceptor loss. A rare disease, it affects about 100,000 people in the United States. There is no cure and no approved medical therapy to slow or reverse RP. The purpose of this clinical trial was to evaluate the safety, reliability, and benefit of the Argus® II Retinal Prosthesis System (Second Sight Medical Products, Inc., Sylmar, CA) in restoring some visual function to subjects completely blind from RP. Herein, we report clinical trial results at 1 and 3 years post-implant. Design The study is a multicenter, single-arm, prospective clinical trial. Subjects There were 30 subjects in 10 centers in the U.S. and Europe. Subjects served as their own controls – i.e., implanted eye vs. fellow eye, and System ON vs. System OFF (native residual vision). Methods The Argus II System was implanted on and in a single eye (typically the worse-seeing eye) of blind subjects. Subjects wore glasses mounted with a small camera and a video processor that converted images into stimulation patterns sent to the electrode array on the retina. Main Outcome Measures The primary outcome measures were safety (the number, seriousness, and relatedness of adverse events) and visual function, as measured by three computer-based, objective tests. Results Twenty-nine out of 30 subjects remained implanted with functioning Argus II Systems at 3 years post-implant. Eleven subjects experienced a total of 23 serious device- or surgery-related adverse events. All were treated with standard ophthalmic care. As a group, subjects performed significantly better with the System ON than OFF on all visual function tests and functional vision assessments. Conclusions The three-year results of the Argus II trial support the long-term safety profile and benefit of the Argus II System for patients blind from RP. Earlier results from this trial were used to gain approval of the Argus II by the FDA and a CE Mark in Europe. The Argus II System is the first and only retinal implant to have both approvals. PMID:26162233

  1. Description and prediction of the income status of borderline patients over 10   years of prospective follow-up.

    PubMed

    Niesten, Isabella J M; Karan, Esen; Frankenburg, Frances R; Fitzmaurice, Garrett M; Zanarini, Mary C

    2016-11-01

    Research shows that individuals suffering from borderline personality disorder are economically disadvantaged, but longitudinal data is lacking. This study examined the income of borderline personality disorder (BPD) patients and axis II comparison subjects over 10 years of follow-up and assessed predictors of income among BPD patients. Data on income was obtained for 264 BPD patients and 63 axis II comparison subjects at 6-year follow-up and for surviving patients at five follow-up waves. Baseline and time-varying predictors of income were assessed using information from interviews and self-report measures. Regardless of diagnosis, a greater proportion of people shifted into the higher income groups over time. Being in a higher income group was more likely to happen and happened more rapidly for axis II comparison subjects than for BPD patients. Results regarding the BPD patients indicated that childhood emotional, verbal and/or physical abuse were associated with a greater likelihood of being in a lower income group, whereas years of education and a higher IQ were associated with a greater likelihood of being in a higher income group. Borderline personality disorder (BPD) patients show enduring lowered economic functioning. Their economic functioning seems to be negatively affected by childhood emotional, verbal and/or physical abuse but positively affected by years of education and IQ. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Predictors of nursing workload in elderly patients admitted to intensive care units.

    PubMed

    Sousa, Cleber Ricardo de; Gonçalves, Leilane Andrade; Toffoleto, Maria Cecília; Leão, Karine; Padilha, Kátia Grillo

    2008-01-01

    The age of patients is a controversial issue in admission to intensive care unit (ICU). The aim of this study was to compare severity and nursing workload of elderly patients with 60-69, 70-79, and e"80 years of age and to identify predictors of nursing workload in elderly patients. A cross sectional study was performed with a sample of 71 elderly patients admitted to three ICU in the city of Sao Paulo, Brazil from October to November 2004. Data were prospectively collected using Nursing Activities Score (NAS) and Simplified Acute Physiology Score II (SAPS II). There was no significant difference in nursing workload among the elderly patients age subgroups (p=0.84). Multiple regression analysis indicated that the independent risk factors of high nursing workload were severity, age e"70 years, and to be a surgical ICU patient. Age as an isolated factor should not be discriminative for elderly patients admission to ICU.

  3. Comparing ECT data of two different inpatient clinics: propofol or thiopental?

    PubMed

    Yazici, Esra; Bosgelmez, Sukriye; Tas, Halil Ibrahim; Karabulut, Umit; Yazici, Ahmet Bulent; Yildiz, Mustafa; Kirpinar, Ismet

    2013-10-01

    This study compares the data of (modified) electroconvulsive theraphy (ECT) applications from two different inpatient clinics in Turkey: Kocaeli Derince Training and Research Hospital (Clinic-I) and Kocaeli University (Clinic-II). Recorded files of patients from the two clinics were compared in terms of ECT indications, number and duration of seizures, and anesthetic agents used (propofol vs. thiopental). ECT applications occurring between January 2011 and January 2013 were included in the study. A total of 86 patients (9.5% of the inpatients) received ECT in Clinic-I and 103 patients (21.1% of the inpatients) in Clinic-II during the period studied. The yearly ECT rate (treated person rate per 10,000 per year) was 0.59/10,000 for Kocaeli (Turkey) as a whole. The overall number of ECT applications was 539 in Clinic-I and 999 in Clinic-II, and the average number of ECT sessions for each patient was 6.4 ± 2.33 in Clinic-I and 9.69 ± 4.66 in Clinic-II. The majority of indications were depressive disorders and insufficient response to medicine. Patients in the clinic which utilized thiopental as the anesthetic agent experienced more cardiovascular and respiratory side effects than the one which used propofol. The number of ECT sessions required was greater for patients with schizoaffective disorder than for others. The administration of ECT was considered to be a reliable method of treatment in these clinics. With respect to specific anesthetic agents, propofol was found to have less hemodynamic side effects and shorter seizure durations than thiopental.

  4. Research and Development Funding in the Proposed Fiscal Year 1985 Budget. Special Study.

    ERIC Educational Resources Information Center

    Schorsch, Louis; Dailey, Theresa

    This report discusses in detail the research and development (R&D) elements of the Reagan Administration's budget for Fiscal Year (FY) 1985. Following an introduction (chapter I), chapter II presents an overview of R&D funding in the President's FY 1985 budget. The chapter begins by describing overall R&D spending in terms of the major catagories…

  5. Summer Institute to Train Data Processing Teachers for the New Oklahoma State-Wide Computer Science System, Phase II. Final Report.

    ERIC Educational Resources Information Center

    Tuttle, Francis

    Twenty-three instructors participated in an 8-week summer institute to develop their technical competency to teach the second year of a 2-year Technical Education Computer Science Program. Instructional material covered the following areas: (1) compiler languages and systems design, (2) cost studies, (3) business organization, (4) advanced…

  6. Space Acceleration Measurement System-II: Microgravity Instrumentation for the International Space Station Research Community

    NASA Technical Reports Server (NTRS)

    Sutliff, Thomas J.

    1999-01-01

    The International Space Station opens for business in the year 2000, and with the opening, science investigations will take advantage of the unique conditions it provides as an on-orbit laboratory for research. With initiation of scientific studies comes a need to understand the environment present during research. The Space Acceleration Measurement System-II provides researchers a consistent means to understand the vibratory conditions present during experimentation on the International Space Station. The Space Acceleration Measurement System-II, or SAMS-II, detects vibrations present while the space station is operating. SAMS-II on-orbit hardware is comprised of two basic building block elements: a centralized control unit and multiple Remote Triaxial Sensors deployed to measure the acceleration environment at the point of scientific research, generally within a research rack. Ground Operations Equipment is deployed to complete the command, control and data telemetry elements of the SAMS-II implementation. Initially, operations consist of user requirements development, measurement sensor deployment and use, and data recovery on the ground. Future system enhancements will provide additional user functionality and support more simultaneous users.

  7. Age and Visual Information Processing.

    ERIC Educational Resources Information Center

    Gummerman, Kent; And Others

    This paper reports on three studies concerned with aspects of human visual information processing. Study I was an effort to measure the duration of iconic storage using a partial report method in children ranging in age from 6 to 13 years. Study II was designed to detect age related changes in the rate of processing (perceptually encoding) letters…

  8. Mature Results of a Prospective Randomized Trial Comparing 5-Flourouracil with Leucovorin to 5-Flourouracil with Levamisole as Adjuvant Therapy of Stage II and III Colorectal Cancer- The Israel Cooperative Oncology Group (ICOG) Study

    PubMed Central

    Figer, Arie; Nissan, Aviram; Shani, Adi; Borovick, Riva; Stiener, Mariana; Baras, Mario; Freund, Herbert R.; Sulkes, Aaron; Stojadinovic, Alexander; Peretz, Tamar

    2011-01-01

    Objective: Survival benefit with adjuvant therapy was shown in patients with Stage III colorectal cancer (CRC). This study evaluates long-term (10-year) outcome in patients with CRC randomly assigned to adjuvant 5-Fluorouracil/Leucovorin (5FU+LV) or 5-FU/Levamisole (5FU+LEV). Methods: Between 1990 and 1995, 398 patients with curatively resected Stage II-III CRC were randomly assigned to adjuvant 5FU+LV or 5FU+LEV for 12 months. Results: No difference was evident in 10-year relapse-free or overall survival between study groups. Grade III toxicity was similar between groups; however, neurotoxicity was significantly greater with 5FU+LEV (p=0.02) and gastrointestinal toxicity with 5FU+LV (p=0.03). Female patients treated with 5FU+LEV had improved overall survival. Conclusions: Adjuvant treatment of CRC is still based on leucovorin modulated fluorouracil. The long-term follow-up results of this trial indicate that the adjuvant treatment of Stage II-III CRC with 5FU+LV or 5FU+LEV is equally effective. The finding of improved survival in female subjects treated with 5FU+LEV warrants further study to determine if Levamisole is a better modulator of 5-FU than Leucovorin in this patient subset. PMID:21475636

  9. 40 CFR 80.45 - Complex emissions model.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) VOCW% = Percentage change in winter VOC emissions from baseline levels (8) Phase II total VOC emissions... its domain Phase I = The years 1995-1999 Phase II = Year 2000 and beyond (b) Weightings and baselines... appropriate pollutant and Phase: Table 1—Normal and Higher Emitter Weightings for Exhaust Emissions Phase I...

  10. Type II diabetes mellitus and menopause: a multinational study.

    PubMed

    Monterrosa-Castro, A; Blümel, J E; Portela-Buelvas, K; Mezones-Holguín, E; Barón, G; Bencosme, A; Benítez, Z; Bravo, L M; Calle, A; Chedraui, P; Flores, D; Espinoza, M T; Gómez, G; Hernández-Bueno, J A; Laribezcoa, F; Lima, S; Martino, M; Mostajo, D; Ojeda, E; Onatra, W; Sánchez, H; Navarro, D; Tserotas, K; Vallejo, M S; Witis, S; Zuñiga, M C

    2013-12-01

    Type II diabetes mellitus causes metabolic changes that may lead to early menopause and worsen climacteric symptoms. To determine the risk factors for type II diabetes mellitus and assess the impact of this disease on the age of menopause and on climacteric symptoms. A total of 6079 women aged between 40 and 59 years from 11 Latin American countries were requested to answer the Menopause Rating Scale and Goldberg Anxiety-Depression Scale. The prevalence of diabetes was 6.7%. Diabetes mellitus was associated with arterial hypertension (odds ratio (OR) 4.49; 95% confidence interval (CI) 3.47-5.31), the use of psychotropic drugs (OR 1.54; 95% CI 1.22-1.94), hormonal therapy (OR 1.46; 95% CI 1.11-1.92), ≥ 50 years of age (OR 1.48; 95% CI 1.17-1.86), overweight or obese (OR 1.47; 95% CI 1.15-1.89), and waist circumference ≥ 88 cm (OR 1.32; 95% CI 1.06-1.65). Factors associated with lower risk of diabetes were the use of hormonal contraceptives (OR 0.55; 95% CI 0.35-0.87), alcohol (OR 0.73; 95% CI 0.54-0.98) and living in cities > 2500 meters above sea level (OR 0.70; 95% CI 0.53-0.91) or with high temperatures (OR 0.67; 95% CI 0.51-0.88). In turn, diabetes tripled the risk of menopause in women under 45 years of age. Diabetes did not increase the risk of deterioration of quality of life due to climacteric symptoms. Menopause does not increase the risk of type II diabetes mellitus. Diabetes is associated with early menopause in women under 45 years of age.

  11. Decline in spirometric variables in grain workers from start of employment: differential effect of duration of follow up.

    PubMed Central

    Zejda, J E; Pahwa, P; Dosman, J A

    1992-01-01

    Prospective study of 164 young men from the start of employment in grain elevators showed that of those seen at the initial evaluation of respiratory state only 30% were available for a complete four year follow up. The drop out of subjects could represent a health related selection leading to the underestimation of respiratory effects of exposure to grain dust as assessed in the survivor group. This hypothesis was examined by comparisons of longitudinal changes in lung function in four groups defined by the duration of follow up involving the initial examination and periodic evaluations after one, two, and four years of work. Sixty four men were tested only on the initial examination (group I), 18 underwent two (group II), 31 underwent three (group III), and 51 (group IV) all four examinations. The groups had similar mean ages (range: 19.4-20.1 years), mean duration of previous exposure to grain dust (range: 8-13 weeks), smoking habits, lung function, and prevalences of respiratory symptoms evaluated on the initial occasion. The average decline in lung function over the first year was associated with duration of follow up. The annual decline in FVC (ml) was 58 in group II, 41 in group III and -55 (increase) in group IV; the decline in FEV1 (ml) was 224, 130, and 70 respectively. The differences for the annual declines of FEV1, FEF25-759 Vmax509 and Vmax25 were significant between groups II and IV, and the FEF25-759 Vmax509 and Vmax25 differed significantly between groups II and III. The results show that the restriction of analysis to the survivors may underestimate the relation between work and respiratory impairment. PMID:1515349

  12. [How traumatized are the children of World War II? The relationship of age during flight and forced displacement and current posttraumatic stress symptoms].

    PubMed

    Wendt, Carolin; Freitag, Simone; Schmidt, Silke

    2012-08-01

    Traumatic events experienced in childhood can be reactivated in older age. The present study investigates the relation of age during flight and forced displacement within World War II (WWII; 2-7 years, 8-13 years, 14-20 years) and the current occurrence of posttraumatic stress disorder (PTSD). Traumatic events and current posttraumatic stress symptoms were assessed by the Harvard Trauma Questionnaire and the Impact of Event Scale-revised. Mean age of participants (N=169) was 73.76 years (SD=4.18). The eldest group reported most war-related traumatic events. In each age group a one-week-prevalence for a full PTSD of 10-11% was found. The prevalence for both full and subthreshold PTSD was higher for the age group 14-20 years (60.5%) compared to the younger age groups (33-35%). People, who experienced WWII as adolescents, show a dose-response-effect indicated by a higher prevalence for subthreshold PTSD. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Sensitivity of the Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-II) to the neurocognitive deficits associated with the semantic dementia variant of frontotemporal lobar degeneration: A case study.

    PubMed

    Gontkovsky, Samuel T

    2017-01-01

    This case study of a 71-year-old woman illustrates the clinical utility of the Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-II) in assessing the neurocognitive sequelae of the semantic dementia variant of frontotemporal lobar degeneration. Obtained scores revealed a decline in estimated Full Scale IQ from the patient's expected premorbid level. Consistent with her initial onset of neuropathology in the left temporal lobe, the WASI-II yielded a difference of 53 standard score points between the Perceptual Reasoning and Verbal Comprehension composites, reflecting the patient's intact capabilities in visuospatial perception and construction in conjunction with marked disturbances of language. The similarities subtest was particularly sensitive to the patient's neurocognitive deficits. WASI-II scores corresponded well with the results obtained from other administered measures, in particular those from the Repeatable Battery for the Assessment of Neuropsychological Status. Findings provide support for use of the WASI-II in the clinical evaluation of semantic dementia and offer preliminary evidence that the test may be helpful in both lateralization and localization of brain lesions.

  14. Long-term safety and tolerability of rotigotine transdermal system in patients with early-stage idiopathic Parkinson's disease: a prospective, open-label extension study.

    PubMed

    Elmer, Lawrence W; Surmann, Erwin; Boroojerdi, Babak; Jankovic, Joseph

    2012-06-01

    This prospective, open-label extension (SP702; NCT00594165) of a 6-month double-blind, randomized study investigated the long-term safety and tolerability of rotigotine transdermal system in early Parkinson's disease (PD). Patients with early-stage idiopathic PD received transdermal rotigotine for up to 6 years at optimal dose (up to 16 mg/24h). Adjunctive levodopa was allowed. Primary outcomes included adverse events (AEs) and extent of rotigotine exposure. Other outcomes included time to levodopa, incidence of dyskinesias, and efficacy using the Unified Parkinson's Disease Rating Scale (UPDRS) II+III total score. Of 217 patients entering the open-label study, 47% were still in the study upon closure; 24% withdrew because of AEs and 6% because of lack of efficacy. The median exposure to rotigotine was 1910 days (≈ 5 years, 3 months; range 1-2188 days). Most common AEs were somnolence (23% per patient-year), falls (17%), peripheral edema (14%), nausea (12%), and application site reactions (ASRs; 12%). 3% withdrew because of ASRs. 26% patients did not initiate levodopa; of those who did, fewer than half started levodopa in the first year. Dyskinesias were reported by 25% patients; the majority (83%) reported their first episode after initiating levodopa. Mean UPDRS II+III total scores remained below double-blind baseline for up to 2 years of open-label treatment. This is the longest interventional study of rotigotine conducted to date. Transdermal rotigotine was generally well tolerated for up to 6 years; AEs reported were similar to those observed in shorter studies and led to discontinuation in only 24% patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. [Septal alcohol ablation in patients with hypertrophic cardiomyopathy].

    PubMed

    López-Aburto, Gustavo; Palacios-Rodríguez, Juan Manuel; Cantú-Ramírez, Samuel; Galván-García, Eduardo; Tolosa-Dzul, Gonzalo; Morán-Benavente, Armando; Ontiveros-Martínez, Raúl

    2013-01-01

    to know the clinical and hemodynamic course in septal obstructive hypertrophic cardiomyopathy (SOHC) after alcohol ablation. this was an observational, longitudinal study, including 21 patients with SOHC with functional class of the New York Heart Association (CF-NYHA) refractory to treatment and/or = 30 mm Hg gradient at rest or = 60 mm Hg provoked, or have systolic anterior motion or mitral incompetence (MI) > grade II by echocardiography. average age was 50 ± 16 years, males 38.1 %, females 61.9 %; symptoms: angina 42.9 %, dyspnea 85.7 %, syncope 23.8 %. Pre-ablation CF-NYHA was III and IV in 61.9 %; after a year follow-up all of them were class I-II. Pre-ablation, after and one year later, interventricle septum measures were 22.7 ± 4.9 and 20.7 ± 3.1 mm; left ventricular ejection fraction was 65.5 ± 7 %, 62.2 % ± 6.5 % and 68.7 ± 6.2 %; the output gradient of the left ventricle were 106.9 ± 29.9, 44.6 ± 24.3 and 22.0 ± 5.7 mm Hg. Pre-ablation MI grade-III and IV were 33.3 % and 47.6 %; after a year it was grade-0, 52.4 %, grade-I 28.6 %, grade-II, 19 %. There were no hospital mortality. the alcohol septal ablation in SOHC patients had a high success treatment with a low complication rate.

  16. Mg II Chromospheric Emission Line Bisectors Of HD39801 And Its Relation With The Activity Cycle

    NASA Astrophysics Data System (ADS)

    García García, Leonardo Enrique; Pérez Martínez, M. Isabel

    2016-07-01

    Betelgeuse is a cool star of spectral type M and luminosity class I. In the present work, the activity cycle of Betelgeuse was obtained from the integrated emission flux of the Mg II H and K lines, using more than 250 spectra taken from the International Ultraviolet Explorer (IUE) online database. Of which it was found, based on a Lomb Scargle periodogram, a cycle of 16 years, along with 2 sub-cycles with a period of the order of 0.60 and 0.65 years, which may be due to turbulence or possible stellar flares. In addition, an analysis of line asymmetry was made by means of the chromospheric emission line bisectors, due to the strong self-absorption observed in this lines, the blue and red wings were analyzed independently. In order to measure such asymmetry, a "line shift" was calculated, from which several cycles of variability were obtained from a Lomb Scargle periodogram, spanning from few months to 4 years. In the sense, the most significant cycle is about 0.44 and 0.33 years in the blue and red wing respectively. It is worth noting, that the rotation period of the star doesn't play an important role in the variability of the Mg II lines. This technique provides us with a new way to study activity cycles of evolved stars.

  17. A novel approach for treatment of skeletal Class II malocclusion: Miniplates-based skeletal anchorage.

    PubMed

    Al-Dumaini, Abdullsalam Abdulqawi; Halboub, Esam; Alhammadi, Maged Sultan; Ishaq, Ramy Abdul Rahman; Youssef, Mohamed

    2018-02-01

    The objective of this study was to evaluate the effect of a new approach-bimaxillary miniplates-based skeletal anchorage-in the treatment of skeletal Class II malocclusion compared with untreated subjects. The study (miniplates) group comprised 28 patients (14 boys, 14 girls) with skeletal Class II malocclusion due to mandibular retrusion, with a mean age of 11.83 years. After 0.017 × 0.025-in stainless steel archwires were placed in both arches, 4 miniplates were fixed bilaterally, 2 in the maxillary anterior areas and 2 in the mandibular posterior areas, and used for skeletal treatment with elastics. Twenty-four Class II untreated subjects (11 boys, 13 girls), with a mean age of 11.75 years, were included as controls. Skeletal and dental changes were evaluated using pretreatment and posttreatment or observational lateral cephalometric radiographs. The treatment changes were compared with the growth changes observed in the control group using independent t tests. Compared with the minimal changes induced by growth in the control group, the skeletal changes induced by miniplates were more obvious. The mandibular length increased significantly (3 mm), and the mandible moved forward, with a significant restraint in the sagittal position of the maxilla (P <0.001). The overjet correction (-4.26 mm) was found to be a net result of skeletal changes (A-Y-axis = -1.18 mm and B-Y-axis = 3.83 mm). The mandibular plane was significantly decreased by 2.75° (P <0.001). This new technique, bimaxillary miniplates-based skeletal anchorage, is an effective method for treating patients with skeletal Class II malocclusions through obvious skeletal, but minimal dentoalveolar, changes. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  18. Positive Factors Influencing the Advancement of Women to the Role of Head Athletic Trainer in the National Collegiate Athletic Association Divisions II and III.

    PubMed

    Mazerolle, Stephanie M; Eason, Christianne M

    2016-07-01

    Research suggests that women do not pursue leadership positions in athletic training due to a variety of reasons, including family challenges, organizational constraints, and reluctance to hold the position. The literature has been focused on the National Collegiate Athletic Association Division I setting, limiting our full understanding. To examine factors that help women as they worked toward the position of head athletic trainer. Qualitative study. Divisions II and III. Seventy-seven women who were employed as head athletic trainers at the Division II or III level participated in our study. Participants were 38 ± 9 (range = 24-57) years old and had an average of 14 ± 8 (range = 1-33) years of athletic training experience. We conducted online interviews. Participants journaled their reflections to a series of open-ended questions pertaining to their experiences as head athletic trainers. Data were analyzed using a general inductive approach. Credibility was secured by peer review and researcher triangulation. Three organizational facilitators emerged from the data, workplace atmosphere, mentors, and past work experiences. These organizational factors were directly tied to aspects within the athletic trainer's employment setting that allowed her to enter the role. One individual-level facilitator was found: personal attributes that were described as helpful for women in transitioning to the role of the head athletic trainer. Participants discussed being leaders and persisting toward their career goals. Women working in Divisions II and III experience similar facilitators to assuming the role of head athletic trainer as those working in the Division I setting. Divisions II and III were viewed as more favorable for women seeking the role of head athletic trainer, but like those in the role in the Division I setting, women must have leadership skills.

  19. The Factor Structure of the CIBS-II-Readiness Assessment

    ERIC Educational Resources Information Center

    Gotch, Chad M.; French, Brian F.

    2011-01-01

    The Brigance Comprehensive Inventory of Basic Skills-II (CIBS-II)-Readiness form is a diagnostic battery intended for children aged 5 and 6 years. The CIBS-II-Readiness is a new version of the CIBS-Revised-Readiness and includes updated normative information on a larger representative sample in comparison to the CIBS-Revised-Readiness. Empirical…

  20. Infection with Trypanosoma cruzi TcII and TcI in free-ranging population of lion tamarins (Leontopithecus spp): an 11-year follow-up.

    PubMed

    Lisboa, Cristiane Varella; Monteiro, Rafael Veríssimo; Martins, Andreia Fonseca; Xavier, Samantha Cristina das Chagas; Lima, Valdirene Dos Santos; Jansen, Ana Maria

    2015-05-01

    Here, we present a review of the dataset resulting from the 11-years follow-up of Trypanosoma cruzi infection in free-ranging populations of Leontopithecus rosalia (golden lion tamarin) and Leontopithecus chrysomelas (golden-headed lion tamarin) from distinct forest fragments in Atlantic Coastal Rainforest. Additionally, we present new data regarding T. cruzi infection of small mammals (rodents and marsupials) that live in the same areas as golden lion tamarins and characterisation at discrete typing unit (DTU) level of 77 of these isolates. DTU TcII was found to exclusively infect primates, while TcI infected Didelphis aurita and lion tamarins. The majority of T. cruzi isolates derived from L. rosalia were shown to be TcII (33 out 42) Nine T. cruzi isolates displayed a TcI profile. Golden-headed lion tamarins demonstrated to be excellent reservoirs of TcII, as 24 of 26 T. cruzi isolates exhibited the TcII profile. We concluded the following: (i) the transmission cycle of T. cruzi in a same host species and forest fragment is modified over time, (ii) the infectivity competence of the golden lion tamarin population fluctuates in waves that peak every other year and (iii) both golden and golden-headed lion tamarins are able to maintain long-lasting infections by TcII and TcI.

  1. Infection with Trypanosoma cruzi TcII and TcI in free-ranging population of lion tamarins (Leontopithecus spp): an 11-year follow-up

    PubMed Central

    Lisboa, Cristiane Varella; Monteiro, Rafael Veríssimo; Martins, Andreia Fonseca; Xavier, Samantha Cristina das Chagas; Lima, Valdirene dos Santos; Jansen, Ana Maria

    2015-01-01

    Here, we present a review of the dataset resulting from the 11-years follow-up of Trypanosoma cruzi infection in free-ranging populations of Leontopithecus rosalia (golden lion tamarin) and Leontopithecus chrysomelas (golden-headed lion tamarin) from distinct forest fragments in Atlantic Coastal Rainforest. Additionally, we present new data regarding T. cruzi infection of small mammals (rodents and marsupials) that live in the same areas as golden lion tamarins and characterisation at discrete typing unit (DTU) level of 77 of these isolates. DTU TcII was found to exclusively infect primates, while TcI infected Didelphis aurita and lion tamarins. The majority of T. cruzi isolates derived from L. rosalia were shown to be TcII (33 out 42) Nine T. cruzi isolates displayed a TcI profile. Golden-headed lion tamarins demonstrated to be excellent reservoirs of TcII, as 24 of 26 T. cruzi isolates exhibited the TcII profile. We concluded the following: (i) the transmission cycle of T. cruzi in a same host species and forest fragment is modified over time, (ii) the infectivity competence of the golden lion tamarin population fluctuates in waves that peak every other year and (iii) both golden and golden-headed lion tamarins are able to maintain long-lasting infections by TcII and TcI. PMID:25946156

  2. Intravitreal aflibercept for neovascular age-related macular degeneration in patients aged 90 years or older: 2-year visual acuity outcomes.

    PubMed

    Chatziralli, Irini; Regan, Shane O; Mohamed, Ryian; Talks, James; Sivaprasad, Sobha

    2018-06-04

    The purpose of this study was to investigate the efficacy of intravitreal aflibercept for neovascular age-related macular degeneration (nAMD) in very elderly patients aged 90 years or older at 2 years after treatment initiation. In this multicentre retrospective data analysis from electronic medical record, consecutive treatment-naive patients with nAMD treated with aflibercept with at least 2 years follow-up were stratified into those aged < 90 years (Group I) and an older cohort aged 90 and over (Group II). We compared the visual acuity (EDTRS letters) outcomes at 4 weekly intervals between the two groups over a 2-year period. The mean visual acuity of Group I at presentation was 56.3 ETDRS letters versus 52.8 letters in Group II. Maximal visual acuity was achieved in both the groups by 6 months after initiating treatment (4.7 vs. 4.0 letters gain). By 2 years, the mean visual acuity of the older cohort fell marginally below their baseline visual acuity (0.8 letter loss), while Group I presented +2.1 letters gain. The number of injections given and the retention rate of the older cohort were no different to the rest of the patients. Very old patients with nAMD benefited from aflibercept, but not to the same degree as the younger patients. The study showed that, on an average, the very elderly patients were able to adhere to the intensive anti-VEGF treatment regimens.

  3. Longitudinal decline in lung function measurements among Saskatchewan grain workers.

    PubMed

    Pahwa, Punam; Senthilselvan, Ambikaipakan; McDuffie, Helen H; Dosman, James A

    2003-04-01

    To evaluate the relationship between the long term effects of grain dust and decline in lung function among grain elevator workers in Saskatchewan, studied over a 15-year period. The Grain Dust Medical Surveillance Program was started by Labour Canada in 1978 and longitudinally studied the respiratory health of Canadian grain elevator workers over a 15-year period (1978 to 1993). Data on respiratory symptoms and pulmonary function tests (forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC]) were collected once every three years; each three-year interval was called a 'cycle'. Data from Saskatchewan were analyzed for this report. A transitional model using the generalized estimating equations approach was fitted using a SAS macro to predict the annual decline in FEV1 and FVC. Previous lung function, as one of the covariates in the transitional model, played an important role. Significant predictors of FEV1 were previous FEV1, base height, weight, years in the grain industry, current smoking status, cycle II, cycle III and cycle V. Significant predictors of FVC were previous FVC, base height, weight, years in the grain industry, cycle II, cycle III and cycle IV. The estimated annual decline in FEV1 and FVC increased according to length of time in the grain industry among nonsmoking, ex-smoking and smoking grain elevator workers. Lung function values improved after dust control, and yearly declines in FEV1 and FVC after dust control were smaller compared with yearly losses before dust control.

  4. Role of oxidants in enhancing dewaterability of anaerobically digested sludge through Fe (II) activated oxidation processes: hydrogen peroxide versus persulfate

    PubMed Central

    Song, Kang; Zhou, Xu; Liu, Yiqi; Gong, Yanyan; Zhou, Beibei; Wang, Dongbo; Wang, Qilin

    2016-01-01

    Improving dewaterability of sludge is important for the disposal of sludge in wastewater treatment plants (WWTPs). This study, for the first time, investigated the Fe(II) activated oxidization processes in improving anaerobically digested sludge (ADS) dewaterability. The combination of Fe(II) (0–100 mg/g total solids (TS)) and persulfate (0–1,000 mg/g TS) under neutral pH as well as the combination of Fe(II) (0–100 mg/g TS) and hydrogen peroxide (HP) (0–1,000 mg/g TS) under pH 3.0 were used to examine and compare their effect on the ADS dewaterability enhancement. The highest ADS dewaterability enhancement was attained at 25 mg Fe(II)/g TS and 50 mg HP/g TS, when the CST (CST: the capillary suction time, a sludge dewaterability indicator) was reduced by 95%. In contrast, the highest CST reduction in Fe(II)-persulfate conditioning was 90%, which was obtained at 50 mg Fe(II)/g TS and 250 mg persulfate/g TS. The results showed that Fe(II)-HP conditioning was comparable with Fe(II)-persulfate conditioning in terms of highest CST reduction. Economic analysis suggested that the Fe(II)-HP conditioning was more promising for improving ADS dewaterability compared with Fe(II)-persulfate conditioning, with the saving being up to $65,000 per year in a WWTP with a population equivalent of 100,000. PMID:27109500

  5. Administrative Coaching Practices: Content, Personalization, and Support

    ERIC Educational Resources Information Center

    Hayashi, Christine A.

    2016-01-01

    This study surveys educators who have completed, or are in their second year of, an administrative coaching program that results in a California Clear Administrative Credential, also known as Tier II. The purpose of the study is to determine the perceptions of these educators regarding whether current practices in administrative coaching programs…

  6. Interdisciplinary Studies Program. Teacher's Guide: Part II.

    ERIC Educational Resources Information Center

    Valencia Community Coll., Orlando, FL.

    This teacher's guide was developed for the second of four courses in Valencia Community College's Interdisciplinary Studies Program, a 2-year core general education curriculum which chronologically examines the major developments in the evolution of human knowledge. The guide provides an introductory overview of the semester's topic (i.e., the…

  7. Effectiveness of orthodontic treatment with functional appliances on maxillary growth in the short term: A systematic review and meta-analysis.

    PubMed

    Nucera, Riccardo; Lo Giudice, Antonino; Rustico, Lorenzo; Matarese, Giovanni; Papadopoulos, Moschos A; Cordasco, Giancarlo

    2016-05-01

    The aim of this systematic review was to evaluate the treatment effects on maxillary growth of removable functional appliances that advance the mandible to a more forward position in patients with Class II malocclusion. Sixteen electronic databases and reference lists of studies were searched up to April 2015. Only randomized clinical trials and prospective controlled clinical trials investigating Class II growing patients treated with removable functional appliances were included. Two authors independently accomplished study selection, data extraction, and risk of bias assessment. All pooled analyses of data were based on random-effects models. Statistical heterogeneity was evaluated. In total, 14 studies were included (5 randomized clinical trials, 9 prospective controlled clinical trials) that collected data from 765 patients (405 treated, 360 untreated controls). The mean differences in treatment effect of functional appliances, relative to the untreated controls, were -0.61° per year (95% CI, -0.69° to -0.25°) for SNA angle, -0.61 mm per year (95% CI, -0.90 to -0.32 mm) for anterior maxillary displacement, and +0.07° per year (95% CI, -0.17° to +0.32°) for maxillary plane rotation. Removable functional appliances in Class II growing patients have a slight inhibitory effect on the sagittal growth of the maxilla in the short term, but they do not seem to affect rotation of the maxillary plane. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  8. Dental attrition and associated factors in adolescents 14 to 19 years of age: a pilot study.

    PubMed

    Casanova-Rosado, Juan F; Medina-Solís, Carlo E; Vallejos-Sánchez, Ana A; Casanova-Rosado, Alejandro J; Maupomé, Gerardo; Avila-Burgos, Leticia

    2005-01-01

    This cross-sectional study evaluated the relationship between attrition and diverse variables in 390 Mexican adolescents aged 14 to 19 years. An ordinal scoring system was used to describe the severity of attrition. Attrition prevalence was 33.3% and was associated with older age, presence of defective restorations, Class II malocclusion, and perception of stress level. Our results suggest that attrition is present in 1 of every 3 adolescents.

  9. Ground-level falls: 9-year cumulative experience in a regionalized trauma system

    PubMed Central

    Cade, Angela; King, Brad; Berne, John; Fernandez, Luis; Norwood, Scott

    2012-01-01

    Ground-level falls (GLFs) are the leading cause of nonfatal hospitalized injuries in the US. We hypothesized that risk-adjusted mortality would not vary between levels of trauma center verification if regional triage functioned appropriately. Data were collected from our regional trauma registry for the years 2001 through 2009. A multilevel mixed-effects logistic regression model was developed to compare risk-adjusted mortality rates by trauma center level and by year. GLF patients numbered 8202 over 9 years with 2.1% mortality. Mean age was 74.5 years and mean probability of death was 0.021 (95% confidence interval [CI], 0.020–0.021). The level I center–treated patients had the highest probability of death (0.033) compared to levels II and III/IV patients (0.023 and 0.018, respectively; P < 0.001), with the highest mortality (6.0%, 3.1%, and 1.1% for levels I, II, and III/IV; P < 0.001). The adjusted odds ratio of mortality was lowest at the level I center (0.71; 95% CI, 0.56–0.91), while no difference existed between level II (1.17; 95% CI, 0.90–1.51) and level III/IV centers (1.22; 95% CI, 0.90–1.66). The 95% CIs for risk-adjusted mortality by year overlapped the 1.0 reference line for each year from 2002 to 2009. In conclusion, regional risk-adjusted mortality for GLF has varied little since 2002. More study is warranted to understand the lower risk-adjusted GLF mortality at the level I center for this growing patient population. PMID:22275774

  10. One-Year Follow-Up of the Effectiveness of Cognitive Behavioral Group Therapy for Patients' Depression: A Randomized, Single-Blinded, Controlled Study.

    PubMed

    Chiang, Kai-Jo; Chen, Tsai-Hui; Hsieh, Hsiu-Tsu; Tsai, Jui-Chen; Ou, Keng-Liang; Chou, Kuei-Ru

    2015-01-01

    The aim of the study was to investigate the long-term (one year) effectiveness of a 12-session weekly cognitive behavior group therapy (CBGT) on patients with depression. This was a single-blind randomized controlled study with a 2-arm parallel group design. Eighty-one subjects were randomly assigned to 12 sessions intervention group (CBGT) or control group (usual outpatient psychiatric care group) and 62 completed the study. The primary outcome was depression measured with Beck Depression Inventory (BDI-II) and Hamilton Rating Scale for Depression (HRSD). The secondary outcomes were automatic thoughts measured by automatic thoughts questionnaire (ATQ). Both groups were evaluated at the pretest (before 2 weeks), posttest (after 12 therapy sessions), and short- (3 months), medium- (6 months), and long-term (12 months) follow-up. After receiving CBGT, the experimental group had a statistically significant reduction in the BDI-II from 40.30 at baseline to 17.82 points at session eight and to 10.17 points at postintervention (P < 0.001). Similar effects were seen on the HRSD. ATQ significantly decreased at the 12th session, 6 months after sessions, and 1 year after the sessions ended (P < 0.001). We concluded that CBGT is effective for reducing depression and continued to be effective at 1 year of follow-up.

  11. Clipping treatment of posterior communicating artery aneurysms associated with arteriosclerosis and calcification: A single center study of 136 cases

    PubMed Central

    Shi, Lei; Yu, Jing; Zhao, Ying; Xu, Kan; Yu, Jinlu

    2018-01-01

    It is widely acknowledged that arteriosclerosis and calcification of the parent artery and aneurysm neck make it difficult to clip posterior communicating artery (PCoA) aneurysms. A total of 136 cases of PCoA aneurysms accompanied by arteriosclerosis and calcification were collected and treated with clipping in the present study. Of the 136 patients, 112 were females (82.4%) and 24 were males (17.6%), with ages ranging from 37 to 76 years (mean age, 60.2 years). Rupture of a PCoA aneurysm was identified in 132 cases (97.1%), and there were 4 cases of unruptured PCoA aneurysms (2.9%). According to the severity of arteriosclerosis and calcification, the aneurysms were divided into type I, II or III. The treatment of type I aneurysms achieved the best curative effect. It is difficult to temporarily occlude type II and III aneurysms during surgery, and temporary occlusion failed in almost 50% of cases. Types II and III were prone to intraoperative aneurysm ruptures. A significantly higher rate of intraoperative aneurysm rupture was seen in type III compared with type II cases. Type II and III cases were more likely to be treated using a fenestrated clip for aneurysm clipping compared with type I cases, and fenestrated clips were used significantly more frequently in type III cases compared with type II cases. Arteriosclerosis and calcification were likely to affect the prognosis of patients, particularly in cases with type III arteriosclerosis and calcification of the parent artery and aneurysm neck. Therefore, the stratification of the arteriosclerosis and calcification of the parent artery and aneurysm neck into types I–III can guide the intraoperative aneurysm clipping strategy, aid in choosing the correct clips, and inform predictions of the occurrence of rupture and hemorrhage, as well as the prognosis for aneurysms. PMID:29434749

  12. Clipping treatment of posterior communicating artery aneurysms associated with arteriosclerosis and calcification: A single center study of 136 cases.

    PubMed

    Shi, Lei; Yu, Jing; Zhao, Ying; Xu, Kan; Yu, Jinlu

    2018-02-01

    It is widely acknowledged that arteriosclerosis and calcification of the parent artery and aneurysm neck make it difficult to clip posterior communicating artery (PCoA) aneurysms. A total of 136 cases of PCoA aneurysms accompanied by arteriosclerosis and calcification were collected and treated with clipping in the present study. Of the 136 patients, 112 were females (82.4%) and 24 were males (17.6%), with ages ranging from 37 to 76 years (mean age, 60.2 years). Rupture of a PCoA aneurysm was identified in 132 cases (97.1%), and there were 4 cases of unruptured PCoA aneurysms (2.9%). According to the severity of arteriosclerosis and calcification, the aneurysms were divided into type I, II or III. The treatment of type I aneurysms achieved the best curative effect. It is difficult to temporarily occlude type II and III aneurysms during surgery, and temporary occlusion failed in almost 50% of cases. Types II and III were prone to intraoperative aneurysm ruptures. A significantly higher rate of intraoperative aneurysm rupture was seen in type III compared with type II cases. Type II and III cases were more likely to be treated using a fenestrated clip for aneurysm clipping compared with type I cases, and fenestrated clips were used significantly more frequently in type III cases compared with type II cases. Arteriosclerosis and calcification were likely to affect the prognosis of patients, particularly in cases with type III arteriosclerosis and calcification of the parent artery and aneurysm neck. Therefore, the stratification of the arteriosclerosis and calcification of the parent artery and aneurysm neck into types I-III can guide the intraoperative aneurysm clipping strategy, aid in choosing the correct clips, and inform predictions of the occurrence of rupture and hemorrhage, as well as the prognosis for aneurysms.

  13. Prevalence of class-I, class-II and class-III obesity in Australian adults between 1995 and 2011-12.

    PubMed

    Keating, Catherine; Backholer, Kathryn; Gearon, Emma; Stevenson, Christopher; Swinburn, Boyd; Moodie, Marj; Carter, Rob; Peeters, Anna

    2015-01-01

    To compare the prevalence of class-I, II and III obesity in Australian adults between 1995, 2007-08 and 2011-12. Prevalence data for adults (aged 18+ years) were sourced from customised data from the nationally representative National Nutrition Survey (1995), the National Health Survey (2007-08), and the Australian Health Survey (2011-12) conducted by the Australian Bureau of Statistics. Obesity classifications were based on measured height and weight (class-I body mass index: 30.0-34.9 kg/m(2), class-II: 35.0-39.9 kg/m(2) and class-III: ≥ 40.0 kg/m(2)). Severe obesity was defined as class-II or class-III obesity. Between 1995 and 2011-12, the prevalence of obesity (all classes combined) increased from 19.1% to 27.2%. During this 17 year period, relative increases in class I, II and III obesity were 1.3, 1.7 and 2.2-fold respectively. In 2011-12, the prevalence of class I, II and III obesity was 19.4, 5.9 and 2.0 per cent respectively in men, and 16.1, 6.9 and 4.2 per cent respectively in women. One in every ten people was severely obese, increasing from one in twenty in 1995, and women were disproportionally represented in this population. Obesity prevalence increased with increasing levels of area-level socioeconomic disadvantage, particularly for the more severely obese classes. Severe obesity affected 6.2% and 13.4% in the least and most disadvantaged quintiles respectively. Over the last two decades, there have been substantial increases in the prevalence of obesity, particularly the more severe levels of obesity. This study highlights high risk groups who warrant targeted weight gain prevention interventions. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  14. Endovascular closure of ascending aortic pseudoaneurysm with a type II Amplatzer vascular plug.

    PubMed

    De Boo, Diederick W; Mott, Nigel; Kavnoudias, Helen; Walton, Antony; Lyon, Stuart M

    2014-05-01

    A 71-year-old man initially presented with an asymptomatic, incidentally detected ascending aortic pseudoaneurysm 25 years following aortic root repair with mechanical aortic valve replacement. This pseudoaneurysm was previously treated with coil embolization but due to coil impaction it reopened 8 years later. Endovascular closure of the pseudoaneurysm was achieved with the off-label use of a type II Amplatzer vascular plug.

  15. Does Ramadan fasting contribute to the increase of peptic ulcer perforations?

    PubMed

    Kocakusak, A

    2017-01-01

    Medical treatment has been widely used in peptic ulcer disease, however perforation is a severe complication. The rationale of this study was to evaluate the effect of Islamic Ramadan fasting on peptic ulcer perforation. Patients (No. 2311) who were operated on due to peptic ulcer perforation in a teaching and reference Hospital of a State University from January 1979 to January 2016 were analyzed. Patients were divided into two groups. Group I (No. 1805) included patients who were operated during other periods of the years without Ramadan fasting (396 months), while Group II (No. 506) constituted of patients who were operated on during the fasting periods (36 months). There was no significant difference in the mean ages between the groups (38 vs. 42 years). The mean monthly number of surgical intervention rates was higher in Group II (14.05 vs. 4.55, p < 0.001). There was a statistically significant rise in the number of male patients during Ramadan months (p = 0.0073). While omentoplasty with upper midline laparotomy vs. other surgical methods was significantly more employed in Group II (p = 0.0024), mortality rates were similar as 2.27 and 2.56% in Group I and II, respectively (p > 0.05). We could not detect any seasonal differences, although hot summer days constituted the longest fasting durations (19 hours) in the country. This study suggested that the occurrence of peptic ulcer perforation was significantly high during Ramadan fasting months due to the long fasting periods especially with significant male predominance.

  16. Rapid increase in Japanese life expectancy after World War II.

    PubMed

    Sugiura, Yasuo; Ju, Young-Su; Yasuoka, Junko; Jimba, Masamine

    2010-02-01

    Japanese life expectancy increased by about 13.7 years during the first decade after World War II, despite the country's post-war poverty. Although it is known that medical progress explains part of this increase, roles of non-medical factors have not been systematically studied. This study hypothesizes that non-medical factors, in addition to medical factors, are associated with the rapid increase in life expectancy in Japan. We analyzed the time trends of potential explanatory factors and used regression analysis with historical data from the Ministry of Internal Affairs and Communications' Historical Statistics of Japan during the period between 1946 and 1983. Time trends analysis revealed that the rapid increase in life expectancy preceded the dramatic growth of per capita Gross Domestic Product (GDP) by 10 years. In education, the nearly universal enrollment in elementary schools and increased advancement to upper secondary schools for both sexes were associated with better health. Regarding legislation, 32 health laws were passed in the first decade after the war and these laws were associated with improved health. Using regression analysis, we found that the enrollment rate in elementary schools, the number of health laws, and expansion of community-based activity staff were significantly associated with the increased life expectancy during the first decade after World War II. To conclude, in addition to medical factors, non-medical factors applied across the country, particularly education, community-based activities and legislation were associated with the rapid increase in Japanese life expectancy after World War II.

  17. Early and mid-term outcomes of trans-sternal and video-assisted thoracoscopic surgery for thymoma.

    PubMed

    Manoly, Imthiaz; Whistance, Robert N; Sreekumar, Rahul; Khawaja, Saud; Horton, Joanne M; Khan, Ali Zamir; Casali, Gianluca; Thorpe, James A; Amer, Khalid; Woo, Edwin

    2014-06-01

    Video-assisted thoracoscopic surgery (VATS) for thymoma has uncertain safety and effectiveness in comparison with trans-sternal resection. This feasibility study compared short- and mid-term outcomes for patients undergoing these two procedures, highlights weaknesses in current research and makes recommendations for long-term technological evaluations in this field. Consecutive thymoma cases between 2004 and 2010 were identified. Patients were divided into two groups according to surgical approach (Group I trans-sternal; Group II VATS) and comparisons were made between groups. The primary outcome was overall survival. Secondary outcomes included operative morbidity and mortality, hospital stay, recurrence rate and disease-free survival. Thirty-nine patients were included (Group I: n = 22 vs Group II: n = 17). There were no differences between groups at baseline for all measured covariates. No deaths occurred within 30 days of surgery. More patients in Group I developed complications (Group I: n = 10 vs Group II: n = 3; P = 0.093), while hospital stay was shorter in Group II (Group I: 6.4 ± 4.6 days vs Group II: 4.4 ± 1.8 days; P = 0.030). Five-year overall survival (Group I: 93.8 ± 6.1% vs Group II: 83.3 ± 11.2%; P = 0.425), 5-year disease-free survival (Group I: 71.0 ± 15.3% vs Group II: 83.3 ± 11.2%; P = 0.827) and recurrence rates at final follow-up (Group I: n = 2 vs Group II: n = 1; P = 0.363) were similar between the groups. VATS thymectomy for thymoma is feasible, safe and has comparable mid-term oncological outcomes to trans-sternal thymectomy. Future research is required to evaluate long-term oncological outcomes of VATS thymectomy for thymoma in national registries and randomized, controlled trials. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  18. Effect of Cu(II) coordination compounds on the activity of antioxidant enzymes catalase and superoxide dismutase in patients with colorectal cancer.

    PubMed

    Kubiak, Katarzyna; Malinowska, Katarzyna; Langer, Ewa; Dziki, Łukasz; Dziki, Adam; Majsterek, Ireneusz

    2011-03-01

    Colorectal cancer (CRC) is a serious medical and economical problem of our times. It is the most common gastrointestinal cancer in the world. In Poland, the treatment and detection of CRC are poorly developed and the pathogenesis is still unclear. One hypothesis suggests a role of reactive oxygen species (ROS) in the pathogenesis of CRC. Experimental studies in recent years confirm the participation of ROS in the initiation and promotion of CRC. The aim of the study was to examine the effect of the following coordination compounds coordination compounds: dinitrate (V) tetra(3,4,5-trimethyl-N1-pyrazole-κN2) copper(II), dichloro di(3,4,5-trimethyl-N1-pyrazole-κN2) copper(II), dinitrate (V) di(1,4,5-trimethyl-N1-pyrazole-κN2) copper(II), dichloro di(1,3,4,5-tetramethyl-N1-pyrazole-κN2) copper(II) on the activity of antioxidant enzymes superoxide dismutase (SOD, ZnCu-SOD) and catalase (CAT) in a group of patients with colorectal cancer (CRC) and in the control group consisting of patients with minor gastrointestinal complaints. The study was conducted in 20 patients diagnosed with colorectal cancer at the age of 66.5±10.2 years (10 men and 10 women) versus the control group of 20 people (10 men and 10 women) aged 57.89±17.10 years without cancer lesions in the biological material - hemolysate prepared in a proportion of 1ml of water per 1 ml of blood. CAT activity was measured by the Beers method (1952), while SOD activity was measured by the Misra and Fridovich method (1972). We found that patients with CRC showed a statistically significant decrease of SOD and CAT activity (CAT - 12,75±1.97 U/g Hb, SOD - 1111.52±155.52 U/g Hb) in comparison with the control group (CAT - 19.65±2,17 U/g Hb, SOD - 2046.26±507.22 U/g Hb). Simultaneously, we observed that the investigated coordination compounds of Cu(II) significantly increased the antioxidant activity of CAT and SOD in patients with CRC (mean: CAT 25.23±4.86 U/g Hb, SOD - 3075.96±940.20 U/g Hb). Patients with colorectal cancer are characterized by reduced activity of antioxidant enzymes catalase and superoxide dismutase which suggests impaired antioxidant barrier. Therefore, coordination compounds of Cu (II), which enhance the activity of CAT and SOD, may prove useful in the prevention and treatment of colorectal cancer.

  19. [Assisted hatching following embryo implantation failure].

    PubMed

    Carballo Mondragón, Esperanza; Durán Monterrosas, Leonor; Campos Cañas, Jorge A; González de Jesús, Patricia; Kably Ambe, Alberto

    2012-08-01

    Assisted hatching in reproduction techniques has improved the successful implantation rates in certain groups of patients with poor prognosis. This study focuses on its effect in groups of patients with previous implantation failure and according to age groups. Compare the pregnancy rates of patients who turned to this technique following an implantation failure using in vitro fertilization with those of patients who did not use assisted hatching before another attempt of in vitro fertilization and according to specific age groups. Cases of patients using assisted hatching in our Center between January 2008 and December 2009 were studied. The results were compared in terms of age in three groups: group I, >35 years; group II, 35-39 years, and group III, > 40 years. Patients in group II had better pregnancy rate (30%) than those in groups I and III (16.98 and 20.83%, respectively). When comparing the results of the group of patients using assisted hatching with those of the group that did not, the first reported a 20% pregnancy rate versus no pregnancy in the other group.

  20. Cirrhosis mortality among former American prisoners of war of World War II and the Korean conflict: results of a 50-year follow-up.

    PubMed

    Page, W F; Miller, R N

    2000-10-01

    In our earlier, 30-year follow-up of American prisoners of war (POWs) of World War II and the Korean conflict, we found evidence of increased cirrhosis mortality. Using federal records, we have now extended our follow-up to 50 years (42 years for Korean conflict veterans) and have used proportional hazards analysis to compare the mortality experience of POWs with that of controls. Compared with their controls, World War II POWs had a 32% higher risk of cirrhosis mortality (statistically significant), and mortality risk was higher in the first 30 years of follow-up and also among those aged 51 years and older. Korean POWs had roughly the same risk of cirrhosis mortality as their controls. Neither self-reported data on alcohol consumption nor supplemental morbidity data satisfactorily explained the differences in risk between POWs and controls, although there was evidence that POWs tended to have higher rates of hepatitis, helminthiasis, and nutritional deprivation.

  1. Economics of immunization information systems in the United States: assessing costs and efficiency.

    PubMed

    Bartlett, Diana L; Molinari, Noelle-Angelique M; Ortega-Sanchez, Ismael R; Urquhart, Gary A

    2006-08-22

    One of the United States' national health objectives for 2010 is that 95% of children aged <6 years participate in fully operational population-based immunization information systems (IIS). Despite important progress, child participation in most IIS has increased slowly, in part due to limited economic knowledge about IIS operations. Should IIS need further improvement, characterizing costs and identifying factors that affect IIS efficiency become crucial. Data were collected from a national sampling frame of the 56 states/cities that received federal immunization grants under U.S. Public Health Service Act 317b and completed the federal 1999 Immunization Registry Annual Report. The sampling frame was stratified by IIS functional status, children's enrollment in the IIS, and whether the IIS had been developed as an independent system or was integrated into a larger system. These sites self-reported IIS developmental and operational program costs for calendar years 1998-2002 using a standardized data collection tool and underwent on-site interviews to verify reported data with information from the state/city financial management system and other financial records. A parametric cost-per-patient-record (CPR) model was estimated. The model assessed the impact of labor and non-labor resources used in development and operations tasks, as well as the impact of information technology, local providers' participation and compliance with federal IIS performance standards (e.g., ensuring the confidentiality and security of information, ensure timely vaccination data at the time of patient encounter, and produce official immunization records). Given the number of records minimizing CPR, the additional amount of resources needed to meet national health goals for the year 2010 was also calculated. Estimated CPR was as high as $10.30 and as low as $0.09 in operating IIS. About 20% of IIS had between 2.9 to 3.2 million records and showed CPR estimates of $0.09. Overall, CPR was highly sensitive to local providers' participation. To achieve the 2010 goals, additional aggregated costs were estimated to be $75.6 million nationwide. Efficiently increasing the number of records in IIS would require additional resources and careful consideration of various strategies to minimize CPR, such as boosting providers' participation.

  2. The effect of scoliosis surgery on pulmonary function in spinal muscular atrophy type II patients.

    PubMed

    Chou, Shih-Hsiang; Lin, Gau-Tyan; Shen, Po-Chih; Lue, Yi-Jing; Lu, Cheng-Chang; Tien, Yin-Chun; Lu, Yen-Mou

    2017-06-01

    Various results of the previous literature related to surgical effect on pulmonary function of spinal muscular atrophy (SMA) patients might be due to different SMA type, different fusion level and technique. The aim of this study was to determine the value of scoliosis surgery for SMA type II patients with regard to pulmonary function, under the same fusion level, fusion technique and average long-term follow-up. Ten SMA II patients who underwent spinal correction procedures from 1993 to 2010 were identified. Data on clinical features and pulmonary function, including forced vital capacity (FVC) and forced expiratory volume in 1st second (FEV 1 ), were collected. The data on pulmonary function were divided into preoperative, postoperative short-term (0-5 years), mid-term (5-10 years), and long-term (>10 years). Statistical comparisons were made using the Wilcoxon test for pulmonary function and body weight analysis. Questions were answered by parents on how surgery influenced the frequency of respiratory infection and the ability to sit at school. The average length of postoperative pulmonary function follow-up was 12.3 years (range 4.9-15.9 years). There was no significant difference in FVC or FEV 1 between preoperative and each postoperative period. However, a significant decline from mid-term to long-term was observed (p = 0.028). Body weight increased significantly in all postoperative periods and was moderately correlated to pulmonary function (r = 0.526 for FVC). The answers to the questionnaire revealed that 80% of the patients had obvious improvement in the frequency of respiratory infection and 100% were tolerable sitting at school. Surgical correction for scoliosis in SMA II patients results in pulmonary function being maintained during long-term follow-up. In addition, the advantages of surgery also include body weight gain, better sitting tolerance, and reduced frequency of respiratory infection.

  3. Changes in fish diversity and community structure in the central and southern Yellow Sea from 2003 to 2015

    NASA Astrophysics Data System (ADS)

    Chen, Yunlong; Shan, Xiujuan; Jin, Xianshi; Johannessen, Arne; Yang, Tao; Dai, Fangqun

    2017-07-01

    The central and southern Yellow Sea is an important overwintering ground for many fish species in the Bohai Sea and Yellow Sea. For better understanding the status of the fish community after years of heavy exploitation, variations in fish community structure and diversity were analyzed using data from bottom trawls during 2003-2015. Five fish assemblage indices all showed fluctuations without clear trends from 2003 to 2015, yet there were strong positive and significant correlations (P < 0.05) among them. The top-five dominant species accounted for a high weight percentage (49.7%-82.1%) in the annual fish catch. Multivariate analysis showed that two year groups could be pooled for the fish community: Group I consisted of the years 2006, 2007, 2008 and 2015, while Group II consisted of the years 2003, 2004, 2005, 2009, 2010 and 2014; the groups aggregated with 63.71% similarity, indicating a high level of similarity among all years. The multivariate dispersion values were 1.455 and 0.818 for Groups I and II, respectively, indicating greater variances in fish assemblage structure in Group I than that in Group II. Similarity of percentage analysis demonstrated that the average similarities for Group I and Group II were 71.58% and 67.51%, respectively. Size-spectra analysis revealed no consistent trend in the intercept and slope (P > 0.05); there were also no significant differences between the slope of the size-spectra and fishing effort. The catch per unit effort and mean individual weight analyses of the whole fish assemblage both showed a significantly decreasing trend over time. Overall, the results showed that the fish community structure in the central and southern Yellow Sea was relatively stable from 2003 to 2015 and the study could be used as a reference for supporting ecosystem-based fishery management.

  4. 40 CFR 86.410-90 - Emission standards for 1990 and later model year motorcycles.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... petroleum gas-fueled motorcycles): (i) Hydrocarbons. 5.0 grams per vehicle kilometer. (ii) Carbon monoxide. 12 grams per vehicle kilometer. (2) Exhaust emissions from 1990 and later model year methanol-fueled motorcycles shall not exceed: (i) Total hydrocarbon equivalent. 5.0 grams per vehicle kilometer. (ii) Carbon...

  5. 40 CFR 86.410-90 - Emission standards for 1990 and later model year motorcycles.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... petroleum gas-fueled motorcycles): (i) Hydrocarbons. 5.0 grams per vehicle kilometer. (ii) Carbon monoxide. 12 grams per vehicle kilometer. (2) Exhaust emissions from 1990 and later model year methanol-fueled motorcycles shall not exceed: (i) Total hydrocarbon equivalent. 5.0 grams per vehicle kilometer. (ii) Carbon...

  6. 40 CFR 86.410-90 - Emission standards for 1990 and later model year motorcycles.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... petroleum gas-fueled motorcycles): (i) Hydrocarbons. 5.0 grams per vehicle kilometer. (ii) Carbon monoxide. 12 grams per vehicle kilometer. (2) Exhaust emissions from 1990 and later model year methanol-fueled motorcycles shall not exceed: (i) Total hydrocarbon equivalent. 5.0 grams per vehicle kilometer. (ii) Carbon...

  7. 40 CFR 86.410-90 - Emission standards for 1990 and later model year motorcycles.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... petroleum gas-fueled motorcycles): (i) Hydrocarbons. 5.0 grams per vehicle kilometer. (ii) Carbon monoxide. 12 grams per vehicle kilometer. (2) Exhaust emissions from 1990 and later model year methanol-fueled motorcycles shall not exceed: (i) Total hydrocarbon equivalent. 5.0 grams per vehicle kilometer. (ii) Carbon...

  8. 40 CFR 86.410-90 - Emission standards for 1990 and later model year motorcycles.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... petroleum gas-fueled motorcycles): (i) Hydrocarbons. 5.0 grams per vehicle kilometer. (ii) Carbon monoxide. 12 grams per vehicle kilometer. (2) Exhaust emissions from 1990 and later model year methanol-fueled motorcycles shall not exceed: (i) Total hydrocarbon equivalent. 5.0 grams per vehicle kilometer. (ii) Carbon...

  9. Building Trades II.

    ERIC Educational Resources Information Center

    Hamlin, Larry

    This packet contains a curriculum guide, a set of lesson plans, a student manual, and a competency test packet for the Building Trades II course, the second year of a 2-year, 2-unit (350 hour) preemployment program for students in grades 11-12. This technical course is designed to develop the basic skills associated with builders. An additional…

  10. Fortpflanzung und Sexualität von Cereus pedunculatus und Actinia equina (Anthozoa, Actiniaria)

    NASA Astrophysics Data System (ADS)

    Schäfer, W.

    1981-12-01

    Sexuality and reproductive behaviour of Cereus pedunculatus (Pennant) and several forms (subspecies) of Actinia equina (L.) from populations collected along the French Atlantic Sea coast and in different habitats along the European Mediterranean coast were studied. At the stage of 96 septae C. pedunculatus and A. e. atlantica II exhibited mature oocytes which developed parthenogenetically into larvae. The latter appeared simultaneously in the gastrocoele. Adolescent A. e. atlantica II developed very few mature oocytes and larvae. Following a sterile period, oocytes and young individuals of different age groups were present almost throughout the whole year in adult anemones. A. e. mediterranea I was dioecious and oviparous in any habitat observed. Samples of the larviparous A. e. mediterranea II (collected near Banyuls, France) exhibited male gonads exclusively and contained larvae. Spontaneous longitudinal fission was occasionally observed in adult A. e. mediterranea I and adolescent A. e. atlantica II.

  11. Thermoradiation therapy in combined modality treatment for locally advanced laryngeal and hypopharyngeal cancer

    NASA Astrophysics Data System (ADS)

    Choynzonov, E. L.; Startseva, Zh. A.; Gribova, O. V.; Mukhamedov, M. R.; Spivakova, I. O.

    2017-09-01

    The article presents the results of combined modality treatment for stage III-IV (T3N0-2M0) laryngeal and hypopharyngeal cancers. All patients (55) were divided into 2 groups. Group I patients (n = 25) received pre-operative thermoradiation therapy and Group II patients (n = 30) received pre-operative radiation therapy alone. The follow-up period was 6-24 months. In Group I patients, partial tumor regression was achieved in 21 (84%) patients and stable disease was observed in 4 (16%) patients. In group II patients, partial tumor regression and stable disease were diagnosed in 18 (60%) and 12 (49%) patients, respectively. Local and regional recurrences occurred in 1 patient (4%) of Group I within the first year of follow-up and in 11 patients of Group II (7 within the first year and 4 within two years of follow-up). The 2-year overall survival rate was 100% in Group I patients and 76.7% ± 10.1% in Group II patients. Disease-free survival rates were 96.6 ± 3.5% and 63.3 ± 13.9%, respectively.

  12. Gender Differences in the Association Between Morbidity and Mortality Among Middle-Aged Men and Women

    PubMed Central

    Guéguen, Alice; Ferrie, Jane; Shipley, Martin; Martikainen, Pekka; Bonenfant, Sébastien; Goldberg, Marcel; Marmot, Michael

    2008-01-01

    Objectives. We examined gender differences in mortality, morbidity, and the association between the 2. Methods. We used health data from 2 studies of middle-aged men and women: the British Whitehall II cohort of employees from 20 civil service departments in London and the 1989 French GAZEL (this acronym refers to the French gas and electric companies) of employees of France's national gas and electricity company. Participants were aged 35 to 55 years when assessed for morbidity and followed up for mortality over 17 years. Results. Male mortality was higher than female mortality in Whitehall II (hazard ratio [HR] = 1.56; 95% confidence interval [CI] = 1.28, 1.91) and the GAZEL cohort (HR = 1.99; CI = 1.66, 2.40). Female excess morbidity was observed for some measures in the Whitehall II data and for 1 measure in the GAZEL data. Only self-reported sickness absence in the Whitehall II data was more strongly associated with mortality among men (P = .01). Conclusions. Mortality was lower among women than among men, but morbidity was not consistently higher. The lack of gender differences in the association between morbidity and mortality suggests that this is not a likely explanation for the gender paradox, which refers to higher morbidity but lower mortality among women than among men. PMID:18235071

  13. Measuring adjustment in Japanese juvenile delinquents with learning disabilities using Japanese version of Kaufman Assessment Battery for Children II.

    PubMed

    Kumagami, Takashi; Kumagai, Keiko

    2014-10-01

    The aim of this study was to create a profile of the cognitive and academic abilities of juvenile delinquents (JD) in Japan using the newly validated Japanese version of the Kaufman Assessment Battery for Children, Second Edition (KABC-II-J). We administered the KABC-II-J to 22 JD (Mage  = 15.9 years, standard deviation [SD] = 1.4), 28 typically developing high school students (Mage  = 16.0 years, SD = 0.08), and (as controls) 12 special education students (Mage  = 16.9, SD = 0.83) with mild intellectual disabilities. We observed significant differences between JD and typically developing students on learning index of the Mental Process Index, and the vocabulary, reading, writing, and mathematics indices on the Achievement Index. JD had lower scores than did typically developing high school students. Fourteen JD had a 1 SD discrepancy (43%) in scores on these indices. These cases were suspected of having learning disabilities. The KABC-II-J is a suitable means of assessing academic and cognitive problems in JD; professionals working in the field of juvenile delinquency should recognize that offenders might have severe academic delays and learning disabilities. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  14. HPV test by Hybrid Capture II for the diagnosis of HR-HPV persistent infection.

    PubMed

    Serour, Y; Bendahmane, M; Abbou Baker, F; Medles, M; Moueddene, B; Kraiba, R

    2017-11-01

    Persistent high-risk HPV (HR-HPV) infection is associated with a greater risk of cervical cancer. Statistical data on the prevalence of HR-HPV infections in the Algerian population is lacking. We conducted a prospective study of 300 women aged between 25 and 50 years, screened for cervical cancer from 2012 to 2015 in Sidi Bel Abbès, a western region of Algeria. We aimed to assess the reliability of the repeated use of the HC II test (three longitudinal HPV tests 9 months apart from each other) in diagnosing the persistence of HR-HPV infection. The prevalence of HR-HPV infection was 7.33% and infected women were aged 37.9±3years. For 90.9% of HR-HPV-positive patients, the infection persisted for a mean of 18.5months [95% CI: 16.9-22.1months]. Among these patients, 55.55% developed CIN1 and 11.11% developed CIN2. The sensitivity of the HC II test was 81.74% [95% CI: 71.3-89.6] and its positive predictive value associated with abnormal cervical biopsy was 27.49% [95% CI: 16.0-33.33]. Repeating the HC II test is a good predictor for identifying women at high risk of cervical cancer. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  15. Biological Systems of Vitamin K: A Plasma Nutriproteomics Study of Subclinical Vitamin K Deficiency in 500 Nepalese Children.

    PubMed

    Lee, Sun Eun; Schulze, Kerry J; Cole, Robert N; Wu, Lee S F; Yager, James D; Groopman, John; Christian, Parul; West, Keith P

    2016-04-01

    Vitamin K (VK) is a fat-soluble vitamin whose deficiency disrupts coagulation and may disturb bone and cardiovascular health. However, the scale and systems affected by VK deficiency in pediatric populations remains unclear. We conducted a study of the plasma proteome of 500 Nepalese children 6-8 years of age (male/female ratio = 0.99) to identify proteins associated with VK status. We measured the concentrations of plasma lipids and protein induced by VK absence-II (PIVKA-II) and correlated relative abundance of proteins quantified by mass spectrometry with PIVKA-II. VK deficiency (PIVKA-II>2 μg/L) was associated with a higher abundance of low-density lipoproteins, total cholesterol, and triglyceride concentrations (p<0.01). Among 978 proteins observed in >10% of the children, five proteins were associated with PIVKA-II and seven proteins were differentially abundant between VK deficient versus sufficient children, including coagulation factor-II, hemoglobin, and vascular endothelial cadherin, passing a false discovery rate (FDR) threshold of 10% (q<0.10). Among 27 proteins associated with PIVKA-II or VK deficiency at a less stringent FDR (q<0.20), a network comprised of hemoglobin subunits and erythrocyte anti-oxidative enzymes were highly and positively correlated each other (all r>0.7). Untargeted proteomics offers a novel systems approach to elucidating biological processes of coagulation, vascularization, and erythrocyte oxidative stress related to VK status. The results may help elucidate subclinical metabolic disturbances related to VK deficiency in populations.

  16. Thirty-two-year follow-up study of Herbst therapy: a biometric dental cast analysis.

    PubMed

    Pancherz, Hans; Bjerklin, Krister; Lindskog-Stokland, Birgitta; Hansen, Ken

    2014-01-01

    The aim of this study was to analyze the very long-term effects of Herbst treatment on tooth position and occlusion. Fourteen patients from a sample of 22 with Class II Division 1 malocclusions consecutively treated with the banded Herbst appliance were reexamined 32 years after therapy. Dental casts were analyzed from before (T1) and after (T2) treatment, and at 6 years (T3) and 32 years (T4) after treatment. Minor changes in maxillary and mandibular dental arch perimeters and arch widths were seen during treatment (T1-T2) and posttreatment (T2-T4). Mandibular incisor irregularity remained, on average, unchanged from T1 to T2 but increased continuously during the 32-year follow-up period (T2-T4). Class II molar and canine relationships were normalized in most patients from T1 to T2. During the early posttreatment period (T2-T3), there was a minor relapse; during the late posttreatment period (T3-T4), molar and canine relationships remained, on average, unchanged. Overjet and overbite were reduced to normal values in all subjects during treatment (T1-T2). After treatment (T2-T4), overjet remained, on average, unchanged, but overbite increased insignificantly. Thirty-two years after Herbst therapy, overall, acceptable long-term results were seen. Stability was found in 64% of the patients for sagittal molar relationships, in 14% for sagittal canine relationships, in 86% for overjet, and in 86% for overbite. A Class II relapse seemed to be caused by an unstable interdigitation of the occluding teeth, a persisting oral habit, or an insufficient retention regimen after treatment. Most posttreatment changes occurred during the first 6 years after treatment. After the age of 20 years, only minor changes were noted. Long-term posttreatment changes in maxillary and mandibular dental arch perimeters and widths as well as in mandibular incisor irregularity seemed to be independent of treatment and a result of physiologic dentoskeletal changes throughout adulthood. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  17. Recent Advances in Understanding of Kinetic Interplay Between Phase II Metabolism and Efflux Transport.

    PubMed

    Wang, Shuai; Xing, Huijie; Zhao, Mengjing; Lu, Danyi; Li, Zhijie; Dong, Dong; Wu, Baojian

    2016-01-01

    Mechanistic understanding of the metabolism-transport interplay assumes great importance in pharmaceutical fields because the knowledge can help to interpret drug/xenobiotic metabolism and disposition studies as well as the drug-drug interactions in vivo. About 10 years ago, it started to recognize that cellular phase II metabolism is strongly influenced by the excretion (efflux transport) of generated metabolites, a kinetic phenomenon termed "phase II metabolism-transport interplay". This interplay is believed to have significant effects on the pharmacokinetics (bioavailability) of drugs/chemicals undergoing phase II metabolism. In this article, we review the studies investigating the phase II metabolism-transport interplay using cell models, perfused rat intestine, and intact rats. The potential confounding factors in exploring such interplay is also summarized. Moreover, the mechanism underlying the phase II metabolism-transport interplay is discussed. Various studies with engineered cells and rodents have demonstrated that there is an interaction (interplay) between phase II enzymes and efflux transporters. This type of interplay mainly refers to the dependence of phase II (conjugative) metabolism on the activities of efflux transporters. In general, inhibiting efflux transporters or decreasing their expression causes the reductions in metabolite excretion, apparent excretion clearance (CLapp) and total metabolism (fmet), as well as an increase in the intracellular level of metabolite (Ci). The deconjugation mediated by hydrolase (acting as a "bridge") is essential for the interplay to play out based on pharmacokinetic modeling/simulations, cell and animal studies. The hydrolases bridge the two processes (i.e., metabolite formation and excretion) and enable the interplay thereof (a bridging effect). Without the bridge, metabolite formation is independent on its downstream process excretion, thus impact of metabolite excretion on its formation is impossible. Deconjugation (mediated by hydrolases) plays an essential role in the conjugation-transport interplay. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  18. Indiana Studies: Hoosier History, Government, and People. Unit V: Depression, Response, and Growth.

    ERIC Educational Resources Information Center

    Barger, Harry D.; And Others

    Unit 5 in this six-unit series on Indiana history designed to be taught in Indiana secondary schools covers the depression years, World War II, and the postwar era. The dramatic changes that took place in Indiana during the depression years are highlighted in chapter 1. The manner in which the state's governor tried to alleviate the effects of the…

  19. The Golden Years; A Study of Income and Expenditure Growth and Distribution of 48 Private Four-Year Liberal Arts Colleges, 1960-1968.

    ERIC Educational Resources Information Center

    Jenny, Hans H.; Wynn, G. Richard

    This report provides a historical overview of income and expenditure growth for 48 private liberal arts colleges between 1960 and 1968. It describes cross-sectionally the income and expenditure structures as they evolved over time, and suggests some of the competitive changes that have taken place within the major findings. Chapter II describes…

  20. Evaluation of Walkers for Elderly People

    DTIC Science & Technology

    2001-10-25

    speed, acceleration, electromyogram I. INTRODUCTION Walking is a basic everyday activity. In an aging society, elderly people need to walk to promote...their health and independence. By retaining ambulatory independence, elderly people increase their quality of life and reduce the costs of both...II. METHODOLOGY Six elderly people aged between 70 and 91 years (average 82±7.9 years) participated in the study. Before the experiment, written

  1. Changes in Mobility of Children with Cerebral Palsy over Time and across Environmental Settings

    ERIC Educational Resources Information Center

    Tieman, Beth L.; Palisano, Robert J.; Gracely, Edward J.; Rosenbaum, Peter L.; Chiarello, Lisa A.; O'Neil, Margaret E.

    2004-01-01

    This study examined changes in mobility methods of children with cerebral palsy (CP) over time and across environmental settings. Sixty-two children with CP, ages 6-14 years and classified as levels II-IV on the Gross Motor Function Classification System, were randomly selected from a larger data base and followed for three to four years. On each…

  2. Content Analysis of the Professional Journal of the College of Speech Therapists II: Coming of Age and Growing Maturity, 1946-65

    ERIC Educational Resources Information Center

    Stansfield, Jois; Armstrong, Linda

    2016-01-01

    Background: Following a content analysis of the first 10 years of the UK professional journal "Speech," this study was conducted to survey the published work of the speech (and language) therapy profession in the 20 years following the unification of two separate professional bodies into the College of Speech Therapists. Aim: To…

  3. Treatment effects of skeletally anchored Forsus FRD EZ and Herbst appliances: A retrospective clinical study.

    PubMed

    Celikoglu, Mevlut; Buyuk, Suleyman Kutalmis; Ekizer, Abdullah; Unal, Tuba

    2016-03-01

    To evaluate the skeletal, dentoalveolar, and soft tissue effects of the Forsus FRD appliance with miniplate anchorage inserted in the mandibular symphyses and to compare the findings with a well-matched control group treated with a Herbst appliance for the correction of a skeletal Class II malocclusion due to mandibular retrusion. The sample consisted of 32 Class II subjects divided into two groups. Group I consisted of 16 patients (10 females and 6 males; mean age, 13.20 ± 1.33 years) treated using the Forsus FRD EZ appliance with miniplate anchorage inserted in the mandibular symphyses. Group II consisted of 16 patients (9 females and 7 males; mean age, 13.56 ± 1.27 years) treated using the Herbst appliance. Seventeen linear and 10 angular measurements were performed to evaluate and compare the skeletal, dentoalveolar, and soft tissue effects of the appliances using paired and Student's t-tests. Both appliances were effective in correcting skeletal class II malocclusion and showed similar skeletal and soft tissue changes. The maxillary incisor was statistically significantly more retruded in the skeletally anchored Forsus FRD group (P < .01). The mandibular incisor was retruded in the skeletally anchored Forsus FRD group (-4.09° ± 5.12°), while it was protruded in the Herbst group (7.50° ± 3.98°) (P < .001). Although both appliances were successful in correcting the skeletal Class II malocclusion, the skeletally anchored Forsus FRD EZ appliance did so without protruding the mandibular incisors.

  4. Evaluation of rotigotine transdermal patch for the treatment of depressive symptoms in patients with Parkinson's disease.

    PubMed

    Chung, Sun Ju; Asgharnejad, Mahnaz; Bauer, Lars; Ramirez, Francisco; Jeon, Beomseok

    2016-08-01

    To evaluate the dopamine receptor agonist, rotigotine, for improving depressive symptoms in patients with Parkinson's disease (PD). Patients were randomized 1:1 to rotigotine or placebo, titrated for ≤7 weeks, and maintained at optimal/maximum dose for 8-weeks. Primary efficacy variable: 17- item Hamilton Depression Rating Scale (HAM-D 17) total score change from baseline to end-of-maintenance. Secondary variables: changes in Beck Depression Inventory-II, Unified Parkinson's Disease Rating Scale (UPDRS) II (activities of daily living [ADL]) and III (motor) subscores, UPDRS II+III total, patient-rated Apathy Scale (AS), and Snaith-Hamilton Pleasure Scale. Of 380 patients randomized, 149/184 (81.0%) rotigotine-treated and 164/196 (83.7%) placebo-treated patients completed the study. mean (±SD) age 65.2 (±8.5) years; time since PD-diagnosis 2.74 (±3.08) years; 42.6% male. The treatment difference (LS mean [95% CI]) in change from baseline HAM-D 17 was -1.12 (-2.56, 0.33; p = 0.1286). UPDRS II, III, II+III and AS scores improved numerically with rotigotine versus placebo. Common adverse events with higher incidence with rotigotine: nausea, application/instillation site reactions, vomiting, and pruritus. Forty-one (10.8%) patients discontinued owing to adverse events (25 rotigotine/16 placebo). No statistically significant improvement in depressive symptoms were observed with rotigotine versus placebo. ADL, motor function, and patient-rated apathy improved numerically. ClinicalTrials.gov: NCT01523301.

  5. The Certification Program, Training, and Competencies--An Examination of the Air Force Contracting Work Force’s Response to the Sufficiency of Professional Training

    DTIC Science & Technology

    1994-09-01

    Training Education I 1 year Contracting Fundamentals De-rce or Contract Pricing 24 hours of business II 2 years Government Contract Law Same as Level I...Contract Pricing I CON 201 Government Contract Law Il CON 221 Intermediate Contract Administration II CON 222 Operational Level Contract II Administration...4-13 Table 4-13. Top Five Courses Perceived as Most AdL.4uate Ranking* I Certification Training Course Title 1 Government Contract Law 2 MDAC - Basic

  6. Adjuvant Chemotherapy for Stage II Right- and Left-Sided Colon Cancer: Analysis of SEER-Medicare Data

    PubMed Central

    Weiss, Jennifer M.; Schumacher, Jessica; Allen, Glenn O.; Neuman, Heather; Lange, Erin O’Connor; LoConte, Noelle K.; Greenberg, Caprice C.; Smith, Maureen A.

    2014-01-01

    Purpose Survival benefit from adjuvant chemotherapy is established for stage III colon cancer; however, uncertainty exists for stage II patients. Tumor heterogeneity, specifically microsatellite instability (MSI) which is more common in right-sided cancers, may be the reason for this observation. We examined the relationship between adjuvant chemotherapy and overall 5-year mortality for stage II colon cancer by location (right- versus left-side) as a surrogate for MSI. Methods Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, we identified Medicare beneficiaries from 1992 to 2005 with AJCC stage II (n=23,578) and III (n=17,148) primary adenocarcinoma of the colon who underwent surgery for curative intent. Overall 5-year mortality was examined with Kaplan-Meier survival analysis and Cox proportional hazards regression with propensity score weighting. Results Eighteen percent (n=2,941) of stage II patients with right-sided cancer and 22% (n=1,693) with left-sided cancer received adjuvant chemotherapy. After adjustment, overall 5-year survival benefit from chemotherapy was observed only for stage III patients (right-sided: HR 0.64; 95% CI, 0.59–0.68, p<0.001 and left-sided: HR 0.61; 95% CI, 0.56–0.68, p<0.001). No survival benefit was observed for stage II patients with either right-sided (HR 0.97; 95% CI, 0.87–1.09, p=0.64) or left-sided cancer (HR 0.97; 95% CI, 0.84–1.12, p=0.68). Conclusions Among Medicare patients with stage II colon cancer, a substantial number receive adjuvant chemotherapy. Adjuvant chemotherapy did not improve overall 5-year survival for either right- or left-sided colon cancers. Our results reinforce existing guidelines and should be considered in treatment algorithms for older adults with stage II colon cancer. PMID:24643898

  7. Stability of interceptive/corrective orthodontic treatment for tooth ankylosis and Class II mandibular deficiency: A case report with 10 years follow-up.

    PubMed

    Guimarães, Carlos Henrique; Henriques, José Fernando Castanha; Janson, Guilherme; Moura, Wilana S

    2015-01-01

    The purpose of this article is to present the treatment of a 8-year-old boy with tooth ankylosis in teeth 85 and Class II division 1 malocclusion and to report a 10-year follow-up result. The patient was initially treated with a sagittal removable appliance, followed by an eruption guidance appliance and braces. The interceptive orthodontic treatment performed to recover the space lost by ankylosis of a deciduous tooth allowed a spontaneous eruption and prevented progression of the problem. The use of an eruption-guidance appliance corrected the dentoskeletal Class II, thus improving the patient's appearance. Besides the treatment producing a good occlusal relationship with the Class I molar, the correction of the overjet and overbite was stable over a ten-year period.

  8. A Study of Selected Developing Colleges and Universities. Case Study II: St. Mary's Junior College, Minneapolis, Minnesota.

    ERIC Educational Resources Information Center

    St. John, Edward P.

    As part of a study of selected developing colleges and universities funded in the Advanced Institutional Development Program (AIDP), this report focuses on St. Mary's Junior College (SMJC), a Roman Catholic, two-year college specializing exclusively in health, health-related and human service fields. The report considers SMJC's state of…

  9. Fluorides in groundwater and its impact on health.

    PubMed

    Shailaja, K; Johnson, Mary Esther Cynthia

    2007-04-01

    Fluoride is a naturally occurring toxic mineral present in drinking water and causes yellowing of teeth, tooth problems etc. Fluorspar, Cryolite and Fluorapatite are the naturally occurring minerals, from which fluoride finds its path to groundwater through infiltration. In the present study two groundwater samples, Station I and Station II at Hyderabad megacity, the capital of Andhra Pradesh were investigated for one year from January 2001 to December 2001. The average fluoride values were 1.37 mg/l at Station I and 0.91 mg/l at Station II. The permissible limit given by BIS (1983) 0.6-1.2 mg/l and WHO (1984) 1.5 mg/l for fluoride in drinking water. The groundwaters at Station I exceeded the limit while at Station II it was within the limits. The study indicated that fluoride content of 0.5 mg/l is sufficient to cause yellowing of teeth and dental problems.

  10. The Influence of Acculturation on Traumatic Stress Following Childbirth Among Hispanic Adolescents.

    PubMed

    Anderson, Cheryl; Strickland, Sarah

    2017-09-01

    Many studies have explored the role of acculturation on health outcomes; however, no studies to date have examined relationships between acculturation and the traumatic stress of childbirth among Hispanic adolescents. A convenience sample of 66 Hispanic adolescents 13 to 19 years of age completed the Acculturation Rating Scale for Mexican Americans-II (ARSMA-II), a demographic sheet, birth appraisal scale, and the Impact of Event Scale within 72 hours of birth. Significant associations were found between the ARSMA-II subscales and acculturation proxy variables, excluding language; however, only the Mexican Orientation Subscale and generation proxy variable influenced the birth experience. The study findings showed that Hispanic adolescents reporting a more traumatic childbirth identified closer with the Mexican culture and reported fewer family generations residing in the United States. As an overlooked area of research, our findings support the need for additional research related to the traumatic stress of birth among Hispanic adolescents. Using multiple acculturation measurements, including the ARSMA-II, with larger, more diverse samples of adolescents, equally balanced between all categories of acculturation and placement within the five-tier generation matrix, can provide some insightful information and directed health care.

  11. Role of hilar resection in the treatment of hilar cholangiocarcinoma.

    PubMed

    Otani, Kazuhiro; Chijiiwa, Kazuo; Kai, Masahiro; Ohuchida, Jiro; Nagano, Motoaki; Kondo, Kazuhiro

    2012-05-01

    The aim of this study was to clarify the role of bile duct resection without hepatectomy (hilar resection) in hilar cholangiocarcinoma. We retrospectively compared surgical results for hilar cholangiocarcinoma between 8 patients treated with hilar resection and 21 patients treated with hepatectomy. All hilar resections were performed for Bismuth type I or II tumors with T2 or less lesions, whereas hepatectomy was done for type III or IV tumors excluding one type II tumor. R0 resection was equally achieved in both groups (62.5% in hilar resection group and 76.2% in hepatectomy group, p=0.469) and overall 5-year survival rates were comparable (21.9% vs. 23.6%, p=0.874). With respect to gross tumor appearance, R0 resection was achieved in all patients with papillary tumor in both groups with the excellent 5-year survivals (100% vs. 100%). In patients with nodular and flat tumors, R0 resection was achieved less frequently in the hilar resection vs. hepatectomy group (50% vs. 77.8%) mainly due to failure to clear the proximal ductal margin, resulting in poorer 5-year survival (0% vs. 18.7%). Hilar resection may be indicated for papillary T1 or 2 tumors in Bismuth type I or II cholangiocarcinoma.

  12. 14-3-3 proteins tune non-muscle myosin II assembly.

    PubMed

    West-Foyle, Hoku; Kothari, Priyanka; Osborne, Jonathan; Robinson, Douglas N

    2018-05-04

    The 14-3-3 family comprises a group of small proteins that are essential, ubiquitous, and highly conserved across eukaryotes. Overexpression of the 14-3-3 proteins σ, ϵ, ζ, and η correlates with high metastatic potential in multiple cancer types. In Dictyostelium , 14-3-3 promotes myosin II turnover in the cell cortex and modulates cortical tension, cell shape, and cytokinesis. In light of the important roles of 14-3-3 proteins across a broad range of eukaryotic species, we sought to determine how 14-3-3 proteins interact with myosin II. Here, conducting in vitro and in vivo studies of both Dictyostelium (one 14-3-3 and one myosin II) and human proteins (seven 14-3-3s and three nonmuscle myosin IIs), we investigated the mechanism by which 14-3-3 proteins regulate myosin II assembly. Using in vitro assembly assays with purified myosin II tail fragments and 14-3-3, we demonstrate that this interaction is direct and phosphorylation-independent. All seven human 14-3-3 proteins also altered assembly of at least one paralog of myosin II. Our findings indicate a mechanism of myosin II assembly regulation that is mechanistically conserved across a billion years of evolution from amebas to humans. We predict that altered 14-3-3 expression in humans inhibits the tumor suppressor myosin II, contributing to the changes in cell mechanics observed in many metastatic cancers. © 2018 by The American Society for Biochemistry and Molecular Biology, Inc.

  13. One year follow-up of post-partum-onset depression: the role of depressive symptom severity and personality disorders.

    PubMed

    Uguz, Faruk; Akman, Cemal; Sahingoz, Mine; Kaya, Nazmiye; Kucur, Rahim

    2009-06-01

    Long-term follow-up and risk factors of persistent post-partum depression (PPD) are fairly unknown compared with its prevalence in the developing countries. In this study, we did a follow-up measure of PPD and examined the factors, which were associated with PPD 1-year post-partum. Our sample comprised of 34 women. Depressive symptoms were assessed by the Edinburgh post-natal depression scale (EPDS) 6 weeks post-partum, and women with scores >12 on this scale was categorised as depressed. Personality disorders were determined at the same occasion by means of the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II). One year post-partum EPDS was completed. The rate of PPD 1-year post-partum was 32.4%, and it was unrelated to age at assessment, primiparity, number of children, employment status, economical status and educational level. Women depressed 1-year post-partum had significantly higher basal scores of EPDS and more often also a diagnosis of any axis II disorder; and specifically dependent and obsessive-compulsive personality disorders. In our sample, the predictors of 1-year post-partum PPD were having higher basal score of EPDS and the existence of a personality disorder. This study suggests that women with PPD, scoring high in the EPDS scale 6 weeks post-partum and having a personality disorder, run a higher risk for depression at 1-year follow-up.

  14. Phase I and II feasibility study report for the 300-FF-5 operable unit

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

    NONE

    1993-12-31

    The purpose of this Phase I/II feasibility study is to assemble and screen a list of alternatives for remediation of the 300-FF-5 operable site on the Hanford Reservation. This screening is based on information gathered in the Phase I Remedial Investigation (RI) and on currently available information on remediation technologies. The alternatives remaining after screening provide a range of response actions for remediation. In addition, key data needs are identified for collection during a Phase II RI (if necessary). This Phase I/II FS represents a primary document as defined by the Tri-Party Agreement, but will be followed by a Phasemore » III FS that will further develop the alternatives and provide a detailed evaluation of them. The following remedial action objectives were identified for the 300-FF-5 operable unit: Limit current human exposure to contaminated groundwater in the unit; Limit discharge of contaminated groundwater to the Columbia River; Reduce contaminant concentrations in groundwater below acceptable levels by the year 2018.« less

  15. Programming jammed Codman Hakim programmable valves: study of an explanted valve and successful programming in a patient.

    PubMed

    Wong, Sui-To; Wen, Eleanor; Fong, Dawson

    2013-08-01

    Malfunction of a Codman Hakim programmable valve due to jamming of its programmable component may necessitate shunt revision. The authors report a method for programming jammed Codman Hakim programmable valves by using a Strata II magnet and additional neodymium magnets. The programming method was derived after studying a jammed valve in the laboratory that was explanted from an 10-year-old boy with a history of fourth ventricle ependymoma. Programming the explanted valve with a Codman programmer failed, but rotating a Strata II magnet above the valve resulted in rotation of the spiral cam in the valve. It was found that the Strata II magnet could be used to program the jammed valve by rotating the magnet 90° or multiples of 90° above the valve. The strength of the magnetic field of the Strata II magnet was able to be increased by putting neodymium magnets on it. The programming method was then successfully used in a patient with a jammed Codman Hakim programmable valve. After successful programming using this method, clinical and radiological follow-up of the patient was advised.

  16. Visual BOLD Response in Late Blind Subjects with Argus II Retinal Prosthesis

    PubMed Central

    Castaldi, E.; Cicchini, G. M.; Cinelli, L.; Rizzo, S.; Morrone, M. C.

    2016-01-01

    Retinal prosthesis technologies require that the visual system downstream of the retinal circuitry be capable of transmitting and elaborating visual signals. We studied the capability of plastic remodeling in late blind subjects implanted with the Argus II Retinal Prosthesis with psychophysics and functional MRI (fMRI). After surgery, six out of seven retinitis pigmentosa (RP) blind subjects were able to detect high-contrast stimuli using the prosthetic implant. However, direction discrimination to contrast modulated stimuli remained at chance level in all of them. No subject showed any improvement of contrast sensitivity in either eye when not using the Argus II. Before the implant, the Blood Oxygenation Level Dependent (BOLD) activity in V1 and the lateral geniculate nucleus (LGN) was very weak or absent. Surprisingly, after prolonged use of Argus II, BOLD responses to visual input were enhanced. This is, to our knowledge, the first study tracking the neural changes of visual areas in patients after retinal implant, revealing a capacity to respond to restored visual input even after years of deprivation. PMID:27780207

  17. Prediction of the 10-year probability of gastric cancer occurrence in the Japanese population: the JPHC study cohort II.

    PubMed

    Charvat, Hadrien; Sasazuki, Shizuka; Inoue, Manami; Iwasaki, Motoki; Sawada, Norie; Shimazu, Taichi; Yamaji, Taiki; Tsugane, Shoichiro

    2016-01-15

    Gastric cancer is a particularly important issue in Japan, where incidence rates are among the highest observed. In this work, we provide a risk prediction model allowing the estimation of the 10-year cumulative probability of gastric cancer occurrence. The study population consisted of 19,028 individuals from the Japanese Public Health Center cohort II who were followed-up from 1993 to 2009. A parametric survival model was used to assess the impact on the probability of gastric cancer of clinical and lifestyle-related risk factors in combination with serum anti-Helicobacter pylori antibody titres and pepsinogen I and pepsinogen II levels. Based on the resulting model, cumulative probability estimates were calculated and a simple risk scoring system was developed. A total of 412 cases of gastric cancer occurred during 270,854 person-years of follow-up. The final model included (besides the biological markers) age, gender, smoking status, family history of gastric cancer and consumption of highly salted food. The developed prediction model showed good predictive performance in terms of discrimination (optimism-corrected c-index: 0.768) and calibration (Nam and d'Agostino's χ(2) test: 14.78; p values = 0.06). Estimates of the 10-year probability of gastric cancer occurrence ranged from 0.04% (0.02, 0.1) to 14.87% (8.96, 24.14) for men and from 0.03% (0.02, 0.07) to 4.91% (2.71, 8.81) for women. In conclusion, we developed a risk prediction model for gastric cancer that combines clinical and biological markers. It might prompt individuals to modify their lifestyle habits, attend regular check-up visits or participate in screening programmes. © 2015 UICC.

  18. Relations between brain volumes, neuropsychological assessment and parental questionnaire in prematurely born children.

    PubMed

    Lind, Annika; Haataja, Leena; Rautava, Liisi; Väliaho, Anniina; Lehtonen, Liisa; Lapinleimu, Helena; Parkkola, Riitta; Korkman, Marit

    2010-05-01

    The objective of this study is to assess the relationship between brain volumes at term equivalent age and neuropsychological functions at 5 years of age in very low birth weight (VLBW) children, and to compare the results from a neuropsychological assessment and a parental questionnaire at 5 years of age. The study group included a regional cohort of 97 VLBW children and a control group of 161 children born at term. At term equivalent age, brain magnetic resonance imaging (MRI) was performed on the VLBW children, and analysed for total and regional brain volumes. At 5 years of age, a psychologist assessed the neuropsychological performance with NEPSY II, and parents completed the Five to fifteen (FTF) questionnaire on development and behaviour. The results of the control group were used to give the age-specific reference values. No significant associations were found between the brain volumes and the NEPSY II domains. As for the FTF, significant associations were found between a smaller total brain tissue volume and poorer executive functions, between a smaller cerebellar volume and both poorer executive functions and motor skills, and, surprisingly, between a larger volume of brainstem and poorer language functions. Even after adjustment for total brain tissue volume, the two associations between the cerebellar volume and the FTF domains remained borderline significant (P = 0.05). The NEPSY II domains Executive Functioning, Language and Motor Skills were significantly associated with the corresponding FTF domains. In conclusion, altered brain volumes at term equivalent age appear to affect development still at 5 years of age. The FTF seems to be a good instrument when used in combination with other neuropsychological assessment.

  19. Does war beget child aggression? Military violence, gender, age and aggressive behavior in two Palestinian samples.

    PubMed

    Qouta, Samir; Punamäki, Raija-Leena; Miller, Thomas; El-Sarraj, Eyad

    2008-01-01

    We examined, first, the relations between children's exposure to military violence and their aggressive behavior and the role of age and gender in that relation in two Palestinian samples. Second, we tested parenting practices as a moderator of the relation between exposure to military violence and aggressive behavior, and third, whether exposure to military violence of different nature (direct victimization versus witnessing) has specific associations with different forms of aggression (reactive, proactive and aggression-enjoyment). Study I was conducted in a relatively calm military-political atmosphere in Palestine-Gaza, and included 640 children, aged 6-16 years whose parents (N=622) and teachers (N=457) provided reports. Older children (> or =12 years) provided self-reports (N=211). Study II included 225 Palestinian children aged 10-14-year, who participated during a high-violence period of the Al Aqsa Intifada characterized by air raids, killing and destruction. Results showed that witnessing severe military violence was associated with children's aggressive and antisocial behavior (parent-reported) in study I, and with proactive, reactive and aggression-enjoyment (child-reported) in the study II. As hypothesized, good and supporting parenting practices could moderate the link between exposure to military violence and aggressive behavior. Aggr. Copyright 2007 Wiley-Liss, Inc.

  20. Prospective case-control study of efficacy of bilateral selective neck dissection in primary surgical treatment of supraglottic laryngeal cancers with clinically negative cervical findings (N0).

    PubMed

    Djordjevic, V; Bukurov, B; Arsovic, N; Dimitrijevic, M; Jesic, S; Nesic, V; Petrovic, Z

    2016-12-01

    To evaluate the efficacy of bilateral selective neck dissection of levels II-IV in elective and therapeutic management of the neck as a part of primary surgical treatment of patients with supraglottic laryngeal cancer and clinically negative cervical findings (N0). Institutional, observational, case-control study with historic control of patients who underwent primary supraglottic tumour surgery, and a prospective cohort of patient, who underwent, besides the operation of primary tumour, bilateral selective neck dissection (level II-IV). University, tertiary level hospital, national referral centre. The study included 193 patients with supraglottic cancer and without palpable or ultrasound positive cervical findings who were surgically treated from 1988 to 2005. Besides the operation of primary tumour, all patients in the study group underwent bilateral selective neck dissection (level II-IV). Patients in the control group (N = 51) underwent primary tumour operation only and were followed up regularly. In cases with postoperative regional recurrences, the radical neck dissection was performed. All patients with histopathological confirmation of occult metastases were administered radiotherapy treatment (60 Gy) in the postoperative period. Five-year overall survival rate. Occult cervical metastases were found in 18% of patients. They were present in level II in 77.5%, in level III in 20% of cases and in one patient in level IV (2.5%); the extracapsular spread was observed in 20% of cases. Postoperative regional metastases were found in 4.15% of cases in the study group, and in 11.8% in the control group, which proved to be significantly higher. The five-year overall survival rate showed no significant difference between the study group and the control group. The incidence of postoperative regional recurrences could be reduced by performing bilateral selective neck dissection simultaneously with primary tumour operation, but with no influence on the survival rate. © 2015 John Wiley & Sons Ltd.

  1. SOMALIA: Background Information for Operation Restore Hope. 1992-1993

    DTIC Science & Technology

    1992-12-31

    AD-A259 959H III II !!!I i I! _ _ SSi Strategic Studies Institute U.S. Army War College SEL_.Et"TE FEB 2 1993. C SSI Special Report /S 93-01850...3234 or DSN 242-3234. .. * ’! .4K! ii | SOMALIA: OPERATION RESTORE HOPE A HANDBOOK FOR STAFF OFFICERS TABLE OF CONTENTS Sections Page 1. Introduction 1 2...Britain in the early years of this century. The consolidation of Ethiopia under Emperor Menelik in the last decade of the 19th century also led to

  2. Belatacept-based immunosuppression in de novo liver transplant recipients: 1-year experience from a phase II randomized study.

    PubMed

    Klintmalm, G B; Feng, S; Lake, J R; Vargas, H E; Wekerle, T; Agnes, S; Brown, K A; Nashan, B; Rostaing, L; Meadows-Shropshire, S; Agarwal, M; Harler, M B; Garcia-Valdecasas, J-C

    2014-08-01

    This exploratory phase II study evaluated the safety and efficacy of belatacept in de novo adult liver transplant recipients. Patients were randomized (N = 260) to one of the following immunosuppressive regimens: (i) basiliximab + belatacept high dose [HD] + mycophenolate mofetil (MMF), (ii) belatacept HD + MMF, (iii) belatacept low dose [LD] + MMF, (iv) tacrolimus + MMF, or (v) tacrolimus alone. All received corticosteroids. Demographic characteristics were similar among groups. The proportion of patients who met the primary end point (composite of acute rejection, graft loss, death by month 6) was higher in the belatacept groups (42–48%) versus tacrolimus groups (15–38%), with the highest number of deaths and grafts losses in the belatacept LD group. By month 12, the proportion surviving with a functioning graft was higher with tacrolimus + MMF (93%) and lower with belatacept LD (67%) versus other groups (90%: basiliximab + belatacept HD; 83%: belatacept HD; 88%: tacrolimus). Mean calculated GFR was 15–34 mL/min higher in belatacept-treated patients at 1 year. Two cases of posttransplant lymphoproliferative disease and one case of progressive multifocal leukoencephalopathy occurred in belatacept-treated patients. Follow-up beyond month 12 revealed an increase in death and graft loss in another belatacept group (belatacept HD), after which the study was terminated.

  3. ACGME case logs: Surgery resident experience in operative trauma for two decades

    PubMed Central

    Drake, Frederick Thurston; Van Eaton, Erik G.; Huntington, Ciara R.; Jurkovich, Gregory J.; Aarabi, Shahram; Gow, Kenneth W.

    2014-01-01

    BACKGROUND Surgery resident education is based on experiential training, which is influenced by changes in clinical management strategies, technical and technologic advances, and administrative regulations. Trauma care has been exposed to each of these factors, prompting concerns about resident experience in operative trauma. The current study analyzed the reported volume of operative trauma for the last two decades; to our knowledge, this is the first evaluation of nationwide trends during such an extended time line. METHODS The Accreditation Council for Graduate Medical Education (ACGME) database of operative logs was queried from academic year (AY) 1989–1990 to 2009–2010 to identify shifts in trauma operative experience. Annual case log data for each cohort of graduating surgery residents were combined into approximately 5-year blocks, designated Period I (AY1989–1990 to AY1993–1994), Period II (AY1994–1995 to AY1998–1999), Period III (AY1999–2000 to AY2002–2003), and Period IV (AY2003–2004 to AY2009–2010). The latter two periods were delineated by the year in which duty hour restrictions were implemented. RESULTS Overall general surgery caseload increased from Period I to Period II (p < 0.001), remained stable from Period II to Period III, and decreased from Period III to Period IV (p < 0.001). However, for ACGME-designated trauma cases, there were significant declines from Period I to Period II (75.5 vs. 54.5 cases, p < 0.001) and Period II to Period III (54.5 vs. 39.3 cases, p < 0.001) but no difference between Period III and Period IV (39.3 vs. 39.4 cases). Graduating residents in Period I performed, on average, 31 intra-abdominal trauma operations, including approximately five spleen and four liver operations. Residents in Period IV performed 17 intra-abdominal trauma operations, including three spleen and approximately two liver operations. CONCLUSION Recent general surgery trainees perform fewer trauma operations than previous trainees. The majority of this decline occurred before implementation of work-hour restrictions. Although these changes reflect concurrent changes in management of trauma, surgical educators must meet the challenge of training residents in procedures less frequently performed. LEVEL OF EVIDENCE Epidemiologic study, level III; therapeutic study, level IV. PMID:23188243

  4. Biochemical criteria at 1 year are not robust indicators of response to ursodeoxycholic acid in early primary biliary cirrhosis: results from a 29-year cohort study

    PubMed Central

    Papastergiou, V; Tsochatzis, E A; Rodriquez-Peralvarez, M; Thalassinos, E; Pieri, G; Manousou, P; Germani, G; Rigamonti, C; Arvaniti, V; Karatapanis, S; Burroughs, A K

    2013-01-01

    Background In primary biliary cirrhosis (PBC), biochemical criteria at 1 year are considered surrogates of response to ursodeoxycholic acid (UDCA). However, due to the slow natural history of PBC, evaluation at 1 year may be suboptimal to assess the therapeutic response, particularly in early disease. Aim To determine whether evaluation of biochemical criteria at 1 year is a reliable surrogate of UDCA response in early PBC. Methods We analysed the prospectively collected data of 215 patients (untreated = 129; UDCA-treated = 86) with early PBC (normal baseline bilirubin/albumin) and a median follow-up of 8 years (range: 1–29.1). The 1-year attainment rates of the Barcelona, Paris-I, Paris-II and Toronto definitions, and their predictive relevance for a poor outcome (death, transplantation, complications of cirrhosis), were assessed either as a result of UDCA or no treatment. Independent associations with attaining each UDCA response definition were identified by multivariate analysis. Results Untreated patients displayed 1-year biochemical features compatible with ‘treatment response’ at rates (Barcelona: 36.4%, Paris-I: 66.7%, Toronto: 59.7%, Paris-II: 40.3%) similar to those obtained under UDCA. Depending on the definition, baseline ALP≤3xULN (OR: 4.80–35.90), AST≤2xULN (OR: 5.63–9.34) and early histological stage (OR: 3.67–3.87) were the stronger predictors for attaining the criteria. UDCA treatment was associated with attaining Barcelona (OR = 2.16) and Paris-II (OR = 2.84), but not Paris-I, and not Toronto definition when excluding late histological cases. Paris-I criteria were significantly predictive of long-term outcomes (HR = 2.83) in untreated patients. Conclusions In early PBC, biochemical criteria at 1 year reflect severity of the disease rather than the therapeutic response to UDCA. PMID:24117847

  5. Efficacy and Safety of Alirocumab Versus Ezetimibe Over 2 Years (from ODYSSEY COMBO II).

    PubMed

    El Shahawy, Mahfouz; Cannon, Christopher P; Blom, Dirk J; McKenney, James M; Cariou, Bertrand; Lecorps, Guillaume; Pordy, Robert; Chaudhari, Umesh; Colhoun, Helen M

    2017-09-15

    The proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab has been shown to substantially reduce low-density lipoprotein cholesterol (LDL-C). Demonstrating whether efficacy and safety are maintained over a long duration of exposure is vital for clinical decision-making. The COMBO II trial compared the efficacy and safety of alirocumab versus ezetimibe over 2 years. A prespecified first analysis was reported at 52 weeks. Here we report the final end-of-study data (on-treatment) and evaluate post hoc the safety profile with longer versus shorter duration of alirocumab exposure. Patients (n = 720) on maximally tolerated statin dose were treated with alirocumab (75/150 mg every 2 weeks) or ezetimibe (10 mg/day). Overall mean adherence for both treatment groups during the first and second year was >97%. At 2 years, LDL-C was reduced by 49% (alirocumab) versus 17% (ezetimibe; p <0.0001), and LDL-C <70 mg/dl was achieved by 73% of alirocumab-treated versus 40% of ezetimibe-treated patients. Overall safety was similar in both treatment groups at 2 years and during the first versus the second year. Local injection-site reactions were reported by 2.5% (alirocumab) versus 0.8% (ezetimibe) during the first year, and 0.2% versus 0.5% during the second year, indicating early occurrence during prolonged alirocumab exposure. Two consecutive calculated LDL-C values <25 mg/dl were observed in 28% of alirocumab-treated patients (vs 0.4% with ezetimibe). Persistent anti-drug antibody responses were observed in 1.3% (6 of 454) of alirocumab-treated versus 0.4% (1 of 231) of ezetimibe-treated patients. Neutralizing antibodies (that inhibit binding in vitro) were observed in 1.5% (7 of 454) of alirocumab-treated patients (0 with ezetimibe), mostly at isolated time points. Alirocumab sustained substantial LDL-C reductions and was well tolerated up to 2 years in the COMBO II trial. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  6. [Atherosclerotic renovascular hypertension: clinical findings and results of treatment over 15 years].

    PubMed

    Alfonzo, J P; Rosario, M N; Ugarte, C; Banasco, J; Fraxedas, R; Lahera, J

    2003-01-01

    The aim of this study was to present our clinical experience and results of different treatments in 83 atherosclerotic renovascular hypertensive patients treated in the last 15 years in the Instituto de nefrologia in Havana. Regardless of the type of treatment the patients were divided in two groups. Group I: 52 (62.3%) cases with standard oral hypotensive drugs alone and control of other cardiovascular risk factors (mean age 53 years old, sex m/f 50/50%, race white/no-white 75/25%, mean known hypertension follow-up 10.2 +/- 10 years, mean SBP 208 +/- 30 mmHg, mean DBP 123 +/- 17 mmHg, mean serum creatinina 1.62 mg/dl and increase peripheral plasma renin value in 61.6% of patients) and group II: 31 (37.7%) cases treated with revascularización procedures (PTA or surgery) or nephrectomy in selected patients (mean age 50 years old, sex m/f 68/32%, race white/no-white 16/84%, mean known hypertension follow-up 8.5 +/- 8.6 years, mean SBP 214 +/- 32 mmHg, mean DBP 1.31 +/- 16 mmHg, mean serum creatinina 1.85 mg/dl and increase peripheral plasma renin value 78.3% of patients). As end point for treatment results we selected: 1) hypertension cure or control, 2) evolution of the serum creatinine value and 3) kidney and patients survival. In those cases with a follow up for more than one year, in 82.9% the blood pressure was cure (21.4%) or controlled (61.4%). The proportion of failed was superior in group I (20.9%) than in group II (11.1%). All 18 cases treated by PTA with a follow up period longer than a year, blood pressure cure in 10 (55.6%), ameliorate in 5 (27.8%) and in 3 (16.6%) was unchanged (one patient lost of follow up). Nine patients were treated by surgery (3 revascularization and 6 nephrectomy), 5 (55.5%) cases cured and 4 (44.5%) ameliorate his blood pressure. Patients in group II maintain normal renal function in more cases than in group I (48.4% vs 30.8%). Both group had similar percentage of normal-normal + pathology-normal renal function (G I: 65.4% vs G II: 77.4%) p = 0.29. When chronic renal function was present at the base line study none of the revascularization procedure were superior. Patient and Kidney actuarial survivals rate do not showed superiority for any treatment procedure after 10 years of follow up. In atherosclerosis renovascular hypertension patients treated with intervention procedure had better BP control than those treated by hypotensive drugs. Not significant different between intervention procedures and drugs treatment in renal function preservation or in patient and kidney actuarial survival rate were found in these patients.

  7. One-year follow-up of the phagocytic activity of leukocytes after exposure of rats to asbestos and basalt fibers.

    PubMed Central

    Hurbánková, M

    1994-01-01

    The phagocytic activity of leukocytes in peripheral blood was investigated after 2, 24, and 48 hr; 1, 2, 4, and 8 weeks; and 6 and 12 months following intraperitoneal administration of asbestos and basalt fibers to Wistar rats. Asbestos and basalt fibers differed in their effects on the parameters studied. Both granulocyte count and phagocytic activity of leukocytes during the 1-year dynamic follow-up in both dust-exposed groups of animals changed in two phases, characterized by the initial stimulation of the acute phase I, followed by the suppression of the parameters in the chronic phase II. Exposure to asbestos and basalt fibers led, in phase II, to impairment of the phagocytic activity of granulocytes. Asbestos fibers also significantly decreased phagocytic activity of monocytes. Exposure to basalt fibers did not affect the phagocytic activity of monocytes in phase II. Results suggest that the monocytic component of leukocytes plays an important role in the development of diseases caused by exposure to fibrous dusts, but basalt fibers have lesser biological effects than asbestos fibers. PMID:7882931

  8. Genital herpes: gynaecological aspects.

    PubMed

    Money, Deborah; Steben, Marc

    2008-04-01

    The purpose of this guideline is to provide recommendations to gynaecology health care providers on optimal management of genital herpes. More effective prevention of complications and transmission of genital herpes. Medline was searched for articles published in French and English related to genital herpes and gynaecology. Additional articles were identified through the references of these articles. All study types and recommendation reports were reviewed. 1. Up to 70% of all genital HSV-2 infections are transmitted during asymptomatic shedding; therefore, the use of condoms is recommended to lessen the likelihood of disease transmission. (II-A) 2. A laboratory-based diagnosis of genital herpes is essential for its effective management. (II-A) 3. Suppressive treatment is suggested for patients who have * at least 6 recurrences per year * significant complications, but fewer than 6 recurrences per year * their quality of life significantly affected * social and sexual dysfunction * to lower the risk of transmission to a sexual partner or fetus/neonate. (II-B) 4. The use of the anti-viral valacyclovir, coupled with condoms and safer sex counselling, is recommended for individuals with proven genital herpes. (I-B) 5. Routine or targeted HSV screening is not indicated.

  9. Undergraduate student mental health at Makerere University, Uganda

    PubMed Central

    OVUGA, EMILIO; BOARDMAN, JED; WASSERMAN, DANUTA

    2006-01-01

    There is little information on the current mental health of University students in Uganda. The present study was carried out to determine the prevalence of depressed mood and suicidal ideation among students at Makerere University. Two student samples participated. Sample I comprised 253 fresh students admitted to all faculties at the University in the academic year 2000/2001, selected by a simple random sampling procedure. Sample II comprised 101 students admitted to the Faculty of Medicine during the academic year 2002/2003. The prevalence of depressed mood was measured using the 13-item Beck Depression Inventory (BDI). The prevalence of depressed mood (BDI score 10 or more) was significantly higher in sample I (16.2%) than sample II (4.0%). Sample I members were significantly more likely than those of sample II to report lifetime and past week suicide ideation. Thus, there is a high prevalence of mental health problems among the general population of new students entering Makerere University and this is significantly higher than for new students in the Faculty of Medicine. PMID:16757997

  10. Comparative study of Waste Isolation Pilot Plant (WIPP) transportation alternatives

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

    Not Available

    WIPP transportation studies in the Final Supplement Environmental Impact Statement for WIPP are the baseline for this report. In an attempt to present the most current analysis, this study incorporates the most relevant data available. The following three transportation options are evaluated for the Disposal Phase, which is assumed to be 20 years: Truck shipments, consisting of a tractor and trailer, with three TRUPACT-IIs or one RH-72B; Regular commercial train shipments consisting of up to three railcars carrying up to 18 TRUPACT-IIs or up to six RH-72Bs; Dedicated train shipments consisting of a locomotive, an idle car, railcars carrying 18more » TRUPACT-IIs or six RH-72Bs, another idle car, and a caboose or passenger car with an emergency response specialist. No other cargo is carried. This report includes: A consideration of occupational and public risks and exposures, and other environmental impacts; A consideration of emergency response capabilities; and An extimation of comparative costs.« less

  11. Vitamin K status in patients with short bowel syndrome.

    PubMed

    Krzyżanowska, Patrycja; Książyk, Janusz; Kocielińska-Kłos, Małgorzata; Banaś, Elżbieta; Kaleta, Małgorzata; Popińska, Katarzyna; Szczapa, Tomasz; Walkowiak, Jarosław

    2012-12-01

    Available evidence suggests that patients with short bowel syndrome (SBS) might be at risk of vitamins A, D, E and B(1) deficiency. However, there is little clinical data describing the vitamin K status. Therefore, in the present study we aimed to assess the body resources of vitamin K in a subset of SBS patients. The study comprised 33 patients aged 1 month to 16 years. PIVKA-II concentrations were determined in all subjects. In all studied subjects, coagulation parameters were normal. PIVKA-II levels indicative of vitamin K deficiency was found in 3 (9.1%) SBS patients. One patient had been receiving an additional intravenous vitamin K dose of 5 mg/week. In all SBS patients with cirrhosis and cholestasis, PIVKA-II concentrations were low (<2 ng/ml). However, all patients with severe liver disease were receiving vitamin K several times a month. Vitamin K deficiency may appear in SBS patients. Copyright © 2012. Published by Elsevier Ltd.

  12. Nursing III. A Course of Study. Health Occupations Education.

    ERIC Educational Resources Information Center

    Rogers, Helen V.

    This curriculum guide for instructors provides a course of study (Nursing III) requisite for the third and concluding portion of a 1-year practical nursing curriculum designed to continue opportunities for career mobility in the health occupations. Content is in three sections: (1) Medical Surgical Nursing II, (2) Mental Health Nursing, and (3)…

  13. Australian Qualifications Framework Lower-Level Qualifications: Pathways to Where for Young People?

    ERIC Educational Resources Information Center

    Stanwick, John

    2005-01-01

    This study investigates where certificate I and II qualifications lead young people aged 15-24 years in terms of employment and further study. A prime motivation for young people undertaking these qualifications is to facilitate transition into the labour market. These qualifications are aimed at developing basic vocational skills or preparatory…

  14. Federal Programs Supporting Educational Change, Vol. VIII: Implementing and Sustaining Innovations.

    ERIC Educational Resources Information Center

    Berman, Paul; McLaughlin, Milbrey Wallin

    This report reviews and synthesizes the findings of a four year, two-phase study conducted by the Rand Corporation to examine and evaluate a national sample of educational innovations funded by Federal programs. Section I of this document provides background information and descriptions of the study. Section II discusses Rand's research approach…

  15. Final Report of NATO/SPS Pilot Study on Clean Products and Processes (Phase I and II)

    EPA Science Inventory

    Early in 1998 the NATO Committee for Challenges to Modern Society (SPS) (Science for Peace and Security) approved the Pilot Study on Clean Products and Processes for an initial period of five years. The pilot was to provide a forum for member country representatives to discuss t...

  16. Monitoring the impact of human papillomavirus vaccines on high-grade pre-invasive cervical lesions: designing a framework of linked immunization information system and cancer registry data in Michigan.

    PubMed

    Potter, Rachel C; Flagg, Elaine W; Datta, S Deblina; Saraiya, Mona; Copeland, Glenn

    2015-03-10

    State immunization and cancer registries contain data that, if linked, could be used to monitor the impact of human papillomavirus (HPV) vaccine on cervical cancer and precancer. Michigan is uniquely positioned to examine these outcomes using two population-based resources: the state-wide cancer registry and immunization information system (IIS). We assessed the feasibility of identifying females in the IIS who had continuous Michigan residence and linking them to the cancer registry. We considered continuous residence necessary for future studies of vaccine impact to avoid misclassifying those who may have been immunized while residing out-of-state and whose immunization therefore may not have been reported in Michigan. We identified females with 1976-1996 birthdates in the IIS and used probabilistic linkage software to match them with Michigan birth records. A stratified random sample of IIS-birth matches was provided to a commercial locator service to identify females with continuous Michigan residence. Cervical carcinoma in situ cases diagnosed in 2006 among females aged 10 through 30 years were also matched with the birth records; cancer registry-birth matches were merged with the IIS-birth matches using the birth record identifier. Overall, 68% of the 1274,282 IIS and 61% of the 1358 cancer registry records could be matched with birth records. Among the sample of IIS-birth matches, most (86%) were continuous residents. Seventy percent or more of cancer registry-birth matches merged with IIS-birth matches for cases born after 1984. This is the first effort in the U.S. to show that linking records across IIS and cancer registries is practical and reasonably efficient. The increasing proportion of matches between the registries and live birth file with birth year, and the use of population-based data, strengthen the utility of this approach. Future steps include use of this method to examine incidence of cervical cancer precursors in HPV immunization-eligible females. Copyright © 2015. Published by Elsevier Ltd.

  17. [Study of the prevalence of severe mental disorder in the penitentiaries Puerto I, II and III of Puerto de Santa María (Cádiz): new strategies of psychiatric care in prison].

    PubMed

    Marín-Basallote, N; Navarro-Repiso, C

    2012-02-01

    In recent years it has been observed that there is a high level of severe mental disorder within the Spanish prison system. A one year descriptive and transversal study of the psychiatric health care demand in the prisons Puerto I, II and III of Puerto de Santa Maria (Cádiz). Of the 128 patients studied, the psychiatric diagnostics with highest prevalence were personality disorders (F60-69) at 35.16%, the next group was psychosis (F20-29) at 25.78%, and in third place mental and behaviour disorders due to use of psychotropic substances (F10-19) at 16.41%. 46.09% suffered conditions which are categorised as severe mental disorders. This study confirms the high levels of severe mental disorder in prisons located in the area of the Puerto Real Hospital. We are making efforts to improve on psychiatric health care provided to these patients by working closely with the Prison system.

  18. NEPSY-II Review: Korkman, M., Kirk, U., & Kemp, S. (2007). "NEPSY--Second Edition" (NEPSY-II). San Antonio, TX: Harcourt Assessment

    ERIC Educational Resources Information Center

    Davis, John L.; Matthews, Robb N.

    2010-01-01

    This article presents a review of the "NEPSY-Second Edition" (NEPSY-II), an updated and modified version of the NEPSY (Korkman, Kirk, & Kemp, 1998). The NEPSY-II is an individually administered compendium of tests designed to assess neuropsychological development in children ranging from 3 to 16.11 years old. The authors of the…

  19. Recent advances in heterobimetallic palladium(II)/copper(II) catalyzed domino difunctionalization of carbon-carbon multiple bonds.

    PubMed

    Beccalli, Egle M; Broggini, Gianluigi; Gazzola, Silvia; Mazza, Alberto

    2014-09-21

    The double functionalization of carbon-carbon multiple bonds in one-pot processes has emerged in recent years as a fruitful tool for the rapid synthesis of complex molecular scaffolds. This review covers the advances in domino reactions promoted by the couple palladium(ii)/copper(ii), which was proven to be an excellent catalytic system for the functionalization of substrates.

  20. Elevated depressive affect is associated with adverse cardiovascular outcomes among African Americans with chronic kidney disease

    PubMed Central

    Fischer, Michael J.; Kimmel, Paul L.; Greene, Tom; Gassman, Jennifer J.; Wang, Xuelei; Brooks, Deborah H.; Charleston, Jeanne; Dowie, Donna; Thornley-Brown, Denyse; Cooper, Lisa A.; Bruce, Marino A.; Kusek, John W.; Norris, Keith C.; Lash, James P.

    2011-01-01

    This study was designed to examine the impact of elevated depressive affect on health outcomes among participants with hypertensive chronic kidney disease in the African-American Study of Kidney Disease and Hypertension (AASK) Cohort Study. Elevated depressive affect was defined by Beck Depression Inventory II (BDI-II) thresholds of 11 or more, above 14, and by 5-Unit increments in the score. Cox regression analyses were used to relate cardiovascular death/hospitalization, doubling of serum creatinine/end-stage renal disease, overall hospitalization, and all-cause death to depressive affect evaluated at baseline, the most recent annual visit (time-varying), or average from baseline to the most recent visit (cumulative). Among 628 participants at baseline, 42% had BDI-II scores of 11 or more and 26% had a score above 14. During a 5-year follow-up, the cumulative incidence of cardiovascular death/hospitalization was significantly greater for participants with baseline BDI-II scores of 11 or more compared with those with scores <11. The baseline, time-varying, and cumulative elevated depressive affect were each associated with a significant higher risk of cardiovascular death/hospitalization, especially with a time-varying BDI-II score over 14 (adjusted HR 1.63) but not with the other outcomes. Thus, elevated depressive affect is associated with unfavorable cardiovascular outcomes in African Americans with hypertensive chronic kidney disease. PMID:21633409

  1. A comparison of the treatment effects of the Forsus Fatigue Resistance Device and the Twin Block appliance in patients with class II malocclusions

    PubMed Central

    Hanoun, Abdulfatah; Al-Jewair, Thikriat S; Tabbaa, Sawsan; Allaymouni, Mhd Amer; Preston, Charles B

    2014-01-01

    Objectives We evaluated the skeletal and dentoalveolar effects of the Forsus Fatigue Resistance Device (FRD) and the Twin Block appliance (TB) in comparison with nontreated controls in the treatment of patients with class II division 1 malocclusion. Materials and methods This retrospective study included three groups: TB (n=37; mean age, 11.2 years), FRD (n=30; mean age, 12.9 years), and controls (n=25; mean age, 12.6 years). Lateral cephalograms were evaluated at T1 (pretreatment) and at T2 (postappliance removal/equivalent time frame in controls). Cephalometric changes were evaluated using the Clark analysis, including 27 measurements. Results Sagittal correction of class II malocclusion appeared to be mainly achieved by dentoalveolar changes in the FRD group. The TB was able to induce both skeletal and dentoalveolar changes. A favorable influence on facial convexity was achieved by both groups. Significant upper incisor retroclination occurred with the TB (−12.42°), whereas only −4° was observed in the FRD group. The lower incisors proclined more in the FRD group than the TB group. Incisor overjet reduction was 62% in the TB group versus 56% in the FRD group. Molar relation was corrected in both functional groups, resulting in a class I relation, although no change appeared in the control sample. Conclusion Both appliances were effective in correcting the class II malocclusion. Both the FRD and the TB induced significant maxillary and mandibular dentoalveolar changes; skeletal changes were induced by TB but not FRD therapy. PMID:25114591

  2. A comparison of the treatment effects of the Forsus Fatigue Resistance Device and the Twin Block appliance in patients with class II malocclusions.

    PubMed

    Hanoun, Abdulfatah; Al-Jewair, Thikriat S; Tabbaa, Sawsan; Allaymouni, Mhd Amer; Preston, Charles B

    2014-01-01

    We evaluated the skeletal and dentoalveolar effects of the Forsus Fatigue Resistance Device (FRD) and the Twin Block appliance (TB) in comparison with nontreated controls in the treatment of patients with class II division 1 malocclusion. THIS RETROSPECTIVE STUDY INCLUDED THREE GROUPS: TB (n=37; mean age, 11.2 years), FRD (n=30; mean age, 12.9 years), and controls (n=25; mean age, 12.6 years). Lateral cephalograms were evaluated at T1 (pretreatment) and at T2 (postappliance removal/equivalent time frame in controls). Cephalometric changes were evaluated using the Clark analysis, including 27 measurements. Sagittal correction of class II malocclusion appeared to be mainly achieved by dentoalveolar changes in the FRD group. The TB was able to induce both skeletal and dentoalveolar changes. A favorable influence on facial convexity was achieved by both groups. Significant upper incisor retroclination occurred with the TB (-12.42°), whereas only -4° was observed in the FRD group. The lower incisors proclined more in the FRD group than the TB group. Incisor overjet reduction was 62% in the TB group versus 56% in the FRD group. Molar relation was corrected in both functional groups, resulting in a class I relation, although no change appeared in the control sample. Both appliances were effective in correcting the class II malocclusion. Both the FRD and the TB induced significant maxillary and mandibular dentoalveolar changes; skeletal changes were induced by TB but not FRD therapy.

  3. Functional fecal retention with encopresis in childhood.

    PubMed

    Loening-Baucke, Vera

    2004-01-01

    The most common cause of encopresis in children is functional fecal retention (FFR). An international working team suggested that FFR be defined by the following criteria: a history of >12 weeks of passage of <2 large-diameter bowel movements (BMs) per week, retentive posturing, and accompanying symptoms, such as fecal soiling. These criteria are usually referred to as the ROME II criteria. The aims of this study were to evaluate how well the ROME II criteria identify children with encopresis; to compare these patients to those identified as having FFR by historical symptoms or physical examination; to determine whether 1-year treatment outcome varied depending on which definition for FFR was used; and to suggest improvements to the ROME II criteria, if necessary. Data were reviewed from the history and physical examination of 213 children with encopresis. One-year outcomes identified were failure, successful treatment, or full recovery. Only 88 (41%) of the patients with encopresis fit the ROME II criteria for FFR, whereas 181 (85%) had symptoms of FFR by history or physical examination. Thirty-two (15%) patients did not fit criteria for FFR, but only 6 (3%) appeared to have nonretentive fecal soiling. Rates of successful treatment (50%) and recovery (39%) were not significantly different in the two groups. The ROME II criteria for FFR are too restrictive and do not identify many children with encopresis who have symptoms of FFR. The author suggests that the ROME II criteria for FFR could be improved by including the following additional items: a history of BMs that obstruct the toilet, a history of chronic abdominal pain relieved by enemas or laxatives, and the presence of an abdominal fecal mass or rectal fecal mass.

  4. Chapter II 1985-86 End-of-Year Report. OEA Evaluation Report.

    ERIC Educational Resources Information Center

    New York City Board of Education, Brooklyn. Office of Educational Assessment.

    During the 1985-86 school year the following three New York City high schools received federal funds under Chapter II, Subchapter C, for the development of special programs in the following subjects: (1) A. Philip Randolph--engineering; (2) Townsend Harris--the humanities; and (3) The Paul Robeson School--business and technology. Each of these…

  5. OATYC Journal, Vol. II, Nos. 1-3, October 1976-Spring 1977.

    ERIC Educational Resources Information Center

    Fullen, James, Ed.

    1977-01-01

    "OATYC Journal," which is published by the Ohio Association of Two-Year Colleges, is designed as a forum for the exchange of concepts, methods, and findings relevant to the two-year college classroom. Along with commentaries and letters of reaction from the readership, the three issues of volume II contain the following major articles:…

  6. Evaluation of Seasonal Changes in Fitness, Anthropometrics, and Body Composition in Collegiate Division Ii Female Soccer Players.

    PubMed

    Peart, Ashley N; Nicks, Clayton R; Mangum, Michael; Tyo, Brian M

    2018-03-22

    The purpose of this study was to investigate anthropometrics, body composition, aerobic and anaerobic fitness of collegiate Division II female soccer players throughout a calendar year. Eighteen (20 ± 0.9y) NCAA division II female soccer players from the same team participated in the study. Anthropometrics and body composition variables were assessed in addition to the Counter Movement Jump (CMJ), Wingate Anaerobic Test (WAT), and peak oxygen uptake (VO2peak). Data were collected over five time points: end of competitive seasons (ECS1 and ECS2), beginning of off-season (BOS), end of off-season (EOS), and pre-season (PS). Repeated-measures analysis of variance (ANOVA) were conducted to compare test scores among all five data collection points. Where appropriate, Bonferroni post-hoc tests were used to determine which points were significantly different. Hip circumference (HC) decreased significantly (p < 0.001) from EOS (98.47 ± 6.5 cm) to PS (94.46 ± 6.8 cm). Fat mass (FM) (12.73 ± 5.4 kg) was significantly different in ECS2 compared to BOS and EOS means (p ≤ 0.05) and percentage of body fat (%BF) (20.08 ± 5.44) significantly different in ECS2 compared to ECS1, BOS, and EOS means (p ≤ 0.05), while fat-free mass (FFM) was maintained from ECS1 to ECS2. CMJ, WAT, and VO2peak performance did not significantly change from ECS1 to ECS2. Anthropometrics and body composition results are similar to previous studies measuring Division II to professional female soccer players. CMJ results remained consistent and are comparable to results on Division I female soccer players. Coaches and researchers can use these data to help design and evaluate training programs throughout a calendar year.

  7. Association Between Use of Traditional Chinese Medicine Herbal Therapy and Survival Outcomes in Patients With Stage II and III Colorectal Cancer: A Multicenter Prospective Cohort Study.

    PubMed

    Xu, Yun; Mao, Jun J; Sun, Lingyun; Yang, Lin; Li, Jie; Hao, Yingxu; Li, Huashan; Hou, Wei; Chu, Yuping; Bai, Yu; Jia, Xiaoqiang; Wang, Jinwan; Shen, Lin; Zhang, Ying; Wang, Jianbin; Liu, Jianping; Yang, Yufei

    2017-11-01

    Chinese cancer patients often use Traditional Chinese Medicine (TCM) herbal medicine during or after active cancer treatments. However, little is known about how TCM herbal medicine impacts cancer outcomes. This study aimed to evaluate the association between TCM herbal therapy and survival outcomes in patients with stage II or III colorectal cancer. We conducted an eight-center prospective cohort study in China among patients who had undergone radical resection for stage II and III colorectal cancer. All patients received comprehensive conventional treatments according to National Comprehensive Cancer Network (NCCN) guidelines, and follow-up visits were conducted over five years. We defined high exposure as a patient's use of TCM individualized herbs for more than one year, ascertained via clinical interviews. The primary outcome was disease-free survival (DFS), with overall survival (OS) as a secondary outcome. Between April 2007 and February 2009, we enrolled 312 patients into the cohort; 166 (53.2%) met the definition of high exposure to TCM herbs. Adjusting for covariates, high exposure to TCM was associated with both better DFS (hazard ratio [HR] = 0.62, 95% confidence interval [CI] = 0.39 to 0.98) and OS (HR = 0.31, 95% CI = 0.14 to 0.68). In subgroup exploratory analysis, the effects demonstrated that the differences in outcomes were statistically significant in patients who had received chemotherapy. Longer duration of TCM herbal use is associated with improved survival outcomes in stage II and III colorectal cancer patients in China. More research is needed to evaluate the effects and underlying mechanisms of herbal medicine on colorectal cancer outcomes. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  8. Cost implications of unwarranted imaging for distant metastasis in women with early-stage breast cancer in Ontario.

    PubMed

    Thavorn, K; Wang, Z; Fergusson, D; van Katwyk, S; Arnaout, A; Clemons, M

    2016-02-01

    Despite the publication of multiple evidence-based guidelines recommending against routine imaging for distant metastasis in patients with early-stage (i/ii) breast cancer, such imaging is frequently performed. The present retrospective cohort study was conducted to estimate the cost of unnecessary imaging tests in women with stage i and ii breast cancer diagnosed between 1 January 2007 and 31 December 2012 in Ontario. We obtained patient-level demographic and tumour data from a large provincial dataset. The total cost of unwarranted imaging tests (in 2015 Canadian dollars) was considered to be equal to the sum of imaging costs incurred between 2007 and 2012 and was stratified by disease stage, imaging modality, and body site. Of the 26,547 identified patients with early-stage breast cancer, 22,811 (85.9%) underwent at least 1 imaging test, with an average of 3.7 tests per patient (3.2 for stage i patients and 4.0 for stage ii patients) over 5 years. At least 1 imaging test was performed in 79.6% of stage i and 92.7% of stage ii patients. During a 5-year period, the cost of unwarranted imaging in patients with early-stage breast cancer ranged from CA$4,418,139 to CA$6,865,856, depending on guideline recommendations. Our study highlights the substantial cost of excess imaging that could be saved and re-allocated to patient care if evidence-based guidelines are followed. Future studies should assess strategies to ensure that evidence-based guidelines are followed and to increase awareness of the cost implications of nonadherence to guidelines.

  9. Efficacy of carvedilol versus propranolol versus variceal band ligation for primary prevention of variceal bleeding.

    PubMed

    Abd ElRahim, Ayman Yosry; Fouad, Rabab; Khairy, Marwa; Elsharkawy, Aisha; Fathalah, Waleed; Khatamish, Haytham; Khorshid, Omayma; Moussa, Mona; Seyam, Moataz

    2018-01-01

    Band ligation and propranolol are the current therapies for primary prevention of variceal bleeding. Carvedilol is a rising nonselective beta-blocker used for reducing portal pressure with favorable outcome. The aim of this study to assess the efficacy of carvedilol, propranolol, and band ligation for primary prevention of variceal bleeding based on the effect of each regimen on progression of Child score and portal hypertensive gastropathy after 1 year. The study included 264 cirrhotic patients with medium/large-sized varices who were candidates for primary prophylaxis of variceal bleeding. Patients were randomly divided into three groups: group I: band ligation; group II: propranolol; group III: carvedilol. Group I showed higher success rate of 75 %, followed by group III with 70.2 % and group II with 65.2 %. Risk of bleeding was comparable between the three groups, with group II carrying the highest rate of complications (34.7 %) followed by group III (14.2 %) and finally group I (5.7 %). After 1 year of follow-up, Child score did not improve in any of the studied groups, while portal hypertensive gastropathy significantly increased in group I but decreased in groups II and III. Band ligation is the best treatment option for primary prevention of variceal bleeding with minimal complications. Carvedilol is a good pharmaceutical alternative medicine to propranolol with lesser side-effects. Progress of liver disease as represented by Child score is not affected by any of the primary variceal prophylactic regimens, although medical treatment reduces portal hypertensive gastropathy. Choice of treatment depends on patient will, compliance with treatment, and endoscopist competence.

  10. Epigenome-wide analysis links SMAD3 methylation at birth to asthma in children of asthmatic mothers.

    PubMed

    DeVries, Avery; Wlasiuk, Gabriela; Miller, Susan J; Bosco, Anthony; Stern, Debra A; Lohman, I Carla; Rothers, Janet; Jones, Anya C; Nicodemus-Johnson, Jessie; Vasquez, Monica M; Curtin, John A; Simpson, Angela; Custovic, Adnan; Jackson, Daniel J; Gern, James E; Lemanske, Robert F; Guerra, Stefano; Wright, Anne L; Ober, Carole; Halonen, Marilyn; Vercelli, Donata

    2017-08-01

    The timing and mechanisms of asthma inception remain imprecisely defined. Although epigenetic mechanisms likely contribute to asthma pathogenesis, little is known about their role in asthma inception. We sought to assess whether the trajectory to asthma begins already at birth and whether epigenetic mechanisms, specifically DNA methylation, contribute to asthma inception. We used the Methylated CpG Island Recovery Assay chip to survey DNA methylation in cord blood mononuclear cells from 36 children (18 nonasthmatic and 18 asthmatic subjects by age 9 years) from the Infant Immune Study (IIS), an unselected birth cohort closely monitored for asthma for a decade. SMAD3 methylation in IIS (n = 60) and in 2 replication cohorts (the Manchester Asthma and Allergy Study [n = 30] and the Childhood Origins of Asthma Study [n = 28]) was analyzed by using bisulfite sequencing or Illumina 450K arrays. Cord blood mononuclear cell-derived IL-1β levels were measured by means of ELISA. Neonatal immune cells harbored 589 differentially methylated regions that distinguished IIS children who did and did not have asthma by age 9 years. In all 3 cohorts methylation in SMAD3, the most connected node within the network of asthma-associated, differentially methylated regions, was selectively increased in asthmatic children of asthmatic mothers and was associated with childhood asthma risk. Moreover, SMAD3 methylation in IIS neonates with maternal asthma was strongly and positively associated with neonatal production of IL-1β, an innate inflammatory mediator. The trajectory to childhood asthma begins at birth and involves epigenetic modifications in immunoregulatory and proinflammatory pathways. Maternal asthma influences epigenetic mechanisms that contribute to the inception of this trajectory. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. Prevalence of Temporomandibular Disorders in an Adult Brazilian Community Population Using the Research Diagnostic Criteria (Axes I and II) for Temporomandibular Disorders (The Maringá Study).

    PubMed

    Progiante, Patrícia Saram; Pattussi, Marcos Pascoal; Lawrence, Herenia P; Goya, Suzana; Grossi, Patrícia Krieger; Grossi, Márcio Lima

    2015-01-01

    The primary objective of this study was to assess the prevalence of temporomandibular disorders (TMDs) and comorbid factors (sleep bruxism and headaches). This study was a cross-sectional population survey in the city of Maringá, state of Paraná, Brazil. Axes I and II of the Research Diagnostic Criteria for TMD (RDC/TMD) were used for assessment of TMD signs and symptoms. The population was users of the Brazilian public health system (SUS), of both sexes, between the ages of 20 and 65 years, and not seeking treatment for TMD. The selected population (N = 1,643) was composed mostly of (a) women (65.9%), (b) married or single individuals (90.6%), (c) Caucasians (70.1%), (d) individuals aged 32.7 ± 10.3 years, (e) individuals earning a medium income (75.1%), and (f) those who had completed a high school education or higher (79.9%). According to the chronic pain grade classification (CPG) in the RDC/TMD Axis II, 36.2% of the population had some degree of TMD pain (CPG I to IV); however, only 5.1% had severe limitation due to pain (CPG III or IV). In the RDC/TMD Axis I diagnoses, 29.5% presented with muscle disorders (group I), 7.9% with disk displacements (group II), and 39.1% with other joint disorders (group III). Headaches were present in 67.9% and awake and sleep bruxism in 30% and 33.4% of the population, respectively. The prevalence of signs and symptoms of TMD was high in this population, but with low disability; however, the proportion of patients in need of treatment was much lower.

  12. Ictal and interictal electric source imaging in presurgical evaluation: a prospective study.

    PubMed

    Sharma, Praveen; Scherg, Michael; Pinborg, Lars H; Fabricius, Martin; Rubboli, Guido; Pedersen, Birthe; Leffers, Anne-Mette; Uldall, Peter; Jespersen, Bo; Brennum, Jannick; Mølby Henriksen, Otto; Beniczky, Sándor

    2018-05-11

    Accurate localization of the epileptic focus is essential for surgical treatment of patients with drug- resistant epilepsy. EEG source imaging (ESI) is increasingly used in presurgical evaluation. However, most previous studies analysed interictal discharges. Prospective studies comparing feasibility and accuracy of interictal (II) and ictal (IC) ESI are lacking. We prospectively analysed long-term video EEG recordings (LTM) of patients admitted for presurgical evaluation. We performed ESI of II and IC signals, using two methods: equivalent current dipole (ECD) and distributed source model (DSM). LTM recordings employed the standard 25-electrode array (including inferior temporal electrodes). An age-matched template head-model was used for source analysis. Results were compared with intracranial recordings (ICR), conventional neuroimaging methods (MRI, PET, SPECT) and outcome one year after surgery. Eighty-seven consecutive patients were analysed. ECD gave a significantly higher proportion of patients with localised focal abnormalities (94%) compared to MRI (70%), PET (66%) and SPECT (64%). Agreement between the ESI methods and ICR was moderate to substantial (k=0.56-0.79). Fifty-four patients were operated (47 for more than one year ago) and 62% of them became seizure-free. Localization accuracy of II-ESI was 51% for DSM and 57% for ECD; for IC-ESI this was 51% (DSM) and 62% (ECD). The differences between the ESI methods were not significant. Differences in localization accuracy between ESI and MRI (55%), PET (33%) and SPECT (40%) were not significant. II and IC ESI of LTM-data have high feasibility and their localisation accuracy is similar to the conventional neuroimaging methods. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. MuSK myasthenia gravis and pregnancy.

    PubMed

    Santos, Ernestina; Braga, Antonio; Gabriel, Denis; Duarte, Sara; Martins da Silva, Ana; Matos, Ilda; Freijo, Marta; Martins, Joao; Silveira, Fernando; Nadais, Goreti; Sousa, Filipa; Fraga, Carla; Santos Silva, Rosa; Lopes, Carlos; Gonçalves, Guilherme; Pinto, Clara; Sousa Braga, Jorge; Leite, Maria Isabel

    2018-02-01

    Muscle specific kinase (MuSK) myasthenia gravis (MG, MuSK-MG) is a rare subgroup of MG affecting mainly women during childbearing years. We investigated the influence of pregnancy in the course of MuSK-MG and pregnancy outcomes in females with MuSK-MG. A multicentre cohort of 17 women with MuSK-MG was studied retrospectively; 13 of them with ≥1 pregnancy. MuSK-MG onset age was 35,4 years; 23,0% had other autoimmune disorder; 46,2% were treatment refractory. Thirteen women experienced 27 pregnancies, either after MG onset (group I) (n = 4; maternal age at conception = 29.8 years) or before MG onset (group II) (n = 23; maternal age at conception = 26.2 years). In group I pregnancy occurred in average 9.8 years after the MG onset; it occurred in average 17.0 years before MG in group II. In group I, all were on steroids at time of conception, one on azathioprine and another receiving IVIG regularly. There were mild exacerbations that responded to treatment adjustments. There were no relapses in the 12 months following the delivery. There was no pre-eclampsia, birth defects or stillbirths in either group; 3 miscarriages in group II. One case of neonatal MG was recorded. In this small series, pregnancy did not seem to precipitate MuSK-MG or to have a major influence in the MuSK-MG course, and there was no apparent negative impact in pregnancy outcomes in those where pregnancy followed the MG onset. The weight was lower in the newborn of the group I mothers, although none had low birth weight. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Informal caregiver burden in middle-income countries: Results from Memory Centers in Lima - Peru.

    PubMed

    Custodio, Nilton; Lira, David; Herrera-Perez, Eder; Del Prado, Liza Nuñez; Parodi, José; Guevara-Silva, Erik; Castro-Suarez, Sheila; Mar, Marcela; Montesinos, Rosa; Cortijo, Patricia

    2014-01-01

    The aim of this study was to evaluate caregiver burden based on Zarit Burden Interview (ZBI) and depression in caregivers on the Beck Depression Inventory-II (BDI-II). Literate individuals, 18 years or older, who spoke Spanish as their native language were included. Demographic characteristics: Age, sex, education, relationship to person with dementia, length of time caregiving, other sources of help for caring, impact on the household economy, family support, and perception of impaired health; and Clinical data on care-recipients: type of dementia, time since diagnosis, treatment, and Global Deterioration Scale (GDS); the ZBI and BDI-II. Descriptive and analytical statistics were employed to assess caregiver burden and predictors of higher burden in caregivers. A total of 92 informal caregivers were evaluated. Regarding care-recipients, 75% were 69 years old or over, 75% had at least one year since diagnosis, 73.9% had Alzheimer's disease, 84.8% received treatment, 75% scored 5 or over on the GDS. For caregivers, 75% were 55.5 years old or over, predominantly female (81.5%), married (83.7%), the spouse of care-recipients (60.87%), had at least 10 years of education (75.0%) and one year of caregiving (75%), reduced entertainment time (90.2%) and self-perception of impaired health (83.7%). Median score on the ZBI was 37.5 (minimum value = 3; and maximum value = 74). The coefficient of BDI was 1.38 (p-value <0.001). This sample of Peruvian informal caregivers showed elevated ZBI values. Self-perception of worsened health, repercussion on the family economy and time caregiving were the main determinants of ZBI, although only BDI was a consistent predictor of ZBI.

  15. Informal caregiver burden in middle-income countries: Results from Memory Centers in Lima – Peru

    PubMed Central

    Custodio, Nilton; Lira, David; Herrera-Perez, Eder; del Prado, Liza Nuñez; Parodi, José; Guevara-Silva, Erik; Castro-Suarez, Sheila; Mar, Marcela; Montesinos, Rosa; Cortijo, Patricia

    2014-01-01

    Objective The aim of this study was to evaluate caregiver burden based on Zarit Burden Interview (ZBI) and depression in caregivers on the Beck Depression Inventory-II (BDI-II). Methods Literate individuals, 18 years or older, who spoke Spanish as their native language were included. Demographic characteristics: Age, sex, education, relationship to person with dementia, length of time caregiving, other sources of help for caring, impact on the household economy, family support, and perception of impaired health; and Clinical data on care-recipients: type of dementia, time since diagnosis, treatment, and Global Deterioration Scale (GDS); the ZBI and BDI-II. Descriptive and analytical statistics were employed to assess caregiver burden and predictors of higher burden in caregivers. Results A total of 92 informal caregivers were evaluated. Regarding care-recipients, 75% were 69 years old or over, 75% had at least one year since diagnosis, 73.9% had Alzheimer's disease, 84.8% received treatment, 75% scored 5 or over on the GDS. For caregivers, 75% were 55.5 years old or over, predominantly female (81.5%), married (83.7%), the spouse of care-recipients (60.87%), had at least 10 years of education (75.0%) and one year of caregiving (75%), reduced entertainment time (90.2%) and self-perception of impaired health (83.7%). Median score on the ZBI was 37.5 (minimum value = 3; and maximum value = 74). The coefficient of BDI was 1.38 (p-value <0.001). Conclusion This sample of Peruvian informal caregivers showed elevated ZBI values. Self-perception of worsened health, repercussion on the family economy and time caregiving were the main determinants of ZBI, although only BDI was a consistent predictor of ZBI. PMID:29213929

  16. Retroperitoneal Varix ligation with sclerotherapy: a prospective randomized comparative study

    PubMed Central

    Abdelsalam, Yaser M.; Saeed, Waleed M.; Elganainy, Ehab O.; Ahmed, Abdelfatah I.

    2017-01-01

    Introduction The aim of this article is to compare the results of high varix ligation with and without sclerotherapy. Material and methods Between November 2014 and December 2015, sixty patients with varicocele were included in this study. Patients were divided into two equal groups; group I (underwent high varix ligation), and group II (underwent high varix ligation with a retrograde injection of 2 mL of 5% ethanolamine oleate in the lower end of the bisected gonadal vein). The operative time, intra- and postoperative complications, postoperative pain, improvement of semen parameters, incidence of recurrence and achieving of unassisted pregnancy were recorded for both groups. Results The age range was 19–34 years in group I and 21–37 years in group II. The operative time was shorter in group I (34.6 ±7.81 min) than group II (43.3 ±8.5 min) (P <0.001), which was statistically significant. Improvement of semen parameters and the occurrence of spontaneous pregnancy were insignificant between both groups. No intraoperative complications occurred. The postoperative complications were statistically insignificant in both groups. Conclusions Combined varix ligation with retrograde sclerotherapy does not offer significant advantages over high varix ligation alone with a longer operative time and prolonged post-operative pain. PMID:29104794

  17. Growth of mature boreal Norway spruce was not affected by elevated [CO(2)] and/or air temperature unless nutrient availability was improved.

    PubMed

    Sigurdsson, Bjarni D; Medhurst, Jane L; Wallin, Göran; Eggertsson, Olafur; Linder, Sune

    2013-11-01

    The growth responses of mature Norway spruce (Picea abies (L.) Karst.) trees exposed to elevated [CO(2)] (CE; 670-700 ppm) and long-term optimized nutrient availability or elevated air temperature (TE; ±3.9 °C) were studied in situ in northern Sweden in two 3 year field experiments using 12 whole-tree chambers in ca. 40-year-old forest. The first experiment (Exp. I) studied the interactions between CE and nutrient availability and the second (Exp. II) between CE and TE. It should be noted that only air temperature was elevated in Exp. II, while soil temperature was maintained close to ambient. In Exp. I, CE significantly increased the mean annual height increment, stem volume and biomass increment during the treatment period (25, 28, and 22%, respectively) when nutrients were supplied. There was, however, no significant positive CE effect found at the low natural nutrient availability. In Exp. II, which was conducted at the natural site fertility, neither CE nor TE significantly affected height or stem increment. It is concluded that the low nutrient availability (mainly nitrogen) in the boreal forests is likely to restrict their response to the continuous rise in [CO(2)] and/or TE.

  18. Comparison of pain intensity, emotional status and disability level in patients with chronic neck and low back pain.

    PubMed

    Altuğ, Filiz; Kavlak, Erdoğan; Kurtca, Mine Pekesen; Ünal, Ayşe; Cavlak, Uğur

    2015-01-01

    This study was planned to compare of pain, emotional status and disability level in patients with chronic neck pain and low back pain. In this study, fifty patients with chronic low back pain (Group I) and fifty patients with chronic neck pain (Group II) at least 6 months were evaluated. A Visual Analog Scale was used to describe pain intensity. To determine emotional status of the subjects, the Beck Depression Scale was used The Oswestry Disability Index and the Neck Disability Index were used to evaluate disability level. The mean age of the patients with low back pain and neck pain were 39.70 ± 9.71 years, 45.44 ± 10.39 years, respectively. It was not found a significant difference between in low back pain (Group I) and neck pain (Group II) in results of pain intensity (p= 0.286) and pain duration (p= 0.382). It was found a significant difference between group I and group II in results of emotional status (p= 0.000) and disability level (p= 0.000). The emotional status and disability level scores were found highest in patient's with low back pain. Chronic low back pain is affect in patients than chronic neck pain as a emotional status and disability level.

  19. Factors associated with mortality of patients with myxoedema coma: prospective study in 11 cases treated in a single institution.

    PubMed

    Rodríguez, I; Fluiters, E; Pérez-Méndez, L F; Luna, R; Páramo, C; García-Mayor, R V

    2004-02-01

    This study was carried out to investigate the clinical and biochemical factors which might be of importance in predicting the outcome of patients with myxoedema coma. Eleven patients (ten female) aged 68.1+/-19.5 years attended our institution over a period of 18 years. Glasgow and APACHE II scores and serum free thyroxine and TSH were measured in all the patients on entry. Patients were selected at random to be treated with two different regimens of l-thyroxine. Four patients died with the mortality rate being 36.4%. The patients in coma at entry had significantly higher mortality rates than those with minor degrees of consciousness (75% vs 14.3% respectively, P=0.04). The surviving patients had significantly higher Glasgow scores than those who died (11.85+/-2.3 vs 5.25+/-2.2 respectively, P<0.001). Comparison of the mean values of APACHE II scores between the surviving group and those who died was significantly different (18.0+/-2.08 vs 31.5+/-2.08 respectively, P<0.0001). The degree of consciousness, the Glasgow score and the severity of the illness measured by APACHE II score on entry were the main factors that determined the post-treatment outcome of patients with myxoedema coma.

  20. Testing mate choice and overdominance at MH in natural families of Atlantic salmon Salmo salar.

    PubMed

    Tentelier, C; Barroso-Gomila, O; Lepais, O; Manicki, A; Romero-Garmendia, I; Jugo, B M

    2017-04-01

    This study aimed to test mate choice and selection during early life stages on major histocompatibility (MH) genotype in natural families of Atlantic salmon Salmo salar spawners and juveniles, using nine microsatellites to reconstruct families, one microsatellite linked to an MH class I gene and one minisatellite linked to an MH class II gene. MH-based mate choice was only detected for the class I locus on the first year, with lower expected heterozygosity in the offspring of actually mated pairs than predicted under random mating. The genotype frequencies of MH-linked loci observed in the juveniles were compared with frequencies expected from Mendelian inheritance of parental alleles to detect selection during early life stages. No selection was detected on the locus linked to class I gene. For the locus linked to class II gene, observed heterozygosity was higher than expected in the first year and lower in the second year, suggesting overdominance and underdominance, respectively. Within family, juveniles' body size was linked to heterozygosity at the same locus, with longer heterozygotes in the first year and longer homozygotes in the second year. Selection therefore seems to differ from one locus to the other and from year to year. © 2017 The Fisheries Society of the British Isles.

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